Internet Mental Health

CYCLOTHYMIC DISORDER






Expanded Quality of Life Scale For Cyclothymic Disorder

Internet Mental Health Quality of Life Scale (Client Version)

Internet Mental Health Quality of Life Scale (Therapist Version)

Big 5 Factors Of Mental Illness And Code For This Disorder
(The "6th Big Factor" of Mental Health, "Physical Health", Is Coded Normal or Green)

Onset:
Cyclothymic Disorder consists of at least 2 years of numerous mild mood swings of elation or unhappiness which occur for no reason and which cause significant distress or disability. This disorder is best thought of as a mild form of Bipolar Disorder in which the criteria for a major depressive, manic, or hypomanic episode has never been met. The spells of unhappiness consist of mild negative emotion (depressed mood, shame, lack of confidence, pessimism, loneliness). The spells of elation consist of mild disinhibition (elated mood, impulsivity, reckless risk taking).

Treatment:
A combination of cognitive behavioral therapy and well-being therapy is somewhat effective in treating Cyclothymic Disorder. Lithium therapy is ineffective.

Prognosis:
Cyclothymic Disorder usually has an insidious onset and a persistent course. Onset after age 40 suggests that this disturbance may be due to another medical condition (e.g., multiple sclerosis).

CYCLOTHYMIC DISORDER

  • Had at least 2 years of mood instability involving numerous periods of mild depression and mild elation which cause significant distress or disability.

  • The periods of mild depression are not severe enough to be diagnosed as major depressive episodes.

  • The periods of mild elation are not severe enough to be diagnosed as hypomania.

  • Over the past 2 years, the numerous periods of mild depression and mild elation have been present for at least half the time, and the individual has not been without these symptoms for more than 2 months at a time.

  • This was not due to a medical or substance use disorder.
Note: Cyclothymic Disorder may no longer exist - The DSM-5 diagnostic criteria is now so restrictive that the majority of patients formerly diagnosed in DSM-4 with Cyclothymic Disorder would now be diagnosed in DSM-5 as having Bipolar Disorder.

Prediction

    Episodic and lasts for years

Problems

Occupational-Economic Problems:

  • Causes significant impairment in academic, occupational and/or social functioning (e.g., may be unpredictable, inconsistent, or unreliable if having prolonged mood swings)

Mood Instability:

  • Elated Mood: During episodes of mild elated mood has less than 3 (or 4 if mood is only irritable) of the following:

    • Elated self-esteem or grandiosity

    • Decreased need for sleep

    • More talkative than usual

    • Flight of ideas or racing thoughts

    • Distractibility

    • Increase in goal-directed activity or psychomotor agitation

    • Reckless over-involvement

  • Depressed Mood: During episodes of mild depressed mood has less than 5 of the following:

    • Depressed mood most of the day

    • Markedly diminished interest or pleasure

    • Significant weight loss when not dieting or weight gain

    • Insomnia or hypersomnia

    • Psychomotor agitation or slowing

    • Fatigue or loss of energy

    • Feelings of worthlessness or excessive guilt

    • Diminished ability to think or concentrate, or indecisiveness

    • Recurrent thoughts of death or suicide (or a suicide attempt)

  • During episodes of mild depressed mood, may also:

    • Have pessimism, loneliness and hypersensitivity to rejection

    • Be quiet, reserved, socially withdrawn

    • Have low self-confidence




Bipolar vs Cyclothymic Disorder


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Click Here For Free Diagnosis

Limitations of Self-Diagnosis

Self-diagnosis of this disorder is often inaccurate. Accurate diagnosis of this disorder requires assessment by a qualified practitioner trained in psychiatric diagnosis and evidence-based treatment.

However, if no such professional is available, our free computerized diagnosis is usually accurate when completed by an informant who knows the patient well. Computerized diagnosis is less accurate when done by patients (because they often lack insight).

