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Moment-to-moment interaction between affectivity and coping behaviours in bipolar disorder and the role of cognitive appraisals

  • Michelle Hoi-ting Leung (a1), Suzanne Ho-wai So (a2), Nate Tsz-Kit Kwok (a3), Iris Hoi-ching Ng (a1), Pui-shuen Chan (a1), Chloe Chor-wing Lo (a1), Shirley Na (a1), Arthur Dun-ping Mak (a4) and Sing Lee (a5)...

Abstract

Background

Individuals with bipolar disorder respond to affective symptoms with a range of coping behaviours, which may further maintain the symptoms.

Aims

To examine moment-to-moment dynamics between affective states and coping behaviours, and to evaluate the role of cognitive appraisals of internal states as moderators.

Method

Forty-six individuals with bipolar disorder completed a clinical interview and an experience sampling assessment over 6 days. Time-lagged analyses were conducted by multilevel regression modelling.

Results

A total of 1807 momentary entries were analysed. Negative affect predicted an increase in rumination at the subsequent time point (β = 0.21, s.e. = 0.08, P = 0.009, 95% CI 0.05–0.36), and vice versa (β = 0.03, s.e. = 0.01, P = 0.009, 95% CI 0.01–0.05). Positive affect predicted an increase in adaptive coping (β = 0.26, s.e. = 0.11, P = 0.018, 95% CI 0.04–0.47), and vice versa (β = 0.02, s.e. = 0.01, P = 0.019, 95% CI 0.00–0.03). Positive affect also predicted a decrease in rumination (β = −0.15, s.e. = 0.06, P = 0.014, 95% CI −0.26 to −0.03), and vice versa (β = −0.03, s.e. = 0.01, P = 0.016, 95% CI −0.06 to −0.01). Extreme cognitive appraisals predicted stronger associations between affective states and coping behaviours.

Conclusions

Feedback loops between affective states and coping behaviours were revealed in the daily life of individuals with bipolar disorder, which were moderated by extreme cognitive appraisals.

Declaration of interest

None.

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Copyright

This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

Corresponding author

Correspondence: Dr Suzanne So, Room 321, Wong Foo Yuan Building, Department of Psychology, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China. Email: shwso@psy.cuhk.edu.hk

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Moment-to-moment interaction between affectivity and coping behaviours in bipolar disorder and the role of cognitive appraisals

  • Michelle Hoi-ting Leung (a1), Suzanne Ho-wai So (a2), Nate Tsz-Kit Kwok (a3), Iris Hoi-ching Ng (a1), Pui-shuen Chan (a1), Chloe Chor-wing Lo (a1), Shirley Na (a1), Arthur Dun-ping Mak (a4) and Sing Lee (a5)...
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