Development of Behavioural Activation for Bipolar Depression: Evidence synthesis, initial acceptability, and process modelling

I will present the plan of work for my PhD thesis, which seeks to contribute towards the development of a behavioural treatment for Bipolar Depression. The first three studies aim to synthesise the evidence for Psychological therapies for Bipolar Depression, study four examines potential mechanism of a behavioural treatment as well as patient reported acceptability and feasibility, and study five tests a key tenet of the theory quantitatively in an analogue sample. There are psychological treatments for bipolar depression but not all meta-analyses have concluded they are effective. This may be due a failure of some meta-analyses to take into account patient depression status and therapy focus when drawing conclusions about depression outcomes specifically. The aim of the first three studies is to test this by conducting a systematic review of meta-analyses, and by conducting a classic and an individual patient level meta-analysis in such a way as to answer questions about depression outcomes specifically. It is well documented that Behavioural Activation (BA) is effective psychological treatment for Unipolar depression. In terms of bipolar depression, BA has gained some research attention but has not been systematically investigated in the U.K. A case series of Behavioural activation adapted to Bipolar depression has been conducted by my supervisor and qualitative data from the participants will be used to explore acceptability, feasibility and potential mechanism of action. In my final study, a key hypothesis about the link between mood and behaviour in people who are at risk of bipolar disorder will be tested: namely that in people at higher risk of Bipolar Disorder the link between intention (behavioural plans) and behaviour will be more susceptible to disruption by extreme mood.