bipolar disorderReferencesDuarte, W., Becerra, R., & Cruise, K.docx

bipolar disorder
References
Duarte, W., Becerra, R., & Cruise, K. (2016). The Relationship
Between Neurocognitive Functioning and Occupational
Functioning in Bipolar Disorder: A Literature Review. Europe's
Journal Of Psychology, 12(4), 659-678.
doi:10.5964/ejop.v12i4.909
Mason, B. L., Brown, E. S., & Croarkin, P. E. (2016). Historical
Underpinnings of Bipolar Disorder Diagnostic Criteria.
Behavioral Sciences (2076-328X), 6(3), 1-19.
doi:10.3390/bs6030014
Ritter, P. S., Sauer, C., Pfeiffer, S., Bauer, M., & Pfennig, A.
(2016). Comparison of Subjective and Objective Sleep
Estimations in Patients with Bipolar Disorder and Healthy
Control Subjects. Sleep Disorders, 1-5.
doi:10.1155/2016/4031535
Brietzke, E., Rosa, A. R., Pedrini, M., Noto, M. N., Kapczinski,
F., & Scott, J. (2016). Challenges and developments in research
of the early stages of bipolar disorder. Revista Brasileira De
Psiquiatria, 38(4), 329-337. doi:10.1590/1516-4446-2016-1975
Neves, M. C., Duarte, D. G., Albuquerque, M. R., Nicolato, R.,
Neves, F. S., de Souza-Duran, F. L., & ... Corrêa, H. (2016).
Neural correlates of hallucinations in bipolar disorder. Revista
Brasileira De Psiquiatria, 38(1), 1-5. doi:10.1590/1516-4446-
2014-1640
Propper, L., Ortiz, A., Slaney, C., Garnham, J., Ruzickova, M.,
Calkin, C. V., & ... Alda, M. (2015). Early-onset and very-
early-onset bipolar disorder: distinct or similar clinical
conditions?. Bipolar Disorders, 17(8), 814-820.
doi:10.1111/bdi.12346
Van den Heuvel, S. H., Goossens, P. J., Terlouw, C., Van
Achterberg, T., & Schoonhoven, L. (2015). Identifying and
describing patients' learning experiences towards self-
management of bipolar disorders: a phenomenological study.

Journal Of Psychiatric & Mental Health Nursing, 22(10), 801-
810. doi:10.1111/jpm.12243
Vasconcelos-Moreno, M. P., Bücker, J., Bürke, K. P.,
Czepielewski, L., Santos, B. T., Fijtman, A., & ... Kauer-
Sant'Anna, M. (2016). Cognitive performance and psychosocial
functioning in patients with bipolar disorder, unaffected
siblings, and healthy controls. Revista Brasileira De Psiquiatria,
38(4), 275-280. doi:10.1590/1516-4446-2015-1868
Rusner, M., Berg, M., & Begley, C. (2016). Bipolar disorder in
pregnancy and childbirth: a systematic review of outcomes.
BMC Pregnancy & Childbirth, 161-18. doi:10.1186/s12884-016-
1127-1
Passarotti, A. M., Trivedi, N., Dominguez-Colman, L., Patel,
M., & Langenecker, S. A. (2016). Differences in Real World
Executive Function between Children with Pediatric Bipolar
Disorder and Children with ADHD. Journal Of The Canadian
Academy Of Child & Adolescent Psychiatry, 25(3), 185-195.
Chapter 12
IT Strategy and Balanced Scorecard
Prepared by Dr. Derek Sedlack, South University
Copyright © 2015 John Wiley & Sons, Inc. All rights reserved.
Learning Objectives
Aligning IT with Business Strategy
Balanced Scorecard

IT Sourcing and Cloud Strategy
IT Strategy and Strategic Planning Process
Value Drivers
Enhance the value of a product or service to consumers,
creating value for the company (such as advanced IT,
reliability, and brand reputation).
Three general types of Business Value Drivers:
Operational Shorter-term factors
Financial Medium-term factors
Sustainability Long-term factors
Chapter 12
IT Strategic Planning

A systematic process for determining what a business should
become and how it can best achieve that goal.
Reactive Approaches Fail
Fail to align IT to real business needs.
and, as a result
Fail to deliver value to the business.
Chapter 12
IT Strategies Support the Business Strategy
Four IT Strategic Plan Objectives:
Improve management’s understanding of IT opportunities and
limitations
Assess current performance
Identify capacity and human resource requirements
Clarify the level of investment required
Chapter 12
IT Deployment Strategies
In-house development
Systems are developed or other IT work is done in-house,
possibly with the help of consulting companies or vendors.
Sourcing
Onshore: sourced to consulting companies or vendors that are
within the same country.
Offshoring: work sourced to other countries.
Chapter 12

Chapter 12
Figure 12.2 IT strategic planning process.
IT Steering Committee
Set the direction
Links corporate strategy with the IT strategy,
Allocate scarce resources
Approves the allocation of resources for and within the
information systems organization including outsourcing policy.
Make staffing decisions
Key IT personnel decisions involve a consultation and approval
process made by the committee, including outsourcing
decisions.
Communicate and provide feedback
Information regarding IT activities should flow freely.
Set and evaluate performance metrics
Establish performance measures for the IT department and see
they are met.
Chapter 12
Governance
Formally established statements that direct the policies
regarding IT alignment with organizational goals and allocation

of resources.
Long-range IT plan (Strategic IT plan)
What IT should do to achieve the goals, objectives, and
strategic position of the firm and how this will be achieved.
The overall direction, requirements, and sourcing of resources.
Time frames are set for three to five years into the future.
Chapter 12
Medium-range IT plan
Identifies general project plans in terms of the specific
requirements and sourcing of resources as well as the project
portfolio.
Tactical Plan (Short-range)
Details budgets and schedules for current-year projects and
activities.
Chapter 12
Project Portfolio
Lists major resource projects that are consistent with the long-
range plan.
Applications Portfolio
A list of major, approved information system projects that are
also consistent with the long-range plan.
Chapter 12

