Background The World Health Organization ranks bipolar disorder (BD) as the 7th leading cause of disability. Although the effects on those with BD are well described, less is reported on the impact of BD on cohabiting partners or any interactions between the two; this requires in vivo data collection measured each day over several months. Objective We set out to demonstrate the utility of ecological momentary assessment with BD couples measured using yoked smartphone apps. When randomly prompted over time, we assumed distinct patterns of association would emerge between BD symptoms (both depression and hypo/mania) and partner mood (positive and negative affect). Methods For this pilot study, we recruited an international sample of young and older adults with BD and their cohabiting partners where available. Both participants and partners downloaded separate apps onto their respective smartphones. Within self-specified “windows of general availability,” participants with BD were randomly prompted to briefly report symptoms of depression and hypo/mania (ie, BDSx), positive and negative mood (ie, POMS-15; partners), and any important events of the day (both). The partner app was yoked to the participant app so that the former was prompted roughly 30 minutes after the participant with BD or the next morning if outside the partner’s specified availability. Results Four couples provided 312 matched BD symptom and partner mood responses over an average of 123 days (range 65-221 days). Both were GPS- and time-stamped (mean 3:11 hrs between questionnaires, SD 4:51 hrs). Total depression had a small but significant association with positive (r=–.14; P=.02) and negative partner affect (r=.15; P=.01]. Yet total hypo/mania appeared to have no association with positive partner affect (r=–.01; P=.87); instead, negative partner affect was significantly correlated with total hypo/mania (r=.26; P=.01). However, when we look specifically at BD factors, we see that negative partner affect is associated only with affrontive symptoms of hypo/mania (r=.38; P=.01); elation or loss of insight appears unrelated to either positive (r=.10; P=.09) or negative partner affect (r=.02; P=.71). Yet affrontive symptoms of hypo/mania were significantly correlated with negative affect, but only when couples were together (r=.41; P=.01), not when apart (r=.22; P=.12). That is, these angry interpersonal symptoms of hypo/mania appear to be experienced most negatively by spouses when couples are together. Conclusions These initial findings demonstrate the utility of in vivo ambulatory data collection in longitudinal mental health research. Preliminary analyses suggest different BD symptoms are associated with negative and positive partner mood. These negative effects appear greater for hypo/mania than depressive symptoms, but proximity to the person with BD is important.

Marital idealization is defined as an interpersonal mode of self-deception whereby husbands and wives convey an exceedingly positive portrayal of their spouse and relationship (e.g., “My spouse has never made me angry”). For the Marriage and Health Study, we obtained responses from 119 long-wed couples at baseline, 1- and 2-years later ( M = 34 years married). We first computed and compared contemporaneous actor-partner interdependence models (APIMs) suggesting that marital satisfaction predicts marital idealization within and between spouses; the reverse APIM was not supported (i.e., marital idealization did not predict marital satisfaction). Yet our analyses suggest the question should be answered with longitudinal data. When reported contemporaneously, husbands’ marital satisfaction predicts marital idealization by their wives. The same cross-over effect is observed for wives—but not concomitantly, only in future. That is, marital satisfaction and idealization reported by wives predicts marital idealization reported by their husbands 2-years later.

Background Reliable and consistent social support is associated with the mental health and well-being of persons with severe mental illness, including bipolar disorder (BD). Yet the COVID-19 pandemic and associated social distancing measures (eg, shelter in place) reduced access to regular social contacts, while social media use (SMU) increased concomitantly. Little is currently known about associations between the well-being of adults with BD and different types of SMU (eg, passive and active). Objective For this study, we had two goals. First, we report descriptive information regarding SMU by persons with BD during COVID-19 (all platforms). Specific to Facebook, we next developed and tested a hypothesized model to identify direct and indirect associations between BD symptoms, social support, loneliness, life satisfaction, and SMU. Responses were collected during the global spread of the Delta variant and prior/concurrent with the Omicron variant, 20 months after the World Health Organization declared COVID-19 a global pandemic. Methods Over 8 weeks, we obtained responses from an international sample of 102 adults with BD using the Qualtrics online platform. Most had previously participated in the BADAS (Bipolar Affective Disorders and older Adults) Study (n=89, 87.3%); the remainder were recruited specifically for this research (n=13, 2.7%). The subsamples did not differ in age (t100=1.64; P=.10), gender (χ22=0.2; P=.90), socioeconomic status (χ26=9.9; P=.13), or time since BD diagnosis (t97=1.27; P=.21). Both were recruited using social media advertising micro-targeted to adults with BD. On average, participants were 53.96 (SD 13.22, range 20-77) years of age, they had completed 15.4 (SD 4.28) years of education, and were diagnosed with BD 19.6 (SD 10.31) years ago. Path analyses were performed to develop and test our hypothesized model. Results Almost all participants (n=95, 93.1%) reported having both Facebook and LinkedIn accounts; 91.2% (n=93) reported regular use of either or both. During the pandemic, most (n=62, 60.8%) reported accessing social media several times a day; 36.3% (n=37) reported using social media more often since the emergence of COVID-19. Specific to Facebook, the model we hypothesized differed somewhat from what emerged. The resulting model suggests that symptoms of depression predict loneliness and, inversely, social support and life satisfaction. Social support predicts social Facebook use, whereas passive Facebook use predicts life satisfaction. Symptoms of depression emerged as indirect predictors of SMU via social support. Conclusions Our findings suggest that the operational definition of passive-active SMU requires further analysis and refinement. In contrast to theory, passive Facebook use appears positively associated with well-being among certain populations. Longitudinal data collection over multiple points is required to identify associations between BD symptoms, SMU, and well-being over time.

