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Recent conceptual and empirical advances have focused on interpersonal dimensions of emotion regulation and, more specifically, to the features of attempted support transactions that shape the outcomes of enacted support. We conducted 2 autobiographical recall studies to investigate receivers' evaluations of intrinsic interpersonal emotion regulation interactions, to ascertain the number of dimensions required to capture variation in those evaluations, and then to examine associations of those dimensions with perceived benefits of the interactions. To do so, we developed a new questionnaire, the Interpersonal Regulation Interaction Scale (IRIS). In Study 1 (n = 390), an exploratory factor analysis (EFA) of the IRIS yielded 4 dimensions, which we labeled responsiveness, hostility, cognitive support, and physical presence. Each dimension was uniquely associated with perceived benefits of receiving interpersonal emotion regulation. In Study 2, we collected multiple, diverse samples (ns = 199-895) and found support for the replicability and generalizability of key findings from Study 1, including the factor structure and associations with perceived benefits. In summary, across 2 studies and multiple, diverse samples, we identified 4 conceptually and practically important dimensions of receivers' evaluations of interpersonal emotion regulation interactions and developed a brief measure that taps interaction variability in these dimensions. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Suicidal ideation is a pervasive and painful experience that varies considerably in its phenomenology. Here, we consider how one key risk variable might inform our understanding of variation in suicidal ideation: emotion-related impulsivity, the trait-like tendency towards unconstrained speech, behaviour, and cognition in the face of intense emotions. We hypothesized that emotion-related impulsivity would be tied to specific features, including severity, perceived lack of controllability, more rapidly fluctuating course, higher scores on a measure of acute suicidal affective disturbance, and more emotional and cognitive disturbance as antecedents.We recruited two samples of adults (Ns = 421, 221) through Amazon Mechanical Turk (MTurk), with oversampling of those with suicidal ideation. Both samples completed psychometrically sound self-report measures online to assess emotion- and non-emotion-related dimensions of impulsivity and characteristics of suicidal ideation.One form of emotion-related impulsivity related to the severity, uncontrollability, dynamic course, and affective and cognitive precursors of ideation.Despite limitations of the cross-sectional design and self-report measures, the current findings highlight the importance of specificity in considering key dimensions of impulsivity and suicidal ideation.

Background. Burgeoning evidence suggests that loneliness during the COVID-19 pandemic is tied to high levels of depression and anxiety. The current study is unique, though, in examining which facets of social behavior and perceived social quality are most tied to internalizing symptoms using longitudinal data, including a pre-pandemic baseline, collected from a community sample of adults with pre-existing mental health concerns (analyzed n = 144). Methods. Participants completed measures of depressive and anxious symptoms pre-pandemic, followed by three weekly surveys during the pandemic. We distinguished four social variables: in-person social engagement, remote social engagement, social disruption, and social distress. OLS and mixed-effects regression models examined 1) pre-pandemic baseline symptoms as predictors of social functioning during the pandemic and 2) time-lagged associations between symptoms and social functioning during the pandemic. Results. Social behavior and social perceptions were dissociable. Baseline depressive, but not anxious, symptoms predicted greater social distress during the pandemic. Both anxious and depressive symptoms were predicted by social variables, but the specific associations differed: depressive symptoms were related to perceived social quality, whereas anxious symptoms were more tied to reported social behavior. Limitations. We relied on self-report indices, and causality should not be inferred directly from these correlational data. Conclusions. Overall, our results indicate that it is possible to follow social guidelines and even to spend relatively few hours socializing with close others, while still feeling connected and rewarded; however, people who struggle with depression and anhedonia were particularly vulnerable to distressing feelings of social disconnection amid the pandemic.

The unique contribution of the serotonin transporter-linked polymorphic region (5-HTTLPR), intronic region 2 (STin2), and monoamine oxidase A (MAO-A) genes to individual differences in personality traits has been widely explored, and research has shown that certain forms of these polymorphisms relate to impulsivity and impulsivity-related disorders. Humans showing these traits are also described as having an asymmetrical prefrontal cortical activity when compared to others. In this explorative study, we examine the relationship between serotonergic neurotransmission polymorphisms, cortical activity features (prefrontal alpha asymmetry, individual alpha peak frequency [iAPF]), emotion-related and non-emotion-related impulsivity in humans. 5-HTTLPR, MAO-A, and STin2 polymorphisms were assessed in blood taken from 91 participants with high emotion-related impulsivity levels. Sixty-seven participants completed resting electroencephalography and a more comprehensive impulsivity index. In univariate analyses, iAPF correlated with both forms of emotion-related impulsivity. In multiple linear regression models, 5-HTTLPR polymorphism (model 1, adj. R2 = 15.2%) and iAPF were significant interacting predictors of emotion-related impulsivity, explaining a large share of the results’ variance (model 2, adj. R2 = 21.2%). Carriers of the low transcriptional activity 5-HTTPLR and MAO-A phenotypes obtained higher emotion-related impulsivity scores than others did. No significant results were detected for non-emotion-related impulsivity or for a form of emotion-related impulsivity involving cognitive/motivational reactivity to emotion. Our findings support an endophenotypic approach to impulsivity, showing that tri-allelic 5-HTTLPR polymorphism, iAPF, and their interaction are relevant predictors of one form of emotion-related impulsivity.

Overreliance on disengagement emotion regulation strategies (e.g., emotion avoidance, emotion suppression) has been shown to relate to poor clinical outcomes. Two traits characterized by difficulties in goal-directed responses to emotion-urgency and distress intolerance-may help explain who is likely to disengage from emotion and when. These traits are associated with diverse forms of psychopathology and greater reliance on disengagement strategies. Gaps remain about how these traits relate to emotion regulation in daily life. The present study uses ecological momentary assessment (EMA) to determine the associations of urgency and distress intolerance with momentary high arousal negative affect and momentary attempts to regulate negative emotions. Participants (N = 101) were college students who endorsed at least weekly behaviors often characterized by emotion dysregulation (e.g., self-harm, binging/purging, alcohol/drug use). Participants completed trait measures at baseline and EMA surveys of momentary affect and emotion regulation, six times daily for 4 days. Results indicated that at certain levels, urgency and distress intolerance moderated the relationship between high arousal negative affect and disengagement from emotion: low urgency scores related to relatively greater disengagement from emotion following reported high arousal negative affect, whereas high distress intolerance scores related to relatively greater disengagement following high arousal negative affect. Findings support the role of both urgency and distress intolerance in the relationship between high arousal negative affect and disengagement, which implicates the utility of clinical interventions that focus on emotion regulation, especially during high arousal states. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Abstract. Emotion-related impulsivity, defined as the tendency to say or do things that one later regret during periods of heightened emotion, has been tied to a broad range of psychopathologies. Previous work has suggested that emotion-related impulsivity is tied to an impaired function of the serotonergic system. Central serotonin synthesis relies on the intake of the essential amino acid, tryptophan and its ability to pass through the blood brain barrier. Objective: The aim of this study was to determine the association between emotion-related impulsivity and tryptophan intake. Methods: Undergraduate participants (N = 25, 16 women, 9 men) completed a self-rated measure of impulsivity (Three Factor Impulsivity Index, TFI) and daily logs of their food intake and exercise. These data were coded using the software NutriNote to evaluate intakes of tryptophan, large neutral amino acids, vitamins B6/B12, and exercise. Results: Correlational analyses indicated that higher tryptophan intake was associated with significantly lower scores on two out of three subscales of the TFI, Pervasive Influence of Feelings scores r = –.502, p

There has been extensive discussion about gender gaps in representation and career advancement in the sciences. However, psychological science itself has yet to be the focus of discussion or systematic review, despite our field’s investment in questions of equity, status, well-being, gender bias, and gender disparities. In the present article, we consider 10 topics relevant for women’s career advancement in psychological science. We focus on issues that have been the subject of empirical study, discuss relevant evidence within and outside of psychological science, and draw on established psychological theory and social-science research to begin to chart a path forward. We hope that better understanding of these issues within the field will shed light on areas of existing gender gaps in the discipline and areas where positive change has happened, and spark conversation within our field about how to create lasting change to mitigate remaining gender differences in psychological science.

