title: Implicit and explicit self-associations in bipolar disorder: a comparison with healthy controls and unipolar depressive disorder.
abstract: According to cognitive theory, negative self-schemas are involved in the occurrence of depression. Whereas implicit depressive self-associations have been found in unipolar depression, it is unknown whether impaired associations with regard to the self are also involved in Bipolar Disorder (BD). This study investigated whether a bias in self-associations is a characteristic of bipolar disorder and whether discrepancies between implicit and explicit self-evaluations may be relevant for understanding bipolar psychopathology. Implicit and explicit self-associations were assessed in patients with BD (n=99), in patients with depressive disorder (n=1236), and healthy controls (n=387). Analyses of variance and correlation analyses were used to compare bipolar patients to controls and unipolar patients on implicit self-associations and the discrepancy between implicit and explicit self-associations. Similar to unipolar patients, patients with BD showed stronger implicit depressive self-associations than controls. Specifically for bipolar patients there was no significant correlation between implicit and explicit depressive self-associations. In a similar vein, discrepancies between implicit and explicit self-associations were relatively pronounced in symptomatic bipolar patients as compared to both healthy controls and unipolar depressed patients. Thus automatic depressive self-associations were characteristic for all mood disorders whereas a lack of concordance between implicit and explicit self-associations was specific for BD.
authors.affiliation: Department of Psychiatry/EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands. Electronic address: n.jabben@maastrichtuniversity.nl.
authors.forename: Nienke
authors.initials: N
authors.lastname: Jabben
authors.affiliation: Department of Clinical Psychology, University of Groningen, Groningen, The Netherlands.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: de Jong
authors.affiliation: Department of Psychiatry/EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Ralph W
authors.initials: RW
authors.lastname: Kupka
authors.affiliation: Department of Clinical Psychology, University of Groningen, Groningen, The Netherlands.
authors.forename: Klaske A
authors.initials: KA
authors.lastname: Glashouwer
authors.affiliation: Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Willem A
authors.initials: WA
authors.lastname: Nolen
authors.affiliation: Department of Psychiatry/EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands; Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Brenda W J H
authors.initials: BW
authors.lastname: Penninx
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000523:psychology*; D003866:Depressive Disorder / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012649:Self Concept
keywords: Automatic associations; Bipolar disorder; Depression; Implicit Association Test; Implicit cognition