What are value drivers?
What are the three categories of value drivers?
Why do reactive approaches to IT investments fail?
What is onshore sourcing?
What is the goal of IT–business alignment?
Why is IT strategic planning revisited on a regular basis?
What are the functions of a steering committee?
Describe the IT strategic planning process.
Chapter 12
Suggested Answers:
1. Value drivers enhance the value of a product or service to
consumers, creating value for the company. Advanced IT,
reliability, and brand reputation are examples.
2. Operational (shorter-term factors that impact cash flow and
the cash generation ability through increased efficiency or
growth),
Financial (medium-term factors that minimize the cost of
capital incurred by the company to finance operations), and
Sustainability (long-term survival factors; factors that enable a
business to continue functioning consistently and optimally for
a long time.)
3. Two of the biggest risks and concerns of top management are
(1) failing to align IT to real business needs and, as a result, (2)
failing to deliver value to the business. Reactive IT investments
tend to be patches that rarely align with the business strategy.

4. Work or development outsourced to consulting companies or
vendors that are within the same country is referred to as
onshore sourcing.
5. Answers may vary. IT–business alignment means how closely
an organization’s IT strategy is interwoven with and driving its
overall business strategy. The goal of IT strategic alignment is
to ensure that IS priorities, decisions, and projects are
consistent with the needs of the entire business. Failure to
properly align IT with the organizational strategy can result in
large investments in systems that have a low payoff, or not
investing in systems that potentially have a high payoff.
6. The business and IT strategic plans are evaluated and
adjusted annually to keep pace with rapid changes in the
industry. Because organizational goals change over time, it is
not sufficient to develop a long-term IT strategy and not re-
examine the strategy on a regular basis. For this reason, IT
planning is an ongoing process. The IT planning process results
in a formal IT strategy or a reassessment each year or each
quarter of the existing portfolio of IT resources.
7. The steering committee is a team of managers and staff
representing various business units that establish IT priorities
and ensure the IT department is meeting the needs of the
enterprise. The steering committee’s major tasks are:
Set the direction. In linking the corporate strategy with the IT
strategy, planning is the key activity.
Allocate scarce resources. The committee approves the
allocation of resources for and within the information systems
organization. This includes outsourcing policy.
Make staffing decisions. Key IT personnel decisions involve a
consultation-and-approval process made by the committee,
including outsourcing decisions.
Communicate and provide feedback. Information regarding IT
activities should flow freely.

Set and evaluate performance metrics. The committee should
establish performance measures for the IT department and see
that they are met. This includes the initiation of SLAs.
The success of steering committees largely depends on the
establishment of IT governance, formally established statements
that direct the policies regarding IT alignment with
organizational goals and allocation of resources.
8. Figure 12.2 shows the IT strategic planning process. The
entire planning process begins with the creation of a strategic
business plan. The long-range IT plan, sometimes referred to as
the strategic IT plan, is then based on the strategic business
plan. The IT strategic plan starts with the IT vision and
strategy, which defines the future concept of what IT should do
to achieve the goals, objectives, and strategic position of the
firm and how this will be achieved. The overall direction,
requirements, and sourcing—either outsourcing or insourcing—
of resources, such as infrastructure, application services, data
services, security services, IT governance, and management
architecture; budget; activities; and timeframes are set for three
to five years into the future. The planning process continues by
addressing lower-level activities with a shorter time frame.
The next level down is a medium-term IT plan, which identifies
general project plans in terms of the specific requirements and
sourcing of resources as well as the project portfolio. The
project portfolio lists major resource projects, including
infrastructure, application services, data services, and security
services that are consistent with the long-range plan. Some
companies may define their portfolio in terms of applications.
The applications portfolio is a list of major, approved
information system projects that are also consistent with the
long-range plan. Expectations for sourcing of resources in the
project or applications portfolio should be driven by the
business strategy. Since some of these projects will take more

than a year to complete, and others will not start in the current
year, this plan extends over several years.
The third level is a tactical plan, which details budgets and
schedules for current-year projects and activities. In reality,
because of the rapid pace of change in technology and the
environment, short-term plans may include major items not
anticipated in the other plans.
The planning process just described is currently practiced by
many organizations. Specifics of the IT planning process, of
course, vary among organizations. For example, not all
organizations have a high-level IT steering committee. Project
priorities may be determined by the IT director, by his or her
superior, by company politics, or even on a first-come, first-
served basis.
The deliverables from the IT planning process should include
the following: an evaluation of the strategic goals and
directions of the organization and how IT is aligned; a new or
revised IT vision and assessment of the state of the IT division;
a statement of the strategies, objectives, and policies for the IT
division; and the overall direction, requirements, and sourcing
of resources.
12
Learning Objectives
Balanced Scorecard

IT Business Alignment Improvement Activities
Commitment to IT planning by senior management.
CIO is a member of senior management.
Understanding IT and corporate planning.
Shared culture and good communication.
Multilevel links.
Chapter 12
Strength of CIO & C-Suite Relationship Influences Performance
Achieve better results.
Adapt quickly.
Think together.
Act together.
More aligned on strategy.
Chapter 12