Theory about the conceptual basis of psychiatric disorders has long emphasized negative emotionality. More recent ideas emphasize roles for positive emotionality and impulsivity as well. This article examines impulsive responses to positive and negative emotions, which have been labelled as urgency. Urgency is conceptually and empirically distinct from other forms of impulsivity. A large body of work indicates that Urgency is more robustly related to psychopathology than are other forms of impulsivity. Researchers have considered four neurocognitive models of urgency: excessive emotion generation, poor emotion regulation, risky decision-making, and poor cognitive control. Little evidence supports emotion generation or risky decision-making as the core issues driving urgency. Rather, urgency appears related to dysfunction in key hubs implicated in the integration of cognitive control and emotion regulation (e.g., the orbitofrontal cortex and anterior insula), expressed as response inhibition deficits that emerge most robustly in high arousal contexts. These neurocognitive processes appear remarkably parallel for positive and negative urgency. We provide methodological suggestions and theoretical hypotheses to guide future research.

Background: Adjunctive psychological interventions improve outcomes in bipolar disorder (BD), but people in latter, more refractory illness stages likely have different clinical needs. The objective here was to test the hypothesis that for people with >‾ 10 episodes of BD, an online mindfulness-based intervention improves quality of life (QoL) relative to a quality-matched psychoeducation control. Methods: A rater-blind, pragmatic superiority randomised clinical trial compared Mindfulness with active control (Psychoeducation). Both interventions were 5-week coach-supported self-management programs with treatment as usual continued. Key inclusion criteria were age 18 to 65 years, confirmed diagnosis of BD, and history of >‾ 10 episodes. Measures were collected at baseline, immediate post-intervention, and 3- and 6- month follow-ups. Main outcome was QoL, measured on the self-report Brief Quality of Life in Bipolar Disorder (Brief QoL.BD) at 5 weeks, using intention-to-treat analyses. The study setting was online, and randomisation was automated into the platform. The trial was prospectively registered on 23 June 2017 through ClinicalTrials.gov (http://www.clinicaltrials.gov, NCT03197974). Findings: Recruitment commenced 19 th September 2017, randomisation target reached 28 th November 2018 (N = 302 randomised) and follow-up data collection completed 6 th July 2019. The primary hypothesis of significant improvement in QoL with Mindfulness relative to Psychoeducation was not supported (Treatment X Time β = -0.69, 95% CI: -2·69, 1·31, p = 0·50). Recruitment was feasible, the platform was safe, both interventions were highly acceptable, but usage was suboptimal. Post hoc analyses found both interventions effective for participants not in remission from depression at baseline. Interpretation: In people with latter-stage BD, an online Mindfulness intervention was not superior to Psychoeducation. More effective future variants could combine mindfulness with psychoeducation content, improve engagement via personalised tailoring of QoL goals, and target more symptomatic individuals. Trial Registration: The trial was prospectively registered on 23 June 2017 through ClinicalTrials.gov (http://www.clinicaltrials.gov, NCT03197974). Funding: Supported by Australian National Health and Medical Research Council (NHMRC; APP1102097). Declaration of Interest: GM has received Grant/Research support from National Health and Medical Research Council (NHMRC), BeyondBlue Barbara Dicker Foundation, Readiness P/L, SiSU Wellness P/L – unrelated to this work, with the exception of the NHMRC funding for the project described here. MB has received Grant/Research Support from the NIH, Cooperative Research Centre, Simons Autism Foundation, Cancer Council of Victoria, Stanley Medical Research Foundation, Medical Benefits Fund, National Health and Medical Research Council, Medical Research Futures Fund, Beyond Blue, Rotary Health, A2 milk company, Meat and Livestock Board, Woolworths, Avant and the Harry Windsor Foundation, has been a speaker for Abbot, Astra Zeneca, Janssen and Janssen, Lundbeck and Merck and served as a consultant to Allergan, Astra Zeneca, Bioadvantex, Bionomics, Collaborative Medicinal Development, Janssen and Janssen, Lundbeck Merck, Pfizer and Servier – all unrelated to this work. NT has received Grant/Research Support from the Australian Government Department of Health, Australian Government Department of Veterans Affairs, Barbara Dicker Brain Sciences Foundation, NHMRC, Mental Health Commission, VicHealth and Victorian State Government Department of Health and Human Services, all unrelated to this work. LB has received Grant/Research Support from the NIH, Australasian Society for Bipolar & Depressive Disorders Ltd, GMHBA, National Health and Medical Research Council, and Servier – all unrelated to this work. SJ has received Grant/Research support from NIHR HTA, EME, RfPB and PGfAR streams all unrelated to this work. Ethical Approval: Swinburne University of Technology Human Research Ethics Committee approved the online trial (2016/289) with international recruitment.

Rumination and emotion-related impulsivity predict suicidal ideation, suicide attempts, and nonsuicidal self-injury (NSSI). Because rumination and emotion-related impulsivity, though, are highly correlated, we consider their unique vs. conjoint influence on suicidal ideation and self-harm.Across two samples of adults (N's = 171 and 191), we examined how rumination and emotion-related impulsivity relate to suicidal ideation, suicide attempts, and NSSI. We assess the more general process of repetitive negative thinking and the more specific process of suicide-related rumination. Participants completed the Three-Factor Impulsivity Index and the self-report Columbia-Suicide Severity Rating Scale. Those in sample 1 completed the Perseverative Thinking Questionnaire and the Deliberate Self-Harm Inventory, and those in Sample 2 completed the Suicide Rumination Scale.Emotion-related impulsivity and both forms of rumination showed robust bivariate correlations with suicidal ideation, suicide attempts, and NSSI. Neither rumination or impulsivity related to suicide attempts controlling for ideation or to NSSI. In multivariable analyses, emotion-related impulsivity but not general rumination was tied to suicidal ideation. In contrast, suicide-related rumination was more directly tied to suicidal ideation than was impulsivity.Findings provide support for a more nuanced approach to the forms of impulsivity and rumination related to suicidal ideation.

Background:Involuntary mental imagery is elevated among people with bipolar disorder, and has been shown to shape biases in interpretation of ambiguous information. However, it is not clear whether biases in interpretation of ambiguous scenarios can be observed in those at risk for bipolar disorder, or whether involuntary imagery is related to such a bias.Aims:In the present study, we extended a prominent model of bipolar cognition to an at-risk sample. We specifically tested whether positive interpretation bias and involuntary mental imagery are linked to a greater risk of bipolar disorder.Method:Young adults (N = 169) completed measures of risk for bipolar disorder (the Hypomanic Personality Scale [HPS]), interpretation bias, and involuntary mental imagery.Results:Higher scores on the HPS were significantly correlated with more positive interpretations of ambiguous scenarios (β = 0.29, p p < .01). There was no evidence of an interaction between interpretation bias and mental imagery in predicting HPS score, β = .04, p = .62.Conclusions:Further research is warranted to determine if intrusive imagery or interpretation bias influence the development of bipolar disorder over time in those at risk.

