Metabolic Brain Disease

, Volume 29, Issue 2, pp 367–375 | Cite as

Mindfulness based cognitive therapy may improve emotional processing in bipolar disorder: pilot ERP and HRV study

  • Fleur M. HowellsEmail author
  • H. G. Laurie Rauch
  • Victoria L. Ives-Deliperi
  • Neil R. Horn
  • Dan J. Stein
Original Paper


Emotional processing in bipolar disorder (BD) is impaired. We aimed to measure the effects of mindfulness based cognitive-behavioral therapy (MBCT) in BD on emotional processing, as measured by event related potentials (ERP) and by heart rate variability (HRV). ERP and HRV were recorded during the completion of a visual matching task, which included object matching, affect matching, and affect labeling. Individuals with BD (n = 12) were compared with controls (n = 9) to obtain baseline data prior to the individuals with BD undergoing an 8-week MBCT intervention. ERP and HRV recording was repeated after the MBCT intervention in BD. Participants with BD had exaggerated ERP N170 amplitude and increased HRV HF peak compared to controls, particularly during the affect matching condition. After an 8-week MBCT intervention, participants with BD showed attenuation of ERP N170 amplitude and reduced HRV HF peak. Our findings support findings from the literature emphasizing that emotional processing in BD is altered, and suggesting that MBCT may improve emotional processing in BD.


Matching task Electroencephalography Heart rate variability Event-related potentials N170 amplitude High frequency peak Face matching 



Bipolar disorder


Mindfulness based cognitive therapy




Heart rate variance


Event related potential


High frequency



The authors wish to thank the International Society of Affective Disorders (ISAN) for funding the present project (PIs VI-D and NRH). FMH wishes to thank the Brain and Behavior Initiative, the Research Committee of the University of Cape Town and the National Research Foundation Innovation postdoctoral fellowships during the time in which this project was conducted. The authors are also grateful to the Department of Human Genetics, and Professor Rajkumar Ramesar, for access to their research cohort, and Sister Gameda Benefeld for her time and clinical diagnoses of participants; Dr Matthew Watkins, clinical psychologist, for implementing the MBCT intervention in the present study; Ms Candice Kotze, research assistant, for her great efforts in the logistical organization and during the data collection period of the present study; and Dr Leesha Singh, psychiatrist, for her time in verifying participants’ psychiatric diagnoses. In addition, we would like to thank the research participants for their time and effort as part of this pilot study of MBCT in BD.

Competing interests

Authors declare that there are no conflicts of interest related to the present paper.


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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Fleur M. Howells
    • 1
    • 3
    Email author
  • H. G. Laurie Rauch
    • 2
  • Victoria L. Ives-Deliperi
    • 2
  • Neil R. Horn
    • 1
  • Dan J. Stein
    • 1
  1. 1.Department of Psychiatry, Faculty of Health SciencesUniversity of Cape TownObservatorySouth Africa
  2. 2.Department of Human Biology, Faculty of Health SciencesUniversity of Cape TownObservatorySouth Africa
  3. 3.Department of PsychiatryUniversity of Cape TownObservatorySouth Africa

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