Looking for bipolar spectrum psychopathology: identification and expression in daily life.

OBJECTIVES: Current clinical and epidemiological research provides support for a continuum of bipolar psychopathology: a bipolar spectrum that ranges from subclinical manifestations to full-blown bipolar disorders. Examining subthreshold bipolar symptoms may identify individuals at risk for clinical disorders, promote early interventions and monitoring, and increase the likelihood of appropriate treatment. The present studies examined the construct validity of bipolar spectrum psychopathology using the Hypomanic Personality Scale. METHODS: Study 1 used interview and questionnaire measures of bipolar spectrum psychopathology in a sample of 145 nonclinically ascertained young adults. Study 2 assessed the expression of the bipolar spectrum in daily life using experience sampling methodology in the same sample. RESULTS: In study 1, Hypomanic Personality Scale scores were positively associated with clinical bipolar disorders, bipolar spectrum disorders, the presence of hypomania or hyperthymia, depressive symptoms, poor psychosocial functioning, cyclothymia, irritability, and symptoms of borderline personality disorder. In study 2, bipolar spectrum psychopathology was associated with negative affect, thought disturbance, risky behavior, and measures of grandiosity. These findings remained independent of clinical bipolar disorders. CONCLUSIONS: In the present studies, bipolar-like disruptions in cognition, affect, and behavior were not limited to clinical diagnoses or mood episodes, providing further validation of the bipolar spectrum construct. The bipolar spectrum model appears to provide a conceptually richer basis for understanding and ultimately treating bipolar psychopathology than current diagnostic formulations.

Being with others and feeling happy: Emotional expressivity in everyday life.

An experience sampling study assessed the relation between psychological functioning in daily life and emotional expressivity as measured by the emotional expressivity scale (EES). Four hundred and twenty-nine participants carried personal digital assistants that signaled them 8 times daily to complete questionnaires assessing affect, activities, and social contact. As predicted, participants high in emotional expressivity were more likely to have elevated state positive affect, but not negative affect. These participants were also less likely to be alone and more likely to demonstrate better social functioning when with others. Cross-level interactions indicated that emotional expressivity moderated the association of social context and functioning in the moment. The findings support the validity of the EES as a measure of emotional expressivity and demonstrate the utility of experience sampling for describing personality traits in daily life.

An experience-sampling study of depressive symptoms and their social context.

Both clinical and subclinical depression are associated with social impairment; however, few studies have examined the impact of social contact in the daily lives of people with depressive symptoms. The current study used the experience-sampling methodology to examine associations between depressive symptoms, social contact, and daily life impairment in 197 young adults. Depressive symptoms were associated with increased isolation, negative affect, anhedonia, and physical symptoms, decreased positive affect, and social and cognitive impairment in daily life. For people with more depressive symptoms, being with social partners who were perceived as close was associated with greater decreases in negative affect, as well as increases in positive affect. Ironically, participants with depressive symptoms reported spending less time with people whom they perceived as close, minimizing the protective effects of socializing. These results suggest that people experiencing depressive symptoms may be especially sensitive to the nature of social interactions.

The expression of adult ADHD symptoms in daily life: an application of experience sampling methodology.

OBJECTIVE: To use experience sampling method (ESM) to examine the impact of inattentive and hyperactive-impulsive ADHD symptoms on emotional well-being, activities and distress, cognitive impairment, and social functioning assessed in the daily lives of young adults. The impact of subjective appraisals on their experiences is also examined. METHOD: Participants (n = 206) complete up to 56 in-the-moment assessments of mood and current activities using Personal Digital Assistants for 1 week. RESULTS: Multilevel modeling techniques reveal that ADHD inattentive and hyperactive-impulsive symptoms differentially relate to daily experiences. Higher inattentive symptoms are associated with indices of general distress, including less positive and more negative mood as well as more concentration problems. Higher hyperactive-impulsive symptoms are associated with reduced sensitivity to contextual factors in perceptions of situations. CONCLUSION: These findings demonstrate predictive validity for adult self-report of ADHD symptoms in a general population sample and suggest future research directions using ESM.

The expression of affective temperaments in daily life.