Example Of Our Computer Generated Diagnostic Assessment

Cyclothymic Disorder 301.13

This diagnosis is based on the following findings:

  • Never had psychotic symptoms for at least 2 weeks in the absence of prominent mood disturbances (when off drugs)

  • This unstable mood is not superimposed on any psychotic disorder

  • Criteria for a Major Depressive, Manic, or Hypomanic Episode have never been met

  • Had years of brief high and low mood swings

  • Never had a 2 month period of stable mood during the years of brief high and low swings

  • Years of brief high and low mood swings caused clinicially significant distress or disability

  • Years of brief high and low mood swings were not due to a physical agent or general medical condition

  • Years of brief high mood swings had abnormally elevated or expansive mood lasting less than 4 days (still present)

  • Years of brief high mood swings had inflated self-esteem or grandiosity lasting less than 4 days (still present)

  • Years of brief low mood swings had sad or depressed mood lasting less than 2 weeks (still present)

  • Years of brief low mood swings had markedly diminished interest or pleasure lasting less than 2 weeks (still present)

  • Years of brief low mood swings had appetite or weight disturbance lasting less than 2 weeks (still present)

  • Years of brief low mood swings had insomnia or hypersomnia lasting less than 2 weeks (still present)

Treatment Goals:

  • Goal: prevent abnormally elated mood.
    If this problem worsened: Her elevated, unusually good, cheerful, or high mood could lead to unceasing and indiscriminate enthusiasm for interpersonal, sexual, or occupational interactions.

  • Goal: prevent inflated self-esteem or grandiosity.
    If this problem worsened: Her uncritical self-confidence could lead to marked grandiosity. Despite lack of any particular experience or talent, she could embark on writing a novel or seek publicity for some impractical invention or cause. This could develop into grandiose delusions (e.g., having a special relationship to God to some public figure from the political, religious, or entertainment world).

  • Goal: prevent depressed mood.
    If this problem worsened: She could feel sad, hopeless, discouraged, "down in the dumps", or "blah". She could emphasize somatic complaints (e.g., bodily aches and pains) rather than reporting feelings of sadness. She could exhibit increased irritability (e.g., persistent anger, a tendency to respond to events with angry outbursts or blaming others, or an exaggerated sense of frustration over minor matters).

  • Goal: prevent loss of interest or pleasure.
    If this problem worsened: She could feel less interested in hobbies, "not caring anymore," or not feeling any enjoyment in activities that were previously considered pleasurable. There could be a significant reduction in her sexual interest or desire.

  • Goal: prevent appetite or weight disturbance.
    If this problem worsened: She could have either abnormally decreased or increased appetite. This could progress to significant loss or gain in weight.

  • Goal: prevent insomnia or hypersomnia.
    If this problem worsened: She could sleep too little or too much. Typically she could have middle insomnia (i.e., waking up during the night and having difficulty returning to sleep) or terminal insomnia (i.e., waking too early and being unable to sleep). Initial insomnia (i.e., difficulty falling asleep) could also occur. Less frequently, she could have oversleeping (hypersomnia).


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Cyclothymia F34.0 - ICD10 Description, World Health Organization
A persistent instability of mood involving numerous periods of depression and mild elation, none of which is sufficiently severe or prolonged to justify a diagnosis of bipolar affective disorder (F31.-) or recurrent depressive disorder (F33.-). This disorder is frequently found in the relatives of patients with bipolar affective disorder. Some patients with cyclothymia eventually develop bipolar affective disorder.
Cyclothymic Disorder - Diagnostic Criteria, American Psychiatric Association

An individual diagnosed with cyclothymic disorder needs to meet all of the following criteria:

  • For at least 2 years (at least 1 year in children and adolescents) there have been numerous periods with hypomanic symptoms that do not meet criteria for a hypomanic episode and numerous periods with depressive symptoms that do not meet criteria for a major depressive episode.

  • During the above 2-year period (1 year in children and adolescents), the hypomanic and depressive periods have been present for at least half the time and the individual has not been without the symptoms for more than 2 months at a time.

  • Criteria for a major depressive, manic, or hypomanic episode have never been met.

  • The hypomanic and depressive symptoms are not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or other specified or unspecified schizophrenia spectrum and other psychotic disorder.

