title: Extreme cognitions in bipolar spectrum disorders: associations with personality disorder characteristics and risk for episode recurrence.
abstract: Bipolar spectrum disorders (BSDs) are often characterized by cognitive inflexibility and affective extremities, including "extreme" or polarized thoughts and beliefs, which have been shown to predict a more severe course of illness. However, little research has evaluated factors that may be associated with extreme cognitions, such as personality disorders, which are often characterized by extreme, inflexible beliefs and are also associated with poor illness course in BSDs. The present study evaluated associations among BSDs, personality disorder characteristics, and extreme cognitions (polarized responses made on measures of attributional style and dysfunctional attitudes), as well as links between extreme cognitions and the occurrence of mood episodes, among euthymic young adults with BSDs (n=83) and demographically matched healthy controls (n=89) followed prospectively for 3years. The relationship between personality disorder characteristics and negative and positive extreme cognitions was stronger among BSD participants than among healthy controls, even after statistically accounting for general cognitive styles. Furthermore, extreme negative cognitions predicted the prospective onset of major depressive and hypomanic episodes. These results suggest that extreme cognitive styles are most common in individuals with BSDs and personality disorder characteristics, and they provide further evidence that extreme negative cognitions may confer risk for mood dysregulation.
authors: Temple University.
authors: Jonathan P
authors: JP
authors: Stange
authors: Temple University.
authors: Ashleigh Molz
authors: AM
authors: Adams
authors: Temple University.
authors: Jared K
authors: JK
authors: O'Garro-Moore
authors: McLean Hospital and Harvard Medical School.
authors: Rachel B
authors: RB
authors: Weiss
authors: University of North Carolina, Chapel Hill.
authors: Mian-Li
authors: ML
authors: Ong
authors: UCLA Semel Institute for Neuroscience and Human Behavior.
authors: Patricia D
authors: PD
authors: Walshaw
authors: University of Wisconsin, Madison.
authors: Lyn Y
authors: LY
authors: Abramson
authors: Temple University. Electronic address: lalloy@temple.edu.
authors: Lauren B
authors: LB
authors: Alloy
mesh_terms: D000293:Adolescent; D000328:Adult; D000339:Affect; D001290:Attitude; D001714:Bipolar Disorder / Q000175:diagnosis / Q000523:psychology*; D016022:Case-Control Studies; D003071:Cognition; D003469:Culture; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010554:Personality Disorders / Q000175:diagnosis / Q000523:psychology*; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011581:Psychological Tests; D012008:Recurrence; D012306:Risk; D055815:Young Adult
keywords: attributional style; bipolar disorder; cognitive style; dysfunctional attitudes; personality disorders
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