Cognitive Behavioral Models of Emotional Dysregulation in Bipolar Disorder

This chapter provides a characterization of cognitive impairment in bipolar disorder and how emotions affect cognition and lead to cognitive biases. The Behavioral Approach System and Interactive Cognitive Model of bipolar disorder are reviewed, along with the newer Interactive Influence Model of Emotion and Cognition, which holds promise in future applications to mood disorders. These models provide a framework for the development and expansion of neurobiological models and psychotherapeutic interventions for bipolar disorder. The authors conclude by noting that, while models of bipolar disorder still need to be expanded to account for cognitive and behavioral influences beyond simple correlations with symptom outcomes, their importance is clearly demonstrated in the development of cognitive behavioral therapies, cognitive remediation therapies, and mindfulness-based cognitive therapies for bipolar disorder. The ability to test the efficacy of these, and other, cognitive behavioral therapeutics in controlled trials based on the predictions of well-characterized models of bipolar disorder will undoubtedly lead to advances in patient care.