Mediation analysis of recovery-focused therapy for recent-onset bipolar disorder
Background: Recovery focused therapy has been shown to improve recovery outcomes in individuals with recent onset bipolar disorder. However the process by which this is achieved is unclear. This paper therefore examines potential mediators of this effect using data from a randomised controlled trial...
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2021-07-01
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doaj-5461f84de8784615b25f64a8e90d81382021-07-17T04:35:31ZengElsevierJournal of Affective Disorders Reports2666-91532021-07-015100175Mediation analysis of recovery-focused therapy for recent-onset bipolar disorderSteven H. Jones0Dawn Knowles1Elizabeth Howarth2Fiona Lobban3Richard Emsley4Spectrum Centre for Mental Health Research, Division of Health Research, Faculty of Health and Medicine Lancaster University; Corresponding author at: Spectrum Centre for Mental Health Research, Division of Health Research, Faculty of Health and Medicine Lancaster University, LA1 4YW.Doctorate in Clinical Psychology, Department of Psychological Sciences, University of LiverpoolCentre for Biostatistics, School of Health Sciences, University of Manchester, Oxford Road, ManchesterSpectrum Centre for Mental Health Research, Division of Health Research, Faculty of Health and Medicine Lancaster UniversityDepartment of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, LondonBackground: Recovery focused therapy has been shown to improve recovery outcomes in individuals with recent onset bipolar disorder. However the process by which this is achieved is unclear. This paper therefore examines potential mediators of this effect using data from a randomised controlled trial comparing recovery focused therapy with treatment as usual (ISRCTN43062149). Methods: A single-blind randomised controlled trial compared treatment as usual (TAU) with recovery-focused therapy (RfT) plus TAU (n = 67) in participants diagnosed with bipolar disorder with onset within 5 years. Impact of treatment at six and twelve months post baseline on potential mediators (mood appraisal, growth and self-concept) for changes in personal recovery, social functioning and quality of life outcomes were first assessed. Mediation effects were evaluated on each outcome for mediators significantly impacted by treatment. Results: RfT had a significant impact on positive self-appraisal and stigma at 12 months and self-esteem and post-trauma growth at six months. Both self-esteem and post-trauma growth significantly mediated the effect of RfT on personal recovery at six months follow-up. Limitations: This is a relatively small study which was not originally powered to test for exploratory mediation effects. Conclusions: Improvements in personal recovery following RfT are linked to improvements in personal growth and self-esteem. This mediation relationship was not apparent for functioning or quality of life.http://www.sciencedirect.com/science/article/pii/S2666915321001025Bipolar disorderPersonal recoveryRecoveryMediationAppraisalSelf-esteem |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Steven H. Jones Dawn Knowles Elizabeth Howarth Fiona Lobban Richard Emsley |
spellingShingle |
Steven H. Jones Dawn Knowles Elizabeth Howarth Fiona Lobban Richard Emsley Mediation analysis of recovery-focused therapy for recent-onset bipolar disorder Journal of Affective Disorders Reports Bipolar disorder Personal recovery Recovery Mediation Appraisal Self-esteem |
author_facet |
Steven H. Jones Dawn Knowles Elizabeth Howarth Fiona Lobban Richard Emsley |
author_sort |
Steven H. Jones |
title |
Mediation analysis of recovery-focused therapy for recent-onset bipolar disorder |
title_short |
Mediation analysis of recovery-focused therapy for recent-onset bipolar disorder |
title_full |
Mediation analysis of recovery-focused therapy for recent-onset bipolar disorder |
title_fullStr |
Mediation analysis of recovery-focused therapy for recent-onset bipolar disorder |
title_full_unstemmed |
Mediation analysis of recovery-focused therapy for recent-onset bipolar disorder |
title_sort |
mediation analysis of recovery-focused therapy for recent-onset bipolar disorder |
publisher |
Elsevier |
series |
Journal of Affective Disorders Reports |
issn |
2666-9153 |
publishDate |
2021-07-01 |
description |
Background: Recovery focused therapy has been shown to improve recovery outcomes in individuals with recent onset bipolar disorder. However the process by which this is achieved is unclear. This paper therefore examines potential mediators of this effect using data from a randomised controlled trial comparing recovery focused therapy with treatment as usual (ISRCTN43062149). Methods: A single-blind randomised controlled trial compared treatment as usual (TAU) with recovery-focused therapy (RfT) plus TAU (n = 67) in participants diagnosed with bipolar disorder with onset within 5 years. Impact of treatment at six and twelve months post baseline on potential mediators (mood appraisal, growth and self-concept) for changes in personal recovery, social functioning and quality of life outcomes were first assessed. Mediation effects were evaluated on each outcome for mediators significantly impacted by treatment. Results: RfT had a significant impact on positive self-appraisal and stigma at 12 months and self-esteem and post-trauma growth at six months. Both self-esteem and post-trauma growth significantly mediated the effect of RfT on personal recovery at six months follow-up. Limitations: This is a relatively small study which was not originally powered to test for exploratory mediation effects. Conclusions: Improvements in personal recovery following RfT are linked to improvements in personal growth and self-esteem. This mediation relationship was not apparent for functioning or quality of life. |
topic |
Bipolar disorder Personal recovery Recovery Mediation Appraisal Self-esteem |
url |
http://www.sciencedirect.com/science/article/pii/S2666915321001025 |
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