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Title: Anxiety and bipolar spectrum disorders : psychological treatments and mental imagery
Author: Stratford, Hannah Joy
Awarding Body: University of Oxford
Current Institution: University of Oxford
Date of Award: 2013
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Anxiety is a clinically significant feature of bipolar spectrum disorders [BP]. The. rate of anxiety symptoms and/or comorbid anxiety diagnoses is high, and it contributes to worse outcomes in a range of domains. There is an accumulation of evidence that psychological therapy is effective for anxiety, which is not so for BP. Mental imagery is implicated in the maintenance of anxiety and is a promising avenue of research in BP. A cognitive model of bipolar disorder posits that imagery is an emotional amplifier in mania and anxiety. Paper A presents a systematic review of the literature of psychological therapies for anxiety in BP. Twenty-two studies were identified, though no formal synthesis was possible. Preliminary data for CBT for obsessive compulsive disorder, generalised anxiety disorder, and post-traumatic stress disorder in a BP population are promising, and further research is warranted. Furthermore, the addition of an anxiety module to CBT for BP effectively reduces anxiety, and may have additional benefits in other domains. Pilot research applying other evidence-based CBT treatments for comorbid anxiety is indicated, as are RCTs for CBT for cyclothymia and rapid cycling BP. The addition of an anxiety module may Improve the effectiveness of psychological therapy for BP, further review and research is necessary to explore this. Paper B presents an empirical study, com paring imagery processes in adults with BP (currently euthymic), mixed anxiety disorders, and non-clinical controls. Genera imagery use, intrusive and deliberate prospective imagery, and characteristics of image ' during different mood states are explored. People with anxiety have high levels 0 general imagery use and intrusive prospective imagery. Unlike the clinical groups, the control group appears to have a bias against negative imagery in a deliberate prospective imagery task. Retrospective report of mental imagery during past low, anxious and high mood states gives partial support to the imagery as an emotional amplifier theory, and similarities between the clinical groups may illuminate the high rates of comorbidity. Future research is discussed.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (D.Clin.Psych.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available