![]() ![]() However, there remains a need to develop and refine psychological models of BD and improve the effectiveness of psychological therapies. Psychological therapy is now recommended as a first-line treatment option for acute episodes and long-term relapse prevention ( National Institute of Health and Care Excellence, 2014), alongside short-term and maintenance pharmacological treatments. In recent years there have been significant developments in our understanding of the psychological processes underlying bipolar disorder (BD). Implications for theory, research and clinical practice are discussed. The evidence base is limited by a relative paucity of prospective studies only 6 of the 31 studies identified. The hypotheses were broadly supported and several consistent findings were not accounted for by alternative psychological models of BD. Research involving individuals with diagnosed mood disorders as well as non-clinical populations is reviewed. 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. This article is the first to review the evidence for this model. The integrative cognitive model provides a comprehensive account of bipolar disorder (BD) that, if empirically supported, has important potential implications for psychological therapies. ![]() 3School of Psychological Sciences, Faculty of Medical and Human Sciences, University of Manchester, Manchester, United Kingdom.2Department of Psychology, Northumbria University, Newcastle-upon-Tyne, United Kingdom.1Psychological Interventions Clinic for Outpatients with Psychosis, Maudsley Psychology Centre, South London and Maudsley NHS Foundation Trust, London, United Kingdom. ![]()
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