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Dysfunctional Attitudes, Attributional Styles, and Phase of Illness in Bipolar Disorder

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Abstract

Whereas an abundance of studies have been devoted to the study of cognitive vulnerability in unipolar depression, comparatively less is known regarding the cognitive styles of patients with bipolar disorder. This study examined the cognitive styles of 395 of the first 500 bipolar patients enrolled in the NIMH Systematic Treatment Enhancement Program for Bipolar Disorder as a function of mood state at study entry. Patients completed diagnostic and mood assessments and two measures of cognitive style: The Dysfunctional Attitudes Scale (DAS) and the Attributional Style Questionnaire (ASQ). Patients in mixed episodes exhibited significantly more negative dysfunctional attitudes and negative attributional styles than euthymic patients and significantly more dysfunctional attitudes than manic/hypomanic patients. The implications of these findings are discussed in relation to episode vulnerability, mood-state dependency of cognitive style, and cognitive-behavioral treatment.

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Acknowledgements

STEP-BD was funded with Federal funds from the National Institute of Mental Health (NIMH), National Institutes of Health, under Contract N01MH80001. Any opinions, findings, and conclusions or recommendations expressed in this publication are those of the authors and do not necessarily reflect the views of the NIMH. The contents of this article were reviewed and approved by the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) Steering Committee. Additional detail on STEP-BD can be located at http://www.nimh.nih.gov/health/trials/practical/step-bd/questions-and-answers-for-thesystematic-treatment-enhancement-program-for-bipolar-disorder-step-bd-studybackground.shtml.

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Authors and Affiliations

  1. Massachusetts General Hospital Bipolar Clinic and Research Program, Harvard Medical School, 50 Staniford Street, Suite 580, Boston, MA, 02114, USA

    Noreen A. Reilly-Harrington & Gary S. Sachs

  2. University of Colorado at Boulder, Boulder, CO, USA

    David J. Miklowitz

  3. Boston University, Boston, MA, USA

    Michael W. Otto

  4. University of Pittsburgh School of Medicine, Pittsburgh, PA, USA

    Ellen Frank & Stephen R. Wisniewski

  5. University of Pennsylvania School of Medicine, Philadelphia, PA, USA

    Michael E. Thase

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  1. Noreen A. Reilly-Harrington
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  2. David J. Miklowitz
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  3. Michael W. Otto
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  4. Ellen Frank
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  5. Stephen R. Wisniewski
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  6. Michael E. Thase
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  7. Gary S. Sachs
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Correspondence to Noreen A. Reilly-Harrington.

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Reilly-Harrington, N.A., Miklowitz, D.J., Otto, M.W. et al. Dysfunctional Attitudes, Attributional Styles, and Phase of Illness in Bipolar Disorder. Cogn Ther Res 34, 24–34 (2010). https://doi.org/10.1007/s10608-008-9218-6

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  • DOI: https://doi.org/10.1007/s10608-008-9218-6

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