Clinical, Educational and Health Psychology, University College London, Gower Street, London WC1E 6BT, London, UK.
Behav Res Ther. 2010 Jul;48(7):698-703. doi: 10.1016/j.brat.2010.04.005. Epub 2010 May 6.
Modifying intrusive memories and images is a powerful intervention in depression and anxiety disorders, but little is known about the presence of these intrusions in bipolar disorder. A semi-structured interview was administered to 29 euthymic patients with bipolar disorder, requiring them to report the intrusive memories and images recalled from their most recent episode of euthymia, depression and hypomania. Euthymia was characterised by intrusive memories of the past, which were less distressing than the memories experienced in depressed states. In addition to intrusive memories, depression was associated with vivid images focussed on death and suicide. Intrusive memories were rare in hypomanic states, which instead were characterised by vivid, enjoyable images of future events. Behaviours and emotions in different bipolar states may be amplified by characteristic intrusive memories and images, suggesting novel opportunities for therapeutic intervention. For example, intrusive images may be particularly important prodromal indicators and hence require greater emphasis in relapse-prevention programmes. Rescripting that incorporates negative elements into overly positive images may also be valuable in minimising the extent of hypomanic episodes.
修改侵入性记忆和图像是一种治疗抑郁症和焦虑症的有效干预手段，但关于双相情感障碍中这些侵入性记忆和图像的存在，我们知之甚少。研究人员对 29 名处于轻躁狂期的双相情感障碍患者进行了半结构化访谈，要求他们报告从最近一次轻躁狂、抑郁和轻躁狂发作中回忆起的侵入性记忆和图像。轻躁狂期的特点是对过去的侵入性记忆，这些记忆的痛苦程度低于在抑郁状态下经历的记忆。除了侵入性记忆外，抑郁还与聚焦于死亡和自杀的生动图像有关。在轻躁狂状态下，侵入性记忆很少见，相反，生动、愉快的未来事件的图像很常见。不同双相情感障碍状态下的行为和情绪可能会被特征性的侵入性记忆和图像放大，这为治疗干预提供了新的机会。例如，侵入性图像可能是特别重要的前驱性指标，因此在预防复发的方案中需要更加重视。将负面元素纳入过度积极的图像中的重写也可能有助于最小化轻躁狂发作的程度。
