Why is it that dysphoric patients do not realize their dysphoric mood?

ABSTRACT

In contrast to the clinical psychopathological approach to emotion, we used aspects of the cognitive emotion theories formulated by Lazarus [1966] and Folkman and Lazarus [1985]. According to these theories, emotion is a product of cognitive appraisal and coping a mechanism regulating emotion. We put into operation four coping types in a two-dimensional way (using the amount of anxiety and social desirability and the repressor-sensitizer concept of Byrne [1961] in the extended version of Krohne [1974]) in order to differentiate 30 patients labeled as 'dysphoric' (n = 15) or 'depressed' (n = 15) from a clinical point of view. It was possible to distinguish subpopulations of dysphoric patients as well as depressed patients (discriminant analysis, analysis of variance), which served as a basis for answering our questions to the effect that a clearly defined group of dysphoric patients - all diagnosed as bipolar manic depressives - predominantly employs rigid repressive coping strategies, i.e. defensively denying anxiety. Thus, rigid defensive reactions (i.e. perceptual defense) prevent a change in the direction of distressing emotions but leave the person in a state of high arousal. This psychological theory of coping disposition agrees very well with the clinical view of dysphoric state.