Background. No study has simultaneously explored key components of Beck's model of cognitive
vulnerability to depression in people with bipolar disorders.
Methods. We compared 41 euthymic bipolar patients with 20 healthy control subjects. All subjects
were assessed on the Hamilton Rating Scale for Depression, the Autobiographical Memory Test
and the Mean Ends Problem-Solving procedure and also completed the Beck Depression Inventory,
the Dysfunctional Attitude Scale, the Sociotropy Autonomy Scale and the Rosenberg Self-Esteem
Results. In comparison to control subjects, patients with bipolar disorder demonstrated significantly
higher levels of dysfunctional attitudes (particularly perfectionism and need for approval) and
sociotropy, significantly greater over-general recall on an autobiographical memory test and
significantly less ability to generate solutions to social problem-solving tasks. These between group
differences remained significant when age, intelligence, latency to respond to autobiographical
memory test cue words, and subjective mood ratings were included as co-variates in the statistical
analysis. Within the patient group, cognitive dysfunction was significantly correlated with level of
morbidity (as measured by number of previous illness episodes).
Conclusions. This study suggests that cognitive vulnerability in patients with bipolar disorder is
similar to that described in unipolar disorders. It is not clear whether this dysfunction is a cause or
an effect of repeated episodes of bipolar disorder. However, the findings may have implications for
clinical treatment as well as suggesting a number of important new avenues of research into
psychological models of affective disorder.