Kim Wright and Dominic

While extensive research into unipolar depressive disorder has resulted in the formulation of various cognitive and behavioural models (e.g., Abramson et al., 1978; Beck, 1967; Lewinsohn, 1974), comprehensive psychological theories of bipolar disorder remain limited in terms of both quantity and empirical support. Some studies comparing the somatic and cognitive symptoms of unipolar and bipolar depression have concluded that the two states are very similar, while others have found differences in the prevalence of symptoms such as psychomotor agitation, anxiety and irritability (Depue & Monroe, 1978; Mitchell et al., 1992). Thus, at present, difficulties exist in applying the findings of unipolar research to the study of bipolar disorder. Moreover, despite depressive symptoms often being present during a manic episode, any comprehensive model of bipolar disorder must account for the development of manic symptoms as well as for those of depression: "The salient fact to bear in mind when contemplating these switches of hedonic capacity is that it is the same person, with the same developmental history and a constant environment, who cycles between, for example, incompetent versus omnipotent self-perceptions" (Carroll, 1994).

In this chapter, we will consider two theories of bipolar affective disorder that have the potential to account for both ends of the bipolar spectrum: a cognitive behavioural approach, and a model that proposes dysregulation of the behavioural activation system (BAS). Both are psychobiological in nature, acknowledging the strong evidence for a genetic contribution to the condition (e.g., Allen etal., 1974; Bertelsenetal., 1977; Cardnoetal., 1999; Kringlen, 1967; Mendlewicz & Rainer, 1977), while proposing a mediating role for cognitive factors in the expression of biological vulnerability. The two approaches converge, and it will be suggested that, taken together, they provide direction for the further development of psychological interventions as well as support for current clinical practice.

Mood Disorders: A Handbook of Science and Practice. Edited by M. Power. © 2004 John Wiley & Sons, Ltd. ISBN 0-470-84390-X.

Bipolar Disorder Uncovered

Bipolar Disorder Uncovered

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