Affective instability in those with and without mental disorders: a case control study

Research output: Contribution to journalArticle

Authors

  • Charlotte Price
  • Jan Scott
  • Scott Weich
  • Aimee Cairns
  • Jeremy Dale
  • Catherine Winsper

External organisations

  • Mental Health and Wellbeing, Division of Health Sciences, University of Warwick
  • Operational Research and Management Sciences Group, Warwick Business School, University of Warwick
  • Newcastle University
  • King's College London
  • Mental Health Research Unit, School of Health and Related Research (ScHARR), University of Sheffield
  • Department of Primary Care, Warwick Medical School, University of Warwick

Abstract

BACKGROUND: Affective instability (AI) is transdiagnostic, and associated with suicidality and healthcare use. It has rarely been compared between diagnoses or to controls. We investigated: whether AI differs between clinical cases and controls and between diagnoses; how different AI components are correlated; and whether AI is associated with functioning in clinical cases.

METHODS: Cases (N = 69) from psychiatric services had a diagnosis of borderline personality disorder, bipolar disorder, major depression or psychosis and were compared to primary care controls (N = 25). Participants completed the affective lability scale (ALS), affective intensity measure (AIM), affective control scale (ACS), scored mood fluctuation rate and the WHO-DAS.

RESULTS: There was a significant difference in affective lability between cases and controls and across diagnostic groups (p < 0.001). Compared to controls, cases showed lower affective control (p < 0.05). There were no differences in affective intensity between cases and controls or between diagnostic groups, or in mood fluctuation rate between groups. ALS score (p < 0.001), and total number of medications (p < 0.046), were associated with functioning, independent of diagnosis.

LIMITATIONS: The sample size was modest. Cases were not in an acute illness episode and this could bias estimates of group difference towards the null.

CONCLUSION: Individuals with mental disorder demonstrate higher levels of affective lability and lower affect control than those without mental disorder. In contrast affective intensity may not be useful in demarcating abnormal affective experience. Independent of diagnosis, affective instability, as measured by affect lability, adversely impacts day-to-day functioning. It could be an important target for clinical intervention.

Details

Original languageEnglish
Pages (from-to)492-498
Number of pages7
JournalJournal of Affective Disorders
Volume241
Early online date14 Aug 2018
Publication statusPublished - 1 Dec 2018

Keywords

  • affective stability, functioning, mood instability, depression, bipolar disorder