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Risk for Mania and its Relationship to Implicit and Explicit Achievement Motivation

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      There is evidence that bipolar disorders are associated with achievement-related cognitions such as setting high goals. A psychodynamic model, the manic defense hypothesis, postulates that a threat to fragile self-esteem triggers grandiosity and manic behaviors in vulnerable people. Vulnerability to bipolar disorders should therefore be positively associated with indicators of explicit hope of success (HS) and implicit fear of failure (FF). Using an online sample ( n = 252), we tested these hypotheses using the well-validated Hypomanic Personality Scale as risk indicator for mania, the Multi-Motive Grid for achievement motivation, controlling for current and lifetime depression. Contrary to expectations, we found that vulnerability for mania was significantly and positively related to implicit HS but not to FF after controlling for depression. All measures were self-report tools. Our results contradict the Manic Defense Hypothesis, but they are in line with the idea that achievement-related cognitions are of relevance to vulnerability in bipolar disorders. This is in line with research focusing on the role of the Behavioral Activation System in relation to vulnerability for mania.

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      Lifetime and 12-month prevalence of bipolar spectrum disorder in the National Comorbidity Survey replication.

      There is growing recognition that bipolar disorder (BPD) has a spectrum of expression that is substantially more common than the 1% BP-I prevalence traditionally found in population surveys. To estimate the prevalence, correlates, and treatment patterns of bipolar spectrum disorder in the US population. Direct interviews. Households in the continental United States. A nationally representative sample of 9282 English-speaking adults (aged >or=18 years). Version 3.0 of the World Health Organization's Composite International Diagnostic Interview, a fully structured lay-administered diagnostic interview, was used to assess DSM-IV lifetime and 12-month Axis I disorders. Subthreshold BPD was defined as recurrent hypomania without a major depressive episode or with fewer symptoms than required for threshold hypomania. Indicators of clinical severity included age at onset, chronicity, symptom severity, role impairment, comorbidity, and treatment. Lifetime (and 12-month) prevalence estimates are 1.0% (0.6%) for BP-I, 1.1% (0.8%) for BP-II, and 2.4% (1.4%) for subthreshold BPD. Most respondents with threshold and subthreshold BPD had lifetime comorbidity with other Axis I disorders, particularly anxiety disorders. Clinical severity and role impairment are greater for threshold than for subthreshold BPD and for BP-II than for BP-I episodes of major depression, but subthreshold cases still have moderate to severe clinical severity and role impairment. Although most people with BPD receive lifetime professional treatment for emotional problems, use of antimanic medication is uncommon, especially in general medical settings. This study presents the first prevalence estimates of the BPD spectrum in a probability sample of the United States. Subthreshold BPD is common, clinically significant, and underdetected in treatment settings. Inappropriate treatment of BPD is a serious problem in the US population. Explicit criteria are needed to define subthreshold BPD for future clinical and research purposes.
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        Development and validation of a scale for hypomanic personality.

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          Mania and dysregulation in goal pursuit: a review.

           Tanya Johnson (2005)
          This paper reviews evidence for deficits in goal regulation in bipolar disorder. A series of authors have described mania as related to higher accomplishment, elevated achievement motivation, and ambitious goal setting. These characteristics appear to be evident outside of episodes, and to some extent, among family members of people with a history of mania. In addition, people with a history of mania demonstrate intense mood reactivity, particularly in response to success and reward. During positive moods, they appear to experience robust increases in confidence. These increases in confidence, coupled with a background of ambitious goals, are believed to promote excessive pursuit of goals. This excessive goal engagement is hypothesized to contribute to manic symptoms after an initial life success.

            Author and article information

            [ 1 ] Psychology and Health, Community Health Newham, London, UK
            [ 2 ] Institute of Neuroscience, Newcastle University, Newcastle Upon Tyne, UK
            Author notes
            Thomas D. Meyer, Institute of Neuroscience/Doctorate in Clinical Psychology, Ridley Bldg., Newcastle University, Newcastle Upon Tyne, NE1 7RU, UK, +44 191 222-8967 thomas.meyer@
            Journal of Individual Differences
            Hogrefe Publishing
            November 25, 2013
            : 34
            : 4
            : 214-221
            jid_34_4_214 10.1027/1614-0001/a000117
            Self URI (journal-page):
            Original Article


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