  • The symptoms are not attributable to the physiological effects of a substance (a drug of abuse, a medication) or another medical condition (e.g., hyperthyroidism).

  • The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.


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Diagnostic Features

This disorder is best thought of as a mild form of Bipolar Disorder in which the criteria for a major depressive, manic, or hypomanic episode has never been met. The individual has frequent mood swings of elation or unhappiness which occur for no reason. These numerous mood swings occur for at least 2 years (or 1 year in childen). During this disorder, the mood swings are present for at least half the time and the individual is not without mood swings for more than 2 months at a time. To be diagnosed, this disorder must cause significant impairment in an individual's life. This disorder is not due to a psychotic disorder, substance use disorder or another medical condition (e.g., hyperthyroidism).

Complications

There is a 15%-50% risk that this disorder will subsequently develop into Bipolar I Disorder or Bipolar II Disorder.

Comorbidity

There are increased rates of Substance Use Disorders, Sleep Disorders, and Attention Deficit - Hyperactivity Disorder.

Associated Laboratory Findings

No laboratory test has been found to be diagnostic of this disorder.

Prevalence

The lifetime prevalence of this disorder is 0.4%-1%. It is equally common in males and females.

Course

This disorder usually begins in adolescence or early life. The mean age of onset in children is 6.5 years. It usually has an insidious onset and a persistent course. Onset after age 40 suggests that this disturbance may be due to another medical condition (e.g., multiple sclerosis).

Outcome

The disorder lasts for years; however the average duration of this disorder is unknown.

Precipitants

The disorder's insidious onset suggests that it lacks specific triggers.

Familial Pattern

Individuals with Cyclothymic Disorder frequently have relatives with Bipolar I Disorder, Bipolar II Disorder, Major Depressive Disorder, or Substance Use Disorder.

Effective Therapies

There have been only two adequately sized studies on the effectiveness of any therapy for Cyclothymic Disorder. One study in 2011 found that a combination of cognitive behavioral therapy and well-being therapy was somewhat effective in treating Cyclothymic Disorder. A second study in 1982 found that lithium therapy was ineffective.

Ineffective therapies

Vitamins, dietary supplements, antidepressant, antianxiety, and antipsychotic medications are ineffective for this disorder.

A Dangerous Cult


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General Information

Stories

Rating Scales


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Rule Out Full-Blown Manic Or Hypomanic Episodes




Rule Out Full-Blown Major Depressive Episodes




Use Standard Psychosocial (But Not Pharmacological) Treatments For Bipolar Disorder




World Health Organization Treatment Guidelines


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Self-Help Resources For Depression

Self-Help Bipolar Resources


Improving Positive Behavior

Philosophers for the past 2,500 years have taught that it is very beneficial to start the day with goal-setting, and end the day with a brief review.

This habit of planning your day in the morning, and reviewing your day in the evening, is a time-proven technique for more successful living.

Note: When each of the following videos finishes; you must exit YouTube (by manually closing the window) in order to return to this webpage.



Morning Meditation (5-Minute Video)



Afternoon Meditation (Learn How To Have Healthy Relationships)



Evening Meditation (5-Minute Video)



Life Satisfaction Scale (Video)



Healthy Social Behavior Scale (Video)



Mental Health Scale (Video)




Click Here For More Self-Help



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    "In physical science a first essential step in the direction of learning any subject is to find principles of numerical reckoning and practicable methods for measuring some quality connected with it. I often say that when you can measure what you are speaking about and express it in numbers you know something about it; but when you cannot measure it, when you cannot express it in numbers, your knowledge is of a meagre and unsatisfactory kind: it may be the beginning of knowledge, but you have scarcely, in your thoughts, advanced to the stage of science, whatever the matter may be."

    Lord Kelvin (1824 – 1907)


  • The best summary on bad research is given by Laura Arnold in this TEDx lecture. If you read nothing else about research, you owe it to yourself to watch this short video - it is excellent!

