Psychological processes in bipolar affective disorder: negative cognitive style and reward processing

BackgroundPsychological processes in bipolar disorder are of both clinical and theoretical importance.AimsTo examine depressogenic psychological processes and reward responsivity in relation to different mood episodes (mania, depression, remission) and bipolar symptomatology.MethodOne hundred and seven individuals with bipolar disorder (34 in a manic/hypomanic or mixed affective state; 30 in a depressed state and 43 who were euthymic) and 41 healthy controls were interviewed with Structured Clinical Interview for DSM–IV and completed a battery of self-rated and experimental measures assessing negative cognitive styles, coping response to negative affect, self-esteem stability and reward responsiveness.ResultsIndividuals in all episodes differed from controls on most depression-related and reward responsivity measures. However, correlational analyses revealed clear relationships between negative cognitive styles and depressive symptoms, and reward responsivity and manic symptoms.ConclusionsSeparate psychological processes are implicated in depression and mania, but cognitive vulnerability to depression is evident even in patients who are euthymic.

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Reward Hypersensitivity in Bipolar Spectrum Disorders

The Oxford Handbook of Positive Emotion and Psychopathology ◽

10.1093/oxfordhb/9780190653200.013.11 ◽

2019 ◽

pp. 160-183

Author(s):

Robin Nusslock ◽

James Glazer ◽

Tommy H. Ng ◽

Madison K. Titone ◽

Lauren B. Alloy

Keyword(s):

Bipolar Disorder ◽

Biological Marker ◽

Reward Processing ◽

Psychosocial Treatment ◽

Behavioral Approach ◽

Neural Activation ◽

Manic Symptoms ◽

Hyperactivity Disorder ◽

Bipolar Spectrum Disorders ◽

Spectrum Disorders

The behavioral approach system (BAS)/reward hypersensitivity model of bipolar disorder proposes that risk for bipolar disorder, in particular hypo/manic episodes, is characterized by a hypersensitivity to goal- and reward-relevant cues. This hypersensitivity can lead to an excessive increase in approach-related affect and motivation to positive or rewarding life events, which, in the extreme, is reflected in hypo/manic symptoms. By contrast, multiple other psychiatric disorders, including major depressive disorder, attention deficit hyperactivity disorder, schizophrenia, and anxiety, appear to be characterized by reduced or unaffected reward processing. This suggests that elevated reward processing may be unique to bipolar disorder and thus important for understanding the differential risk for bipolar symptoms and the pathophysiology of hypo/manic episodes. The objective of the present chapter is four-fold. First, the literature on reward processing and reward-related neural activation in bipolar disorder is reviewed, in particular risk for hypomania/mania. Second, it is proposed that reward-related neural activation reflects a unique biological marker of risk for bipolar disorder that may help facilitate psychiatric assessment and differential diagnosis. Third, the pharmacological and psychosocial treatment implications of research on reward-processing and reward-related neural activation in bipolar disorder are addressed. Finally, new and novel directions of research on reward processing in bipolar disorder are discussed, including an integrated reward and circadian rhythm dysregulation model of bipolar symptoms and our neuroimmune network hypothesis of abnormalities in reward processing across mood-related disorders.

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Cognitive impairment in patients with a primary episode of bipolar affective disorder

Biomedical and Biosocial Anthropology ◽

10.31393/bba36-2019-01 ◽

2020 ◽

pp. 5-10

Author(s):

Yu. I. Mysula

Keyword(s):

