Acceptance, Values and Mindfulness May Differentially Affect Functioning on Bipolar Disorder in Remission; A Single-Center Study

Abstract

Background: It is known that psychosocial functioning is low in bipolar disorder (BD) euthymic period. We aimed to demonstrate the impact of some psychological flexibility proceses (experiential avoidence, present-to-moment and being contact with values) on psychosocial functioning in BD euthymic state. Methods: The study was carried out with 106 patients diagnosed with BD. All patients were in remission and the remission state was confirmed by a 17-item Hamilton Depression Rating Scale score less than 7 and a Young Mania Rating Scale score less than 5 and characteristic of BD was assessed by The Bipolarity Index (BI). For the assessment of psychological flexibility processes Acceptance and Action Questionnaire-II (AAQ-II), Freiburg Mindfulness Inventory (FMI) and The Valued Living Questionnaire (VLQ) were used. In the assessment of functioning, Functioning Assessment Short Test (FAST) was applied which includes the dimensions such as autonomy, occupational functioning, cognitive functioning, financial issues, interpersonal relations, and leisure time. In the statistical analysis, regression analysis was performed. Results: Higher scores of AAQ-II were positively and higher scores of VLQi were negatively correlated with the functioning in the correlation analysis. FMI, BI and VLQc didn't show a significant correlation with functioning. In the multiple regression analysis, the models including both total score (R2 = 0.150, F = 3.535, p = 0.006) and leisure (R2 = 0.184, F = 4.511, p = 0.001), autonomy (R2 = 0.156, F = 3.704, p = 0.004) and interpersonal relationship (R2 = 0.122, F = 2.786, p = 0.02) dimensions were found statistically significant in the model established for each of the dimensions related to psychosocial functioning. AAQ-II and VLQi have been assessed as the strongest predictive variables in the relevant functioning models in regression analyses. Conclusions: It is concluded that experiential avoidence has an negative impact on general functioning and some specific areas of functioning like interpersonal, leisure, autonomic dimentions. But being in contact with values had a positive effect on improving autonomic, financial, leisure and general functionality in euthymic BD patients. On the other hand present-to-moment and commited actions processes does not show any effect on functioning.