CIO Skillset
Political savvy
Influence, leadership, and power
Relationship management
Resourcefulness
Strategic planning
Doing what it takes
Leading employees
Chapter 12
IT/Business Alignment
CIO drives business change through the use of digital
technology, not just supporting business, but introducing
profitable new lines of business.
Even older organizations, considered traditional and slow-
moving, can become agile, even innovative through technology.
Chapter 12
How can IT–business alignment be improved?
How does strong collaboration among the CIO and other chief-
level officers influence performance?
What skills are important to a CIO’s success?
How did the CIO of CBA contribute to the bank’s

competitiveness?
Chapter 12
Suggested Answers:
1. Alignment is a complex management activity, and its
complexity increases as the pace of global competition and
technological change increases. IT–business alignment can be
improved by focusing on the following activities:
Commitment to IT planning by senior management. Senior
management commitment to IT planning is essential to success.
CIO is a member of senior management. The key to achieving
IT-business alignment is for the CIO to attain strategic
influence. Rather than being narrow technologists, CIOs must
be both business and technology savvy.
Understanding IT and corporate planning. A prerequisite for
effective IT–business alignment for the CIO is to understand
business planning and for the CEO and business planners to
understand their company's IT planning.
Shared culture and good communication. The CIO must
understand and buy into the corporate culture so that IS
planning does not occur in isolation. Frequent, open, and
effective communication is essential to ensure a shared culture
and keep everyone aware of planning activities and business
dynamics.
Multi-level links. Links between business and IT plans should
be made at the strategic, tactical, and operational levels.
2. According to PwC’s 5th annual Digital IQ global survey,
compared to less collaborative companies, strong collaborators:
Achieve better results. They are four times more likely to be top
performers than those with less collaborative teams. IT

initiatives are more likely to be on time, on budget, and within
project scope.
Adapt quickly. They adapt quickly to market changes to
maintain an advantage over competitors.
Think together. IT and business leaders share the same
understanding of the corporate strategy and the costs needed to
implement the strategic road map. They view their CEO as a
champion of IT and understand IT risks that may impact the
business.
Act together. They have explicit processes in place to link the
IT road map to the corporate strategy. They invest more
aggressively in social, mobile, cloud, and analytics and map IT
to strategic initiatives like new product and service
development and market share growth.
More aligned on strategy. In a majority of strong collaborators
(82 percent), the CEO is a champion of IT and actively involves
IT in the strategic and operational plans, compared with 54
percent for less collaborative companies.
In addition, strong relationships support more frequent and
frank conversations about problems and collaborative problem
solving. Too many IT projects fail because foundational issues
are not dealt with candidly and fast enough. The Digital IQ
study clearly shows that strong executive leadership and
collaboration are crucial to building lasting value from IT.
3. Skills of CIOs needed to improve IT–business alignment and
governance include:
Political savvy. Effectively understand managers, workers, and
their priorities and use that knowledge to influence others to
support organizational objectives.
Influence, leadership, and power. Inspire a shared vision and
influence subordinates and superiors.
Relationship management. Build and maintain working
relationships with co-workers and those external to the
organization. Negotiate problem solutions without alienating
those impacted. Understand others and get their cooperation in

non-authority relationships.
Resourcefulness. Think strategically and make good decisions
under pressure. Can set up complex work systems and engage in
flexible problem resolution.
Strategic planning. Capable of developing long-term objectives
and strategies and translating vision into realistic business
strategies.
Doing what it takes. Persevering in the face of obstacles.
Leading employees. Delegating work to employees effectively;
broadening employee opportunities; and interacting fairly with
employees.
4. Kaching is the mobile, social, and NFC payments apps from
CBA. With the success of Kaching, CBA’s CIO Michael Harte
had not just supported business activities, he had introduced a
profitable new line of business (LeMay, 2013). By leading with
mobile, social, NFC technology, CBA has become an innovative
financial institution.
18
Learning Objectives
Balanced Scorecard

Balanced Scorecard
Old Approach to Business
Lagging Indicators
P&L, Cash Flow, Balance Sheets
Confirm what has happened.
Evaluate outcomes and achievements.
Represent history, not ideal for managing day-to-day operations
and planning.
Multidimensional Approach to Business
Leading indicators
Predict future events to identify opportunities.
Chapter 12
Balanced Scorecard
Chapter 12
Figure 12.3 Balanced Scorecard (BSC) uses four metrics to
measure performance.

Balanced Scorecard
Balanced Approach Metrics
Financial
Revenue, earnings, asset utilization
Customer
Market share, Brand image, price-value relationship
Business processes
Cycle times, cost per process/transaction
Innovation, learning and growth
Employee skills, IT capabilities, R&D
Chapter 12
Balanced Scorecard
IT & Business Strategy Alignment through BSC
Clarify and update strategy
Align IT strategy with business strategy
Link strategic objective to long-term goals and annual budgets
Chapter 12
Balanced Scorecard
Chapter 12
The BSC methodology process.
Identify performance metrics

Select meaningful objectives
Select effective measures and targets
Revise actions
Collect, analyze, and data with targets
Implement necessary data collection tools
Alignment
Balanced Scorecard
How did the BSC approach differ from previous measurement
approaches?