Prior research has indicated that ideal affect (i.e., the affective states that people value and would ideally like to experience) may be relevant to mental health outcomes. Studies to date, however, have not used comprehensive multivariate models that account for covariation among facets of ideal affect and incorporate multiple clinical outcomes. In the present studies, we used structural equation modeling to examine the multivariate effects of ideal affect on symptoms of depression, anxiety, and alcohol abuse in 2 moderately large samples of undergraduates (N = 293 and N = 146). Exploratory results of Study 1 indicated that valuation of high arousal positive affective states was significantly associated with lower depression symptoms but higher anxiety and alcohol abuse symptoms and that valuation of high arousal negative states was specifically associated with greater anxiety symptoms. These results were shown to be structurally invariant across samples and ethnicities in Study 2, which also found that ideal-actual affect discrepancies were significantly associated with symptoms of depression and anxiety. These findings support and extend the hypothesis that ideal affect is implicated in clinical outcomes by highlighting the importance of jointly considering multiple facets of ideal and actual affect as they relate to a range of clinical syndromes. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Background Mania is associated with social conflict, reduced social support, and reduced social interaction quality (Breyer et al., 2003; Coryell et al., 1998; Morriss et al., 2007). Chronic stress in interpersonal relationships is related to the worsening of mood symptoms (Kim et al., 2007), suggesting the importance of characterizing the mechanism of interpersonal relationship disruption in bipolar disorder. The current study was designed to investigate exaggerated dominance tendencies present in at-risk individuals (Gardner, 1982; Wilson and Price, 2006), which may represent one such mechanism. Methods Sixty-nine University undergraduate participants (50.7% female, 22 categorized as high mania risk) completed an implicit measure of power motivation and series of self-report questionnaires designed to assess dominance-relevant traits. Results Risk for mania was related to a tendency to experience contempt, and an implicit index of dominance tendencies, and also to trait-like tendencies to experience pride, perceptions of being more powerful and influential across relationships,. Limitations Use of an undergraduate population and a dimensional measure of mania risk (rather than diagnosed individuals) are limitations. Conclusions Mania risk is tied not only to the pursuit of dominance, but also to beliefs and actions consistent with a sense of power. Current findings provide evidence that the dominance system profile observed in those at risk for mania could be one source of interpersonal problems.

This article considers self and self-concept in bipolar disorder. Bipolar disorder, defined on the basis of manic symptoms, is a highly debilitating psychopathology. It is heavily grounded in biology but symptom course is still very responsive to psychological and social forces in the lives of persons who have the disorder. This review assumes an overall view of the self that is typical of personality psychology: self as traits, self as goals and aspirations, and ongoing efforts to attain those goals. In this review, we will discuss two different facets of self and identity in bipolar disorder. First, we review a body of goal pursuit literature suggesting that persons with bipolar disorder endorse heightened ambitions for attaining goals and recognition from others. Second, we will review multiple findings which suggest that among persons with bipolar disorder, self-worth depends on measurable success in an extreme way. We will consider how the intersection of these two themes may lead to unique identity challenges for people with bipolar disorder, drawing from self-report, behavioral, and neuroscience findings to critically examine this viewpoint.

Blunted and exaggerated neuronal response to rewards are hypothesized to be core features of schizophrenia spectrum disorders (SZ) and bipolar disorder (BD), respectively. Nonetheless, direct tests of this hypothesis, in which response between SZ and BD is compared in the same study, are lacking. Here we examined the functional correlates of reward processing during the Incentivized Control Engagement Task (ICE-T) using 3T fMRI. Reward-associated activation was examined in 49 healthy controls (HCs), 52 recent-onset individuals with SZ, and 22 recent-onset individuals with Type I BD using anterior cingulate (ACC), anterior insula, and ventral striatal regions of interest. Significant group X reward condition (neutral vs. reward) interactions were observed during reward anticipation in the dorsal ACC (F(2,120) = 4.21, P = 0.017) and right insula (F(2,120) = 4.77, P = 0.010). The ACC interaction was driven by relatively higher activation in the BD group vs. HCs (P = 0.007) and vs. individuals with SZ (P = 0.010). The insula interaction was driven by reduced activation in the SZ group relative to HCs (P = 0.018) and vs. people with BD (P = 0.008). A composite of reward anticipation-associated response across all associated ROIs also differed significantly by diagnosis (F(1,120) = 5.59, P = 0.02), BD > HC > SZ. No effects of group or group X reward interactions were observed during reward feedback. These results suggest that people with SZ and BD have opposite patterns of activation associated with reward anticipation but not reward receipt. Implications of these findings in regard to Research Domain Criteria-based classification of illness and the neurobiology of reward in psychosis are discussed.

Background Theory and research suggest that social dominance is important for multiple forms of psychopathology, and yet few studies have considered multiple dimensions of psychopathology simultaneously, and relatively few have used well-validated behavioral indices. Method Among 81 undergraduates, we used a well-validated experimental approach of assigning participants to a leadership or subordinate position, and we examined how self-rated severity of depression, social anxiety, manic tendencies, and psychopathy relate to psychophysiological and affective reactivity to this role. Results Consistent with hypotheses, manic symptoms related to more discomfort in the subordinate role compared to the leadership role, as evidenced by more decline in positive affect, more discomfort, and a larger RSA decline, while depression symptoms related to a more positive response to the subordinate role than the leadership role, including more positive affect and more comfort in the assigned role. Social anxiety was related to discomfort regardless of the assigned role, and those with higher psychopathy symptoms did not show differential response to assigned roles. Limitations Findings are limited by the mild symptom levels and absence of hormonal data. Conclusions Findings provide novel transdiagnostic evidence for the importance of social dominance to differentiate diverse forms of psychopathology.

Turner et al. (2021) subtly relapse in conceptualizing the Examination for Professional Practice in Psychology (Part 2-Skills) exam as a competency evaluation despite Association of State and Provincial Psychology Boards' (ASPPB) prior concession that Part 2 measures only the knowledge of skills (not skill competency). They do not address the purpose of redundant evaluation or the other concerns raised in Callahan et al. (2020). Instead, Turner et al. remain narrowly focused on defense of content validity and a reliance on outdated standards that fail to meet contemporary expectations for assessment of health care professionals. The adopted processes and procedures, albeit time consuming and effortful, are known to be methodologically inadequate. ASPPB's methods demonstrably foster linguistic biases and systemic racism that constricts licensure of diverse individuals as psychologists. Specific suggestions are offered, and ASPPB is urged to take drastic corrective action. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Background In a time of rapid environmental change, understanding how the challenges experienced by one generation can influence the fitness of future generations is critically needed. Using tolerance assays and transcriptomic and methylome approaches, we use zebrafish as a model to investigate cross-generational acclimation to hypoxia. Results We show that short-term paternal exposure to hypoxia endows offspring with greater tolerance to acute hypoxia. We detected two hemoglobin genes that are significantly upregulated by more than 6-fold in the offspring of hypoxia exposed males. Moreover, the offspring which maintained equilibrium the longest showed greatest upregulation in hemoglobin expression. We did not detect differential methylation at any of the differentially expressed genes, suggesting that other epigenetic mechanisms are responsible for alterations in gene expression. Conclusions Overall, our findings suggest that an epigenetic memory of past hypoxia exposure is maintained and that this environmentally induced information is transferred to subsequent generations, pre-acclimating progeny to cope with hypoxic conditions.

Clinical science has benefited tremendously from taking seriously the proposition that putatively maladaptive behaviors serve psychological functions, prominently among these affect regulation (AR). These functionalist accounts have not only advanced basic clinical science, but also formed the bedrock for the development of effective treatments. Drawing heavily on reinforcement learning theory, we aim to elucidate functional relationships between maladaptive behavior and AR. Specifically, we take the view that maladaptive behaviors are frequently motivated and reinforced by hedonic AR functions (i.e., decreasing negative affect and increasing positive affect) but are also susceptible to becoming stimulus-bound habits. We review empirical evidence related to one such behavior, nonsuicidal self-injury. We close with a brief reflection on future directions. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Objective The goal of this study was to develop and validate a measure of self-rated positive and negative beliefs about one’s NSSI, the Experiences of Self-Injury Questionnaire (ESIQ).Method Psychometric properties and validation against NSSI severity and shame were tested in two US and two UK samples of individuals who endorsed a history of NSSI.Results Exploratory and confirmatory factor analyses indicated five factors. Subscales were labeled Positive Beliefs, Personal Dislike, Interpersonal Concern, Emotional Suppression, and Emotional Expression. The Positive Beliefs subscale covers beliefs that NSSI is valuable. Scores on this subscale were associated with endorsement of NSSI frequency, NSSI urges, and perceived likelihood of future NSSI. Other subscales showed validity in that they all showed unique effects on outcome indices of NSSI severity or shame.Conclusion The ESIQ shows promise as a brief reliable measure of beliefs about and experiences of NSSI.