  • Canadian researchers who commit scientific fraud are protected by privacy laws: There are criminals in every community - even in the scientific research community (especially if a lot of money is at stake). Criminal researchers can hide their fraud behind outdated privacy laws.

  • The power of asking "what if?"

  • The active placebo effect: 2300 years ago, the Greek Stoic philosophers taught that it is not the objective event, but our subjective judgment about the event, that determines our behavior. The active placebo effect bears witness to this ancient wisdom.

  • Criteria For High Quality Research Studies

  • It is troubling that a recent study found that two-thirds of important psychological research studies couldn't be replicated. High quality research must meet the following criteria:

    • Randomized Controlled Trial:
      Ask: Was the trial randomized? Was the randomization procedure described and was it appropriate? The best research design is to have research subjects randomly assigned to an experimental or control group. It is essential that confounding factors be controlled for by having a control group or comparator condition (no intervention, placebo, care as usual etc.).

    • Representative Sample:
      Ask: Do the research subjects represent a normal cross-section of the population being studied? Many psychological research studies using university students are flawed because their subjects are not representative of the normal population since they are all W.E.I.R.D. (White, Educated, Intelligent, Rich, and living in a Democracy).

    • Single Blind Trial:
      Ask: Was the treatment allocation concealed? It is essential that the research subjects are kept "blind" as to whether they are in the experimental or control group (in order to control for any placebo effects).

    • Double Blind Trial (Better Than Single Blind Trial):
      Ask: Were blind outcome assessments conducted? In a double blind study, neither the research subjects nor the outcome assessors know if the research subject is in the experimental or control group. This controls for both the placebo effect and assessor bias.

    • Baseline Comparability:
      Ask: Were groups similar at baseline on prognostic indicators? The experimental and control groups must be shown to be comparable at the beginning of the study.

    • Confounding Factors:
      Ask: Were there factors, that weren't controlled for, that could have seriously distorted the study's results? For example, research studies on the effectiveness of mindfulness cognitive therapy in preventing depressive relapse forgot to control for whether the research subjects were also simultaneously receiving antidepressant medication or other psychological treatments for depression.

    • Intervention Integrity:
      Ask: Was the research study protocal strictly followed? The research subjects must be shown to be compliant (e.g., taking their pills, attending therapy) and the therapists must be shown to be reliably delivering the intervention (e.g., staying on the research protocol).

    • Statistical analysis:
      Ask: Was a statistical power calculation described? The study should discuss its statistical power analysis; that is whether the study size is large enough to statistically detect a difference between the experimental and control group (should it occur) and usually this requires at least 50 research subjects in the study.

      Ask: Are the results both statistically significant and clinically significant? The results should be both statistically significant (with a p-value <0.05) and clinically significant using some measure of Effect Size such as Standardized Mean Difference (e.g., Cohen's d >= 0.33). The summary statistics should report what percentage of the total variance of the dependent variable (e.g., outcome) can be explained by the independent variable (e.g., intervention). In clinical studies, the study should report the number needed to treat for an additional beneficial outcome (NNTB), and the number needed to treat for an additional harmful outcome (NNTH).

        Number Needed To Benefit (NNTB): This is defined as the number of patients that need to be treated for one of them to benefit compared with a control in a clinical trial. (It is defined as the inverse of the absolute risk reduction.) Note: Statistically, the NNTB depends on which control group is used for comparison - e.g., active treatment vs. placebo treatment, or active treatment vs. no treatment.

        Number Needed To Harm (NNTH): This is defined as the number of patients that need to be treated for one of them to be harmed compared with a control in a clinical trial. (It is defined as the inverse of the absolute increase in risk of harm.)

        Tomlinson found “an NNTB of 5 or less was probably associated with a meaningful health benefit,” while “an NNTB of 15 or more was quite certain to be associated with at most a small net health benefit.”

      Ask: Does the researcher accept full responsibility for the study's statistical analysis? The researcher should not just hand over the study's raw data to a corporation (that may have $1,000 million invested in the study) to do the statistical analysis.

