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Examining the Inner Experience of Individuals with Bipolar Disorder UNLV Theses, Dissertations, Professional Papers, and Capstones December 2015 Examining the Inner Experience of Individuals with Bipolar Disorder Johanah Yoosun Kang University of Nevada, Las Vegas Follow this and additional works at: https://digitalscholarship.unlv.edu/thesesdissertations Part of the Clinical Psychology Commons Repository Citation Kang, Johanah Yoosun, "Examining the Inner Experience of Individuals with Bipolar Disorder" (2015). UNLV Theses, Dissertations, Professional Papers, and Capstones. 2546. http://dx.doi.org/10.34917/8220116 This Dissertation is protected by copyright and/or related rights. It has been brought to you by Digital Scholarship@UNLV with permission from the rights-holder(s). You are free to use this Dissertation in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s) directly, unless additional rights are indicated by a Creative Commons license in the record and/or on the work itself. This Dissertation has been accepted for inclusion in UNLV Theses, Dissertations, Professional Papers, and Capstones by an authorized administrator of Digital Scholarship@UNLV. For more information, please contact [email protected]. EXAMINING THE INNER EXPERIENCE OF INDIVIDUALS WITH BIPOLAR DISORDER By Johanah Yoosun Kang Bachelor of Arts – Psychology University of Nevada, Las Vegas 2008 Master of Arts – Psychology University of Nevada, Las Vegas 2013 A doctoral dissertation submitted in partial fulfillment of the requirements for the Doctor of Philosophy – Psychology Department of Psychology College of Liberal Arts The Graduate College University of Nevada, Las Vegas December 2015 ! Dissertation Approval The Graduate College The University of Nevada, Las Vegas November 9, 2015 This dissertation prepared by Johanah Yoosun Kang entitled Examining the Inner Experience of Individuals with Bipolar Disorder is approved in partial fulfillment of the requirements for the degree of Doctor of Philosophy - Psychology Department of Psychology Christopher Heavey, Ph.D. Kathryn Hausbeck Korgan, Ph.D. Examination Committee Chair Graduate College Interim Dean Russel T. Hurlbert, Ph.D. Examination Committee Member Daniel N. Allen, Ph.D. Examination Committee Member Jennifer R. Keene, Ph.D. Graduate College Faculty Representative ii ABSTRACT Bipolar disorder (BD) is a serious, chronic mood disorder. The diagnostic criteria for BD provide a description of expected experiences of individuals with BD (e.g., sadness, expansive mood, inflated self-esteem, anhedonia). Despite these criteria, the details of inner experience of individuals with BD are generally unknown. Understanding the inner experience of individuals with BD may provide greater understanding of the lived experience of BD and may provide insights into treating BD. The present study examined the inner experience of six individuals with BD using Descriptive Experience Sampling (DES), a method aimed at apprehending high- fidelity accounts of momentary inner experience. Results revealed that our participants varied in their ability to have clear inner experience, but they had clear experiences of sensory awareness and/or inner seeing. They had a high frequency of no clear inner experience or inner experience that was unclear in some way in the moment. They also had a low frequency of the coherent experience of feelings. Lastly, four participants experienced noteworthy perceptual experiences at a higher than average frequency as compared to the inner experience of individuals without a psychiatric diagnosis. This study highlights the importance of increasing efforts to explore the inner experience of individuals diagnosed with BD and/or other mental illnesses, and the utility of the DES method for investigating these individuals’ inner experience. iii ! ACKNOWLEDGMENTS It is with great enthusiasm that I thank those who made this dissertation possible. First, to the six individuals who participated in sampling for this project: Thank you for your courage and willingness to share the personal moments of your inner experience with us. I am enormously grateful to Dr. Chris Heavey for his mentorship throughout this study, and for inspiring me to pursue my doctorate in clinical psychology. Thank you to Dr. Russ Hurlburt for your guidance throughout this study as well as throughout my time as a member of the DES lab. Thanks to my committee members for your thoughtful feedback and expressing your interest in DES studies. I am grateful to Dr. Sharon Jones-Forrester for being my warmest and enthusiastic supporter throughout my clinical training. Thank you to my family and friends for your endless words and acts of encouragement that have helped me along this journey of earning my degree. Lastly, I give special thanks to Eric for being my most loving supporter. ! iv TABLE OF CONTENTS ABSTRACT ................................................................................................................................... iii ACKNOWLEDGMENTS ............................................................................................................. iv CHAPTER 1 INTRODUCTION ...................................................................................................1 CHAPTER 2 DEFINITIONS OF BIPOLAR DISORDER ...........................................................5 History of Bipolar Disorder .............................................................................................................5 Current Diagnostic Features ............................................................................................................6 Assessment .......................................................................................................................................7 CHAPTER 3 NATURE OF BIPOLAR DISORDER ..................................................................10 Epidemiology .................................................................................................................................10 Natural History and Course ...........................................................................................................12 Etiology ..........................................................................................................................................14 Comorbidity ...................................................................................................................................15 CHAPTER 4 CONSEQUENCES OF BIPOLAR DISORDER ..................................................17 Impairments in Social Relationships .............................................................................................17 Occupational Impairment ...............................................................................................................19 Cognitive Impairment ....................................................................................................................20 Lack of Insight ...............................................................................................................................20 Impulsivity .....................................................................................................................................21 Sleep Disturbance ..........................................................................................................................21 CHAPTER 5 METHODS OF STUDYING THE EXPERIENCE OF BIPOLAR DISORDER. 23 First-Person Accounts ....................................................................................................................23 Interviews .......................................................................................................................................24 Experience Sampling Methods ......................................................................................................27 Diary Methods ...............................................................................................................................32 Descriptive Experience Sampling (DES) .......................................................................................34 The Present Study ..........................................................................................................................42 CHAPTER 6 METHOD ..............................................................................................................44 Participants .....................................................................................................................................44 Apparatus .......................................................................................................................................44 Procedure .......................................................................................................................................45 Analysis of Data .............................................................................................................................48 CHAPTER 7 IDIOGRAPHIC DESCRIPTION OF JOSH’S EXPERIENCES ..........................51 Josh’s Sampling Experience ..........................................................................................................53 Sensory Awareness ........................................................................................................................54 Inner Seeing ...................................................................................................................................58
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