BACKGROUND The World Health Organization ranks bipolar disorder (BD) as the 7th leading cause of disability. Although the effects on those with BD are well described, less is reported on the impact of BD on cohabiting partners or any interactions between the two; this requires in vivo data collection measured each day over several months. OBJECTIVE We set out to demonstrate the utility of ecological momentary assessment with BD couples measured using yoked smartphone apps. When randomly prompted over time, we assumed distinct patterns of association would emerge between BD symptoms (both depression and hypo/mania) and partner mood (positive and negative affect). METHODS For this pilot study, we recruited an international sample of young and older adults with BD and their cohabiting partners where available. Both participants and partners downloaded separate apps onto their respective smartphones. Within self-specified “windows of general availability,” participants with BD were randomly prompted to briefly report symptoms of depression and hypo/mania (ie, BDS_x), positive and negative mood (ie, POMS-15; partners), and any important events of the day (both). The partner app was yoked to the participant app so that the former was prompted roughly 30 minutes after the participant with BD or the next morning if outside the partner’s specified availability. RESULTS Four couples provided 312 matched BD symptom and partner mood responses over an average of 123 days (range 65-221 days). Both were GPS- and time-stamped (mean 3:11 hrs between questionnaires, SD 4:51 hrs). Total depression had a small but significant association with positive (r=–.14; <i>P</i>=.02) and negative partner affect (r=.15; <i>P</i>=.01]. Yet total hypo/mania appeared to have no association with positive partner affect (r=–.01; <i>P</i>=.87); instead, negative partner affect was significantly correlated with total hypo/mania (r=.26; <i>P</i>=.01). However, when we look specifically at BD factors, we see that negative partner affect is associated only with affrontive symptoms of hypo/mania (r=.38; <i>P</i>=.01); elation or loss of insight appears unrelated to either positive (r=.10; <i>P</i>=.09) or negative partner affect (r=.02; <i>P</i>=.71). Yet affrontive symptoms of hypo/mania were significantly correlated with negative affect, but only when couples were together (r=.41; <i>P</i>=.01), not when apart (r=.22; <i>P</i>=.12). That is, these angry interpersonal symptoms of hypo/mania appear to be experienced most negatively by spouses when couples are together. CONCLUSIONS These initial findings demonstrate the utility of in vivo ambulatory data collection in longitudinal mental health research. Preliminary analyses suggest different BD symptoms are associated with negative and positive partner mood. These negative effects appear greater for hypo/mania than depressive symptoms, but proximity to the person with BD is important.

BACKGROUND Reliable and consistent social support are associated with the psychological well-being of those with severe mental illness, including bipolar disorder (BD). Yet the COVID-19 pandemic and associated social distancing measures (e.g., shelter-in-place) have reduced access to regular social support. Concomitantly, use of social media during the pandemic has increased (i.e., social, non-social, passive social media usage). OBJECTIVE We set out to identify associations between BD symptoms, social support and social media use (SMU) during the pandemic. METHODS Using micro-targeted Facebook advertising, we recruited 102 adults with BD, most lived in North America (Canada = 45, USA = 15), Western Europe (e.g., UK=18, Ireland=10), South Africa (4) and Oceania (e.g., Australia=4, New Zealand=3). On average, participants were 53.96 years of age (SD = 13.22, range 20-77 years); they completed questionnaires online 32 months after the World Health Organization declared COVID-19 a global pandemic. RESULTS Consistent with previous research, symptoms of hypo/mania and depression are correlated; and symptoms of depression predict loneliness, social support and life satisfaction. Social support predicts social Facebook usage whereas passive Facebook use predicts life satisfaction. Symptoms of depression emerged as indirect predictors of SMU via social support. CONCLUSIONS Most participants (60.8%) reported accessing social media several times a day during the pandemic, and 36% reported using social media more often since the emergence of COVID-19. Our findings suggest bidirectional associations between social media use and well-being with BD. Longitudinal data collection is required to identify associations between BD symptoms, social media use and well-being over time.