Mood stability versus mood instability in bipolar disorder: A possible role for emotional mental imagery

Holmes, Emily A.; Deeprose, Catherine; Fairburn, Christopher G.; Wallace-Hadrill, Sophie M. A.; Bonsall, Michael B.; Geddes, John; Goodwin, Guy M.

doi:10.1016/j.brat.2011.06.008

Cited by 99 publications

(114 citation statements)

References 46 publications

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“…Recurrently imagining dreaded future situations potentiates fears and can even support the development and maintenance of anxiety disorders (8,11,13). The reported studies tested the hypothesis that such simulations can be suppressed with the opposite effect of down-regulating apprehensiveness.…”

Section: Discussionmentioning

confidence: 99%

“…Suppression can have a beneficial impact on our outlook toward the future. The observation that suppression is less effective in anxious individuals suggests that deficits in this process may be involved in sustaining psychological disorders that are characterized by intrusive prospective thoughts (8,9).…”

Section: Discussionmentioning

confidence: 99%

“…Thinking about past and future affairs-rather than about current activities-can induce unhappiness (7), and exaggerated future simulation may even be integral to psychological disorders such as bipolar disorder (8) and anxiety (9)(10)(11). Highly anxious individuals think of more negative future experiences than healthy people (10,12), their imagination of those episodes is more vivid (12), and anticipatory processing of distressing situations aggravates symptoms (13).…”

mentioning

confidence: 99%

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Reducing future fears by suppressing the brain mechanisms underlying episodic simulation

Benoit

Davies

Anderson

2016

Proc. Natl. Acad. Sci. U.S.A.

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Imagining future events conveys adaptive benefits, yet recurrent simulations of feared situations may help to maintain anxiety. In two studies, we tested the hypothesis that people can attenuate future fears by suppressing anticipatory simulations of dreaded events. Participants repeatedly imagined upsetting episodes that they feared might happen to them and suppressed imaginings of other such events. Suppressing imagination engaged the right dorsolateral prefrontal cortex, which modulated activation in the hippocampus and in the ventromedial prefrontal cortex (vmPFC). Consistent with the role of the vmPFC in providing access to details that are typical for an event, stronger inhibition of this region was associated with greater forgetting of such details. Suppression further hindered participants’ ability to later freely envision suppressed episodes. Critically, it also reduced feelings of apprehensiveness about the feared scenario, and individuals who were particularly successful at down-regulating fears were also less trait-anxious. Attenuating apprehensiveness by suppressing simulations of feared events may thus be an effective coping strategy, suggesting that a deficiency in this mechanism could contribute to the development of anxiety.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Reducing future fears by suppressing the brain mechanisms underlying episodic simulation

Benoit

Davies

Anderson

2016

Proc. Natl. Acad. Sci. U.S.A.

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“…It thus augments episodic simulations with the richness of past experiences (56). Although prospection is not always accurate (57), and exaggerated or distorted future thinking may, in some cases, be detrimental to our well-being (58,59), the vmPFC offers a flexible mechanism that enables us to experience the merits and pitfalls of possible future episodes, thereby aiding farsighted decisions.…”

Section: Discussionmentioning

confidence: 99%

Ventromedial prefrontal cortex supports affective future simulation by integrating distributed knowledge

Benoit

Szpunar

Schacter

2014

Proc. Natl. Acad. Sci. U.S.A.

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172

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Although the future often seems intangible, we can make it more concrete by imagining prospective events. Here, using functional MRI, we demonstrate a mechanism by which the ventromedial prefrontal cortex supports such episodic simulations, and thereby contributes to affective foresight: This region supports processes that (i) integrate knowledge related to the elements that constitute an episode and (ii) represent the episode's emergent affective quality. The ventromedial prefrontal cortex achieves such integration via interactions with distributed cortical regions that process the individual elements. Its activation then signals the affective quality of the ensuing episode, which goes beyond the combined affective quality of its constituting elements. The integrative process further augments long-term retention of the episode, making it available at later time points. This mechanism thus renders the future tangible, providing a basis for farsighted behavior.episodic future thinking | episodic memory | functional MRI | ventromedial prefrontal cortex | subjective value

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“…Instead, such expectancies about the effects of alcohol observed among young men with increased rates of hypomanic experiences might promote alcohol consumption, further increasing risk for AUDs. These increased expectancies may relate to cognitive aspects of the bipolar phenotype that may influence behavioral choices that are just starting to be examined including, for example, more intense use of imagery in predicting the impact of future events (Holmes et al, 2011).…”

Section: Discussionmentioning

confidence: 99%

Reduced Subjective Response to Acute Ethanol Administration Among Young Men with a Broad Bipolar Phenotype

Yip

Doherty

Wakeley

et al. 2012

Neuropsychopharmacol

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Elevated lifetime prevalence rates of alcohol use disorders (AUDs) are a feature of bipolar disorder (BD). Individuals at-risk for AUDs exhibit blunted subjective responses to alcohol (low levels of response), which may represent a biomarker for AUDs. Thus, individuals atrisk for BD may exhibit low responses to alcohol. Participants were 20 unmedicated adult males who reported high rates of hypomanic experiences (bipolar phenotype participants; BPPs), aged 18 to 21 years, and 20 healthy controls matched on age, gender, IQ, BMI, and weekly alcohol intake. Subjective and pharmacokinetic responses to acute alcohol (0.8 g/kg) vs placebo administration were collected in a randomized, double-blind, cross-over, placebo-controlled, within-subjects design. BPP participants reported significantly lower subjective intoxication effects ('feel high': F ¼ 14.2, p ¼ 0.001; 'feel effects': F ¼ 8.1, p ¼ 0.008) across time, but did not differ in their pharmacokinetic, stimulant, or sedative responses. Paradoxically, however, the BPP participants reported significantly higher expectations of the positive effects of alcohol than controls. Our results suggest that unmedicated young males with previous hypomanic experiences exhibit diminished subjective responses to alcohol. These blunted alcohol responses are not attributable to differences in weekly alcohol intake, pharmacokinetic effects (eg, absorption rates), or familial risk of AUDs. These observations suggest that the dampened intoxication may contribute to the increased rates of alcohol misuse in young people at-risk for BD, and suggest possible shared etiological factors in the development of AUDs and BD.

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Mood stability versus mood instability in bipolar disorder: A possible role for emotional mental imagery

Cited by 99 publications

References 46 publications

Reducing future fears by suppressing the brain mechanisms underlying episodic simulation

Reducing future fears by suppressing the brain mechanisms underlying episodic simulation

Ventromedial prefrontal cortex supports affective future simulation by integrating distributed knowledge

Reduced Subjective Response to Acute Ethanol Administration Among Young Men with a Broad Bipolar Phenotype

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