Bipolar Disorder ◽

Cognitive Impairment ◽

Bipolar Affective Disorder ◽

Rapid Change ◽

Bipolar Disorders ◽

Rapid Rise ◽

Men And Women ◽

Manic Symptoms ◽

Subsequent Decrease ◽

Depressive And Manic Symptoms

An increasing number of studies on cognitive impairment associated with bipolar disorder indicate the relevance of the topic in psychiatry. The aim of the study was to investigate the features of cognitive functioning of patients with primary episode of bipolar disorder, taking into account sex and clinical variant. According to the method of «Remembering the Ten Words», 153 patients were examined: with prevalence of depressive symptoms (44 men and 75 women), with prevalence of manic symptoms (15 men and 8 women) and with simultaneous presence of depressive and manic symptoms or with rapid change of phases (6 men and 5 women). Statistical analysis was performed using the non-parametric Mann-Whitney test. It was found that in the depressive variant, the memorization curve was characterized by difficulties of fixing information and difficulty in holding it: 4.2±1.2 words, 4.6±1.4 words, 5.9±1.8 words, 5.8±1.4 words, 4.4±1.3 words, 2.6±1.4 words (in men – 4.2±1.4 words, 4.6±1.5 words, 6.1±1.9 words, 5.7±1.5 words, 4.4±1.3 words, 2.6±1.4 words, in women – 4.2±1.1 words, 4.5±1.4 words, 5,9±1.7 words, 5.8±1.3 words, 4.4±1.3 words, 2.5±1.3 words); at manic – rapid rise with subsequent decrease and the lowest reproduction rates in an hour: 4.7±1.3 words, 7.5±1.3 words, 7.2±1.3 words, 6.7±1.8 words , 4.7±1.0 words, 2.0±1.0 words (in men – 4.9±1.3 words, 7.3±1.3 words, 7.1±1.2 words, 6, 3±1.7 words, 4.7±0.9 words, 1.9±0.9 words, in women – 4.3±1.4 words, 7.9±1.4 words, 7.5±1,5 words, 7.5±1.7 words, 4.6±1.3 words, 2.3±1.2 words); when mixed – combined fixation difficulties and low reproduction rates: 4.5±0.9 words, 5.1±1.3 words, 5.9±1.1 words, 5.6±0.8 words, 4.2±1.1 words, 2.4±0.9 words (in men – 4.5±0.8 words, 5.5±1.0 words, 5.8±1.0 words, 5.8±0, 8 words, 4.5±1.0 words, 2.0±0.9 words, in women – 4.6±1.1 words, 4.6±1.5 words, 6.0±1.4 words, 5.4±0.9 words, 3.8±1.1 words, 2.8±0.8 words). Certain differences in cognitive impairment were found depending on the clinical version of the primary episode; however, the differences between men and women are insignificant. Further prospects are related to the improvement of methods for predicting and treating cognitive impairment in bipolar disorders.

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Associations Between Self-Report of Emotional State and the EEG Patterns in Affective Disorders Patients

Journal of Psychophysiology ◽

10.1027/0269-8803/a000004 ◽

2010 ◽

Vol 24 (1) ◽

pp. 33-40 ◽

Cited By ~ 7

Author(s):

Miroslaw Wyczesany ◽

Jan Kaiser ◽

Anton M. L. Coenen

Keyword(s):

State Energy ◽

Emotional State ◽

Spectral Power ◽

Bipolar Affective Disorder ◽

Affective State ◽

Manic Episode ◽

High Energy ◽

Self Report ◽

Major Depressive ◽

High Tension

The study determines the associations between self-report of ongoing emotional state and EEG patterns. A group of 31 hospitalized patients were enrolled with three types of diagnosis: major depressive disorder, manic episode of bipolar affective disorder, and nonaffective patients. The Thayer ADACL checklist, which yields two subjective dimensions, was used for the assessment of affective state: Energy Tiredness (ET) and Tension Calmness (TC). Quantitative analysis of EEG was based on EEG spectral power and laterality coefficient (LC). Only the ET scale showed relationships with the laterality coefficient. The high-energy group showed right shift of activity in frontocentral and posterior areas visible in alpha and beta range, respectively. No effect of ET estimation on prefrontal asymmetry was observed. For the TC scale, an estimation of high tension was related to right prefrontal dominance and right posterior activation in beta1 band. Also, decrease of alpha2 power together with increase of beta2 power was observed over the entire scalp.

