The Effectiveness of Behavioral Activation on Affective Lability and Bipolar Symptoms
Downloads
Objective: This study aimed to evaluate the effectiveness of behavioral activation in reducing affective lability and bipolar symptoms in individuals diagnosed with bipolar disorder.
Methods and Materials: This study utilized a randomized controlled trial design with 30 participants diagnosed with bipolar disorder, recruited from mental health clinics in Tehran. Participants were randomly assigned to either an intervention group receiving eight sessions of behavioral activation or a control group receiving no psychological intervention. Both groups continued their routine pharmacological treatments. The Affective Lability Scale (ALS) and Mood Disorder Questionnaire (MDQ) were administered at three time points: pre-test, post-test, and five-month follow-up. Data were analyzed using repeated measures ANOVA to assess the main effects of the intervention over time, and Bonferroni post-hoc comparisons were used to examine specific group differences.
Findings: The results indicated a significant reduction in affective lability and bipolar symptoms in the intervention group over time compared to the control group. The repeated measures ANOVA revealed significant main effects for group (F(1,54) = 20.45, p = 0.001, η² = 0.28) and time (F(2,54) = 18.67, p = 0.001, η² = 0.26) for affective lability, as well as for bipolar symptoms (F(1,54) = 16.58, p = 0.002, η² = 0.24). Bonferroni post-hoc comparisons confirmed that improvements in the intervention group were significant between pre-test and post-test (p = 0.001) and sustained at follow-up (p = 0.001). The control group showed no significant changes over time.
Conclusion: These findings support the effectiveness of behavioral activation in reducing affective lability and bipolar symptoms, with sustained benefits at follow-up. Given its impact on emotional regulation, behavioral activation may serve as a valuable adjunctive treatment for individuals with bipolar disorder.
Downloads
Abedin, M., Barghi Irani, Z., & Akbari, H. (2023). Comparison of the effecacy of compassion-based therapy and behavioral activation therapy on perceived stress and self-efficacy in women with breast cancer. Journal of Psychological Science, 22(122), 409-422. https://psychologicalscience.ir/browse.php?a_id=1845&sid=1&slc_lang=en&ftxt=1
Anestis, M. D., Selby, E. A., Crosby, R. D., Wonderlich, S. A., Engel, S. G., & Joiner, T. E. (2010). A comparison of retrospective self-report versus ecological momentary assessment measures of affective lability in the examination of its relationship with bulimic symptomatology. Behaviour Research and Therapy, 48(7), 607-613.
Arab Vornusfaderani, M., Fatehi Zadeh, M., Bahrami, F., Jazayeri, R. a.-S., & Ebrahimi, A. (2017). Effectiveness of Acceptance and Commitment-Based Couple Therapy on Marital Adjustment in Men with Bipolar Disorder Type 2. Journal of Behavioral Sciences Research, 15(3), 261-276. https://rbs.mui.ac.ir/article-1-541-fa.html
Asvadi Ghoshe Gonbadi, J., Bakhshipour, A., & Akbari Amarghan, H. (2023). Comparison of the Effectiveness of Mindfulness-Based Cognitive Therapy and Behavioral Activation Therapy on Cognitive Avoidance and Emotion Regulation in People with Generalized Anxiety Disorder. Journal of Sabzevar University of Medical Sciences, 30(4), 428-441. https://doi.org/10.30468/jsums.2023.1575