How does the BSC approach “balance” performance
measurements?
What are the four BSC metrics?
Give an example of each BSC metric.
How does BSC align IT strategy with business strategy?
Chapter 12
Suggested Answers:
1. Prior to the BSC concept, the typical business objective could
be summed up simply as to make a profit. Performance metrics
were based on:
P&L (profit and loss) reports: revenue, expenses, net profit
Cash flow statements: enough cash to pay its current liabilities
Balance sheets that reflected the overall status of finances at a
certain date
These financial metrics are lagging indicators because they
quantify past performance. As such, they represent historical
information and are not ideal tools for managing day-to-day
operations and planning.
What was novel about BSC in the 1990s was that it measured a
company’s performance using a multidimensional approach of
leading indicators as well as lagging indicators.
2. The BSC method is “balanced” because it does not rely solely
on traditional financial measures. Instead, it balances financial
measures with three forward-looking nonfinancial measures.
3. Financial. To succeed financially, how should we appear to
our investors and shareholders?
Customer. To achieve our vision, how should we provide value

to our customers?
Business processes. To satisfy our shareholders and customers,
what business processes must we focus on and excel at?
Innovation, learning, and growth. To achieve our vision, how
will we sustain our ability to innovate, learn, change, and
improve?
4. Answers may vary.
Metric or
Indicator Examples of Measurement Criteria
Financial • Revenue and revenue growth rates
• Earnings and cash flow
• Asset utilization
Customer • Market share
• Customer acquisition, retention, loyalty
• Customer relationships, satisfaction, likes,
recommendations, loyalty
• Brand image, reputation
• Price–value relationship
Business • Cycle times, defect rate
processes • Production throughput, productivity rates
• Cost per process
• Cost per transaction
Innovation, • Employee skills, morale, turnover, capacity for
change
learning and • IT capabilities
growth • Employee motivation
• R&D
• Percentage of revenue from new products/services
5. BSC can be used to translate strategic plans and mission
statements into a set of objectives and performance metrics that
can be quantified and measured.

BSC is used to clarify and update the strategy, align the IT
strategy with the business strategy, and link strategic objectives
to long-term goals and annual budgets.
The astute student may realize that the balanced scorecard can
be applied to link KPIs of IT to business goals to determine the
impact on the business. The focus for the assessment could be,
for example, the project portfolio or the applications portfolio.
The balanced scorecard can be used to assess the IT project
portfolio by listing projects along the vertical dimension, and
specific measures, critical to what the organization needs to
track, horizontally.
25
Learning Objectives
Balanced Scorecard

Cloud Strategy and Services
Cloud Strategy
Short for cloud computing IT strategy.
Edge Service
Term that refers to a cloud service.
Tactical Adoption Approach
Incremental deployment resulting in apps and services, patched
to create end-to-end business processes.
Chapter 12
Cloud Complexity
Extensibility
The ability to get data into and out of the cloud service.
Migration Issues
Cybersecurity, privacy, data availability, and service
accessibility.
Newer Challenges
Cloud integration with on-premises resources, extensibility, and
reliability.
Chapter 12
Sourcing Driving Factors

Generate revenue
Increase efficiency
Agile enough to respond to market changes
Focus on core competency
Cut operational costs
More accepted IT strategy
Cloud and SaaS have been proven
Move IT from capital to recurring operating expenditure
Chapter 12
Outsourcing Risks
Shirking
The vendor deliberately underperforms while claiming full
payment.
Poaching
The vendor develops a strategic application for a client and then
uses it for other clients.
Opportunistic repricing
Client enters into a long-term contract with a vendor, the vendor
changes financial terms at some point or overcharges for
unanticipated enhancements and contract extensions.
Chapter 12
Work Not Readily Offshored
Work that has not been routinized.
Work that if offshored would result in the client company losing
too much control over critical operations.

Situations in which offshoring would place the client company
at too great a risk to its data security, data privacy, or
intellectual property and proprietary information.
Business activities that rely on an uncommon combination of
specific application domain knowledge and IT knowledge in
order to do the work properly.
Chapter 12
Outsourcing Lifecycle
Chapter 12
Strategy
Reassessment
Selection
Negotiation
Implementation
Oversight Management

Vendor Selection Criteria
Experience with very similar systems of similar size, scope, and
requirements; experience with the ITs that are needed,
integrating those ITs into the existing infrastructure and the
customer’s industry.
Financial and qualified personnel stability. A vendor’s
reputation impacts its stability.
Chapter 12
Focus On Value Not Costs
Costs undermine goals.
Close relationships are mutually beneficial.
Both sides are best served viewing relationship over simple
transaction.
Before Signing…
Do a trial run.
Create SLAs.
Chapter 12
What contributes to the complexity of a cloud strategy?
How does tactical adoption of cloud services differ from a
coordinated cloud strategy?
What are the major reasons for sourcing?
What types of work are not readily outsourced offshore?
When selecting a vendor, what two criteria need to be assessed?
What is the risk of an overemphasis on cost when selecting or
dealing with an IT vendor?

What needs to be done before signing a contract with an IT
vendor?
Chapter 12
Suggested Answers:
1. While the concept of cloud is simple, an enterprise’s cloud
strategy tends to be quite complex. Cloud is being adopted
across more of the enterprise, but mostly in addition to on-
premises systems—not as full replacements for them. Hybrid
solutions create integration challenges. Cloud services—also
referred to as edge services—have to integrate back to core
internal systems.
2. Tactical adoption is a short-sighted approach, deploying
cloud services incrementally, resulting in apps and services that
are patched together to create end-to-end business processes.
3. Enterprises choose outsourcing for several reasons:
To generate revenue
To increase efficiency
To be agile enough to respond to changes in the marketplace
To focus on core competency
To cut operational costs
Because offshoring has become a more accepted IT strategy
Because cloud computing and SaaS have proven to be effective
IT strategies
To move IT investment from a capital expenditure to a recurring
operational expenditure
To differentiate from competitors—while reducing the burden
on the IT organization
4. Based on case studies, the types of work that are not readily