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ADOECIMENTO DE PROFESSORES UNIVERSITÁRIOS COM DIAGNÓSTICO DE TRANSTORNO AFETIVO BIPOLAR UMA REVISÃO DE LITERATURA

REVISTA FIMCA ◽

10.37157/fimca.v6i3.21 ◽

2019 ◽

Vol 6 (3) ◽

pp. 1-6

Author(s):

Pâmela Gomes Artioli ◽

Natiely Souza Lima ◽

Camila Silva

Keyword(s):

Higher Education ◽

Bipolar Disorder ◽

Bipolar Affective Disorder ◽

Physical Work ◽

Education Professionals ◽

Work Related ◽

Analysis Technique ◽

Work Routine ◽

Teaching Area

Introdução: Com o passar dos anos, além de doenças laborais físicas, surge um novo cenário de doenças emocionais que vem afetando gradativamente profissionais da área da docência a pesquisa em questão visou identificar os transtornos mentais que mais provocam afastamento de docentes em instituições de ensino superior, (com ênfase no transtorno bipolar), onde contribuiu para se aprofundar a análise de fatores relacionados a esse tipo de transtorno. Objetivos: os objetivos deste estudo, são de realizar análise crática e reflexiva quanto ao número elevado de professores de ensino superior com o Transtorno Afetivo Bipolar, e a relação dos fatores associados a este impedimento dos profissionais, destacar também questões relativas à saúde mental, e identificar quais são as consequências que implicam na rotina de trabalho desses professores e o aumento de docentes com diagno?stico de Transtorno Bipolar. Materiais e Métodos: Quanto à fundamentação teórica, trata-se de um referencial bibliográfico ao passo que utiliza de literaturas científicas disponibilizadas por meio eletrônico. Utilizando-se como técnica de análise de dados a análise de conteúdo interpretativa. Os critérios de inclusão que foram usados são: publicações em português, entre os anos de 2000 a 2018 disponíveis na íntegra. Conclusão: Por fim chegou-se ao entendimento de que além da sobrecarga os docentes remanescentes, o adoecimento crescente dos profissionais da educação compromete a qualidade de vida desses profissionais. Introduction: Over the years, in addition to physical work-related illnesses, a new scenario of emotional diseases emerges that has gradually affected professionals in the teaching area. The research in question aimed at identifying the mental disorders that cause the most withdrawal of teachers in higher education institutions, (with emphasis on bipolar disorder), where it contributed to deepen the analysis of factors related to this type of disorder. Objectives: The objectives of this study are to perform a critical and reflexive analysis regarding the high number of teachers of higher education with Bipolar Affective Disorder, and the relation of the factors associated with this impediment of the professionals, also highlight issues related to mental health, and identify what are the consequences that imply in the work routine of these teachers and the increase of teachers diagnosed with Bipolar Disorder. Materials and Methods: Regarding the theoretical basis, it is a bibliographical reference while using scientific literatures made available electronically. The analysis of interpretive content was used as data analysis technique. The inclusion criteria that were used are: publications in Portuguese, between the years 2000 to 2018 available in full. Conclusion: Finally, it was understood that in addition to overloading the remaining teachers, the growing sickness of education professionals compromises the quality of life of these professionals.

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Adapting a neuroscience-informed intervention to alter reward mechanisms of anorexia nervosa: a novel direction for future research

Journal of Eating Disorders ◽

10.1186/s40337-021-00417-5 ◽

2021 ◽

Vol 9 (1) ◽

Author(s):

Ann F. Haynos ◽

Lisa M. Anderson ◽

Autumn J. Askew ◽

Michelle G. Craske ◽

Carol B. Peterson

Keyword(s):