Bibi, H., Naz, S., & Afsar, F. K. (2022). Impact Of Mindfulness On Intolerance Of Uncertainty And Affective Lability Among Individuals With Histrionic Personality Features. Pakistan Journal of Social Research, 4(2), 295-305. https://pjsr.com.pk/wp-content/uploads/2022/05/30.-Vol-4.-Issue-2-Apr-Jun-2022-Bibi-Naz-Afsar-Impact-of-Mindfulness-on-Intolerance-of-Uncertainty.pdf
Burr, E. K., Dvorak, R. D., Stevenson, B. L., Schaefer, L. M., & Wonderlich, S. A. (2021). Ability to tolerate distress moderates the indirect relationship between emotion regulation difficulties and loss-of-control over eating via affective lability. Eating behaviors, 43, 101561. https://doi.org/10.1016/j.eatbeh.2021.101561
Çınaroğlu, M. (2024). Psychotherapies for the Treatment of Bipolar Disorder. Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry, 16(2), 373-382. https://doi.org/10.18863/pgy.1332919
Clayton, D., & Burlingame, G. M. (2024). Evidence-Based Group Therapy for Mood Disorders: Treatment for Depression and Bipolar Disorders. Group Dynamics Theory Research and Practice, 28(3), 132-147. https://doi.org/10.1037/gdn0000218
Cochran, A. L., Maronge, J. M., Victory, A., Hoel, S., McInnis, M. G., & Thomas, E. B. (2023). Mobile Acceptance and Commitment Therapy in Bipolar Disorder: Microrandomized Trial. Jmir Mental Health, 10, e43164. https://doi.org/10.2196/43164
Conklin, D., & Gao, K. (2015). Mindfulness-Based Cognitive Therapy for Bipolar Disorder. Journal of Psychiatric Practice, 21(6), 484-486. https://doi.org/10.1097/pra.0000000000000115
Ebrahimi, F., Barghi irani, Z., & Ali Akbari, M. (2023). Comparison of Cognitive-Behavioral Therapy and Acceptance and Commitment Therapy in Reducing Mood Swings, Sleep Quality and Sexual Performance in Postmenopausal Women. Health Psychology, 11(44), 73-88. https://doi.org/10.30473/hpj.2023.59513.5289
El-Sayed, M. M. (2023). Efficacy of Acceptance and Commitment Therapy on Impulsivity and Suicidality Among Clients With Bipolar Disorders: A Randomized Control Trial. BMC Nursing, 22(1). https://doi.org/10.1186/s12912-023-01443-1
Fung, K. P.-L., Vahabi, M., Moosapoor, M., Akbarian, A., Jing-Wen Liu, J., & Wong, J. P.-H. (2021). Implementation of an Internet-Based Acceptance and Commitment Therapy for Promoting Mental Health Among Migrant Live-in Caregivers in Canada: Protocol [Protocol]. JMIR Res Protoc, 10(9), e31211. https://doi.org/10.2196/31211
Ghodrati Isfahani, Z., & Moradi, A. (2020). Effectiveness of Psychological Capital Training and Behavioral Activation Therapy on the Hope of Isfahan Gril Students in Dormetory. Woman in Development & Politics, 18(2), 293-312. https://doi.org/10.22059/jwdp.2020.296246.1007783
Ghorbanikhah, E., Mohammadyfar, M. A., Moradi, S., & Delavarpour, M. (2023). The Effectiveness of Acceptance-and-Commitment-Based Parenting Training on Mood and Anxiety in Children and Self-compassion in Parents. PCP, 11(1), 81-92. https://doi.org/10.32598/jpcp.11.1.860.1
Gladwyn-Khan, M., & Morris, R. (2023). The efficacy of therapist-supported acceptance and commitment therapy-based bibliotherapy for psychological distress after stroke: a single-case multiple-baseline study. Behavioural and Cognitive Psychotherapy, 51(1), 87-104. https://doi.org/10.1017/S135246582200042X
Golparvar, M., & Akbari, M. (2019). The Effectiveness of Integrative Acceptance Commitment-Cognitive Behavioral Therapy (ACT-CBT) and Parent Management Training (PMT) on the Affective Capital of Adolescent Boy with Sexual Abuse. Culture of Counseling Quarterly and Psychotherapy, 10(39), 71-98. https://doi.org/10.22054/qccpc.2019.41608.2133