    • Completeness of follow-up data:
      Ask: Was the number of withdrawals or dropouts in each group mentioned, and were reasons given for these withdrawals or dropouts? Less than 20% of the research subjects should drop out of the study. The intervention effect should persist over an adequate length of time.

    • Handling of missing data:
      Ask: Was the statistical analysis conducted on the intention-to-treat sample? There must be use of intention-to-treat analysis (as opposed to a completers-only analysis). In this way, all of the research subjects that started the study are included in the final statistical analysis. A completers-only analysis would disregard those research subjects that dropped out.

    • Replication of Findings:
      Ask: Can other researchers replicate this study's results? The research study's methodology should be clearly described so that the study can be easily replicated. The researcher's raw data should be available to other researchers to review (in order to detect errors or fraud).

    • Fraud:
      Ask: Is there a suspicion of fraud? In a research study, examine the independent and dependent variables that are always measured as a positive whole number (e.g., a variable measured on a 5-point Likert-type scale ranging from "1 = definitely false to 5 = definitely true" etc.). For each of these variables, look at their sample size (n), mean (M) and standard deviation (SD) before they undergo statistical analysis. There is a high suspicion of fraud in a study's statistics:

      • If the M is mathematically impossible (online calculator): This is one of the easiest ways to mathematically detect fraud. The mean (M) is defined as "the sum (Sum) of the values of each observation divided by the total number (n) of observations". So: M = Sum/n. Thus: (Sum) = (M) multiplied by (n). We know that, if a variable is always measured as a positive whole number, the sum of these observations always has to be a whole number. For these variables to test for fraud: calculate (M) multiplied by (n). This calculates the Sum which MUST be a positive whole number. If the calculated Sum isn't a positive whole number; the reported mean (M) is mathematically impossible - thus the researcher either cooked the data or made a mistake. A recent study of 260 research papers published in highly reputable psychological journals found that 1 in 2 of these research papers reported at least one impossible value, and 1 in 5 of these research papers reported multiple impossible values. When the authors of the 21 worst offending research papers were asked for their raw data (so that its reliability could be checked) - 57% angrily refused. Yet such release of raw data to other researchers is required by most scientific journals. (Here is an example of a research paper filled with mathematically impossible means.)

      • If the SD is mathematically impossible (online calculator): When researchers fraudulently "cook" their data, they may accidently give their data a mean and standard deviation that is mathematically impossible for a (normally distributed) strictly positive variable (because the "cooked" M and SD would mathematically require the strictly positive variable's range of data to include negative numbers). For a normally distributed sample of size of 25-70, this occurs when the SD is greater than one-half of the M; for a sample size of 70+, this occurs when the SD is greater than one-third of the M [using these formulas].

      • If the SD/M is very small (i.e., the variable's standard deviation is very small compared to the mean suggesting data smoothing).

      • If the SD's are almost identical (i.e., the variables have different means but almost identical standard deviations).

      • If the 4th digit of the values of the variables aren't uniformly distributed - since each should occur 10% of the time (Benford's Law).

      • If the researcher is legally prevented from publishing negative findings about a drug or therapy because that would violate the "nondisclosure of trade secrets" clause in the research contract (i.e., it is a "trade secret" that the drug or therapy is ineffective - hence this can not be "disclosed"). Approximately half of all registered clinical trials fail to publish their results.

      • If the researcher refuses to release his raw data to fellow researchers (so that they can check its validity). In order to be published in most scientific journals, a researcher must promise to share his raw data with fellow researchers. Thus a researcher's refusal to do so is almost a sure indicator of fraud.

      • If the research study's data contradicts the study's own conclusions - surprisingly, this often occurs.

  • Calling Bullshit In The Age of Big Data - "Bullshit is language, statistical figures, data graphics, and other forms of presentation intended to persuade by impressing and overwhelming a reader or listener, with a blatant disregard for truth and logical coherence." Reading the syllabus of this university course should be required reading for every student of mental health. This syllabus is absolutely fantastic!