offshored include the following:
Work that has not been routinized
Work that if offshored would result in the client company losing
too much control over critical operations
Situations in which offshoring would place the client company
at too great a risk to its data security, data privacy, or
intellectual property and proprietary information
Business activities that rely on an uncommon combination of
specific application-domain knowledge and IT knowledge in
order to do the work properly.
5. When selecting a vendor, two criteria to assess first are
experience and stability:
Experience with very similar systems of similar size, scope, and
requirements. Experience with the ITs that are needed,
integrating those ITs into the existing infrastructure and the
customer’s industry.
Financial and qualified personnel stability. A vendor’s
reputation impacts its stability.
6. Many corporate customers lose out on the potential benefit of
close relationships by an overemphasis on costs instead of
value. Ideally, a customer/vendor relationship is a mutually
beneficial partnership, and both sides are best served by treating
it as such.
7. Vendors often buy hardware or software from other vendors.
In order to avoid problems with the primary IT vendor, check
secondary suppliers as well. Ask the primary vendor how they
will deliver on their promises if the secondary vendors go out of
business or otherwise end their relationship.
Vendors may offer the option to test their products or services
in a pilot study or a small portion of the business to verify that
it fits the company’s needs. If the vendor relationship adds
value on a small scale, then the system can be rolled out on a

larger scale. If the vendor cannot meet the requirements, then
the company avoids a failure.
Before entering into any service contract with an IT vendor, get
a promise of service in writing. By making both parties aware
of their responsibilities and when they may be held liable for
failing to live up to those responsibilities, a strong SLA can
help prevent many of the disruptions and dangers that can come
with sourcing or migrating to the cloud. The provisions and
parameters of the contract are the only protections a company
has when terms are not met or the arrangement is terminated.
No contract should be signed without a thorough legal review.
SLAs are designed to protect the service provider, not the
customer, unless the customer takes an informed and active role
in the provisions and parameters. There is no template SLA and
each cloud solution vendor is unique. Certainly, if a vendor’s
SLA is light on details, this alone may be an indicator that the
vendor is light on accountability. Additionally, if a sourcing or
cloud vendor refuses to improve its SLAs or negotiate vital
points, then that vendor should not be considered.
35
Bipolar disorder 1
ANNOTATED BIBLIOGRAPHY
Duarte, W., Becerra, R., & Cruise, K. (2016). The Relationship
Between Neurocognitive Functioning and Occupational
Functioning in Bipolar Disorder: A Literature Review. Europe's
Journal Of Psychology, 12(4), 659-678.
doi:10.5964/ejop.v12i4.909
Mr Walace Duarte is a Clinical Psychologist Registrar who
completed a Masters in Clinical Psychology. He has a
background in employment services and mental health,

community mental health, and drug and alcohol services. Dr
Rodrigo Becerra is a senior Lecturer and a senior Clinical
Psychologist. Dr Kate Cruise is undertaking a Masters in
Clinical. Her research background involves the assessment of
neuropsychological and psychosocial functioning of clinical
populations including Bipolar Disorder and Parkinson’s disease.
The authors are a research group at Edith Cowan University.
Neurocognitive impairment in Bipolar Disorder (BD) has been
widely reported, even during remission. Neurocognitive
impairment has been identified as a contributing factor towards
unfavorable psychosocial functioning within this population.
The objective of this review was to investigate the association
between neurocognitive impairment and occupational
functioning in BD. Factors that have been associated with
impaired psychosocial functioning in BD include current
symptomatology, particularly depressive symptoms.
Neurocognitive impairment is another factor that has emerged
from the research and is thought to undermine psychosocial
functioning in BD. The method used for this literature review is
a search of the PsychINFO, Scopus and ISI Web of Sciences
databases for relevant English language, peer-reviewed original
journal articles, dating from January 1990 to November 2013.
The results consisted of twenty-three articles in the current
review. Twenty studies identified a relationship between
neurocognitive functioning and occupational functioning in BD.
The major finding reported among these studies was that
neurocognitive impairment was associated with diminished
occupational functioning. The aim of this paper was to
investigate the association between neurocognitive and
occupational functioning in BD. Of the papers reviewed, most
(20) identified a relationship between impaired neurocognitive
functioning and reduced occupational functioning in BD. In
summary, the current review identified a relationship between
impaired neurocognitive and occupational functioning in BD.
There were a number of methodological limitations associated
with the variety of neuropsychological assessments employed

across studies and the definition and measurement of
occupational status that make it difficult to generalize across
studies.
Mason, B. L., Brown, E. S., & Croarkin, P. E. (2016). Historical
Underpinnings of Bipolar Disorder Diagnostic Criteria.
Behavioral Sciences (2076-328X), 6(3), 1-19.
doi:10.3390/bs6030014
The research authors are Brittany L. Mason, E. Sherwood
Brown, and Paul E. Croarkin, they are with the department of
psychiatry. The research is based on historical links to defining
a mental disorder. Mental disorders separate from a
temperament started as early as Hippocrates, who distinguished
between these two, defining the disease “melancholia” (nosos
melancholiké) and the personality (typos melancholicós). The
outermost ends of this spectrum highlight two states, the lowest
low, melancholia, and the highest high, mania. These mood
extremes have been documented repeatedly in human history,
being first systematically described by Hippocrates. Nineteenth
century contemporaries Falret and Baillarger described two
forms of an extreme mood disorder, with the validity and
accuracy of both debated. Recognition of a cycling disorder,
including both ends of the mood spectrum to Kraepelin’s
characterization of a broad mood spectrum to the modern
diagnosis of episodic experiences of manic mood and depressed
mood, bipolar disorder has been examined and described based
on the most available clinical evidence. Arguments pertaining to
the validity of the current diagnostic framework include the
push for a more spectrum-based approach in which more
attention is paid to sub-syndromal or sub-threshold experiences
of perturbed mood. It is hoped that exploration of the varied
mood states experienced by those patients with bipolar disorder
can lead us toward a categorization which provides the most
clinically relevant evidence to guide effective treatments.

