The Interpretation of, and Responses to, Changes in Internal States: An Integrative Cognitive Model of Mood Swings and Bipolar Disorders
Abstract
A cognitive approach to understanding mood swings and bipolar disorders is provided, with the interpretation of changes in internal state as a central explanatory factor. The model explains how attempts at affect regulation are disturbed through the multiple and conflicting extreme personal meanings that are given to internal states. They prompt exaggerated efforts to enhance or exert control over internal states, which paradoxically provoke further internal state changes, thereby feeding into a vicious cycle that can maintain or exacerbate symptoms. Counterproductive attempts at control are classified as either ascent behaviours (increasing activation), or descent behaviours (decreasing activation). It is suggested that appraisals of extreme personal meaning are influenced by specific sets of beliefs about affect and its regulation, and about the self and relations with others, leading to an interaction that raises vulnerability to relapse. Pertinent literature is reviewed and found to be compatible with such a model. The clinical implications are discussed and compared to existing interventions.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
A cognitive model of bipolar disorders and mood swings was developed to address the above issues.
“A cognitive model of bipolar disorders and mood swings was developed to address the above issues (Mansell, Morrison, Reid, Lowens, & Tai, 2007).”
From What are People's Experiences of a Novel Cognitive Behavioural Therapy for Bipolar Disorders? A Qualitative Investigation with Participants on the TEAMS Trial. (2017) · cites this paper as Mansell, Morrison, Reid, Lowens, & Tai, 2007
The Mansell et al. (2007) model informed a new CBT for bipolar disorders and mood swings, called TEAMS.
“The Mansell et al. (2007) model informed a new cognitive behavioural therapy (CBT) for bipolar disorders and mood swings, called “Think Effectively About Mood Swings” (TEAMS).”
From What are People's Experiences of a Novel Cognitive Behavioural Therapy for Bipolar Disorders? A Qualitative Investigation with Participants on the TEAMS Trial. (2017) · cites this paper as Mansell et al., 2007
This is consistent with Mansell et al.'s (2007) model.
“This is consistent with Mansell et al.'s (2007) model.”
From What are People's Experiences of a Novel Cognitive Behavioural Therapy for Bipolar Disorders? A Qualitative Investigation with Participants on the TEAMS Trial. (2017) · cites this paper as Mansell et al., 2007
This technique aims to elicit conflicting beliefs about moods.
“This technique aims to elicit conflicting beliefs about moods (Mansell et al., 2007).”
From What are People's Experiences of a Novel Cognitive Behavioural Therapy for Bipolar Disorders? A Qualitative Investigation with Participants on the TEAMS Trial. (2017) · cites this paper as Mansell et al., 2007
Cites
Nolen-Hoeksema, S., & Morrow, J. (1991) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.61.1.115 · Cited by 3,276 · see citing works
Kapur, S. (2003) · American Journal of Psychiatry · doi:10.1176/appi.ajp.160.1.13 · Cited by 2,813 · see citing works
GILBERT, P., & ALLAN, S. (1998) · Psychological Medicine · doi:10.1017/s0033291798006710 · Cited by 972 · see citing works
Morrison, A. P. (2001) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465801003010 · Cited by 673 · see citing works
Wells, A., & Davies, M. I. (1994) · Behaviour Research and Therapy · doi:10.1016/0005-7967(94)90168-6 · Cited by 640 · see citing works
Anxiety disorders: Why they persist and how to treat them
Clark, D. M. (1999) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(99)00048-0 · Cited by 556 · see citing works
An empirical test of a clinical metacognitive model of rumination and depression
Papageorgiou, C., & Wells, A. (2003) · Cognitive Therapy and Research · doi:10.1023/a:1023962332399 · Cited by 550 · see citing works
Rumination and overgeneral memory in depression: Effects of self-focus and analytic thinking.
Watkins, E., & Teasdale, J. D. (2001) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.110.2.333 · Cited by 536 · cited 1× · see citing works
“In particular, there is evidence that rumination in response to low mood predicts increased severity of depressive symptoms (Nolen-Hoeksema and Morrow, 1991; Watkins, Teasdale and Williams, 2000; Watkins and Teasdale, 2001).”
BackgroundTreatment of childhood memories: Theory and practice
Arntz, A., & Weertman, A. (1999) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(98)00173-9 · Cited by 488 · see citing works
(1987) · American Journal of Psychiatry · doi:10.1176/ajp.144.2.201 · Cited by 346 · see citing works
Hackmann, A., & Holmes, E. (2004) · Memory · doi:10.1080/09658210444000133 · Cited by 180 · see citing works
Control theory and psychopathology: an integrative approach.
