Bipolar

Question 1

CBT Based interventions - Scott et al (2006)

Answer 1

• conducted a large scale, multi-site trial of CBT for complex and severe presentations of BD
• over half of ppts experienced a relapse 12 months post CBT
• no beneficial effect of CBT over ‘treatment as usual’

Question 2

Criticism?

Answer 2

Lam - (2006)

Question 3

Jones and Burrell-Hodgson (2008)

Answer 3

More positive outcomes have been reported amongst those earlier in the course of BD or with less acute/severe symptoms

Question 4

Jones (2004)

Answer 4

• still quality issues associated with CBT trials for BD
• lack of adequate control groups
• treatment adherence
• theoretical basis to therapy

Question 5

What have other clinical trials focused on? (Specific issues/BD symptoms)

Answer 5

1. Co-morbid alcohol use (jones et al. 2019)
2. Co-morbid anxiety (jones et al 2018)
3. Mindfulness (Murray et al. 2015)

Question 6

Circadian rhythms

Answer 6

Physiological rhythms corresponding to the 24 hour daily cycle

Question 7

Why are they important?

Answer 7

In regulating the physiological systems

• melatonin levels
• sleep awake cycles
• activity levels

Question 8

What are they set by?

Answer 8

Zeitgebers

Question 9

What are these?

Answer 9

Environmental events that set and regulate the internal body clock

Question 10

What can they be disturbed by?

Answer 10

Air travel
Changes in routines
Seasons

Question 11

Juahar and weller (1982), young (1995)

Answer 11

• air travel eastwards is associated with higher rates of manic symptoms than westwards travel
• eastward travel associated more with greater jet lag, greater sleep loss, greater circadian disruption

Question 12

How are these changes important when determining bipolar symptoms?

Answer 12

When these disruptions are appraised in an extreme self-positive manner
- leads to formation of positive self schema, increases in behavioural activity and mood

Question 13

Jones et al (2006)

Answer 13

• overly positive interpretations of changes in internal state and objective measures of circadian disruption bipolar individuals

Question 14

Ankers and Jones (2009)

Answer 14

• high risk individuals for BD also have these overly positive appraisals and more variable bedtimes