Major depressive disorder (MDD) is associated with working memory (WM) impairments. These deficits often persist following remission and are associated with rumination, a recognized risk factor for depression relapse. The efficacy of WM-targeted cognitive remediation as a potential relapse prevention tool has not been investigated. The present pilot study aimed to investigate the feasibility, acceptability, and cognitive benefits of a WM-targeted cognitive remediation program in remitted depression. Twenty-eight MDD participants in remission were recruited. The intervention consisted of twenty-five 30–40-minute training sessions, coupled with weekly coaching, administered over a 5-week period. Before and after the intervention, a battery of objective neuropsychological tests and self-report measures was administered. Key outcomes were WM, inhibition and rumination. Acceptability of the intervention was observed, with 83% showing high motivation, along with WM gains for all completers (n = 18, 64% of recruited participants). The cognitive remediation selectively improved targeted WM functions, as measured by objective tests. This did not translate into self-reported improvements in everyday WM or inhibition. However, all but one completer achieved at least one personal goal related to WM and 44% achieved two or, the maximum possible, three such goals. For remitters whose WM was significantly enhanced after the intervention, the cognitive remediation also decreased dysphoric-mood related rumination. The successful pilot testing of the WM-targeted intervention supports the conduct of a fully powered randomized controlled trial as a relapse prevention approach in remitted MDD. publishedVersion

Impulsiveness has been studied as an aspect of personality and psychopathology for generations. There are longstanding disagreements about how to define it and whether it should be viewed as one construct or several. This article begins by briefly reviewing some earlier and some more recent work on impulsiveness. Several approaches have recently converged to focus on a distinction between impulsive reactions to emotion and impulsive properties that are not initiated by emotion. From this review, we turn to psychopathology. It is well known that impulsiveness is related to externalizing psychopathology, but some have concluded that a similar relation does not exist for internalizing psychopathology. A recent literature is described that challenges the latter conclusion, linking impulsive reactivity to emotion to both externalizing and internalizing aspects of psychopathology. Discussion then turns to emotion-related impulsiveness and other constructs to which it is conceptually and empirically related, reexamining whether other conceptual targets should be added to the discussion. The article closes with a consideration of how important it is to continue to remain open to new conceptual perspectives. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Background One previous study suggested that the presence of a manic episode before bipolar depression is related to worse response to antidepressants. Method To examine this effect in a larger sample, we used data from the large, multi-site STEP-BD study. We hypothesized that among persons treated with antidepressants for bipolar depression, manic or mixed episodes before depression onset (as compared to euthymia) would predict lower rate of recovery, more sustained depressive symptoms and higher rate of switching into mania/hypomania after antidepressant treatment of bipolar depression. 320 participants were available for analyses (140 male) diagnosed with bipolar I, bipolar II, cyclothymia, bipolar disorder not otherwise specified, or schizoaffective disorder bipolar subtype. Patients were randomly assigned to 3 treatment randomization strata (placebo, bupropion, and paroxetine) as adjuncts to mood stabilizers. Results Analyses were conducted to examine the effect of episode status before the depressive episode on the degree of change in depressive symptoms at 3 and 6 months, the likelihood of depression recovery and the likelihood of anti-depressant induced switching. Presence of a manic episode before depression in patients with bipolar disorder did not significantly predict response to antidepressants. Limitations The study was limited by a high rate of attrition, and consideration of only two antidepressant medications. Conclusions Our findings are in agreement with other past studies suggesting that mania and depression may operate separately for those with bipolar disorder, with differential predictors of the onset and offset of mania versus depression. Future directions may consider vulnerability for these episodes separately.

Positive urgency, defined as a tendency to become impulsive during positive affective states, has gained support as a form of impulsivity that is particularly important for understanding psychopathology. Despite this, little is known about the emotional mechanisms and correlates of this form of impulsivity. We hypothesized that positive urgency would be related to greater emotional reactivity in response to a positive film clip. Seventy-five undergraduates watched a positive film clip, and a multimodal assessment of emotion was conducted, including subjective emotional experience, physiological activation (i.e., heart rate, respiratory sinus arrhythmia, skin conductance), and facial emotional behavior (i.e., objectively coded using the Facial Action Coding System). Positive urgency was not significantly related to greater positive emotional reactivity but rather a more complex array of emotions expressed in facial behavior, as indexed by similar levels of positive yet greater levels of negative behavior. These findings show that positive urgency may be linked to altered emotionality, but does not appear related to heightened positive emotional reactivity. Potential implications for functional outcomes are discussed. (PsycINFO Database Record

Current adjunctive psychosocial interventions for bipolar disorder (BD) aim to impact illness course via information sharing/skill development. This focus on clinical outcomes contrasts with the emergent recovery paradigm, which prioritises adaptation to serious mental illness and movement towards personally meaningful goals. The aim of this review is to encourage innovation in the psychological management of BD by considering three recovery-oriented trends in the literature. First, the importance of quality of life as a target of recovery-oriented clinical work is considered. Second, the recent staging approach to BD is described, and we outline implications for psychosocial interventions tailored to stage. Finally, we review evidence suggesting that mindfulness-based psychosocial interventions have potential across early, middle and late stages of BD. It is concluded that the humanistic emphasis of the recovery paradigm provides a timely stimulus for development of a next generation of psychosocial treatments for people with BD.

Objective: Dysfunction in positive affect is a defining symptom of bipolar I disorder (BD), both during and between mood episodes. We hypothesize that helping people with BD learn skills to create balance in their affective experiences by engaging in strategies that increase low activation positive emotion (LAP; e.g., relaxation) could help to improve well-being during periods of symptom remission. We discuss the development and preliminary outcomes of a positive emotion regulation (PER) group treatment for people with BD, designed as a supplement to pharmacological treatment. Method: The Learning Affective Understanding for a Rich Emotional Life (LAUREL) intervention is a group-based intervention covering 10 empirically supported skills designed to increase LAP. Sixteen people with BD enrolled in the LAUREL intervention and twelve completed baseline and post-intervention assessments. Results: Participants who completed the study (n = 12) attended the majority of groups (87.96%) and reported practicing skills, on average, 16 times a week. We were unable to detect significant differences in mania symptoms following engagement in this PER intervention. Finally, participants reported increases in several areas associated with well-being post-intervention, including mindfulness, reappraisal, and self-compassion. Conclusion: This study provides a theoretical framework and preliminary support for a PER intervention for BD.

Although neurocognitive deficits and emotion regulation are closely linked within unipolar depression, little research has tested links between these two variables within bipolar disorder. The present study tested whether working memory is related to individual differences in emotion regulation strategies in bipolar disorder and whether working memory and emotion regulation can explain variability in symptoms over time. Fifty-nine euthymic adults with bipolar I disorder completed a working memory span task, symptom interviews assessing depression and mania, and questionnaires assessing brooding rumination, reappraisal, and suppression. At baseline, working memory was unrelated to emotion regulation. Symptom interviews were repeated at six months (n = 41) and 12 months (n = 36) follow-up. At 12 months, baseline working memory significantly interacted with baseline suppression to predict higher mania. Tests of simple slopes showed that at lower working memory levels, low use of suppression was associated with significantly greater mania symptoms. These results help to clarify previous inconsistent findings regarding cognitive functioning and emotion regulation strategies in bipolar disorder, suggesting that deficits in both domains combine to predict outcomes.

