Publications arising from EROS - Academic
Abstract
Background: An integrative cognitive model proposed that ascribing extreme personal
appraisals to changes in internal state is key to the development of the symptoms of bipolar
disorder. The Hypomanic Attitudes and Positive Predictions Inventory (HAPPI) was developed
to measure these appraisals. Aims: The aim of the current study was to validate an expanded
61-item version of the HAPPI. Method: In a largely female student sample (N = 134),
principal components analysis (PCA) was performed on the HAPPI. Associations between the
HAPPI and analogue bipolar symptoms after 3 months were examined. Results: PCA of the
HAPPI revealed six categories of belief: Self Activation, Self-and-Other Critical, Catastrophic,
Extreme Appraisals of Social Approval, Appraisals of Extreme Agitation, and Loss of Control.
The HAPPI predicted all analogue measures of hypomanic symptoms after 3 months when
controlling for baseline symptoms. In a more stringent test incorporating other psychological
measures, the HAPPI was independently associated only with activation (e.g. thoughts racing)
at 3 months. Dependent dysfunctional attitudes predicted greater conflict (e.g. irritability),
depression and reduced well-being, hypomanic personality predicted self-reported diagnostic
bipolar symptoms, and behavioural dysregulation predicted depression. Conclusions: Extreme
beliefs about internal states show a modest independent association with prospective analogue
bipolar symptoms, alongside other psychological factors. Further work will be required to
improve the factor structure of the HAPPI and study its validity in clinical samples.