Ritter, P. S., Sauer, C., Pfeiffer, S., Bauer, M., & Pfennig, A.
(2016). Comparison of Subjective and Objective Sleep
Estimations in Patients with Bipolar Disorder and Healthy
Control Subjects. Sleep Disorders, 1-5.
doi:10.1155/2016/4031535
The researchers are Philipp S. Ritter, Cathrin Sauer, Steffi
Pfeiffer, Michael Bauer, and Andrea Pfennig. The research
project is to test the hypothesis that patients with bipolar
disorder display a systematic bias to underestimate sleep
duration and overestimate sleep latency. The methodology used
to assess sleep latency and duration in 49 euthymic participants
(bipolar = 21; healthy controls = 28) for 5–7 days. Participants
simultaneously recorded estimated sleep duration and sleep
latency daily via an online sleep diary. Group differences in the
discrepancy between subjective and objective parameters were
calculated using t -tests and corrected for multiple comparisons.
The results were that patients with bipolar disorder significantly
underestimated their sleep duration but did not overestimate
their sleep latency compared to healthy controls. The conclusion
is that studies utilizing diaries or questionnaires alone in
patients with bipolar disorders may systematically
underestimate sleep duration compared to healthy controls. The
additional use of objective assessment methods such as
actimetry is advisable.
Brietzke, E., Rosa, A. R., Pedrini, M., Noto, M. N., Kapczinski,
F., & Scott, J. (2016). Challenges and developments in research
of the early stages of bipolar disorder. Revista Brasileira De
Psiquiatria, 38(4), 329-337. doi:10.1590/1516-4446-2016-1975
The researchers are Elisa Brietzke, Adriane R. Rosa, Mariana
Pedrini, Mariane N. Noto, Flavio Kapczinski, and Jan Scott. The
objective of this paper is to comprehensively review the
literature regarding the early stages of BD, to explore recent
discoveries on the neurobiology of these stages, and to discuss
implications for research and clinical care. The following
databases were searched: PubMed, PsycINFO, Cochrane

Library, and SciELO. Articles published in English from
inception to December 2015 were retrieved. Several research
approaches were used, including examination of offspring
studies, retrospective studies, prospective studies of clinical
high-risk populations, and exploration of the progression after
the first manic episode. Investigations with neuroimaging,
cognition assessments, and biomarkers provide promising
(although not definitive) evidence of alterations in the neural
substrate during the at-risk stage. Research on bipolar disorder
should be expanded to encompass at-risk states and aligned with
recent methodological progress in neuroscience. In short, early
intervention could play a crucial role in preventing illness
progression (and any associated cognitive/functional decline) in
BD. The complications that presented in this study is that the
current use of disparate criteria makes it difficult to compare
findings across studies and to generalize findings to other
locations or to clinical practice. Another challenge in predicting
outcomes is the need to develop and apply big-data
bioinformatics platforms to analyze and integrate the volume of
data available from large samples, multiple samples, and
international multicenter studies. Despite gaps in our
knowledge, it is still vital to raise awareness among mental
health professionals of the need for more timely and accurate
diagnosis of BD, so as to enable recognition of the putative
prodromes of BD as early as possible and, consequently, to
minimize the use of antidepressant or psychostimulant
monotherapies in at-risk individuals.
Neves, M. C., Duarte, D. G., Albuquerque, M. R., Nicolato, R.,
Neves, F. S., de Souza-Duran, F. L., & ... Corrêa, H. (2016).
Neural correlates of hallucinations in bipolar disorder. Revista
Brasileira De Psiquiatria, 38(1), 1-5. doi:10.1590/1516-4446-
2014-1640
The researchers in this study are Maila de C. Neves, Dante G.
Duarte, Maicon R. Albuquerque, Rodrigo Nicolato, Fernando S.
Neves, Fábio L. de Souza-Duran, Geraldo Busatto, and
Humberto Corrêa. Approximately one-half of all patients

affected by bipolar disorder present with psychotic features on
at least one occasion. Several studies have found that alterations
in the activity of mesolimbic and prefrontal regions are related
to aberrant salience in psychotic patients. The aim of the
present study was to investigate the structural correlates of a
history of hallucinations in a sample of euthymic patients with
bipolar I disorder (BD-I). Methods: The sample consisted of 21
euthymic patients with BD-I and no comorbid axis I DSM-IV-
TR disorders. Voxel based morphometry (VBM) was used to
compare patients with and without a lifetime history of
hallucinations. Preprocessing was performed using the
Diffeomorphic Anatomical Registration through Exponentiated
Lie Algebra (DARTEL) algorithm for VBM in SPM8. Images
were processed using optimized VBM. Results: The main
finding of the present study was a reduction in gray matter
volume in the right posterior insular cortex of patients with BD-
I and a lifetime history of hallucinations, as compared to
subjects with the same diagnosis but no history of
hallucinations. Conclusions: This finding supports the presence
of abnormalities in the salience network in BD patients with a
lifetime history of hallucinations. These alterations may be
associated with an aberrant assignment of salience to the
elements of one's own experience, which could result in
psychotic symptoms.
Propper, L., Ortiz, A., Slaney, C., Garnham, J., Ruzickova, M.,
Calkin, C. V., & ... Alda, M. (2015). Early-onset and very-
early-onset bipolar disorder: distinct or similar clinical
conditions?. Bipolar Disorders, 17(8), 814-820.
doi:10.1111/bdi.12346
The researchers in this study Lukas Propper, Abigail Ortiz,
Claire Slaney, Julie Garnham, Martina Ruzickova, Cynthia V
Calkin, Claire O'Donovan, Tomas Hajek, and Martin Alda
aimed to examine differences in the clinical presentation of
very-early-onset (VEO) and early-onset (EO) bipolar disorder
(BD) not fully explored previously. Includes relevant evidence
based on two groups of subjects with BD from the Maritime