ObjectivesBoth sleep disruption and impulsivity are important predictors of the course of bipolar disorder (BD). Although sleep disruption has been shown to intensify impulsivity, little research has considered how these two important domains interact within BD. Adolescence is a critical period for the onset of BD, and is often associated with increases in impulsivity and substantial changes in sleep. We tested the hypothesis that disruptions in sleep would increase impulsivity among adolescents, and that this effect would be more pronounced among those with BD.MethodsThirteen- to nineteen-year-olds diagnosed with BD-I (n=33, age [mean ± standard deviation (SD)] 16.2± 1.66years, 54.5% female) and psychiatrically healthy controls (n=26, age [mean ± SD] 15.5 ± 1.45years, 55.6% female) reported their past-week bedtime, rise time, and sleep duration, separately for school days and weekends, and completed a self-report questionnaire on impulsivity. Stepwise regression was used to examine the effects of sleep on impulsivity, and the moderation of this effect by BD status.ResultsAdolescents with BD reported significantly higher impulsivity, later and more variable rise time, and more variable time in bed and sleep duration on school days than did controls. Greater change in sleep duration between school days and weekends was associated with significantly more impulsivity among adolescents with BD as compared to controls.ConclusionsThese findings highlight the important effect of sleep on impulsivity among adolescents with BD and add to the growing evidence that establishing sleep routines may be an important therapeutic target for youth with BD.

Suicide is the second leading cause of death among adolescents, and impulsivity has emerged as a promising marker of risk. The present study tested whether distinct domains of impulsivity are differentially associated with suicide ideation, plans, and attempts. Adolescents (n = 381; boys = 106, girls = 275) aged 13-19years (M = 15.62, SD = 1.41) were recruited from an acute, residential treatment program. Within 48h of admission to the hospital, participants were administered structured clinical interviews assessing mental health disorders and suicidality. Following these interviews, participants completed self-report questionnaires assessing symptom severity and impulsivity. Consistent with past research, an exploratory factor analysis of our 90-item impulsivity instrument resulted in a three-factor solution: Pervasive Influence of Feelings, Feelings Trigger Action, and Lack of Follow-Through. Concurrent analysis of these factors confirmed hypotheses of unique associations with suicide ideation and attempts in the past month. Specifically, whereas Pervasive Influence of Feelings (i.e., tendency for emotions to shape thoughts about the self and the future) is uniquely associated with greater suicidal ideation, Feelings Trigger Action (i.e., impulsive behavioral reactivity to emotions) is uniquely associated with the occurrence of suicide attempts, even after controlling for current psychiatric diagnoses and symptoms. Exploratory gender analyses revealed that these effects were significant in female but not male adolescents. These findings provide new insight about how specific domains of impulsivity differentially increase risk for suicide ideation and attempts. Implications for early identification and prevention of youth suicide are discussed.

A growing body of research suggests that the social environment exerts a powerful influence on the course of bipolar depression. This article reviews longitudinal research to suggest that trauma, negative life events, social support deficits, and family difficulties are common and predict a more severe course of depression when present among those diagnosed with bipolar disorder. The triggers of bipolar depression overlap with those documented for unipolar depression, suggesting that many of the treatment targets for unipolar depression may be applicable for bipolar depression.

Despite the centrality of emotion disturbance in neurobiological models of bipolar disorder, the behavioral literature has not yet clearly identified the most central aspects of emotion disturbance in bipolar disorder. Toward this aim, we gathered a battery of emotion-related measures in 67 persons diagnosed with bipolar I disorder as assessed with the SCID and a well-matched control group of 58 persons without a history of mood disorders. Those with bipolar disorder were interviewed monthly until they achieved remission, and then tested on emotion measures. A subset of 36 participants with bipolar disorder completed symptom severity interviews at 12-month follow-up. Factor analyses indicated 4 emotion factor scores: Negative Emotion, Positive Emotion, Reappraisal, and Suppression. Bivariate analyses suggested that bipolar disorder was tied to a host of emotion disturbances, but multivariate analyses suggested that bipolar disorder was particularly tied to elevations of Negative Emotion. High Negative Emotion, low Positive Emotion, and high Suppression were conjointly related to lower functioning. Reappraisal predicted declines in depression over time for those with bipolar disorder. Findings highlight the importance of considering the overall profile of emotion disturbance in bipolar disorder. Emotion and emotion regulation appear central to a broad range of outcomes in bipolar disorder.

Recent evidence suggests that anger and aggression are of concern even during remission for persons with bipolar I disorder, although there is substantial variability in the degree of anger and aggression across individuals. Little research is available to examine psychological models of anger and aggression for those with remitted bipolar disorder, and that was the goal of this study. Participants were 58 persons diagnosed with bipolar I disorder using the Structured Clinical Interview for DSM-IV, who were followed with monthly symptom severity interviews until they achieved remission, and then assessed using the Aggression-Short Form. We examined traditional predictors of clinical parameters and trauma exposure, and then considered three trait domains that have been shown to be elevated in bipolar disorder and have also been linked to aggression outside of bipolar disorder: emotion-relevant impulsivity, approach motivation, and dominance-related constructs. Emotion-relevant impulsivity was related to anger, hostility, verbal aggression, and physical aggression, even after controlling for clinical variables. Findings extend the importance of emotion-relevant impulsivity to another important clinical outcome and suggest the promise of using psychological models to understand the factors driving aggression and anger problems that persist into remission among persons with bipolar disorder.

Trait-like tendencies to respond impulsively to emotion, labelled emotion-related impulsivity, are robustly related to aggression. We developed and tested an online intervention to address emotion-related impulsivity and aggression. The 6-session intervention focused on behavioral techniques shown to decrease arousal and aggression, supplemented with implementation intentions and smartphone prompts to facilitate skills transfer into daily life. First, we piloted the intervention in-person with 4 people. Then, 235 participants were randomly assigned to take the online intervention immediately or after a wait-list period; those in the waitlist were then invited to take part in the intervention. Participants completed the self-rated Feelings Trigger Action Scale to assess emotion-related impulsivity, the interview-based Modified Overt Aggression Scale and the self-rated Buss Perry Aggression Questionnaire. Participants who took part in the treatment completed daily anger logs. Attrition, as with other online programs, was high; however, treatment completers reported high satisfaction, and outcomes changed more rapidly during treatment than waitlist across all key outcome indices. In analyses including all participants who took part in the treatment (immediate or delayed), we observed moderate-to-large treatment gains, which were maintained as of the 3-month follow-up assessment. This work supports the usefulness of an intervention for addressing emotion-related impulsivity and aggression.

Background Maladaptive perfectionism is a transdiagnostic risk and maintaining factor for a range of mental health conditions, including bipolar disorder (BD). Self-compassion represents a potential protective factor against maladaptive perfectionism, however no studies to date have examined the relationship of these constructs in BD. The aim of the present study was to examine associations between maladaptive perfectionism, self-compassion and symptoms among individuals with BD. Methods Baseline data were collected from 302 participants with a DSM-IV diagnosis of BD participating in an international randomised controlled trial. Participants completed measures of maladaptive perfectionism, self-compassion, symptom severity and emotion regulation difficulties. Clinician-administered measures of depression and mania severity were additionally collected. Correlation and mediation analyses were conducted. Results Maladaptive perfectionism was positively associated with depression, anxiety and emotion regulation difficulties. Lower levels of self-compassion correlated with greater self-reported depression, anxiety and emotion regulation difficulties. Self-compassion partially mediated relationships between maladaptive perfectionism, depression, anxiety and emotion regulation difficulties. Limitations The cross-sectional design limits conclusions about causal relationships between study variables. Results may not be generalizable to other BD populations. The role of maladaptive perfectionism and self-compassion in elevated mood states of BD remains unclear. Conclusion Self-compassion represents one mechanism through which maladaptive perfectionism influences symptoms of depression, anxiety and emotion regulation difficulties in BD. Self-compassion represents a modifiable treatment target; individuals with BD exhibiting maladaptive perfectionistic tendencies may benefit from interventions fostering self-compassion.

