Interactional patterns of bipolar patients and their spouses

  • Dennis L. McKnight
  • Rosemery O. Nelson-Gray
  • Eugenia Gullick


This study examined the interactional patterns of eight bipolar patients (when manic and in remission) and their spouses by videotaping the couples' interactions and then quantifying those interactions using the Marital Interaction Coding system. These couples' interactions were compared to the interactions of eight happily and eight unhappily married nonbipolar psychiatric control patients and their spouses. The purposes were to determine (a) whether the interactional pattern between bipolar patients and their spouses changes or remains the same when the patient is in a manic vs. a nonmanic state and (b) how the interaction patterns of bipolar patients when manic and nonmanic compare to happily and unhappily married nonbipolar psychiatriccontrol patients. Significant differences in interactions were found between manic and nonmanic states, in addition to significant differences between these patients and the control groups. There were also expected differences between happily and unhappily married psychiatric control groups. Implications are discussed for marital therapy for manies that involves problemsolving and communication training.

Key words

bipolar affective disorder marital interactions marital therapy 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Ablon, S. L., Davenport, Y. B. Gershon, E. S., & Adland, M. L. (1975). The married manic.American Journal of Orthopsychiatry, 45, 854–866.Google Scholar
  2. American Psychiatric Association (1980).Diagnostic and statistical manual of mental disorders (3rd ed.). Washington, DC: APA.Google Scholar
  3. American Psychiatric Association (1987).Diagnostic and statistical manual of mental disorders (3rd ed.-revised). Washington, DC: APA.Google Scholar
  4. Azrin, N. H., Naster, B. J., & Jones, R. (1973). Reciprocity counseling: A rapid learning-based procedure for marital counseling.Behaviour Research and Therapy, 11, 365–382.Google Scholar
  5. Beigel, A., Murphy, P. L., & Bunney, W. E. (1971). The manic-state rating scale.Archives of General Psychiatry, 25, 256–262.Google Scholar
  6. Birchler, G. R., & Webb, L. J. (1977). Discriminating interaction behaviors in happy and unhappy marriages.Journal of Consulting and Clinical Psychology, 45, 494–495.Google Scholar
  7. Coppen, A., Metcalfe, M., & Wood, K. (1982). Lithium. In E. S. Paykel (Ed.),Handbook of affective disorders (pp. 276–285). New York: Guilford.Google Scholar
  8. Davenport, Y. B., Ebert, M. H., Adland, M. L., & Goodwin, F. K. (1977). Couples group therapy as an adjunct to lithium maintenance of the manic patient.American Journal of Orthopsychiatry, 47, 495–502.Google Scholar
  9. Fitzgerald, R. G. (1972). Mania as a message.American Journal of Psychotherapy, 26, 547–554.Google Scholar
  10. Gerbino, L., Oleshansky, M., & Gershon, S. (1978). Clinical use and mode of action of lithium. In M. A. Lipton, A. DiMascio, & K. F. Killam (Eds.),Psychopharmacology: A generation of progress (pp. 1261–1275). New York: Raven Press.Google Scholar
  11. Hathaway, S. R., & McKinley, J. C. (1942).Minnesota Multiphasic Personality Inventory. Minneapolis, MN: University of Minnesota Press.Google Scholar
  12. Hoover, C. F., & Fitzgerald, R. G. (1981). Mental conflict of manic-depressive patients.Archives of General Psychiatry, 38, 65–67.Google Scholar
  13. Hops, H., Wills, T. A., Patterson, G. R., & Weiss, R. L. (1971).Marital Interaction Coding System. Eugene: University of Oregon and Oregon Research Institute.Google Scholar
  14. Jacobson, N. S., & Margolin, G. (1979).Marital therapy. New York: Brunner-Mazel.Google Scholar
  15. Locke, H. J., & Wallace, K. M. (1959). Short-term marital adjustment and production tests: Their reliability and validity.Journal of Marriage and Family Living, 21, 251–255.Google Scholar
  16. Mayo, J. A. (1979). Marital therapy with manic-depressive patients treated with lithium.Comprehensive Psychiatry, 20, 419–426.Google Scholar
  17. Vincent, J. P., Weiss, R. L., & Birchler, G. R. (1975). A behavioral analysis of problem solving in distressed and nondistressed married and stranger dyads.Behavior Therapy, 6, 475–487.Google Scholar
  18. Wadeson, H. S., & Fitzgerald, R. G. (1971). Marital relationship in manic-depressive illness.Journal of Nervous and Mental Disease, 153, 180–196.Google Scholar

Copyright information

© Plenum Publishing Corporation 1989

Authors and Affiliations

  • Dennis L. McKnight
    • 1
    • 2
  • Rosemery O. Nelson-Gray
    • 3
  • Eugenia Gullick
    • 4
  1. 1.University of North Carolina at GreensboroGreensboro
  2. 2.Charter Hospital of Winston-SalemNorth Carolina
  3. 3.Psychology DepartmentUniversity of North CarolinaGreensboro
  4. 4.Salem Psychiatric AssociatesWinston-Salem

Personalised recommendations