Kelly Rebecca E, Dodd Alyson L, Mansell Warren
Psychological Interventions Clinic for Outpatients with Psychosis, Maudsley Psychology Centre, South London and Maudsley NHS Foundation TrustLondon, United Kingdom.
Department of Psychology, Northumbria UniversityNewcastle-upon-Tyne, United Kingdom.
Front Psychol. 2017 Aug 4;8:1235. doi: 10.3389/fpsyg.2017.01235. eCollection 2017.
The integrative cognitive model provides a comprehensive account of bipolar disorder (BD) that, if empirically supported, has important potential implications for psychological therapies. This article is the first to review the evidence for this model. We evaluate the evidence (up to 2017) for four hypotheses derived uniquely from the model: extreme positive and negative appraisals of internal states are associated with (1) risk of developing BD; (2) BD diagnosis; (3) relevant clinical and functional outcomes including hypomanic and depressive mood symptoms; and (4) outcomes over time. Research involving individuals with diagnosed mood disorders as well as non-clinical populations is reviewed. The hypotheses were broadly supported and several consistent findings were not accounted for by alternative psychological models of BD. The evidence base is limited by a relative paucity of prospective studies; only 6 of the 31 studies identified. Implications for theory, research and clinical practice are discussed.
整合认知模型对双相情感障碍（BD）给出了全面的阐释，若得到实证支持，该模型对心理治疗具有重要的潜在意义。本文首次对支持该模型的证据进行综述。我们评估了（截至2017年）仅从该模型推导得出的四个假设的证据：对内在状态的极端积极和消极评价与（1）双相情感障碍的发病风险；（2）双相情感障碍的诊断；（3）包括轻躁狂和抑郁情绪症状在内的相关临床和功能结局；以及（4）随时间推移的结局相关。我们回顾了涉及已确诊情绪障碍个体以及非临床人群的研究。这些假设得到了广泛支持，双相情感障碍的其他心理学模型无法解释一些一致的研究发现。证据基础受到前瞻性研究相对较少的限制；在已确定的31项研究中，只有6项是前瞻性研究。我们还讨论了该模型对理论、研究和临床实践的意义。