  • Statistical Methods in Psychology Journals: Guidelines and Explanations - American Psychologist 1999

  • Not All Scientific Studies Are Created Equal - video

  • The efficacy of psychological, educational, and behavioral treatment

  • Estimating the reproducibility of psychological science

  • Psychologists grapple with validity of research

  • Industry sponsorship and research outcome (Review) - Cochrane Library

  • 'We've been deceived': Many clinical trial results are never published - (text and video)

  • Junk science misleading doctors and researchers

  • Junk science under spotlight after controversial firm buys Canadian journals

  • Medicine with a side of mysticism: Top hospitals promote unproven therapies - Are some doctors becoming modern witchdoctors?

  • When Evidence Says No, But Doctors Say Yes

  • Major pharmaceutical company fined $3 billion US for making false claims - (text and video) [Editor: This is an example of how a major pharmaceutical company purposely produced fraudulant research in order to increase its sales.] In 2001, GlaxoSmithKline, the manufacturer of the antidepressant Paxil, published research that falsely claimed that Paxil was effective in the treatment of adolescent depression. This claim and others were found to be fraudulant, and in 2012 GlaxoSmithKline was fined $3 billion US in court settlements. Subsequent independent reanalysis of the original Paxil research data clearly proved that the original study was fraudulant. This fraudulant research paper was published in a top psychiatric journal, and has never been retracted or corrected.

  • Cochrane Collaboration - the best evidence-based, standardized reviews available

Research Topics

Cyclothymic Disorder - Latest Research (2016-2017)


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Which Behavioral Dimensions Are Involved?

Research has shown that there are 5 major dimensions (the "Big 5 Factors") of personality disorders and other mental disorders. There are two free online personality tests that assess your personality in terms of the "Big 5 dimensions of personality". Although not computerized online, the Big Five Inventory (BFI) is a 44-item test often used in personality research.

This website uses these 5 major dimensions of human behavior to describe all mental disorders. (This website adds one more dimension, "Physical Health", but our discussion will focus on the first 5 major dimensions.)

These major dimensions of human behavior seem to represent the major dimensions whereby our early evolutionary ancestors chose their hunting companions or spouse. To maximize their chance for survival, our ancestors wanted companions who were agreeable, conscientious, intelligent, sociable, emotionally stable, and physically healthy.

    Which Dimensions of Human Behavior are Impaired in Cyclothymic Disorder?

    THE POSITIVE SIDE OF THE "BIG 5" PERSONALITY DIMENSIONS THE NEGATIVE SIDE OF THE "BIG 5" PERSONALITY DIMENSIONS THIS DISORDER
    Agreeableness Antagonism       Agreeableness
    Conscientiousness Disinhibition       Disinhibition
    Intellect Decreased Intellect       Intellect
    Sociability (Extraversion) Detachment       Sociability (Extraversion)
    Emotional Stability Negative Emotion       Negative Emotion


The 5 Major Dimensions of Mental Illness

The Big 5 Factors or dimensions of mental illness each has a healthy side and an unhealthy side. Thus the Big 5 Factors are: (1) Agreeableness vs. Antagonism, (2) Conscientiousness vs. Disinhibition, (3) Intellect vs. Decreased Intellect, (4) Sociability (Extraversion) vs. Detachment (Introversion), and (5) Emotional Stability vs. Negative Emotion.

The Following Will Only Discuss The Dimensions of Mental Illness That Are Abnormal In This Disorder

The problems that are diagnostic of this disorder are highlighted in   Pink  . Other problems that are often seen in this disorder are highlighted in   Yellow  .