Mansell, W. (2005) · Psychology and Psychotherapy: Theory, Research and Practice · doi:10.1348/147608304x21400 · Cited by 133 · see citing works
Self-citationMansell, W., & Jones, S. H. (2006) · Journal of Affective Disorders · doi:10.1016/j.jad.2006.04.004 · Cited by 65 · cited 1× · see citing works
“This finding was replicated in a more extensive study that controlled for current symptoms (Mansell and Jones, 2006).”
ResultSelf-citationNolen-Hoeksema, S., & Morrow, J. (2012) · PsycTESTS Dataset · doi:10.1037/t03823-000 · Cited by 51 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Positive emotion regulation in emotional disorders: A theoretical review
Carl, J. R., Soskin, D. P., Kerns, C., & Barlow, D. H. (2013) · Clinical Psychology Review · doi:10.1016/j.cpr.2013.01.003 · Cited by 391 · see citing works
Cognitions in bipolar affective disorder and unipolar depression: imagining suicide
Hales, S. A., Deeprose, C., Goodwin, G. M., & Holmes, E. A. (2011) · Bipolar Disorders · doi:10.1111/j.1399-5618.2011.00954.x · Cited by 157 · see citing works
When trying is not enough: Emotion regulation and the effort–success gap in bipolar disorder.
Gruber, J., Harvey, A. G., & Gross, J. J. (2012) · Emotion · doi:10.1037/a0026822 · Cited by 151 · see citing works
Gilbert, K. E., Nolen-Hoeksema, S., & Gruber, J. (2013) · Behaviour Research and Therapy · doi:10.1016/j.brat.2013.08.004 · Cited by 112 · see citing works
Emotion regulation strategies in bipolar disorder: A systematic and critical review
Dodd, A., Lockwood, E., Mansell, W., & Palmier-Claus, J. (2019) · Journal of Affective Disorders · doi:10.1016/j.jad.2018.12.026 · Cited by 90 · see citing works
Self-citationPsychological therapy for anxiety in bipolar spectrum disorders: A systematic review
Stratford, H. J., Cooper, M. J., Di Simplicio, M., Blackwell, S. E., & Holmes, E. A. (2015) · Clinical Psychology Review · doi:10.1016/j.cpr.2014.11.002 · Cited by 63 · see citing works
Does unstable mood increase risk of suicide? Theory, research and practice
Palmier-Claus, J. E., Taylor, P. J., Varese, F., & Pratt, D. (2012) · Journal of Affective Disorders · doi:10.1016/j.jad.2012.05.030 · Cited by 57 · see citing works
Gilbert, K., & Gruber, J. (2014) · Cognitive Therapy and Research · doi:10.1007/s10608-014-9602-3 · Cited by 40 · see citing works
Buffering against Maladaptive Perfectionism in Bipolar Disorder: The Role of Self-Compassion
Fletcher, K., Yang, Y., Johnson, S. L., Berk, M., Perich, T., Cotton, S., Jones, S., Lapsley, S., Michalak, E., & Murray, G. (2019) · Journal of Affective Disorders · doi:10.1016/j.jad.2019.03.003 · Cited by 40 · see citing works
Evolutionary and genetic insights for clinical psychology
Crespi, B. J. (2020) · Clinical Psychology Review · doi:10.1016/j.cpr.2020.101857 · Cited by 18 · see citing works
Joyce, E., Tai, S., Gebbia, P., & Mansell, W. (2017) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2040 · Cited by 13 · see citing works
Self-citation
- Authors
- Mansell, W., Morrison, A. P., Reid, G., Lowens, I., & Tai, S.
- Affiliations
- University of Manchester (GB)
- Venue
- Behavioural and Cognitive Psychotherapy
- Publisher
- Cambridge University Press (CUP)
- Published
- 2007-06-27
- Volume
- 35
- Issue
- 5
- Pages
- 515-539
- ISSN
- 1352-4658 (ISSN-L)
- 1469-1833
- OpenAlex
- W2142236009
- Cited by
- 195
- References
- 14
- Citations by year
- 2026: 5 · 2025: 6 · 2024: 16 · 2023: 9 · 2022: 6 · 2021: 7 · 2020: 10 · 2019: 15 · 2018: 9 · 2017: 9 · 2016: 11 · 2015: 10 · 2014: 15 · 2013: 18 · 2012: 12
- FWCI
- 3.84
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Behavioural and Cognitive Psychotherapy (publishedVersion)
- Research Explorer (The University of Manchester) (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- mood swings, bipolar disorder, cognitive models, internal state, emotion regulation, personal meaning, affective beliefs, self-belief, vicious circle, relapse vulnerability
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
