Self-efficacy in bipolar disorder: Development and validation of a self-report scale.

Background: Successful management of bipolar disorder (BPD) typically involves individuals undertaking a complex array of self-management tasks (e.g., taking medication, monitoring symptoms, following a regular sleep routine). Many people with BPD doubt they can successfully undertake these tasks. This low sense of self-efficacy may lead to the perpetuation of BPD symptoms, poor quality of life, and low adherence to treatment. Research on self-efficacy in BPD has been hampered by the lack of a short, reliable and valid self-report scale that is practical to use in clinical and research settings. We sought to develop such a scale.

Methods: BPD patients (N = 303) completed a new battery of items measuring their self-efficacy for performing BPD self-management tasks. Modern psychometric techniques such as bifactor analyses were used to refine the scale, determine an appropriate scoring algorithm, and establish reliability and validity.

Results: The Bipolar Self-Efficacy Scale (BPSES) comprises 17 items. BPSES scores were reliable, sensitive to change, and correlated with theoretically related constructs such as social adjustment and positive affect. BPSES scores had substantially higher associations with depression and quality of life than an alternative instrument that measured self-efficacy in general, rather than self-efficacy specifically related to bipolar disorder self-management.

Limitations: Patients were required to be medically managed while attending adjunctive psychological treatment of BPD.

Conclusions: The BPSES is a brief scale that can be used to reliably and validly measure bipolar self-efficacy. It may be fruitful to use the scale in clinical practice, and studies investigating treatment outcomes, mechanisms, and moderators.