This study attempted to validate a psychological formulation which proposes that manic-depressives have a self-concept which is extremely sensitive to losses of status occurring in particular domains of the person's world. The person considers such a loss to be so negative that the loss becomes unthinkable (in a first person sense). Should such a loss occur, the person will see the world as if the loss had not occurred, thereby distorting reality. The manic-depressive's increasingly unrealistic attempts to regain status in the face of this loss constitute the manic episode itself.

Twenty-two remitted bipolar patients were compared with 26 non-psychiatric controls and 20 neurotic outpatients on a series of tasks, designed to assess the unthinkability component of the formulation and a general sensitivity to status changes. The groups did not differ significantly in the amount of accreditation and degradation portrayed in a story completion task, but when presented with completed stories portraying status changes, significant differences among the groups were found. The manic-depressive women liked significantly less the portrayals of accreditation, whereas both the neurotics and the manic-depressive men liked significantly less the portrayals of degradation. The groups did not differ in their ratings of neutral stories which did not portray status change. The manic-depressives' relative preference for the membership aspects of high statuses was found to be significantly greater than the other groups'. While significant differences were found among the groups' status ratings of accredited and degraded versions of person descriptions, the small cell size limited interpretation. The groups also did not differ significantly in whether an accredited or degraded person description was chosen to role play. Questions were raised about the adequacy of the operationalizations to test the unthinkability component because of its presumed specificity.

Significant differences were evident between how manic-depressive men and women respond to status issues and a pattern of sensitization-repression of these issues was suggested. Conclusions were drawn that a subtle status sensitivity was present in the manic-depressive group, although not necessarily unique to that group, and that further research is indicated. [491 pp.]