Evaluating the emotion regulation of positive mood states among people with bipolar disorder using hierarchical clustering

doi:10.5498/wjp.v11.i9.619

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World Journal of Psychiatry

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Psychiatr. Sep 19, 2021; 11(9): 619-634
Published online Sep 19, 2021. doi: 10.5498/wjp.v11.i9.619

Table 1 Correlations of major variables

Variable	BAS_D	BAS_FS	BAS_RR	CTR	AA	DD	ISS_ACT	ISS_WB
BAS_D	1	0.29^b	0.41^b	-0.11	-0.05	0.13	0.01	0.02
BAS_FS		1	0.36^b	0.01	0.18	0.14	0.20	0.07
BAS_RR			1	0.06	0.33^b	0.30^b	0.24^a	0.34^b
CTR				1	0.42^b	0.28^b	0.04	0.30^b
AA					1	0.57^b	0.18	0.29^b
DD						1	0.06	-0.01
ISS_ACT							1	0.70^b
ISS_WB								1

^aP < 0.05.

^bP < 0.01.

AA: Behavioral-activation/emotion-amplifying coping; ACT: Activation; BAS: Behavioral approach system; CTR: Perceived controllability; D: Drive; DD: Behavioral-deactivation/emotion-diminishing coping; FS: Fun-seeking; ISS: Internal state scale; RR: Reward responsiveness; WB: Well-being.

Table 2 Descriptive statistics and comparison of major variables for the three clusters

	Cluster 1, n = 26		Cluster 2, n = 26		Cluster 3, n = 38
Variables	Goal achievers with a high mass of coping		Goal preservers with a high mass of coping		Goal achievers with a low mass of coping
	n	%	n	%	n	%	Statistics
Sociodemographic factors
Sex							χ² = 2.13 (P = 0.345)
Female	19	73.1	14	53.8	23	60.5
Male	7	26.9	12	46.2	15	39.5
Education level							χ² = 7.46 (P = 0.281)
Primary	8	30.8	4	15.4	9	23.7
Secondary	10	38.4	8	30.8	6	15.8
Tertiary	8	30.8	14	53.8	23	60.5
Marital status							χ² = 6.72 (P = 0.347)
Single	12	46.2	19	73.1	19	50.0
Married/cohabited	14	53.8	7	26.9	19	50.0
Living status							χ² = 0.345 (P = 0.987)
Living alone	6	23.0	5	19.3	7	18.4
Living with others	20	77.0	21	80.7	31	81.6
Working status							χ² = 18.8 (P = 0.171)
Unemployed	17	65.4	11	42.3	17	44.7
Employed	9	34.6	15	57.7	21	55.3
	M	SD	M	SD	M	SD	Statistics
Age	48.04	9.64	41.31	12.27	41.47	10.89	F = 3.378 (P = 0.039), 1 > 2, 1 > 3
Baseline affective symptoms
MHRSD	1.19	1.13	1.38	1.47	1.18	1.25	F = 0.217 (P = 0.805)
BRMS	0.50	1.03	0.38	0.80	0.18	0.56	F = 1.31 (P = 0.275)
BAS sensitivity level
BAS_D	12.85	1.62	11.62	1.68	12.79	1.76	F = 4.622 (P = 0.012) 1 > 2, 3 > 2
BAS_FS	12.19	2.43	11.42	2.47	11.13	2.70	F = 1.351 (P = 0.264)
BAS_RR	17.85	2.05	15.65	3.11	16.05	2.27	F = 5.924 (P = 0.004) 1 > 2, 1 > 3
Coping
CTR	2.80	0.74	2.5	0.64	1.68	0.66	F = 23.505 (P < 0.001) 1 > 3, 2 > 3
VCTR	2.70	2.41	1.88	1.10	2.90	2.30	F = 1.998 (P = 0.142)
AA	5.90	1.25	4.68	0.94	2.72	1.27	F = 58.999 (P < 0.001) 1 > 2, 1 > 3, 2 > 3
VAA	1.46	1.83	1.95	1.33	2.08	2.10	F = 0.919 (P = 0.403)
DD	4.28	0.88	2.19	0.61	1.72	0.99	F = 71.542 (P < 0.001) 1 > 2, 1 > 3, 2 > 3
VDD	1.23	0.92	0.94	0.79	0.74	0.62	F = 3.242 (P = 0.044)
Post-event mood states
ISS_ACT	226.15	99.08	162.31	111.94	182.89	116.90	F = 2.281 (P = 0.108)
ISS_WB	194.62	65.38	139.62	79.22	156.84	77.50	F = 3.728 (P = 0.028)