Background The primary objective of this randomised controlled trial (RCT) is to establish the effectiveness of a novel online quality of life (QoL) intervention tailored for people with late stage (≥ 10 episodes) bipolar disorder (BD) compared with psychoeducation. Relative to early stage individuals, this late stage group may not benefit as much from existing psychosocial treatments. The intervention is a guided self-help, mindfulness based intervention (MBI) developed in consultation with consumers, designed specifically for web-based delivery, with email coaching support. Methods/design This international RCT will involve a comparison of the effectiveness and cost-effectiveness of two 5-week adjunctive online self-management interventions: Mindfulness for Bipolar 2.0 and an active control (Psychoeducation for Bipolar). A total of 300 participants will be recruited primarily via social media channels. Main inclusion criteria are: a diagnosis of BD (confirmed via a phone-administered structured diagnostic interview), no current mood episode, history of 10 or more mood episodes, no current psychotic features or active suicidality, under the care of a medical practitioner. Block randomisation will be used for allocation to the interventions, and participants will retain access to the program for 6 months. Evaluations will be conducted at pre- and post- treatment, and at 3- and 6- months follow-up. The primary outcome measure will be the Brief Quality of Life in Bipolar Disorder Scale (Brief QoL.BD), collected immediately post-intervention at 5 weeks (T1). Secondary measures include BD-related symptoms (mania, depression, anxiety, stress), time to first relapse, functioning, sleep quality, social rhythm stability and resource use. Measurements will be collected online and via telephone assessments at baseline (T0), 5 weeks (T1), three months (T2) and six months (T3). Candidate moderators (diagnosis, anxiety or substance comorbidities, demographics and current treatments) will be investigated as will putative therapeutic mechanisms including mindfulness, emotion regulation and self-compassion. A cost-effectiveness analysis will be conducted. Acceptability and any unwanted events (including adverse treatment reactions) will be documented and explored. Discussion This definitive trial will test the effectiveness and cost-effectiveness of a novel QoL focused, mindfulness based, online guided self-help intervention for late stage BD, and investigate its putative mechanisms of therapeutic action. Trial registration ClinicalTrials.gov: NCT03197974. Registered 23 June 2017. Electronic supplementary material The online version of this article (10.1186/s12888-018-1805-9) contains supplementary material, which is available to authorized users.

Researchers and clinicians have long noted the overlap among features and high comorbidity of bipolar disorder and borderline personality disorder. The shared features of impulsivity and labile mood in both disorders make them challenging to distinguish. We tested the hypothesis that variables related to goal dysregulation would be uniquely related to risk for mania, while emotion-relevant impulsivity would be related to risk for both disorders. We administered a broad range of measures related to goal regulation traits and impulsivity to 214 undergraduates. Findings confirmed that risk for mania, but not for borderline personality disorder, was related to higher sensitivity to reward and intense pursuit of goals. In contrast, borderline personality disorder symptoms related more strongly than did mania risk with threat sensitivity and with impulsivity in the context of negative affect. Results highlight potential differences and commonalities in mania risk versus borderline personality disorder risk.

OBJECTIVE: Beyond evidence for an association, little is known about the mechanism linking creativity bipolar spectrum conditions. Theory suggests that ambition, which is heightened in bipolar disorder (BD) and associated with creativity in the general population, might be an important variable. The overarching aim of this project was to evaluate whether ambition is related to creativity among those with bipolar spectrum conditions. METHOD: Across two studies, we examined correlations between a validated self-report measure of ambition, the WASSUP, and creativity. In Study One, 22 individuals diagnosed with BD who self-identified as highly creative completed the WASSUP and a measure of lifetime creative accomplishment. In Study Two, 221 undergraduates completed the WASSUP, a measure of mania risk (the Hypomanic Personality Scale, HPS) and a measure designed to assess creativity in business projects and tasks. RESULTS: In Study One, WASSUP scores were significantly elevated compared to normative levels in BD, and WASSUP scores were correlated with lifetime creative accomplishment within the artistic sample. In Study Two, mania risk was related to greater ambition and creativity, and ambition was also directly related to greater creativity. LIMITATIONS: Both studies were limited by the reliance on self-reported ambition. CONCLUSION: Ambition could be one important component of creative success across the bipolar spectrum.

Bipolar disorder (BD) has been related to heightened creativity, yet core questions remain unaddressed about this association. We used qualitative methods to investigate how highly creative individuals with BD understand the role of symptoms and treatment in their creativity, and possible mechanisms underpinning this link. Twenty-two individuals self-identified as highly creative and living with BD took part in focus groups and completed quantitative measures of symptoms, quality of life (QoL), and creativity. Using thematic analysis, five themes emerged: the pros and cons of mania for creativity, benefits of altered thinking, the relationship between creativity and medication, creativity as central to one’s identity, and creativity’s importance in stigma reduction and treatment. Despite reliance on a small sample who self-identified as having BD, findings shed light on previously mixed results regarding the influence of mania and treatment and suggest new directions for the study of mechanisms driving the creative advantage in BD.

Background Substantial literature has linked bipolar disorder and risk for bipolar disorder with creative accomplishment, but few multimodal studies of creativity are available, and little is known about mechanisms. Methods We use a multi-method approach to test the association of bipolar risk with several creativity measures, including creative accomplishments, creative personality traits, and a laboratory index of insight. We also examined whether multiple facets of motivation accounted for the links of bipolar risk with creativity. Among 297 undergraduates, mania risk, as measured with the Hypomanic Personality Scale was related to lifetime creativity and creative personality, but not to performance on the insight task. Motivational traits appeared to mediate the links of mania risk with both lifetime creative accomplishments and self-rated creativity. Limitations The study relied on a cross-sectional design and a convenience sample. Conclusions Future studies would benefit from exploring motivation as a positive aspect of manic vulnerability that may foster greater creativity.

Psychology is in the early stages of examining a crisis of replicability stemming from several high-profile failures to replicate studies in experimental psychology. This important conversation has largely been focused on social psychology, with some active participation from cognitive psychology. Nevertheless, several other major domains of psychological science—including clinical science—have remained insulated from this discussion. The goals of this article are to (a) examine why clinical psychology and allied fields, such as counseling and school psychology, have not been central participants in the replicability conversation; (b) review concerns and recommendations that are less (or more) applicable to or appropriate for research in clinical psychology and allied fields; and (c) generate take-home messages for scholars and consumers of the literature in clinical psychology and allied fields, as well as reviewers, editors, and colleagues from other areas of psychological science.

Introduction People with bipolar disorder often show more approach-related behavior and positive appraisals of others during social interactions. This may be due to an increased sensitivity to positive contexts or to tendencies toward positive affectivity. In this study, we investigated the influence of reward versus prosocial positive contexts on social decision-making in people at high (n = 21) and low (n = 111) risk for bipolar disorder. Methods Participants completed a computerized task consisting of two blocks. In the No Context block, participants were presented with a face and asked to make decisions related to approach, appraisal, and trust behavior toward that person. In the Context block, designed to assess the influence of contextual information on decision-making, each face was preceded by a written statement describing a positive or neutral context. Results Compared to the low risk group, the high-risk group made significantly higher approach and appraisal ratings, regardless of the context condition. Effects were sustained controlling for positive affect. We did not find any effect of bipolar risk on trust ratings. Limitations The study was conducted in an analogue sample. Discussion Taken together, these results suggest risk for bipolar disorder is associated with greater positive social approach and appraisal tendencies, and that these effects are not secondary to social context or positive affect. Implications for understanding social decision-making in the bipolar spectrum are discussed.

