Stability of self‐esteem in bipolar disorder: comparisons among remitted bipolar patients, remitted unipolar patients and healthy controls1
Abstract
OBJECTIVES: Changes in beliefs about the self are a central feature of bipolar disorder, with grandiose self-belief common in mania and low self-esteem evident in periods of depression. We investigated whether unstable self-esteem is a characteristic of bipolar disorder in remission. METHODS: We compared 18 patients with DSM-IV bipolar disorder in remission, 16 patients with unipolar disorder in remission, and 19 healthy controls. The primary measure was a diary kept for one week and completed twice each day, measuring self-esteem and positive and negative affect. We also administered Winters and Neale's (J Abnorm Psychol 1985; 94: 282-290) implicit measure of attributional style. RESULTS: Whereas mean levels of self-esteem and affect were not abnormal in the remitted bipolar patients, the bipolar patients showed strong fluctuations in these processes. In common with the unipolar patients, they also showed a pessimistic attributional style on the Pragmatic Inference Task (PIT). CONCLUSIONS: Instability of self-esteem and affect is present in bipolar patients, even when their symptoms are in remission, and has previously been found in people at genetic risk of the disorder. It may be a marker of vulnerability to the disorder.
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At least some MDD patients in remission continue to experience relatively high current levels of negative affect and stress even when they no longer meet diagnostic criteria for a current major depressive episode.
“from these studies it appears that at least some patients continue to experience relatively high current levels of NA and stress even when they no longer meet diagnostic criteria for a current major depressive episode.”
From Mood Disorders in Everyday Life: A Systematic Review of Experience Sampling and Ecological Momentary Assessment Studies (2012) · cites this paper as Knowles et al., 2007
ESM/EMA studies in remitted MDD patients have identified chronic high levels of negative affect and stress as residual symptoms that may over time contribute to relapse.
“In summary, ESM/EMA studies in remitted MDD patients have identi fi ed various residual symptoms that may over time contribute to relapse: lingering complaints about physical symptoms and a poor quality of life (Barge-Schaapveld & Nicolson, 2002) chronic high levels of NA and stress (Husky et al., 2009; Knowles et al., 2007), and perhaps a low motivation to engage in physical activity (Wichers”
From Mood Disorders in Everyday Life: A Systematic Review of Experience Sampling and Ecological Momentary Assessment Studies (2012) · cites this paper as Knowles et al., 2007
BD patients in remission are different from healthy controls.
“BD patients in remission are also different from healthy controls (Knowles et al., 2007; Myin-Germeys et al., 2003).”
From Mood Disorders in Everyday Life: A Systematic Review of Experience Sampling and Ecological Momentary Assessment Studies (2012) · cites this paper as Knowles et al., 2007
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- Authors
- Knowles, R., Tai, S., Jones, S. H., Highfield, J., Morriss, R., & Bentall, R. P.
- Affiliations
- University of Manchester (GB)
- University of Liverpool (GB)
- Corresponding author
- Bentall, Richard P
- Venue
- Bipolar Disorders
- Publisher
- Wiley
- Published
- 2007-08
- Volume
- 9
- Issue
- 5
- Pages
- 490-495
- ISSN
- 1398-5647 (ISSN-L)
- 1399-5618
- OpenAlex
- W1995084148
- Cited by
- 130
- References
- 36
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 4 · 2023: 5 · 2022: 1 · 2021: 9 · 2020: 7 · 2019: 9 · 2018: 7 · 2017: 7 · 2016: 10 · 2015: 10 · 2014: 9 · 2013: 11 · 2012: 10
- FWCI
- 3.42
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Bipolar Disorders (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Keywords
- bipolar disorder, self-esteem, remission, major depressive disorder, neuroticism, attributional style, daily diary, vulnerability indicators
- MeSH terms
- Adult, Bipolar Disorder, Depressive Disorder, Female, Humans, Male, Middle Aged, Remission Induction, Self Concept
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