AA: Behavioral-activation/emotion-amplifying coping; ACT: Activation; BAS: Behavioral approach system; BRMS: Bech-rafaelsen mania scale; CTR: Perceived controllability; D: Drive; DD: Behavioral-deactivation/emotion-diminishing coping; FS: Fun-seeking; ISS: Internal state scale; MHRSD: Modified Hamilton Rating Scale for Depression; RR: Reward responsiveness; VAA: Variance of behavioral-activation/emotion-amplifying coping; VCTR: Variance of perceived controllability; VDD: Variance of behavioral-deactivation/emotion-diminishing coping; WB: Well-being.

Table 3 Mediating effect of behavioral-activation/emotion-amplifying coping between behavioral approach system sensitivity level and mood states (with dependent variable as internal state scale_well-being)

Variables	B	*SE B*	β
Step 1
Outcome: ISS_WB
Predictor: BAS_RR	9.841	2.953	0.335^b
Step 2
Outcome: AA
Predictor: BAS_RR	0.244	0.074	0.332^b
Step 3
Outcome: ISS_WB
Mediator: AA	8.054	4.186	0.202^a
Predictor: BAS_RR	7.873	3.084	0.268^b

^aP < 0.05.

^bP < 0.01.

AA: Behavioral-activation/emotion-amplifying coping; BAS: Behavioral approach system; ISS: Internal state scale; RR: Reward responsiveness; WB: Well-being.

Table 4 Moderating effect of coping between behavioral approach system sensitivity level and mood states (with dependent variable as internal state scale_well-being)

Variables	B	*SE B*	β	R²	R² change	F change
Moderator: AA coping
Block 2				0.137	0.069	3.405^a
BAS_D	-0.236	7.417	-0.003
AA	15.417	7.861	0.200
Block 3				0.234	0.097	10.609^b
BAS_D × AA	24.777	7.607	0.323^b
Moderator: CTR
Block 2				0.153	0.085	4.256^a
BAS_D	1.107	7.552	0.014
CTR	18.150	7.757	0.236^a
Block 3				0.214	0.061	6.570^a
BAS_D × CTR	16.691	6.512	0.258^a
Moderator: VCTR
Block 2				0.086	0.019	0.864
BAS_FS	7.192	8.021	0.093
VCTR	8.918	7.934	0.116
Block 3				0.142	0.056	5.437^a
BAS_FS × VCTR	-15.334	6.576	-0.239^a

^aP < 0.05.

^bP < 0.01.

AA: Behavioral-activation/emotion-amplifying coping; BAS: Behavioral approach system; CTR: Perceived controllability; D: Drive; FS: Fun-seeking; ISS: Internal state scale; VCTR: Variance of perceived controllability; WB: Well-being.

Citation: Chan SHW, Yu CH, Liu KHK, Lau C, Fung AOY, Tse S. Evaluating the emotion regulation of positive mood states among people with bipolar disorder using hierarchical clustering. World J Psychiatr 2021; 11(9): 619-634
URL: https://www.wjgnet.com/2220-3206/full/v11/i9/619.htm
DOI: https://dx.doi.org/10.5498/wjp.v11.i9.619