BackgroundComorbid psychiatric symptoms in bipolar disorder (BD) predict poorer course of illness and treatment outcome. The sheer number of comorbid symptoms has thwarted developing treatments to address these comorbid concerns. The goal of this study was to develop a more parsimonious approach to understanding clusters of comorbid symptoms within BD.MethodData were collected as part of the National Epidemiologic Survey on Alcohol and Related Conditions. Structured diagnostic interviews were conducted with 43,093 participants using the Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-IV (AUDADIS-IV). Analyses were conducted on lifetime symptom counts for the most common 14 comorbid disorders among the 1411 persons who met lifetime criteria for bipolar I disorder.ResultsAn exploratory factor analysis with promax rotation as well as confirmatory factor analyses revealed a three-factor solution of Externalizing, Anxiety, and Mood syndromes, with a higher order Internalizing factor comprised of the Mood and Anxiety factors.LimitationsFurther research is needed in a clinical sample.ConclusionsComorbid symptoms in BD tend to cohere into Internalizing and Externalizing disorders, which could simplify research and treatment on comorbidity in BD.

Reward function appears to be modulated by the circadian system, but little is known about the neural basis of this interaction. Previous research suggests that the neural reward response may be different in the afternoon; however, the direction of this effect is contentious. Reward response may follow the diurnal rhythm in self-reported positive affect, peaking in the early afternoon. An alternative is that daily reward response represents a type of prediction error, with neural reward activation relatively high at times of day when rewards are unexpected (i.e., early and late in the day). The present study measured neural reward activation in the context of a validated reward task at 10.00 h, 14.00 h, and 19.00 h in healthy human males. A region of interest BOLD fMRI protocol was used to investigate the diurnal waveform of activation in reward-related brain regions. Multilevel modeling found, as expected, a highly significant quadratic time-of-day effect focusing on the left putamen (p< 0.001). Consistent with the “prediction error” hypothesis, activation was significantly higher at 10.00 h and 19.00 h compared with 14.00 h. It is provisionally concluded that the putamen may be particularly important in endogenous priming of reward motivation at different times of day, with the pattern of activation consistent with circadian-modulated reward expectancies in neural pathways (i.e., greater activation to reward stimuli at unexpected times of day). This study encourages further research into circadian modulation of reward and underscores the methodological importance of accounting for time of day in fMRI protocols.SIGNIFICANCE STATEMENTThis is one of the first studies to use a repeated-measures imaging procedure to explore the diurnal rhythm of reward activation. Although self-reported reward (most often operationalized as positive affect) peaks in the afternoon, the present findings indicate that neural activation is lowest at this time. We conclude that the diurnal neural activation pattern may reflect a prediction error of the brain, where rewards at unexpected times (10.00 h and 19.00 h) elicit higher activation in reward brain regions than at expected (14.00 h) times. These data also have methodological significance, suggesting that there may be a time of day influence, which should be accounted for in neural reward studies.

Background Repetitive negative thinking (RNT) is a cognitive process that is repetitive, passive, relatively uncontrollable, and focused on negative content, and is elevated in emotional disorders including depression and anxiety disorders. Repetitive positive thinking is associated with bipolar disorder symptoms. The unique contributions of positive versus negative repetitive thinking to emotional symptoms are unknown. The first aim of this study was to use confirmatory factor analyses to evaluate the psychometrics of two transdiagnostic measures of RNT, the Repetitive Thinking Questionnaire (RTQ-10) and Perseverative Thinking Questionnaire (PTQ), and a measure of repetitive positive thinking, the Responses to Positive Affect (RPA) Questionnaire. The second aim was to determine incremental predictive utility of these measures. Method All measures were administered to a sample of 2088 undergraduate students from the Netherlands (n = 992), Australia (n = 698), and America (n = 398). Results Unidimensional, bifactor, and three-factor models were supported for the RTQ-10, PTQ, and RPA, respectively. A common factor measured by all PTQ items explained most variance in PTQ scores suggesting that this measure is essentially unidimensional. The RNT factor of the RTQ-10 demonstrated the strongest predictive utility, although the PTQ was also uniquely although weakly associated with anxiety, depression, and mania symptoms. The RPA dampening factor uniquely predicted anxiety and depression symptoms, suggesting that this scale is a separable process to RNT as measured by the RTQ-10 and PTQ. Limitations Findings were cross-sectional and need to be replicated in clinical samples. Conclusions Transdiagnostic measures of RNT are essentially unidimensional, whereas RPA is multidimensional. RNT and RPA have unique predictive utility.

Motivational and hedonic impairments are core features of a variety of types of psychopathology. An important aspect of motivational function is reinforcement learning (RL), including implicit (i.e., outside of conscious awareness) and explicit (i.e., including explicit representations about potential reward associations) learning, as well as both positive reinforcement (learning about actions that lead to reward) and punishment (learning to avoid actions that lead to loss). Here we present data from paradigms designed to assess both positive and negative components of both implicit and explicit RL, examine performance on each of these tasks among individuals with schizophrenia, schizoaffective disorder, and bipolar disorder with psychosis, and examine their relative relationships to specific symptom domains transdiagnostically. None of the diagnostic groups differed significantly from controls on the implicit RL tasks in either bias toward a rewarded response or bias away from a punished response. However, on the explicit RL task, both the individuals with schizophrenia and schizoaffective disorder performed significantly worse than controls, but the individuals with bipolar did not. Worse performance on the explicit RL task, but not the implicit RL task, was related to worse motivation and pleasure symptoms across all diagnostic categories. Performance on explicit RL, but not implicit RL, was related to working memory, which accounted for some of the diagnostic group differences. However, working memory did not account for the relationship of explicit RL to motivation and pleasure symptoms. These findings suggest transdiagnostic relationships across the spectrum of psychotic disorders between motivation and pleasure impairments and explicit RL. (PsycINFO Database Record

A growing body of research suggests that impulsive responses to emotion more robustly predict suicidality than do other forms of impulsivity. This issue has not yet been examined within bipolar disorder, however. Participants diagnosed with bipolar I disorder (n=133) and control participants (n=110) diagnosed with no mood or psychotic disorder completed self-report measures of emotion-triggered impulsivity (Negative and Positive Urgency Scales) and interviews concerning lifetime suicidality. Analyses examined the effects of emotion-triggered impulsivity alone and in combination with gender, age of onset, depression severity, comorbid anxiety, comorbid substance use, and medication. A history of suicide ideation and attempts, as well as self-harm, were significantly more common in the bipolar disorder group compared with the control group. Impulsive responses to positive emotions related to suicide ideation, attempts, and self-harm within the bipolar group. Findings extend research on the importance of emotion-triggered impulsivity to a broad range of key outcomes within bipolar disorder. The discussion focuses on limitations and potential clinical implications.

