Fear of Relapse as Mediator in the Association between Current Mood State and Dampening of Positive Affect in a Bipolar Population

Abstract

Background: Bipolar disorder (BD) is a severe mood disorder, characterized by recurrent episodes of disrupted emotional functioning. So far, research has mainly focused on the regulation of negative emotions. As the use of maladaptive emotion regulation strategies can lead to further dysregulation of a patient’s mood, it is important to gain more insight in psychological factors that may relate to the regulation of positive emotions in BD. Objective: The present study aimed to investigate the possible mediating role of fear of relapse in the association between current mood symptoms and dampening responses to positive affect (PA) among patients with BD. Methods: The sample consisted of 95 patients who were diagnosed with BD-I, BD-II, BD-NOS (Not Otherwise Specified) and substance induced BD. As part of the intake procedure, participants completed a set of questionnaires to measure current (hypo)manic symptoms, current depressive symptoms, fear of relapse and dampening of PA. Results: Although no significant association was found between current (hypo)manic symptoms and dampening of PA, current depressive symptoms were positively associated with dampening of PA. Current mood symptoms were positively related to fear of relapse and an indirect effect was found of (hypo)manic symptoms on dampening of PA via fear of relapse. Conclusion: This study improves our understanding of the psychological factors that contribute to the use of ER strategies in patients with BD. Fear of relapse can be taken into account in treatment interventions as a possible underlying motive for the use of dampening responses to PA. Adaptive ER strategies and the functional relevance of positive emotions may be addressed in interventions to support maintaining an emotional balance. Further research may sharpen the operationalisation of fear of relapse and longitudinal research is recommended.