Appraisal of hypomania-relevant experiences: development of a questionnaire to assess positive self-dispositional appraisals in bipolar and behavioural high risk samples.

BACKGROUND This paper reports two studies concerned with the development and validation of the Hypomania Interpretations Questionnaire (HIQ) designed to assess positive self-dispositional appraisals for hypomania-relevant experiences. METHODS Study 1: 203 late adolescent participants completed the HIQ along with additional measures of general symptom interpretation, dysfunctional attitudes and hypomanic personality. Study 2: 56 adults with a self-reported diagnosis of bipolar disorder and 39 controls completed a revised HIQ and a measure of current mood symptoms. RESULTS Study 1: The final 10 item HIQ had two subscales: a) positive self-dispositional appraisals (HIQ-H); and b) normalising appraisals (HIQ-NE). Internal and test-retest reliability were adequate. Hypomanic personality scores were significantly and uniquely predicted by recent hypomania-relevant experiences and HIQ-H score. Study 2: HIQ remained internally reliable within this sample. Bipolar participants (BD) reported more subsyndromal mood symptoms than controls (C) and scored significantly higher on HIQ-H even after covarying for these. HIQ-H was the primary predictor of diagnostic group. Its ability to discriminate BD from C was confirmed by ROC analysis. LIMITATIONS The studies are cross-sectional and did not include non-bipolar psychiatric control groups. CONCLUSIONS HIQ appears to be a reliable and valid measure for the assessment of positive self-dispositional appraisals which seem to be linked to both hypomanic personality and bipolar disorder. The relevance of such appraisals for symptom exacerbation, relapse and psychological treatment would merit future investigation.