(PS3-A3) The Effects of Symptom Impact and Reactions from Others on Assessment of “sunny” and “dark” Features of Hypomania

Introduction

DSM criteria defines hypomania as causing little to no impairment. However, hypomania has been found to negatively impact adaptive and social functioning. Furthermore, underreporting of hypomania and misdiagnosis of bipolar disorders can lead to delayed or inappropriate treatment and poorer functional outcomes. The Hypomania Checklist (HCL-32) is a screening tool developed to improve the detection of bipolar disorders in individuals with major depression. The current study aims to investigate how self-perceptions of symptom impact and perceived reactions from others are associated with risk of hypomania as indicated by scores on the active/elated (i.e., Sunny) and irritable/risk taking (i.e., Dark) factors of the HCL-32. 

Methods

De-identified responses on the HCL-32 were collected from 2018 through 2023 through an online screening center housed on the Depression and Bipolar Support Alliance website, in cooperation with Helping Give Away Psychological Science. Respondents included individuals ages 18-90 years old (N=13,844). ANOVA tested score differences on the Sunny and Dark factors of the HCL-32 across different ratings of impact (i.e., Positively, Negatively, Positively and negatively, and No impact) within four life domains (i.e., Family, Social, Work, and Leisure), and across different ratings of reactions from others (i.e., Positive, Negative, Positive and negative, Neutral, and No reaction). 

Results

Scores on the Sunny factor varied significantly across different ratings of impact within the Family (F = 296.7, η2 = .05, p < .001), Social (F = 1090, η2 = .16, p < .001), Work (F = 712, η2 = .11, p < .001), and Leisure (F = 653.1, η2 = .10, p < .001) life domains. Scores on the Sunny factor also varied significantly across different ratings of reactions from others (F = 340.7, η2 = .07, p < .001). Scores on the Dark factor varied significantly across different ratings of impact within the Family (F = 1282, η2 = 0.18, p< .001), Social (F = 868.8, η2 = 0.13, p< .001), Work (F = 800.7, η2 = 0.12, p< .001), and Leisure (F = 771.6, η2 = 0.12, p< .001) life domains. Scores on the Dark factor also varied significantly across different ratings of reactions from others (F = 1038, η2 = .19, p < .001). Differences in scores on the Sunny factor were most strongly linked with impacts on social life, whereas differences in scores on the Dark factor were most strongly related to  impacts on family life and perceived reactions from others. 

Conclusions

How individuals perceive the impact of “highs” on their life, and the perceived reactions that others have to these “highs,” shows moderate to strong association with endorsement of items on the Sunny and Dark factors of the HCL-32. Social impacts may be particularly bound up with “Sunny” features of hypomania, and family impacts and reactions from others may be particularly related to “Dark” features of hypomania. Although hypomania is associated with minimal impairment, these findings suggest that assessing the functional and social consequences of symptoms, particularly within family and social life, can provide valuable information when assessing hypomania.