Chan SHW, Yu CH, Liu KHK, Lau C, Fung AOY, Tse S. Evaluating the emotion regulation of positive mood states among people with bipolar disorder using hierarchical clustering. World J Psychiatr 2021; 11(9): 619-634 [PMID: 34631465 DOI: 10.5498/wjp.v11.i9.619]
Corresponding Author of This Article
Sunny Ho-Wan Chan, PhD, Assistant Professor, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China. sunny.hw.chan@polyu.edu.hk
Research Domain of This Article
Psychiatry
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Psychiatr. Sep 19, 2021; 11(9): 619-634 Published online Sep 19, 2021. doi: 10.5498/wjp.v11.i9.619
Evaluating the emotion regulation of positive mood states among people with bipolar disorder using hierarchical clustering
Sunny Ho-Wan Chan, Chong Ho Yu, Ken Ho Kan Liu, Charlie Lau, Anna On Yee Fung, Samson Tse
Sunny Ho-Wan Chan, Ken Ho Kan Liu, Charlie Lau, Anna On Yee Fung, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
Chong Ho Yu, School of Behavioral and Applied Science, Azusa Pacific University, Azusa, CA 91702, United States
Samson Tse, Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
Author contributions: Chan SHW conceived and guided the study; Liu KHK, Lau C and Fung AOY completed the literature search; Liu KHK, Lau C and Fung AOY coordinated the data collection; Chan SHW and Yu CH performed the statistical analyses; Chan SHW and Tse S wrote and revised the paper; all authors approved the final version of the manuscript.
Institutional review board statement: The study was conducted according to the Declaration of Helsinki and the ethical guidelines established by the University of Hong Kong/West Cluster of the Hong Kong Hospital Authority.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare having no conflicts of interest.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author. Participants gave informed consent for data sharing in which the presented data are anonymized and risk of identification is low.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sunny Ho-Wan Chan, PhD, Assistant Professor, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China. sunny.hw.chan@polyu.edu.hk
Received: March 11, 2021 Peer-review started: March 11, 2021 First decision: July 15, 2021 Revised: July 25, 2021 Accepted: August 18, 2021 Article in press: August, 18, 2021 Published online: September 19, 2021 Processing time: 188 Days and 8.9 Hours
Abstract
BACKGROUND
People with bipolar disorder (BD) frequently struggle with the recurrence of affective symptoms. However, the interplay between coping mechanism and positive mood state remains under-researched.
AIM
To explore the associations among behavioral approach system (BAS) sensitivity level, coping, and positive mood states among people with BD.
METHODS
Using a cross-sectional study design, 90 participants with BD were presented with four BAS-activating life event scenarios and assessed with regard to their BAS trait sensitivity, coping flexibility, and mood states. A hierarchical clustering method was used to identify different groups with different styles of coping. Multiple hierarchical regression analyses were conducted to examine the mediating and moderating roles of different components of coping on mood states.
RESULTS
A three-cluster solution was found to best fit the present data set. The findings showed that a low mass of coping combined with low BAS sensitivity level protects people with BD from detrimentally accentuating mood states when they encounter BAS-activating life events. Moreover, coping flexibility is demonstrated to mediate and moderate the relationships between BAS sensitivity level and mood states. Specifically, subduing the perceived controllability and reducing the use of behavioral-activation/emotion-amplifying coping strategies could help buffer the effect of positive affect.
CONCLUSION
The judicious use of coping in emotion regulation for people with BD when encountering BAS-activating life events was indicated. Practical applications and theoretical implications are highlighted.
Core Tip: Individuals with bipolar disorder (BD) essentially fail to regulate their emotions and behavior effectively due to their behavioral approach system (BAS) hypersensitivity. This research, based on the BAS dysregulation theory, explores the dynamic role of coping in emotion regulation for managing positive mood states due to BAS-activating life events. Results show that a low mass of coping combined with low BAS sensitivity level protects people with BD from detrimentally accentuating mood states. Practical applications for the improvement of stress management programs and theoretical implication for the extension of coping frameworks to include positive mood states are highlighted.
