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This paper aimed to explore the presence of DA in BD in comparison to clinical and non\u2010clinical groups. Also explored were the associations between DA and mood states of depression, mania or euthymia in BD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic review and meta\u2010analysis were conducted. A total of 47 articles were included in the systematic review of which 23 were included in the meta\u2010analysis. The quality of each study was rated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The meta\u2010analysis showed significantly higher DA in BD than healthy controls (\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u2009.70). However, no difference was observed between BD and unipolar participants (\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u2009\u2212.16). When reviewing mood state within BD, a significant mean difference was found between DA scores for euthymic and depressed participants (\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u2009\u2212.71), with those who were depressed scoring higher. Three studies found that psychological therapies significantly reduce DA in BD (d\u2009= \u2212.38).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These findings imply not only that DA are both a characteristic of BD that is not as prevalent in healthy populations but also that a depressed mood state is associated with increased severity. This implies that DA could possibly go \u2018offline\u2019 when mood symptoms are not present. Psychological therapies appear to reduce DA in BD. Implications for future research as well as practice\u2010based implications are expanded on in the discussion.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bjc.12442","type":"journal-article","created":{"date-parts":[[2023,10,11]],"date-time":"2023-10-11T19:48:48Z","timestamp":1697053728000},"page":"16-53","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Are dysfunctional attitudes elevated and linked to mood in bipolar disorder? 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