Relationship between dysfunctional beliefs, self-esteem, extreme appraisals, and symptoms of mania and depression over time in bipolar disorder.

OBJECTIVES: Bipolar disorder (BD) is a mental health problem characterized by episodes of mania and depression which can lead to significant difficulties impairing one's daily functioning. Cross-sectional research has highlighted self-esteem and dysfunctional beliefs in those with this diagnosis, but there has been little research into how self-esteem and dysfunctional beliefs relate to symptoms of mania and depression over time. DESIGN: A secondary data analysis of a prospective cohort study was used. METHODS: Forty patients with BD attending a community adult mental health service completed the Dysfunctional Attitudes Scale, Rosenberg Self-Esteem Scale, Brief Hypomanic Attitudes and Positive Predictions Inventory, Centre for Epidemiologic Studies Depression Scale, and Altman Self-Rating Mania Scale at two time points 4 months apart. RESULTS: Cross-sectional correlations revealed significant associations between elevated goal attainment dysfunctional beliefs and higher symptoms of mania; however, this did not hold over time. Elevated dependency-related dysfunctional beliefs and lower self-esteem were linked to higher symptoms of depression, and this relationship held over time. There was no impact of achievement-related dysfunctional beliefs on mood. Extreme appraisals were correlated with higher depression symptoms at baseline, but this did not hold over time. CONCLUSIONS: Findings suggest lower self-esteem and specific dysfunctional beliefs around dependency may precede symptoms of depression. Further research is required to further explore these associations. PRACTITIONER POINTS: Elevated dysfunctional beliefs around dependency on others and lower levels of self-esteem may precede symptoms of depression in BD. Therapeutic interventions and relapse prevention targeting these psychological factors may help reduce the risk of depression relapse.

Memory and the operational witness: Police officer recall of firearms encounters as a function of active response role.

Investigations after critical events often depend on accurate and detailed recall accounts from operational witnesses (e.g., law enforcement officers, military personnel, and emergency responders). However, the challenging, and often stressful, nature of such events, together with the cognitive demands imposed on operational witnesses as a function of their active role, may impair subsequent recall. We compared the recall performance of operational active witnesses with that of nonoperational observer witnesses for a challenging simulated scenario involving an armed perpetrator. Seventy-six police officers participated in pairs. In each pair, 1 officer (active witness) was armed and instructed to respond to the scenario as they would in an operational setting, while the other (observer witness) was instructed to simply observe the scenario. All officers then completed free reports and responded to closed questions. Active witnesses showed a pattern of heart rate activity consistent with an increased stress response during the event, and subsequently reported significantly fewer correct details about the critical phase of the scenario. The level of stress experienced during the scenario mediated the effect of officer role on memory performance. Across the sample, almost one-fifth of officers reported that the perpetrator had pointed a weapon at them although the weapon had remained in the waistband of the perpetrator's trousers throughout the critical phase of the encounter. These findings highlight the need for investigator awareness of both the impact of operational involvement and stress-related effects on memory for ostensibly salient details, and reflect the importance of careful and ethical information elicitation techniques.