Bipolar Registry based on age at onset of first major mood
episode (VEO with onset prior to age 15 years; EO ranging from
15 to 18 years) and compared them with a reference group
(onset after 18 years of age). There were 363 subjects, 240 with
bipolar I disorder and 123 with bipolar II disorder; mean age
44.2 ± 12.8 (SD) years, with 41 subjects in the VEO and 95 in
the EO groups. All interviewers underwent extensive training
prior to conducting assessments, and all diagnostic information
was subsequently reviewed by a panel of experienced clinical
investigators. In this study, most of the subjects were
interviewed in their adulthood, and used the Schedule for
Affective Disorders and Schizophrenia-Lifetime version
(SADS-L) format (14) for diagnostic interviews. The diagnoses
were based on both Research Diagnostic Criteria (15) and DSM-
IV criteria. The family history was obtained using the SADS-L
interviews in first-degree relatives available for direct
interviews and the Family History-Research Diagnostic Criteria
(FH-RDC) (16). Heterogeneity of BD may be a major
contributing factor to varying outcomes and to difficulties in
replicating clinical, biological and treatment findings (18, 19)
and there has been considerable controversy regarding what
constitutes juvenile-onset BD. This study has several
limitations, including the fact that the data regarding the age of
onset were obtained in a retrospective fashion, thus imposing
some restrictions regarding the generalizability of the results.
The conclusion supports the view of the researchers that very-
early-onset BD represents a distinct, more severe subtype of the
illness that tends to differ from both adolescent-and adult-onset
BD by a rapidly fluctuating, rather unstable, and unremitting
clinical course (34), with depression being almost always the
first major mood episode. The study was supported by a Grant
from the Canadian Institutes of Health Research to MA.
Van den Heuvel, S. H., Goossens, P. J., Terlouw, C., Van
Achterberg, T., & Schoonhoven, L. 2015). Identifying and
describing patients' learning experiences towards self-
management of bipolar disorders: a phenomenological study.

Journal Of Psychiatric & Mental Health Nursing, 22(10), 801-
810. doi:10.1111/jpm.12243
This study describes learning experiences of service users in
self-managing bipolar disorder that provide a possible
explanation for varying effectiveness. The researchers have
conducted a phenomenological study via face-to-face, in-depth
interviews, guided by a topic list, along service users with BD I
or II (n = 16) in three specialized community care clinics across
the Netherlands. Interviews were digitally recorded and
transcribed verbatim. The current study found that self-
management of BD is a learning process that takes place in a
collaborative network. The researchers Van den Heuvel,
Goossens, Terlouw, Van Achterberg, and Schoonhoven
identified five categories: acknowledgment, processing the
information load, illness management, reflecting on living with
BD, and self-management of bipolar disorder. The success of
self-management depends on the acknowledgment of individual
limitations in learning to cope with BD and willingness to use a
social network as a back-up instead. The researchers took six
steps to conduct the phenomenological content analysis,
wherein steps 1 and 2 resemble the epoche, e.g. ruling out
subjective ideas of a phenomenon from a natural attitude. Steps
3 to 5, bracketing, e.g. withholding from a definitive
conceptualization about the phenomenon, and step 6 considered
as the eidetic reduction, e.g. different subjective ideas on a
phenomenon transferred to a unified concept of a phenomenon.
This research was ethical and all participants received written
information on this study and signed informed consent forms
before starting the interview process. The researcher’s findings
are that trust and open communication are key attitudes that
promote learning activities to reflect on. Also, a social network
that functions as a safe back-up environment is an important
precondition for self-management of BD.
Vasconcelos-Moreno, M. P., Bücker, J., Bürke, K. P.,
Czepielewski, L., Santos, B. T., Fijtman, A., & ... Kauer-
Sant'Anna, M. (2016). Cognitive performance and psychosocial

