Study data published in Psychiatry Research indicate that coping flexibility in patients with bipolar disorder is strongly predictive of mood state following life events.

Participants with a diagnosis of bipolar disorder type I or type II (n=90) were age- and sex-matched with 90 healthy controls. At the time of the study, participants with bipolar disorder had been in symptomatic remission for 2 months or more. Pre-event affective symptoms, Behavioral Approach System (BAS) sensitivity, and psychosocial functioning levels were obtained at baseline. Study participants were then shown role-play video clips depicting any of 10 BAS-activating life events, including hosting a social event, accomplishing an important task at work, or receiving large amounts of money. Participants then reported perceived controllability of the situation, individual coping strategies, and post-event mood state per the Internal State Scale.

After controlling for demographic features, BAS sensitivity accounted for 5.4% (P <.001) and 7.9% (P <.001) of variance between study groups on the Well-Being and Activation subscales of the Internal State Scale, respectively. In patients with bipolar disorder, coping flexibility had value in predicting post-event mood state beyond BAS sensitivity and psychosocial functioning. Specifically, perceived controllability was significantly predictive of post-event mood symptoms in the bipolar group, whereas in the control group coping strategy-situation fit had the most significant association with mood symptoms. Perceived controllability also had a moderating effect on the relationship between mood states and bipolar disorder diagnosis.

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These data suggest that coping flexibility and perceived controllability are crucial to the mood states of patients with bipolar disorder following BAS-activating stimuli. Further research is needed to identify the most effective strategies for mood regulation following significant life events.


Chan SHW, Tse S. An explorative study on coping flexibility with behavioral approach system-activating stimuli: a comparison of people with and without bipolar disorder. Psychiatry Res. 2018;269:399-407.