Self-efficacy in bipolar disorder: Development and validation of a self-report scale.

BACKGROUND: Successful management of bipolar disorder (BPD) typically involves individuals undertaking a complex array of self-management tasks (e.g., taking medication, monitoring symptoms, following a regular sleep routine). Many people with BPD doubt they can successfully undertake these tasks. This low sense of self-efficacy may lead to the perpetuation of BPD symptoms, poor quality of life, and low adherence to treatment. Research on self-efficacy in BPD has been hampered by the lack of a short, reliable and valid self-report scale that is practical to use in clinical and research settings. We sought to develop such a scale. METHODS: BPD patients (N = 303) completed a new battery of items measuring their self-efficacy for performing BPD self-management tasks. Modern psychometric techniques such as bifactor analyses were used to refine the scale, determine an appropriate scoring algorithm, and establish reliability and validity. RESULTS: The Bipolar Self-Efficacy Scale (BPSES) comprises 17 items. BPSES scores were reliable, sensitive to change, and correlated with theoretically related constructs such as social adjustment and positive affect. BPSES scores had substantially higher associations with depression and quality of life than an alternative instrument that measured self-efficacy in general, rather than self-efficacy specifically related to bipolar disorder self-management. LIMITATIONS: Patients were required to be medically managed while attending adjunctive psychological treatment of BPD. CONCLUSIONS: The BPSES is a brief scale that can be used to reliably and validly measure bipolar self-efficacy. It may be fruitful to use the scale in clinical practice, and studies investigating treatment outcomes, mechanisms, and moderators.

A qualitative approach to identifying psychosocial issues faced by bipolar patients.

Many studies have examined factors influencing or associated with the outcome of bipolar disorder. However, little is known about bipolar patients' subjective experiences of their illness and the issues that are of significance to them. The use of a client-focused approach in identifying these issues is important for planning treatment and clinical medical management to address patients' specific needs. Focus group discussions and individual interviews were conducted with 18 bipolar patients and transcribed verbatim. The data were then analyzed and interpreted according to the phenomenological approach to qualitative research. The data were interpreted in terms of how patients view themselves, their lives and community, and their future. Implications for treatment and future research are discussed.