BACKGROUND: Numerous validation studies have examined the TEMPS-A in both clinical and nonclinical samples. However, the majority of these studies utilized cross-sectional assessments in laboratory or clinical settings. The present study is the first to examine the expression of affective temperaments in daily life using experience sampling methodology (ESM). METHODS: 138 participants completed the TEMPS-A and received a personalized digital assistant that signaled them eight times daily for one week to complete questionnaires that assessed affect, cognition, behavior, sense of self, and social interaction. RESULTS: As expected, cyclothymic/irritable temperament was positively associated with negative affect, risky behavior, and restlessness, and was negatively associated with positive affect and preference to be with others in daily life. In contrast, hyperthymic temperament was associated with positive affect, fullness of thought, doing many and exciting things, grandiosity, and preference to be with others in daily life. Dysthymic temperament was modestly associated with worry, and was positively associated with trouble concentrating, fullness of thought, and a preference for social contact. Cross-level interactions indicated that cyclothymic/irritable temperament was associated with elevated stress reactivity in daily life. LIMITATIONS: ESM data collection was limited to one week. Longer assessment periods might better capture the cyclical nature of affective temperaments. CONCLUSIONS: This was the first study to examine affective temperaments in daily life. The findings offer further validation of the TEMPS-A, as well as the maladaptive nature of the cyclothymic/irritable temperament.

Diagnostic specificity of poor premorbid adjustment: comparison of schizophrenia, schizoaffective disorder, and mood disorder with psychotic features.

Individuals with schizophrenia have significant deficits in premorbid social and academic adjustment compared to individuals with non-psychotic diagnoses. However, it is unclear how severity and developmental trajectory of premorbid maladjustment compare across psychotic disorders. This study examined the association between premorbid functioning (in childhood, early adolescence, and late adolescence) and psychotic disorder diagnosis in a first-episode sample of 105 individuals: schizophrenia (n=68), schizoaffective disorder (n=22), and mood disorder with psychotic features (n=15). Social and academic maladjustment was assessed using the Cannon-Spoor Premorbid Adjustment Scale. Worse social functioning in late adolescence was associated with higher odds of schizophrenia compared to odds of either schizoaffective disorder or mood disorder with psychotic features, independently of child and early adolescent maladjustment. Greater social dysfunction in childhood was associated with higher odds of schizoaffective disorder compared to odds of schizophrenia. Premorbid decline in academic adjustment was observed for all groups, but did not predict diagnosis at any stage of development. Results suggest that social functioning is disrupted in the premorbid phase of both schizophrenia and schizoaffective disorder, but remains fairly stable in mood disorders with psychotic features. Disparities in the onset and time course of social dysfunction suggest important developmental differences between schizophrenia and schizoaffective disorder.

The expression of bipolar spectrum psychopathology in daily life.

BACKGROUND: Bipolar psychopathology has traditionally been defined by categorical diagnoses. However, these disorders may simply reflect the extremes of a broader spectrum of clinical and subclinical bipolar psychopathology. METHOD: The present study examined the validity of the Hypomanic Personality Scale (HPS) as a measure of bipolar spectrum psychopathology in 305 young adults using experience sampling methodology. The participants completed the HPS and were signaled randomly eight times daily for seven days to complete brief questionnaires on their current experiences. RESULTS: High HPS scores were associated with elevated energetic-enthusiasm, irritability, dysphoria, flight of ideas, mild grandiose beliefs, and risky behavior, as well as increased variability in affect in daily life. High HPS scores were also associated with greater reactivity in negative affect and behavior in response to viewing themselves as unsuccessful in their activities. LIMITATIONS: It is not clear to what extent the participants had diagnosable bipolar disorders. CONCLUSIONS: The findings support a broader spectrum of bipolar psychopathology and the validity of the HPS as a measure of this construct.

When the need to belong goes wrong: the expression of social anhedonia and social anxiety in daily life.

People possess an innate need to belong that drives social interactions. Aberrations in the need to belong, such as social anhedonia and social anxiety, provide a point of entry for examining this need. The current study used experience-sampling methodology to explore deviations in the need to belong in the daily lives of 245 undergraduates. Eight times daily for a week, personal digital assistants signaled subjects to complete questionnaires regarding affect, thoughts, and behaviors. As predicted, higher levels of social anhedonia were associated with increased time alone, greater preference for solitude, and lower positive affect. Higher social anxiety, in contrast, was associated with higher negative affect and was not associated with increased time alone. Furthermore, greater social anxiety was associated with greater self-consciousness and preference to be alone while interacting with unfamiliar people. Thus, deviations in the need to belong affect social functioning differently depending on whether this need is absent or thwarted.

For whom the mind wanders, and when: an experience-sampling study of working memory and executive control in daily life.

An experience-sampling study of 124 undergraduates, pretested on complex memory-span tasks, examined the relation between working memory capacity (WMC) and the experience of mind wandering in daily life. Over 7 days, personal digital assistants signaled subjects eight times daily to report immediately whether their thoughts had wandered from their current activity, and to describe their psychological and physical context. WMC moderated the relation between mind wandering and activities' cognitive demand. During challenging activities requiring concentration and effort, higher-WMC subjects maintained on-task thoughts better, and mind-wandered less, than did lower-WMC subjects. The results were therefore consistent with theories of WMC emphasizing the role of executive attention and control processes in determining individual differences and their cognitive consequences.