title: Reactivity of affect and self-esteem during remission in bipolar affective disorder: an experimental investigation.
abstract: BACKGROUND
  Bipolar affective disorder (BPAD) is characterised by a lifelong vulnerability to develop episodes of depressed or elevated mood in response to stressful life events involving achievement or failure. We hypothesised that this latent vulnerability can manifest as reactivity of affect and self-esteem to experimentally induced experiences of success and failure and is shaped by history of childhood adversity.
  
  
  METHODS
  Twenty-four people with remitted BPAD and twenty-four healthy controls underwent anagram-solving tasks designed to generate experiences of success and failure in two separate sessions. Positive and negative affect and implicit and explicit self-esteem were measured before and after each task. Early adversity was measured by Childhood Trauma Questionnaire.
  
  
  RESULTS
  People with BPAD showed larger reactivity of affect and explicit self-esteem in response to experimental success and failure than did healthy controls. There were no significant differences in reactivity of implicit self-esteem. History of childhood trauma predicted increased affective reactivity to failure but not to success.
  
  
  CONCLUSIONS
  We used a convenience sample.
  
  
  CONCLUSIONS
  The present experimental paradigm reveals reactivity of affect and self-esteem as features of BPAD, which are present even during good remission and thus are accessible as targets of interventions aiming at relapse prevention. Differential associations with childhood adversity indicate aetiological heterogeneity, with reactivity to failure influenced by early trauma and reactivity to success driven by other mechanisms.
authors.affiliation: Institute of Psychiatry, King's College London, London, UK. barbara.pavlova@kcl.ac.uk
authors.forename: Barbara
authors.initials: B
authors.lastname: Pavlova
authors.forename: Rudolf
authors.initials: R
authors.lastname: Uher
authors.forename: Louis
authors.initials: L
authors.lastname: Dennington
authors.forename: Kim
authors.initials: K
authors.lastname: Wright
authors.forename: Catherine
authors.initials: C
authors.lastname: Donaldson
mesh_terms: D000124:Achievement; D000328:Adult; D000339:Affect; D001714:Bipolar Disorder / Q000517:prevention & control / Q000523:psychology*; D016022:Case-Control Studies; D002648:Child; D003863:Depression / Q000523:psychology; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D012649:Self Concept; D011795:Surveys and Questionnaires; D014947:Wounds and Injuries / Q000523:psychology*