Anorexia Nervosa ◽

Eating Disorder ◽

Anxiety Disorders ◽

Reward Processing ◽

Future Research ◽

Restrictive Eating ◽

Eating Disorder Symptoms ◽

Mood And Anxiety Disorders ◽

Reward Responsivity ◽

Eating Disorder Behaviors

AbstractAccumulating psychobiological data implicate reward disturbances in the persistence of anorexia nervosa (AN). Evidence suggests that individuals with AN demonstrate decision-making deficits similar to those with mood and anxiety disorders that cause them to under-respond to many conventionally rewarding experiences (e.g., eating, interacting socially). In contrast, unlike individuals with other psychiatric disorders, individuals with AN simultaneously over-respond to rewards associated with eating-disorder behaviors (e.g., restrictive eating, exercising). This pattern of reward processing likely perpetuates eating-disorder symptoms, as the rewards derived from eating-disorder behaviors provide temporary relief from the anhedonia associated with limited responsivity to other rewards. Positive Affect Treatment (PAT) is a cognitive-behavioral intervention designed to target reward deficits that contribute to anhedonia in mood and anxiety disorders, including problems with reward anticipation, experiencing, and learning. PAT has been found to promote reward responsivity and clinical improvement in mood and anxiety disorders. This manuscript will: (1) present empirical evidence supporting the promise of PAT as an intervention for AN; (2) highlight nuances in the maintaining processes of AN that necessitate adaptations of PAT for this population; and (3) suggest future directions in research on PAT and other reward-based treatments that aim to enhance clinical outcomes for AN.

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Cognitive errors assessed by observer ratings in bipolar affective disorder: relationship with symptoms and therapeutic alliance

The Cognitive Behaviour Therapist ◽

10.1017/s1754470x09990043 ◽

2009 ◽

Vol 2 (2) ◽

pp. 92-105 ◽

Cited By ~ 5

Author(s):

Ueli Kramer ◽

Guy Bodenmann ◽

Martin Drapeau

Keyword(s):

Cognitive Therapy ◽

Affective Disorder ◽

Mood Disorders ◽

Bipolar Affective Disorder ◽

Cognitive Model ◽

Control Group ◽

Cognitive Errors ◽

Manic Symptoms ◽

Observer Ratings ◽

Depressive Patients

AbstractThe construct of cognitive errors is clinically relevant for cognitive therapy of mood disorders. Beck's universality hypothesis postulates the relevance of negative cognitions in all subtypes of mood disorders, as well as positive cognitions for manic states. This hypothesis has rarely been empirically addressed for patients presenting bipolar affective disorder (BD). In-patients (n= 30) presenting with BD were interviewed, as were 30 participants of a matched control group. Valid and reliable observer-rater methodology for cognitive errors was applied to the session transcripts. Overall, patients make more cognitive errors than controls. When manic and depressive patients were compared, parts of the universality hypothesis were confirmed. Manic symptoms are related to positive and negative cognitive errors. These results are discussed with regard to the main assumptions of the cognitive model for depression; thus adding an argument for extending it to the BD diagnostic group, taking into consideration specificities in terms of cognitive errors. Clinical implications for cognitive therapy of BD are suggested.

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Who Responds to Prophylactic Lithium Therapy?

The British Journal of Psychiatry ◽

10.1192/s0007125000292441 ◽

1993 ◽

Vol 163 (S21) ◽

pp. 20-26 ◽

Cited By ~ 24

Author(s):

M. T. Abou-Saleh

Keyword(s):

Bipolar Disorder ◽

Family History ◽

Bipolar Affective Disorder ◽

Positive Family History ◽

Specific Treatment ◽

Predictors Of Outcome ◽

Powerful Predictor ◽

Bipolar Illness ◽

History Of ◽

Psychotic Features

The search for predictors of outcome has not been particularly rewarding, and the use of lithium remains empirical: a trial of lithium is the most powerful predictor of outcome. However, lithium is a highly specific treatment for bipolar disorder. In non-bipolar affective disorder, factors of interest are correlates of bipolar disorder: mood-congruent psychotic features, retarded-endogenous profile, cyclothymic personality, positive family history of bipolar illness, periodicity, and normality between episodes of illness.