Haghighat, S., & Mohammadi, A. (2018). Comparison of the Effectiveness of Cognitive Behavioral Therapy and Acceptance and Commitment Therapy on Reducing Mood Symptoms in Patients With Substance Abuse. International Clinical Neuroscience Journal, 5(4), 158-163. https://doi.org/10.15171/icnj.2018.28
Jamali, S., Najafi, M., Quraishi, F. S., & Rahimian, I. (2021). The Effectiveness of Acceptance and Commitment Therapy on Suicidal Thoughts and Psychological Flexibility in Patients with Bipolar Disorder. Psychological studies, 17(1), 7-22. https://psychstudies.alzahra.ac.ir/article_5625.html?lang=en
Kiaeian-Mousavi, F., Mafakheri, A., & Mohammadzadeh, A. (2022). Comparison of the effectiveness of cognitive-behavioral therapy with behavioral activation therapy on learned helplessness and cognitive emotion regulation in individuals with depressive symptoms. KAUMS, 26(2), 156-165. https://doi.org/10.48307/FMSJ.2022.26.2.156
Mahini, E. A., Hosseyni, S. A., Ebrahimkhani, M., Mohammadi, M., & Shokri, S. (2024). Bipolar Disorder and Its Factors. Advances in Social Sciences Research Journal, 11(9), 01-11. https://doi.org/10.14738/assrj.119.17524
O’Donoghue, E., & Kane, F. (2024). Acceptance and Commitment Therapy for Bipolar Disorder: The Balancing ACT Group. 387-411. https://doi.org/10.1007/978-3-031-63349-2_15
Rezapour, H., Bahramipour Isfahani, M., & Turkan, H. (2023). Comparing the Effectiveness of Behavioral Activation and Mode Deactivation Therapy on Antisocial Core Beliefs and Social Problem Solving in Adolescent Boys with High Social Anxiety. Social Psychology Research, 13(50), 77-92. https://doi.org/10.22034/spr.2023.391235.1826
Russell, T. (2024). Mindfulness-Based Therapies With Bipolar Disorder. 327-367. https://doi.org/10.1007/978-3-031-63349-2_13
Salehi, H., Sheykholeslami, A., & Taklavi, S. (2024). The effectiveness of behavioral activation training on sexual satisfaction and sexual assertiveness of women suffering from sexual problems. Journal of Research in Psychopathology, 5(15), 31-38. https://doi.org/10.22098/jrp.2023.13004.1179
Vacca, N. A. (2024). The Contribution of Tonic Inhibition to Cognitive Deficits in a Mouse Model of Bipolar Disease. URNCST Journal, 8(3), 1-8. https://doi.org/10.26685/urncst.557
Ying, J., & Parsakia, K. (2024). Behavioral Activation Therapy: Boosting Happiness and Creativity Among College Students. KMAN Counseling & Psychology Nexus, 2(2), 57-65. https://doi.org/10.61838/kman.psynexus.2.2.9
Simon BS, Budo MDLD, Garcia RP, Gomes TF, Oliveira SG, da Silva MM.(2013). Social support network to the caregiving family of an individual with a chronic disease: integrative review. J Nurs UFPE on line; 7(5): 4243-50.
Smith,SH.M., Sun,R., Gordon,M.(2019). Racial Discrimination and Psychological Distress among African American Adolescents: Investigating the Social Support Deterioration Model, Journal of Child and Family Studies,28(6), 1613-1622.
Szinovacz ME, Davey A.(2017). Caregiving contexts: Cultural, familial, and societal implications: Springer Publishing Company.
Watson1,R.J., Grossman,A.H., Russell,S.T.(2019). Sources of Social Support and Mental Health Among LGB Youth, Journal of Youth & Society 51(1) 30-48
Yaghoubi, H. (2015). Psychometric properties of the 10-item version of the Kessler Psychological Distress Scale. Journal of Applied Psychological Research, 4(6), 45-57.
Copyright (c) 2025 International Journal of Body, Mind and Culture
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