Treatment Goals for Individuals With Disinhibition

CONSCIENTIOUSNESS VS. DISINHIBITION
.
CONSCIENTIOUSNESS
.
Description: Conscientiousness is synonymous with being self-disciplined, industrious and orderly. The Conscientiousness dimension measures the behaviors that are central to the concept of SELF-CONTROL - organizing and controlling one's behavior in order to achieve one's goals. This involves traits like paying attention, controlling impulses, and delaying gratification. High conscientiousness is associated with better: longevity, health, school and job performance. (This dimension appears to measure the behaviors that differentiate behavioral order and inhibition from chaos and disinhibition.)
Descriptors: Industrious, self-disciplined, rule-abiding, organized
Language Characteristics: Many positive emotion words (e.g. happy, good), few negative emotion words (e.g. hate, bad), more perspective, careful to check that information is conveyed correctly, straight to the point, formal, few negations, few swear words, few references to friends, few disfluencies or filler words, many insight words, not impulsive.
Research: Higher scores on Conscientiousness predict greater success in school and at work. *MRI research found that Conscientiousness was associated with increased volume in the lateral prefrontal cortex, a region involved in planning and the voluntary control of behavior.
"I do a thorough job. I want everything to be 'just right'. I want every detail taken care of."
"I am careful."
"I am a reliable hard-worker."
"I am organized. I follow a schedule and always know what I am doing."
"I like order. I keep things tidy."
"I see that rules are observed."
"I do things efficiently. I get things done quickly."
"I carry out my plans and finish what I start."
"I am not easily distracted."
.
Rigid Perfectionism
.
"Even though it drives other people crazy, I insist on absolute perfection in everything I do."
"I simply won't put up with things being out of their proper places."
"People complain about my need to have everything all arranged."
"People tell me that I focus too much on minor details."
"I have a strict way of doing things."
"I postpone decisions."
.
DISINHIBITION
.
Description: Disinhibition is synonymous with being distractible, impulsive and disorganized.
Descriptors: Distractible, impulsive, irresponsible, disorganised, unreliable, careless, forgetful
Language Characteristics: Few positive emotion words, many negative emotion words, less perspective, less careful, more vague, informal, many negations, many swear words, many references to friends (e.g. pal, buddy), many disfluencies or filler words, few insight words, impulsive.
.
* Irresponsibility:
"I've skipped town to avoid responsibilities."
"I just skip appointments or meetings if I'm not in the mood."
"I'm often pretty careless with my own and others' things."
"Others see me as irresponsible."
"I make promises that I don't really intend to keep."
"I often forget to pay my bills."
.
* Impulsivity [During "Highs"]:
"I usually do things on impulse without thinking about what might happen as a result."
"Even though I know better, I can't stop making rash decisions."
"I feel like I act totally on impulse."
"I'm not good at planning ahead."
.
* Distractibility:
"I can't focus on things for very long."
"I am easily distracted."
"I have trouble pursuing specific goals even for short periods of time."
"I can't achieve goals because other things capture my attention."
"I often make mistakes because I don't pay close attention."
"I waste my time ."
"I find it difficult to get down to work."
"I mess things up."
"I don't put my mind on the task at hand."
.
* Reckless Risk Taking [During "Highs"]:
"I like to take risks."
"I have no limits when it comes to doing dangerous things."
"People would describe me as reckless."
"I don't think about getting hurt when I'm doing things that might be dangerous."
.
* Hyperactivity:
"I move excessively (e.g., can't sit still; restless; always on the go)."
"I'm starting lots more projects than usual or doing more risky things than usual."
.
* Over-Talkativeness:
"I talk excessively (e.g., I butt into conversations; I complete people's sentences)."
"Often I talk constantly and cannot be interrupted."
.
* Elation [During "Highs"]:
"I feel very happy or exhilarated."
"I'm feeling a rush of good feelings."
.
("Conscientiousness vs. Disinhibition" modified from "PID-5" by Kreuger RF, Derringer J, Markon KE, Watson D, Skodol AE and Between facets and domains: 10 aspects of the Big Five)
*MRI Research: Testing predictions from personality neuroscience. Brain structure and the big five.



