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The immediate processing of schema discrepant meaning in Bipolar Disorder
Palmer, A. & BARNARD, P.
Bipolar Disorders, Supplement no 1, Vol 5, p73 Poster, 5th International Conference on Bipolar Disorders, June 2003
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The Interacting Cognitive Subsystems model (Teasdale & Barnard 1993) holds that executive processing involving two levels of meaning (propositional and schematic) leads to a state of ideational interlock in depression. This study applies the same theoretical framework to manic states, this time arguing that the processing of meaning is under controlled in mania and over-controlled in depression. It examines the specific hypothesis that meaning is preferentially processed in different ëmodesí during depressed and manic phases, with more attention being devoted to "propositional" meaning during depressed states and more to "schema-based" meaning during manic states. Patients with BD were assessed in a longitudinal design on two cognitive tasks and their performance compared to that of matched controls. One task measured sustained attention where demands to process meaning were minimal. The other involved answering questions about the content of simple statements. Test questions referenced a plausible inference based on natural schemas for everyday events and were designed to assess the extent to which discrepant meanings were actively being scrutinized. Patients with BD were less accurate than controls on sustained attention, in depressed, manic and euthymic states. On the question-answering task, the pattern of performance on filler questions indicated some impairment of sentence memory - but at equivalent levels in manic and depressed states. As predicted, patients with BD were more likely to detect discrepant meanings in the test questions when depressed than when manic. They were also more likely to answer questions consistent with a schema-based inference when manic than when depressed. Results are consistent with the idea that meaning may be processed in different modes during mania and depression. It is suggested that research on executive functions in BD might benefit from focussing more attention on tasks requiring semantic interpretation.