title: Mental imagery in bipolar affective disorder versus unipolar depression: investigating cognitions at times of 'positive' mood.
abstract: BACKGROUND
  Compared to unipolar depression (UD), depressed mood in bipolar disorder (BD) has been associated with amplified negative mental imagery of the future ('flashforwards'). However, imagery characteristics during positive mood remain poorly explored. We hypothesise first, that unlike UD patients, the most significant positive images of BD patients will be 'flashforwards' (rather than past memories). Second, that BD patients will experience more frequent (and more 'powerful') positive imagery as compared to verbal thoughts and third, that behavioural activation scores will be predicted by imagery variables in the BD group.
  
  
  METHODS
  BD (n=26) and UD (n=26) patients completed clinical and trait imagery measures followed by an Imagery Interview and a measure of behavioural activation.
  
  
  RESULTS
  Compared to UD, BD patients reported more 'flashforwards' compared to past memories and rated their 'flashforwards' as more vivid, exciting and pleasurable. Only the BD group found positive imagery more 'powerful', (preoccupying, 'real' and compelling) as compared to verbal thoughts. Imagery-associated pleasure predicted levels of drive and reward responsiveness in the BD group.
  
  
  CONCLUSIONS
  A limitation in the study was the retrospective design. Moreover pathological and non-pathological periods of "positive" mood were not distinguished in the BD sample.
  
  
  CONCLUSIONS
  This study reveals BD patients experience positive 'flashforward' imagery in positive mood, with more intense qualities than UD patients. This could contribute to the amplification of emotional states and goal directed behaviour leading into mania, and differentiate BD from UD.
authors.affiliation: Northamptonshire Healthcare NHS Foundation Trust, Northampton, UK.
authors.forename: Annabel
authors.initials: A
authors.lastname: Ivins
authors.affiliation: MRC Cognition and Brain Sciences Unit, Cambridge CB2 7EF, UK. Electronic address: martina.disimplicio@mrc-cbu.cam.ac.uk.
authors.forename: Martina
authors.initials: M
authors.lastname: Di Simplicio
authors.affiliation: Oxford Health NHS Foundation Trust, Oxford, UK.
authors.forename: Helen
authors.initials: H
authors.lastname: Close
authors.affiliation: Department of Psychiatry, University of Oxford, Oxford, UK.
authors.forename: Guy M
authors.initials: GM
authors.lastname: Goodwin
authors.affiliation: MRC Cognition and Brain Sciences Unit, Cambridge CB2 7EF, UK.
authors.forename: Emily
authors.initials: E
authors.lastname: Holmes
mesh_terms: D000328:Adult; D000339:Affect; D001714:Bipolar Disorder / Q000523:psychology*; D003071:Cognition; D003863:Depression / Q000523:psychology; D003865:Major Depressive Disorder / Q000523:psychology*; D004644:Emotions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
keywords: Bipolar disorder; Cognitive therapy; Goals; Mania; Mental imagery