Positive Affect Regulation and Depressive Symptoms in Hospitalized Patients with Bipolar Disorder

Bipolar disorder (BD) is characterized by alternating mood episodes, with individuals often experiencing heightened positive emotions. This study investigated strategies for regulating positive emotions—amplification and dampening—and their association with depressive symptoms and childhood trauma.

This longitudinal case-control study included 49 hospitalized BD patients (73% BD-I) and 24 matched healthy controls (HCs). At baseline, participants completed the Responses to Positive Affect questionnaire and the Childhood Trauma Questionnaire - Short Form, with mood assessments every two weeks. Group differences and interrelations were analyzed using t-tests, ANCOVAs, and Pearson correlations. Linear mixed models examined the longitudinal impact of positive affect regulation on depressive symptoms.

BD patients showed significantly higher dampening than HCs, while positive rumination strategies were similar between groups. Dampening correlated with more exposure to childhood trauma, particularly emotional abuse, but did not predict changes in depressive symptoms during hospitalization. Emotion-focused positive rumination was inversely related to depressive symptoms but had no longitudinal effect.

Hospitalized BD patients used more dampening than HCs, which is linked to more childhood trauma exposure. Positive rumination strategies were comparable and showed limited impact on depressive symptoms. Further research is needed to clarify the clinical role of these affect regulation strategies in BD management.