Introduction Bipolar disorder is characterized by recurrent episodes of depression and/or mania along with inter-episodic mood symptoms that interfere with psychosocial functioning. Despite periods of symptomatic recovery, many individuals with bipolar disorder continue to experience substantial residual mood symptoms that often lead to the recurrence of mood episodes. Aims The present study explored whether a new mindfulness-based cognitive therapy (MBCT) for bipolar disorder would increase mindfulness, reduce residual mood symptoms, and increase emotion regulation abilities, psychological well-being, positive affect and psychosocial functioning. Following a baseline clinical assessment, 12 individuals with DSM-IV bipolar disorder were treated with 12 group sessions of MBCT. Results At the end of treatment, as well as at the 3-months follow-up, participants showed increased mindfulness, lower residual depressive mood symptoms, less attentional difficulties, and increased emotion regulation abilities, psychological well-being, positive affect and psychosocial functioning. Conclusions These findings suggest that treating residual mood symptoms with MBCT may be another avenue to improving mood, emotion regulation, well-being and functioning in individuals with bipolar disorder.

Although individual differences exist in how people respond to positive affect (PA), little research addresses PA regulation in people with anxiety disorders. The goal of this study was to provide information about responses to PA in people with symptoms of social phobia, generalized anxiety disorder, panic disorder, agoraphobia, and obsessive-compulsive disorder. The tendency to dampen PA and the ability to savor PA were examined in an undergraduate sample. Analyses examined the unique links between these reactions and symptoms of anxiety disorders, controlling for a history of depression. Given the high comorbidity of depression and anxiety, exploratory analyses further controlled for generalized anxiety disorder. Results demonstrated that one or both measures of affect regulation made a unique and substantial contribution to predicting each anxiety disorder except agoraphobia, above and beyond prediction afforded by symptoms of depression and generalized anxiety disorder. Clinical implications and areas for future research are discussed.

This project examined cognitive responses to failure and success and their association with depression and mania within bipolar disorder. Many cognitive variables that are associated with unipolar depression have been found to be involved in bipolar disorder, more specifically bipolar depression. This research was the first to examine tendencies to hold high standards, engage in selfcriticism, and generalize from failure to an overall sense of self-worth. In Study 1, undergraduates were screened for risk of mood disorders and completed structured diagnostic interviews. History of bipolar spectrum disorders and history of depression had separate associations with negative generalization. The association of generalization with bipolar spectrum disorders was accounted for by current depressive symptoms. For Study 2, the authors developed a measure of the tendency to engage in positive generalization following success experiences. In a sample of 276 undergraduates, this measure related uniquely to risk for mania. Results of these 2 studies suggest that responses to failure are associated with a history of depression, whereas responses to success are associated with a risk for mania. Implications for future research and clinical work are discussed.Keywords bipolar disorder; mania; cognition; success; failure Bipolar disorder is one of the most severe of psychiatric disorders. Although it is well established that mood-stabilizing medications are helpful, rates of relapse (Judd et al., 2002) and suicide (Angst, Stassen, Clayton, & Angst, 2002;Mitchell, Slade, & Andrews, 2004) remain quite high even with best available medications (Keller et al., 1992). Given this, substantial effort has been directed toward developing psychosocial treatments that can be offered as adjuncts to medication treatment (Johnson & Leahy, 2003).At least three books have been published detailing cognitive therapy as intervention to supplement medications for bipolar disorder (Basco & Rush, 1996, 2005Lam, Jones, Bright, & Hayward, 1999;Newman, Leahy, Beck, & Reilly-Harrington, 2002). The results of cognitive therapy outcome trials in bipolar disorder have been mixed (Lam, Hayward, Watkins, Wright, & Sham, 2005;Scott et al., 2006), perhaps in part due to differences across samples. Regardless, as cognitive therapy becomes increasingly popular, it becomes important to document aspects of cognition that are disturbed among people with bipolar disorder. A better understanding of the cognitive variables involved in this disorder should help refine treatment approaches. Copyright 2008 by the American Psychological AssociationCorrespondence concerning this article should be addressed to Lori R. Eisner, Department of Psychology, University of Miami, Coral Gables, FL 33124-0751. E-mail: leisner@psy.miami.edu. NIH Public AccessAuthor Manuscript J Abnorm Psychol. Author manuscript; available in PMC 2010 January 29. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author ManuscriptMuch of the literature on cognition in bipolar disorder focus...

The countless hypomanias, and mania itself, all have brought into my life a different level of sensing and feeling and thinking. Even when I have been most psychotic-delusional, hallucinating, frenzied-I have been aware of finding new corners in my heart and mind. Some of those corners were incredible and beautiful and took my breath away and made me feel as though I could die right then and the images would sustain me.- Jamison (2004, pp. 218-219) Bipolar disorder (BPD) is one of the most debilitating of psychiatric disorders. In those who are affected, divorce, unemployment, and hospitalization are all too common (Mitchell, Slade, & Andrews, 2004), and suicide is approximately 12 to 15 times higher than in the general population (Angst, Stausen, Clayton, & Angst, 2002). To improve intervention efforts, we need to understand the basic mechanisms involved in bipolar disorder. Here, we review evidence that one mechanism underlying bipolar disorder involves disturbed emotional responses.We begin by defining key terms used throughout this chapter. According to the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; American Psychiatric Association, 2000), a manic episode is defined as an elated or irritable mood lasting at least 1 week, accompanied by three associated symptoms (four if mood is irritable only), such as a decreased need for sleep and an elevated sense of self-esteem. Bipolar I disorder is a mood disorder defined by one or more lifetime episode(s) of mania (or a mixed episode, which involves simultaneous manic and depressive symptoms). Although depression is not required to receive a diagnosis of bipolar I disorder, many people who experience manic episodes also experience depressive episodes. The presence of two distinct mood poles certainly complicates the study of bipolar illness. A variety of milder forms of disorder have also been 123