title: Appraisals of Internal States and their Consequences: Relationship to Adolescent Analogue Bipolar Symptoms.
abstract: BACKGROUND
  Extreme appraisals of internal states correlate with and prospectively predict mood symptoms in adults, and discriminate individuals with bipolar disorder from individuals with unipolar depression and non-clinical controls.
  
  
  OBJECTIVE
  These findings required replication in adolescents. This study sought to investigate the relationships between appraisals of internal states, mood symptoms and risk for bipolar disorder in an adolescent sample.
  
  
  METHODS
  A non-clinical sample (n = 98) of adolescents completed measures of mood symptoms, appraisals, and mania risk, alongside covariates.
  
  
  RESULTS
  Appraisals of internal states were associated with analogue bipolar symptoms, independently of impulsivity and responses to positive affect. Positive appraisals of activated mood states were uniquely associated with hypomania, whilst negative appraisals were uniquely associated with depression and irritability symptoms. Individuals who appraised activated states as both extremely positive and extremely negative were more likely to score at high or moderate risk for future mania.
  
  
  CONCLUSIONS
  This study is the first to demonstrate associations between appraisals of internal states, analogue mood symptoms and mania risk in adolescents. Clinical implications are discussed.
authors.affiliation: South London and Maudsley NHS Foundation Trust, andInstitute of Psychiatry,Psychology and Neuroscience,King's College London,UK.
authors.forename: Rebecca E
authors.initials: RE
authors.lastname: Kelly
authors.affiliation: Institute of Psychiatry,Psychology and Neuroscience,King's College London,UK.
authors.forename: Patrick
authors.initials: P
authors.lastname: Smith
authors.affiliation: South London and Maudsley NHS Foundation Trust, andInstitute of Psychiatry,Psychology and Neuroscience,King's College London,UK.
authors.forename: Eleanor
authors.initials: E
authors.lastname: Leigh
authors.affiliation: University of Manchester,UK.
authors.forename: Warren
authors.initials: W
authors.lastname: Mansell
mesh_terms: D000293:Adolescent; D000339:Affect; D000367:Age Factors; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000523:psychology*; D003863:Depression / Q000175:diagnosis / Q000523:psychology; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D019964:Mood Disorders / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D015203:Reproducibility of Results; D012307:Risk Factors; D057566:Self Report
keywords: Adolescents; appraisals; bipolar disorder; cognitive model; mania risk