Prominent cognitive deficits have been documented in bipolar disorder, and multiple studies suggest that these deficits can be observed among non-affected first-degree relatives of those with bipolar disorder. Although there is variability in the degree of cognitive deficits, these deficits are robustly relevant for functional outcomes. A separate literature documents clear difficulties in emotionality, emotion regulation, and emotion-relevant impulsivity within bipolar disorder, and demonstrates that these emotion-relevant variables are also central to outcome. Although cognitive and emotion domains are typically studied independently, basic research and emergent findings in bipolar disorder suggest that there are important ties between cognitive deficits and the emotion disturbances observed in bipolar disorder. Understanding these relationships has relevance for fostering more integrative research, for clarifying relevant aspects related to functionality and vulnerability within bipolar disorder, and for the development of novel treatment interventions. Bipolar disorder (BD) is a severe psychiatric illness that has been ranked as one of the 20 leading medical causes of disability (WHO, 2011). BD has been shown to be the psychiatric disorder with the highest rates of completed suicide across two major cohort studies (Ilgen et al., 2010; Nordentoft, Mortensen, & Pedersen, 2011). In a cross-national representative sample, one in four persons diagnosed with bipolar I disorder reported a suicide attempt (Merikangas et al., 2011). Rates of relapse remain high despite available treatments (Gitlin, Swendsen, Heller, & Hammen, 1995), and in the year after hospitalization for manic episode, two-thirds of patients do not return to work (Strakowski et al., 1998). Poverty, homelessness, and incarceration are all too common (Copeland et al., 2009). Despite the often poor outcomes, there is also evidence for outstanding accomplishments and creativity among those with milder forms of the disorder and their family members (Coryell et al., 1989; Jamison, 1993; Murray & Johnson, 2010). Some individuals appear to achieve more than the general population, suggesting the importance of understanding the variables that predict differential outcome within bipolar disorder. Within this paper, we focus on two key predictors of outcomes within bipolar disorder: cognition and emotionality. We review evidence that problems in cognition and emotionality are prominent among those diagnosed with the disorder, are not artifacts of symptom state, and relate substantively to poorer outcomes. Although traditionally studied separately, new work points toward the idea that cognition and emotionality are intricately linked within bipolar disorder. Drawing from research within bipolar disorder as well as outside of bipolar disorder, we build a model of how cognition and emotionality might be tied within bipolar disorder. We then provide suggestions for future research. Before considering findings, it is worth noting that there are several forms of the disorder, defined by varying degrees and duration of manic symptoms (APA, 2013; WHO, 1993). Manic episodes are defined by abnormally elevated or irritable mood, accompanied by increased activity and at least three symptoms (four if mood is only irritable) such as decreased need for sleep, increased self-confidence, racing thoughts or flight of ideas, rapid speech, distractibility, goal-directed activity, and engagement in pleasurable activities without regard to potential negative consequences. To meet criteria for mania, these symptoms must persist for at least one week or require hospitalization, and must lead to difficulties with functioning. If functional impairment is not more than mild and duration is between 4 and 6 days, the episode is considered a hypomanic episode. Bipolar I disorder (BD I) is diagnosed on the basis of at least one lifetime manic episode within the DSM-5 and by at least two episodes within the ICD, whereas bipolar II disorder is diagnosed on the basis of at least one hypomanic episode (and no manic episodes) as well as major depressive episodes. Cyclothymic disorder is defined by chronic but milder fluctuations between manic and depressive symptoms. Most research focuses on BD I. In addition to diagnosed samples, research has focused on those at high risk for bipolar disorder, including first-degree relatives of those with BD. This work draws on the evidence for extremely high heritability of BD I, with estimates from community-based twin studies of 0.85 (Kieseppa, Partonen, Haukka, Kaprio, & Lonnqvist, 2014). Other research has considered high risk for BD by virtue of lifetime subsyndromal symptoms, as measured by scales such as the Hypomanic Personality Scale (Eckblad & Chapman, 1986) or the General Behavior Inventory (Depue, Krauss, Spoont, & Arbisi, 1989). The study of high-risk individuals provides a way to decipher whether deficits are present before the onset of the disorder, of importance given models suggesting that episodes of the disorder may change brain function (Chang, Steiner, & Ketter, 2000; Strakowski, 2012) as well as individuals' perceptions of their emotion regulation. Beyond defining BD, it is worth defining some of the many different neuropsychological tasks that have been widely studied in BD. Perhaps no area has received more attention than executive function. Executive function is related to three core functions: 1) inhibition, the ability to suppress irrelevant information in working memory in order to accomplish an established goal; 2) working memory, the ability to hold and manipulate information in mind; and 3) cognitive flexibility, the ability to shift strategies in response to feedback (Diamond, 2013; Miyake et al., 2000). Attention (defined as the process of selecting information reception from internal or external cues) is implicated in all three of these aspects of executive function. Much of the literature we will discuss focuses on response inhibition, or the ability to suppress a prepotent response, which is considered a subtype of inhibition. Some tests measure multiple facets of executive function; for example the Trails B test likely requires working memory and cognitive flexibility (Sanchez-Cubillo et al., 2009). Aside from executive function, multiple other facets of cognition have been widely studied in bipolar disorder. Verbal and non-verbal memory are related to the ability to register, store and retrieve verbal or visual information (Lezak, 1995). Verbal fluency is measured as the number of verbal responses a person can generate to a given target, such as a specific semantic category (e.g., animals, furniture) or phonetic category (e.g., words that begin with letter F) (Diamond, 2013). Although cognitive tasks have been designed to evaluate these specific functions, it is important to note that most measures are highly inter-correlated and may assess multiple overlapping functions to some extent (for example, the Trails B test is often described as an "executive function" task, although this task likely involves both working memory and cognitive flexibility. Not surprisingly, then, some authors label the function of certain tests differently, and this is particularly evident in meta-analyses of cognition. As we describe findings in this paper, we will use the terms proposed by the authors but will also identify key tests used to define a cognitive construct. With this background in mind, we turn to a discussion of cognitive deficits, then of emotion-related traits. Our hope is that those concise summaries provide evidence for the importance of both domains, but also specificity regarding the facets of emotion and cognition that are most impaired in BD. This specificity then guides our consideration of models that integrate cognition and emotion.

Research has implicated motivation and goal regulation in susceptibility to mood disorders. We studied for the first time key facets of motivation and goal regulation concurrently in relation to affective symptoms. The cross-national sample comprised 510 university students from the United States (n = 279) and United Kingdom (n = 231). Participants completed self-report measures of motivation, conditional goal setting, urgency, depression, anxiety, and mania risk. Structural Equation Modeling results found that behavioral activation system scores correlated negatively with depression and positively with mania risk, but were unrelated to anxiety. High conditional goal setting correlated uniquely with higher depression but not to anxiety or mania risk. Urgency correlated with higher anxiety, depression, and mania risk. Behavioral inhibition system scores correlated negatively with mania risk but unexpectedly did not correlate with anxiety in the multivariate model. The behavioral activation, behavioral inhibition, conditional goal setting, and urgency results showed shared and distinct patterns of relationships with depression, anxiety and mania risk. Our findings indicate unique and common risk vulnerabilities in depressive, anxious, and manic syndromes and extend an integrative knowledge of these syndromes in relation to goal regulation.

Objectives The dominance behavioural system (DBS) is multi-faceted, and various aspects of this system have links with a range of psychopathologies. Different scales have been used across psychopathologies though, and no single measure captures the core dimensions of the DBS. Our goal was to assess the importance of multiple DBS dimensions across psychopathologies. Methods Undergraduates (N = 612) completed a broad set of dominance items (many from pre-existing measures) and measures of lifetime depression, anxiety, and manic symptoms. Results Factor analysis suggested six distinct DBS factors: Authentic Pride, Hubristic Pride, Cooperation, Power/Influence, Discomfort with Leadership, and Ruthless Ambition. Depressive and anxious symptoms related to notably similar DBS profiles, characterized by lower authentic pride, lower perceived power, and greater willingness to endorse hubris. In contrast, hypomanic tendencies related to heightened pride, and an emphasis on the pursuit of power despite interpersonal costs. Conclusions With a multi-faceted approach, the DBS appears to be relevant for understanding multiple forms of psychopathology. Although limited by the reliance on self-report questionnaires, this is the first transdiagnostic study to consider these multiple facets of the DBS. Practitioner points The dominance system involves multiple separable dimensions. Manic tendencies appear tied to experiencing a heightened sense of pride and being willing to use more aggressive behavioural strategies to pursue dominance. Anxious and depressive tendencies appear particularly tied to low levels of subjective power, and more willingness to describe oneself as having hubris. Pride, the subjective sense of achieving power, and behavioural approaches to achieving power appear to be important dimensions of the dominance system for understanding psychopathology.