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Neurocysticercosis presenting as bipolar disorder: a case report

General Psychiatry ◽

10.1136/gpsych-2021-100663 ◽

2021 ◽

Vol 34 (6) ◽

pp. e100663

Author(s):

Surbhi Batra ◽

Sumit Kumar ◽

Lokesh Singh Shekhawat

Keyword(s):

Bipolar Disorder ◽

Case Report ◽

Depressive Symptoms ◽

Affective Disorder ◽

Postpartum Period ◽

Bipolar Affective Disorder ◽

Taenia Solium ◽

Manic Episode ◽

Symptoms And Signs ◽

Rule Out

Neurocysticercosis is the most common neuro-parasitosis caused by the larval stage of Taenia solium. The most common manifestations include seizures and hydrocephalus. Psychiatric abnormalities are relatively rare but depressive symptoms are frequent in patients with neurocysticercosis. However, mania as a presentation is relatively rare. Pregnancy and the postpartum period are relatively vulnerable times and they can lead to reactivation of existing neurocysterci lesions. We are discussing the case of a 23-year-old female patient with neurocysticercosis leading to the reactivation of lesions in the peripartum and postpartum period leading to bipolar affective disorder. Improvement in the patient was seen with a combination of antipsychotics, antihelmintics, antiepileptics and steroids, along with improved radiological signs of neurocysterci lesions. Although neurocysticercosis is a common illness, its prevalence presenting as a manic episode is merely 2.6% and, hence, missed easily. Therefore, it is important to rule out organic aetiology in patients even with a classic presentation of bipolar affective disorder and those having any other neurological symptoms and signs.

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Characteristics of verbal fluency in patients with a primary episode of bipolar affective disorder

Psychiatry Neurology and Medical Psychology ◽

10.26565/2312-5675-2020-13-02 ◽

2020 ◽

Keyword(s):

Depressive Symptoms ◽

Affective Disorder ◽

Test Performance ◽

Verbal Fluency ◽

High Speed ◽

Bipolar Affective Disorder ◽

Rapid Change ◽

Verbal Fluency Test ◽

Manic Symptoms ◽

Fluency Test

A study was conducted using the verbal fluency test of 153 patients with a primary episode of bipolar affective disorder: with prevalence of depressive symptoms (44 men and 75 women), with prevalence of manic symptoms (15 men and 8 women), and with simultaneous presence of depressive symptoms and manic symptoms phase change (6 men and 5 women). Significant impairment of test performance in patients with depression with respect to phonetic and semantic verbal fluency was revealed: the average number of words per letter "K" per 60 sec. in all patients 14,1±2,7 words, in men – 13,8±3,1 words, in women - 14,3±2,4 words, on the letter "P" – 12,5±2,8 respectively words, 12.3±3.2 words, 12.6±2.6 words, "Male Names" – 13.1±2.6 words respectively, 12.8±3.0 words, 13.3±2,4 words; "Fruits / furniture" – 12.0±2.4 words, 11.9±2.8 words, 12.1±2.1 words. Deterioration in the performance of semantic and phonemic verbal fluency test reflects the state of bradypsychism inherent in patients with depressive variant, which manifests a slow thinking rate, difficulty concentrating attention, motor inhibition, deterioration of operational capacity, rapid exhaustion. In patients with a maniacal variant, the high speed of the test is offset by a large number of errors due to the chaotic mental activity, instability and scattering of attention, the difficulty of maintaining focus of attention: the indicators were respectively 21.7±5.7 words, 22.5±5.7 words, 20,3±6.0 words; 20.3±5.6 words, 21.1±5.5 words, 19.0±5.9 words; 20.5±5.4 words, 21.2±5.2 words, 19.1±5.7 words; 19.5±5.4 words, 20.2±5.2 words, 18.1±5.7 words. In patients with mixed variants, the indicators of verbal fluency are reduced due to the influence of complex polymorphic symptoms with rapid change of state: respectively 16.5±5.6 words, 18.2±6.1 words, 14.4±4.8 words; 14.5±5.4 words, 16.2±5.7 words, 12.4±4.8 words; 15.4±5.4 words, 17.0±5.8 words, 13.4±4.8 words; 13.9±5.0 words, 15.5±5.3 words, 12.0±4.3 words. The differences in scores across all subtests in all groups between men and women are statistically insignificant (p>0.05).

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