Development and validation of a short version of the Hypomanic Attitudes and Positive Predictive Inventory (HAPPI): Measuring extreme appraisals of internal states and bipolar risk.

Backgrounds: Mood instability is often experienced by those with and at risk for bipolar disorders (BD). The Integrative Cognitive Model proposes that mood instability is linked to an individual's self-appraisals of current states and one's attempts to up or downregulate emotions. The Hypomanic Attitudes and Positive Predictions Inventory (HAPPI-61) was developed to measure these appraisals. However, its length has made it too cumbersome to use within clinical and research settings. The goal of this study was to create a psychometrically valid short version of the HAPPI-61, define its factor structure, and explore its associations with mania risk and mood and emotion outcomes.

Methods: Participants (n = 1192) were recruited from 3 continents (North America, Australia, Europe) using Prolific in 2022. Classical test theory, item response theory, and differential item functioning were used to shorten the HAPPI-61 to 20 items.

Results: Factor analysis of the HAPPI-61 identified 5 factors that were replicated in the HAPPI-20: Self-critical, Grandiose/Need for Social Approval, Perceived Criticism from Others, Impulsivity/Drive for Activation, and Loss of Control. The HAPPI-20 had good internal consistency, item-scale correlations, discrimination parameters, and no differential item functioning. Both the HAPPI-61 and HAPPI-20 were associated with mania risk, anxious arousal, and negative affect. There were differential associations among the factors with positive affect and anhedonic depression.

Conclusions: The HAPPI-20 had strong psychometric properties and consistent patterns of associations with mood measures compared to the original scale. The HAPPI-20, and its new proposed scoring, has utility in understanding how appraisals are associated with BD risk.