They represent the “high” phase of bipolar disorder, during which people experience heightened and often disorganized goal-directed behavior, risk-taking, impulsivity, and euphoria intermixed with tension or anger outbursts.
While full-blown manic episodes involve severe impairment, hypomania refers to attenuated manic symptoms that do not significantly debilitate functioning.
Key Points
Rationale
To understand the mechanisms underlying manic mood states, research during active manic states is needed. However, inducing clinical mania ethically is not feasible.
A viable alternative is experimentally inducing manic-like moods in nonclinical groups to study psychological traits associated with BD (Vannucci et al., 2022).
However, previous mood induction methods show inconsistent effectiveness partially due to only inducing singular mood aspects, rather than the multidimensional nature of mania encompassing both pleasant (euphoric) and unpleasant (tense) affective features (Benazzi & Akiskal, 2003).
This study tested a new virtual reality paradigm targeting dual excitation of excitement and tension to approximate hypomanic states.
Method
This pilot studymeasured emotional reactivity in students to either a neutral or hypomania-activating VR environment.
The VR mood induction task was designed to elicit excitement, goal-directedness, and tension using immersive simulated scenarios.
Participants self-reported levels of various emotions, including excitement, happiness, irritation, and tension, before and after the 15-minute VR induction.
Changes in these affective states served to index emotional reactivity.
Additionally, all participants completed a standardized behavioral risk-taking task called the Balloon Analogue Risk Task (BART), modeled after real-world risky behavior.
Risk-taking propensity is operationalized as average number of pumps on balloons that did not explode. The BART aimed to assess whether changes in mood states translated to measurable increases in actual risky orreward-driven behavior.
Sample
The sample comprised 65 university students without bipolar diagnoses. Trait hypomania risk was measured using the Hypomanic Personality Scale (HPS).
Statistical Analysis
Emotional reactivity was analyzed using 2 (condition: neutral, activating) x 2 (time: pre, post) x 2 (HPS group: high, low) ANOVAs. BART risk-taking was analyzed using condition x HPSANOVAs.
Results
Emotional Reactivity:
Risk-Taking Behavior:
Insight
This study demonstrates an effective method of inducing relevant emotional features resembling hypomanic states using immersive VR technology.
The attenuated excitement response seen in the high HPS group aligns with theories that mania-prone individuals have a blunted hedonic capacity.
The tensions induction also replicates the dual affective nature of mania.
The paradigm provides a moreecologically validand ethically acceptable means of studying BD mood instability than pharmacological provocations or clinical inductions.
Strengths
Limitations
Implications
This proof-of-concept study demonstrates the utility of immersive VR environments for studying psychological mechanisms involved in bipolar mood dysregulation.
The mood induction effectively approximated key emotional features of hypomania. Individual differences in reactivity suggest stable trait-based mood sensitivity patterns.
The findings support reward hypersensitivity models of BD.
Further research should replicate this study in bipolar samples to establish clinical relevance.
Clinically, the paradigm could aid the development of novel psychological interventions targeting mania escalation.
References
Primary reference
Glas, R. V., de Kleijn, R. E., Regeer, E. J., Kupka, R. W., & Koenders, M. A. (2023). Do you feel up when you go up? A pilot study of a virtual reality manic‐like mood induction paradigm.British journal of clinical psychology.https://doi.org/10.1111/bjc.12445
Other references
Benazzi, F., & Akiskal, H. S. (2003). The dual factor structure of self-rated MDQ hypomania: energized-activity versus irritable-thought racing.Journal of Affective Disorders,73(1-2), 59-64.
Carpenter, R. W., Stanton, K., Emery, N. N., & Zimmerman, M. (2020). Positive and Negative Activation in the Mood Disorder Questionnaire: Associations with psychopathology and emotion dysregulation in a clinical sample.Assessment,27(2), 219-231.https://doi.org/10.1177/1073191119851574
Kessler, R. C., Berglund, P., Demler, O., Jin, R., Koretz, D., Merikangas, K. R., … & Wang, P. S. (2003). The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R).Jama,289(23), 3095-3105.https://doi.org/10.1001/jama.289.23.3095
Vannucci, C., Bonsall, M. B., Di Simplicio, M., Cairns, A., Holmes, E. A., & Burnett Heyes, S. (2022). Positive moods are all alike? Differential affect amplification effects of ‘elated’versus ‘calm’mental imagery in young adults reporting hypomanic-like experiences.Translational psychiatry,12(1), 453.https://doi.org/10.1038/s41398-022-02213-4
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Saul McLeod, PhD
BSc (Hons) Psychology, MRes, PhD, University of Manchester
Saul McLeod, PhD., is a qualified psychology teacher with over 18 years of experience in further and higher education. He has been published in peer-reviewed journals, including the Journal of Clinical Psychology.
Olivia Guy-Evans, MSc
BSc (Hons) Psychology, MSc Psychology of Education
Olivia Guy-Evans is a writer and associate editor for Simply Psychology. She has previously worked in healthcare and educational sectors.