Treatment Goals for Individuals With Negative Emotion

EMOTIONAL STABILITY VS. NEGATIVE EMOTION
.
EMOTIONAL STABILITY
.
Description: Emotional Stability is synonymous with being calm and emotionally stable. The Emotional Stability dimension measures the behaviors that are central to the concept of COURAGE - having calm composure and endurance when confronting adversity. High emotional stability is associated with better: longevity, leadership, job [team] performance, and marital success. (This dimension appears to measure the behaviors that differentiate safety from danger.)
Descriptors: Calm, even-tempered, peaceful, confident
Language Characteristics: Pleasure talk, agreement, compliment, low verbal productivity, few repetitions, neutral content, calm, few self-references, many short silent pauses, few long silent pauses, many tentative words, few aquiescence, little exaggeration, less frustration, low concreteness.
"I am relaxed, and I handle stress well."
"I am emotionally stable, and not easily upset."
"I remain calm in tense situations."
"I rarely get irritated."
"I keep my emotions under control."
"I rarely lose my composure."
"I am not easily annoyed."
"I seldom feel blue."
"I feel comfortable with myself."
"I rarely feel depressed."
"I am not embarrassed easily."
.
NEGATIVE EMOTION
.
Description: Degree to which people experience persistent anxiety or depression and are easily upset. (This could be thought of as high threat sensitivity or low stress tolerance.)
Descriptors: Emotionally unstable, anxious, separation-insecure, depressed, self-conscious, oversensitive, vulnerable.
Language Characteristics: Problem talk, dissatisfaction, high verbal productivity, many repetitions, polarised content, stressed, many self-references, few short silent pauses, many long silent pauses, few tentative words, more aquiescence, many self references, exaggeration, frustration, high concreteness.
Research: Lower scores on Emotional Stability are associated with unhappiness, dysfunctional relationships, and mental health problems. *MRI research found that Low Emotional Stability (= Negative Emotion or Neuroticism) was associated with increased volume of brain regions associated with threat, punishment, and negative emotions.
.
* Emotional Instability:
"I get emotional easily, often for very little reason."
"I get emotional over every little thing."
"My emotions are unpredictable."
"I never know where my emotions will go from moment to moment."
"I am a highly emotional person."
"I have much stronger emotional reactions than almost everyone else."
"My emotions sometimes change for no good reason."
"I get angry easily."
"I get upset easily."
"I change my mood a lot."
"I am a person whose moods go up and down easily."
"I get easily agitated."
"I can be stirred up easily."
.
* Anxiety:
"I worry about almost everything."
"I'm always fearful or on edge about bad things that might happen."
"I always expect the worst to happen."
"I am a very anxious person."
"I get very nervous when I think about the future."
"I often worry that something bad will happen due to mistakes I made in the past."
"I am filled with doubts about things."
"I feel threatened easily."
"I am afraid of many things."
.
* Separation Insecurity:
"I fear being alone in life more than anything else."
"I can't stand being left alone, even for a few hours."
"I’d rather be in a bad relationship than be alone."
"I'll do just about anything to keep someone from abandoning me."
"I dread being without someone to love me."
.
* Submissiveness:
"I usually do what others think I should do."
"I do what other people tell me to do."
"I change what I do depending on what others want."
.
* Perseveration:
"I get stuck on one way of doing things, even when it's clear it won't work."
"I get stuck on things a lot."
"It is hard for me to shift from one activity to another."
"I get fixated on certain things and can’t stop."
"I feel compelled to go on with things even when it makes little sense to do so."
"I keep approaching things the same way, even when it isn’t working."
.
* Depressed Mood [During Lows]:
"I have no worth as a person."
"Everything seems pointless to me."
"I often feel like a failure."
"The world would be better off if I were dead."
"The future looks really hopeless to me."
"I often feel just miserable."
"I'm very dissatisfied with myself."
"I often feel like nothing I do really matters."
"I know I'll commit suicide sooner or later."
"I talk about suicide a lot."
"I feel guilty much of the time."
"I'm so ashamed by how I've let people down in lots of little ways."
"I am easily discouraged."
"I become overwhelmed by events."
.
("Emotional Stability vs. Negative Emotion" modified from "PID-5" by Kreuger RF, Derringer J, Markon KE, Watson D, Skodol AE and Between facets and domains: 10 aspects of the Big Five)
*MRI Research: Testing predictions from personality neuroscience. Brain structure and the big five.




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Internet Mental Health © 1995-2018 Phillip W. Long, M.D.