functioning in patients with bipolar disorder, unaffected
siblings, and healthy controls. Revista Brasileira De Psiquiatria,
38(4), 275-280. doi:10.1590/1516-4446-2015-1868
The researchers study is to assess cognitive performance
and psychosocial functioning in patients with bipolar disorder
(BD), in unaffected siblings, and in healthy controls. The study
was approved by a research ethics committee. Written informed
consent was obtained from all the participants prior to any study
procedures. Psychosocial functioning was accessed using the
Functioning Assessment Short Test (FAST). A sub-group of
patients with BD (n=21), unaffected siblings (n=14), and
healthy controls (n=22) also underwent a battery of
neuropsychological tests: California Verbal Learning Test
(CVLT), Stroop Color and Word Test, and Wisconsin Card
Sorting Test (WCST). Clinical and sociodemographic
characteristics were analyzed using one-way analysis of
variance or the chi-square test; multivariate analysis of
covariance was used to examine differences in
neuropsychological variables. The findings were that patients,
siblings, and healthy controls all showed very low sub-threshold
symptoms, as indicated by mood rating scale scores. The
researcher’s Vasconcelos-Moreno, M. P., Bücker, J., Bürke, K.
P., Czepielewski, L., Santos, B. T., Fijtman, A., and Kauer-
Sant'Anna, conclusion was that unaffected siblings of patients
with BD may show poorer functional performance compared to
healthy controls. FAST scores may contribute to the
development of markers of vulnerability and endophenotypic
traits in at-risk populations.
Rusner, M., Berg, M., & Begley, C. (2016). Bipolar disorder in
pregnancy and childbirth: a systematic review of outcomes.
BMC Pregnancy & Childbirth, 161-18. doi:10.1186/s12884-016-
1127-1
The researchers Marie Rusner, Marie Berg and Cecily Begley
conducted a peer-reviewed study to summarize the outcome of
pregnancy and childbirth, in mother and child, when the mother
is diagnosed with bipolar disorder before pregnancy. The

research question guiding this systematic review was: What are
the outcomes of pregnancy and childbirth (childbirth defined as
labor and birth, and the first year postpartum) for women with
bipolar disorder and their fetus/infant, when compared with
outcomes for women with bipolar disorder, who are not
pregnant, experiencing labor and birth, or postnatal. The study
method was a systematic search conducted in PubMed,
CINAHL, Scopus, PsycINFO and Cochrane databases in March
2015. There were no restrictions for age, party, ethnicity, or
other variables. The participants involved in peer-reviewed
studies were women with a diagnosis of bipolar disorder prior
to pregnancy, who were pregnant and/or followed up to one year
postpartum. After the screening assessment using the EPHPP
and AMSTAR tools, nine papers were included in this study.
Due to heterogeneity of data, particularly the use of differing
definitions of bipolar disorder, narrative synthesis was used for
most outcomes, rather than a meta-analysis. It is evident that
adverse outcomes are more common in women with BD and
their babies. Adverse out-comes such as gestational
hypertension and antepartum hemorrhage occur in pregnant
women with bipolar disorder. They are also prone to increased
rates of induction of labor and caesarean section, and have an
increased risk of mood disorders in the postnatal period. Large
cohort studies examining fetal abnormality outcomes for women
with BD who are not on mood stabilizers in pregnancy are
required, as are studies on maternal-infant interaction.
Passarotti, A. M., Trivedi, N., Dominguez-Colman, L., Patel,
M., & Langenecker, S. A. (2016). Differences in Real World
Executive Function between Children with Pediatric Bipolar
Disorder and Children with ADHD. Journal Of The Canadian
Academy Of Child & Adolescent Psychiatry, 25(3), 185-195.
The researchers Alessandra M. Passarotti PhD, Nidhi Trivedi
MA, Liza Dominguez-Colman MD, Manharkumar Patel MD, and
Scott A. Langenecker PhD conducted a study to find the
function between children with pediatric bipolar disorder and
children with ADHD. Sixteen children and adolescents with

pediatric bipolar disorder (PBD) were used in this study by
researchers, 17 children and adolescents with ADHD, Type
Combined, and 13 children and adolescents with PBD and
comorbid ADHD (PBD+ADHD) (mean age=12.70, SD=2.21)
were assessed using the Behavioral Rating Inventory of
Executive Function – Parental Report (BRIEF-PR), clinical
scales and neuropsychological tests of attention, working
memory and executive function. All participants consent from
legal guardian and assent from the child participant were
obtained. Children and adolescents with a diagnosis of PBD or
ADHD were recruited from the Pediatric Mood Disorder Clinic,
at the Department of Psychiatry, University of Illinois at
Chicago (UIC), and from the Greater Chicago area. Patients
were excluded from the study if they had a history of head
trauma with loss of consciousness for more than ten minutes,
neurological symptoms, speech or hearing difficulties,
pervasive developmental disorder, a primary diagnosis other
than bipolar disorder or ADHD, and an IQ score lower than 70.
The finding of the present study is that the two PBD groups
exhibited dual dysfunction in both cognitive domains (i.e.,
Inhibition, Shifting and Monitoring) and the Emotional Control
domain of the BRIEF-PR, while the ADHD group exhibited a
more circumscribed deficit in cognitive domains.
Paper Rubric
Directions: This paper does not have a required page count.
Correct spelling, grammar, sentence
structure is imperative. Student will be graded on thoroughness
of content area, correct spelling,
grammar, sentence structure, and correct use of APA.
—Performance is outstanding; significantly above

the usual expectations.
—Skills and standards are at the level of
expectation.
—Skills and standards are acceptable but improvements
are needed to meet expectations well.
—Performance is weak; the skills or standards are not
sufficiently demonstrated at this time.
Criteria
% of
paper Novice Basic Proficient Exceptional
The writing is scholarly in nature; well
organized and coherent with a description
of the primary behavioral problems that
need to be addressed
15% 0-3 points 3-5 points 5-10 points 11-15 points
The student discussed the DSM-5
diagnostic criteria and provided an
accurate presentation of th disorder.
The student also presented prevalence
and incidence rates. The student also
discussed at least two theories of
etiology and contrasted the theories.

The student incorporated the core value
of respect into the discussion on
assessment and diagnosis.
The student discussed treatment
interventions based on the theories of
etiology presented. The student
provided a case example from the
liertaure that portrayed the disorder
accurately.
Correct grammar, punctuation, sentence
structure is evident; all written sections
have proper citations
References are appropriately cited using
APA Style. The paper is in APA format
with a title Page and Abstract.

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