Psychological mechanisms and the ups and downs of personal recovery in bipolar disorder

Alyson Lamont Dodd, Barbara Mezes, Anne Fiona Lobban, Steven Huntley Jones

    Research output: Contribution to journalArticlepeer-review


    Background: Personal recovery is recognized as an important outcome for individuals with bipolar disorder (BD) and is distinct from symptomatic and functional recovery. Recovery-focused psychological therapies show promise. As with therapies aiming to delay relapse and improve symptoms, research on the psychological mechanisms underlying recovery is crucial to inform effective recovery-focused therapy. However, empirical work is limited. This study investigated whether negative beliefs about mood swings and self-referent appraisals of mood-related experiences were negatively associated with personal recovery.DesignCross-sectional online survey. Method: People with a verified research diagnosis of BD (n = 87), recruited via relevant voluntary sector organizations and social media, completed online measures. Pearson's correlations and multiple regression analysed associations between appraisals, beliefs, and recovery. Results: Normalizing appraisals of mood changes were positively associated with personal recovery. Depression, negative self-appraisals of depression-relevant experiences, extreme positive and negative appraisals of activated states, and negative beliefs about mood swings had negative relationships with recovery. After controlling for current mood symptoms, negative illness models (relating to how controllable, long-term, concerning, and treatable mood swings are; β = −.38), being employed (β = .39), and both current (β = −.53) and recent experience of depression (β = .30) predicted recovery. Limitations: Due to the cross-sectional design, causality cannot be determined. Participants were a convenience sample primarily recruited online. Power was limited by the sample size. Conclusions: Interventions aiming to empower people to feel able to manage mood and catastrophize less about mood swings could facilitate personal recovery in people with BD, which might be achieved in recovery-focused therapy. Practitioner points:
    •Personal recovery is an important outcome for people living with bipolar disorder
    •More positive illness models are associated with better personal recovery in bipolar disorder, over and above mood symptoms
    •Recovery-focused therapy should focus on developing positive illness models
    •Recovery-focused therapy should address personally meaningful goals such as gaining employment
    Original languageEnglish
    Pages (from-to)310-328
    Number of pages19
    JournalBritish Journal of Clinical Psychology
    Issue number3
    Publication statusPublished - 22 May 2017


    • appraisals
    • bipolar disorder
    • depression
    • illness perceptions
    • mania
    • psychological processes
    • recovery


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