Proportion of Negative Events

FIG. 4.2. Residualized change in Halberstadt Mania Inventory (HMI) scores at Time 2 as a function of attributional style for positive events and the proportion of negative life events (total negative events/total events) experienced. High ASQ-PC refers to a more internal, stable, global attributional style for positive events and Low ASQ-PC is a less internal, stable, global attributional style for positive events. Adapted from "Cognitive Styles and Life Events in Subsyndromal Unipolar and Bipolar Mood Disorders: Stability and Prospective Prediction of Depressive and Hypomanic Mood Swings," by L. B. Alloy, N. Reilly-Harrington, D. M. Fresco, W. G. Whitehouse, and J. S. Zechmeister, 1999, Journal of Cognitive Psychotherapy: An International Quarterly, 13, p. 35. Adapted with permission from Springer Publishing Co.

nation with positive cognitive styles. Thus, more work is needed to understand the conditions under which positive versus negative events and positive versus negative cognitive styles provide vulnerability to mania/ hypomania. Second, given that some of the studies reviewed here found that negative life events interact with negative cognitive styles and information processing to predict increases in both depressive and manic symptoms, what determines which type of episode a bipolar individual will experience at any particular time? Reilly-Harrington et al. (1999) speculated that the particular kind of stressful event may be key, with manic/ hypomanic episodes more likely to follow stressors that disrupt the sleep-wake cycle (i.e., social rhythm disruptors; Malkoff-Schwartz et al.,

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