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Introduction
Individuals with bipolar disorder (BD) cycle through episodes of mania, depression and euthymia, demonstrating dramatic fluctuations in energy, social behaviour, mood and cognitive functioning. However, few theoretical proposals have attempted to account for the variation in affective processing across depressed, euthymic and manic states. Cognitive models based on Beck's model of affective disorder (Beck, 1976, 1983) have been proposed that attempt to take account of the complex interaction of biological, psychological and social elements that characterize BD. However, difficulties with what may be termed 'single level theories of emotion' have been described both clinically and conceptually (e.g. Power & Dalgleish, 1997). To answer concerns about the limitations of such models, multi-level theories have been devised to provide a framework through which to formulate the relationship between cognition and emotion.
The Interacting Cognitive Subsystems (ICS; Teasdale & Barnard, 1993) is an example of a multi-level theory that was initially developed to account for cognitive processing identified in individuals with depression. Unlike in models of cognitive therapy, the emphasis in this model is on the mode of processing rather than the content of the structures. In brief, the ICS provides a framework that addresses all aspects of information processing by defining a complete cognitive system composed of nine different subsystems. Two of the levels considered central to many activities, including the maintenance and moderation of emotional states, are the implicational and propositional levels. It is hypothesized that specific meanings are represented in patterns of propositional code. Meanings at this level are explicit, correspond to the kind of meaning conveyed by a single sentence, and are not difficult to grasp. By contrast, patterns of implicational code represent higher order implicit meanings, or schematic mental models, of experience. The meaning from these models cannot be easily conveyed, and the knowledge is implicit, rather than explicit. Within the ICS, higher order implicational meanings are the only level of representation that can directly produce emotion. It follows that modification of emotional response, as in emotional processing, necessarily involves changes in affect-related schematic models. Teasdale & Barnard (1993) proposed that implicational representations are generic schematic models that integrate the products of processing propositional meaning with the immediate products of processing sensory information, including activated or...