Effectiveness of Family-Focused Therapy on Impulsivity in Individuals with Bipolar Disorder Type II

Abstract

Background: Bipolar disorder type II (BD-II) is a chronic mood disorder characterized by recurrent hypomanic and depressive episodes, frequently accompanied by impulsivity that impairs interpersonal and occupational functioning. Objectives: This study aimed to assess the effectiveness of family-focused therapy (FFT) in reducing impulsivity among individuals with bipolar disorder (BD), given the critical influence of family dynamics on symptom presentation. Methods: This clinical trial employed a pre-test, post-test, and three-month follow-up design with a control group. The study population comprised individuals aged 25 - 45 diagnosed with BD-II, recruited from Zareh Psychiatric Hospital, psychological clinics, and private psychiatric offices in Sari between March 2023 and June 2024. A purposive sample of 30 participants, each accompanied by a chosen family member, was selected based on predefined inclusion and exclusion criteria. Participants were randomly assigned to an experimental group (n = 15) receiving 10 weekly 90-minute FFT sessions or a control group (n = 15) receiving no intervention. Impulsivity, including its non-planning, motor, and attentional subscales, was assessed using the Barratt Impulsiveness Scale (BIS-11). Data were analyzed using repeated measures ANOVA in SPSS (version 26). Results: The results revealed a significant reduction in impulsivity scores among individuals with BD from pre-test to post-test and pre-test to three-month follow-up (P < 0.01), with the experimental group showing significantly greater reductions than the control group post-intervention, as indicated by a significant group-by-time interaction. No significant difference was observed between post-test and follow-up scores, indicating sustained treatment effects. Conclusions: In this small-scale trial with a three-month follow-up, FFT demonstrated preliminary effectiveness in reducing impulsivity in individuals with BD-II. Thus, a family-focused approach may offer a promising adjunctive strategy for managing impulsivity in this population, pending replication in larger studies.