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Glas VFJ, Koenders MA, Kupka RW, Regeer EJ. How to study psychological mechanisms of mania? A systematic review on the methodology of experimental studies on manic mood dysregulation of leading theories on bipolar disorder. Bipolar Disord 2024. [PMID: 39043623 DOI: 10.1111/bdi.13463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/25/2024]
Abstract
INTRODUCTION Although there are several psychological theories on bipolar disorders (BD), the empirical evidence on these theories through experimental studies is still limited. The current study systematically reviews experimental methods used in studies on the main theories of BD: Reward Hypersensitivity Theory (RST) or Behavioral Activation System (BAS), Integrative Cognitive Model (ICM), Positive Emotion Persistence (PEP), Manic Defense theory (MD), and Mental Imagery (MI). The primary aim is to provide an overview of the used methods and to identify limitations and suggest areas of improvement. METHODS A systematic search of six databases until October 2023 was conducted. Study selection involved two independent reviewers extracting data on experimental study design and methodology. RESULTS A total of 84 experimental studies were reviewed. BAS and RST were the most frequently studied theories. The majority of these experimental studies focus on mechanisms of reward sensitivity. Other important elements of the reviewed theories, such as goal setting and-attainment, situation selection (avoidance or approach), activation, affective/emotional reactivity, and regulatory strategies, are understudied. Self-report and neuropsychological tasks are most often used, while mood induction and physiological measures are rarely used. CONCLUSION There is a need for more consensus on the operationalization of psychological theories of mania. Standardization of test batteries could improve comparability among studies and foster a more systematic approach to experimental research. Research on affective (activated) states is still underrepresented in comparison with studies on trait vulnerabilities.
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Affiliation(s)
- V F J Glas
- Altrecht Institute for Mental Health Care, Utrecht, The Netherlands
- Department of Psychiatry and Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Vrije Universiteit, Amsterdam, The Netherlands
| | - M A Koenders
- Clinical Psychology Unit, Leiden University, Leiden, The Netherlands
| | - R W Kupka
- Altrecht Institute for Mental Health Care, Utrecht, The Netherlands
- Department of Psychiatry and Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Vrije Universiteit, Amsterdam, The Netherlands
| | - E J Regeer
- Altrecht Institute for Mental Health Care, Utrecht, The Netherlands
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Zhu W, Chen X, Wu J, Li Z, Im H, Chen S, Deng K, Zhang B, Wei C, Feng J, Zhang M, Yang S, Wang H, Wang Q. Neuroanatomical and functional substrates of the hypomanic personality trait and its prediction on aggression. Int J Clin Health Psychol 2023; 23:100397. [PMID: 37560478 PMCID: PMC10407439 DOI: 10.1016/j.ijchp.2023.100397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 07/10/2023] [Indexed: 08/11/2023] Open
Abstract
Hypomanic personality manifests a close link with several psychiatric disorders and its abnormality is a risk indicator for developing bipolar disorders. We systematically investigated the potential neuroanatomical and functional substrates underlying hypomanic personality trait (HPT) and its sub-dimensions (i.e., Social Vitality, Mood Volatility, and Excitement) combined with structural and functional imaging data as well as their corresponding brain networks in a large non-clinical sample across two studies (n = 464). Behaviorally, HPT, specifically Mood Volatility and Excitement, was positively associated with aggressive behaviors in both studies. Structurally, sex-specific morphological characteristics were further observed in the motor and top-down control networks especially for Mood Volatility, although HPT was generally positively associated with grey matter volumes (GMVs) in the prefrontal, temporal, visual, and limbic systems. Functionally, brain activations related to immediate or delayed losses were found to predict individual variability in HPT, specifically Social Vitality and Excitement, on the motor and prefrontal-parietal cortices. Topologically, connectome-based prediction model analysis further revealed the predictive role of individual-level morphological and resting-state functional connectivity on HPT and its sub-dimensions, although it did not reveal any links with general brain topological properties. GMVs in the temporal, limbic (e.g., amygdala), and visual cortices mediated the effects of HPT on behavioral aggression. These findings suggest that the imbalance between motor and control circuits may be critical for HPT and provide novel insights into the neuroanatomical, functional, and topological mechanisms underlying the specific temperament and its impacts on aggression.
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Affiliation(s)
- Wenwei Zhu
- Faculty of Psychology, Tianjin Normal University, Tianjin 300387, China
| | - Xiongying Chen
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100069, China
| | - Jie Wu
- Faculty of Psychology, Tianjin Normal University, Tianjin 300387, China
- Key Research Base of Humanities and Social Sciences of the Ministry of Education, Academy of Psychology and Behavior, Tianjin Normal University, Tianjin 300387, China
- Tianjin Social Science Laboratory of Students’ Mental Development and Learning, Tianjin 300387, China
| | - Zixi Li
- Faculty of Psychology, Tianjin Normal University, Tianjin 300387, China
| | - Hohjin Im
- Department of Psychological Science, University of California, Irvine, CA 92697-7085, USA
| | - Shuning Chen
- Faculty of Psychology, Tianjin Normal University, Tianjin 300387, China
| | - Kun Deng
- Faculty of Psychology, Tianjin Normal University, Tianjin 300387, China
| | - Bin Zhang
- Faculty of Psychology, Tianjin Normal University, Tianjin 300387, China
| | - Chuqiao Wei
- Faculty of Psychology, Tianjin Normal University, Tianjin 300387, China
| | - Junjiao Feng
- Faculty of Psychology, Tianjin Normal University, Tianjin 300387, China
- Key Research Base of Humanities and Social Sciences of the Ministry of Education, Academy of Psychology and Behavior, Tianjin Normal University, Tianjin 300387, China
- Tianjin Social Science Laboratory of Students’ Mental Development and Learning, Tianjin 300387, China
| | - Manman Zhang
- Faculty of Psychology, Tianjin Normal University, Tianjin 300387, China
- Key Research Base of Humanities and Social Sciences of the Ministry of Education, Academy of Psychology and Behavior, Tianjin Normal University, Tianjin 300387, China
- Tianjin Social Science Laboratory of Students’ Mental Development and Learning, Tianjin 300387, China
| | - Shaofeng Yang
- Faculty of Psychology, Tianjin Normal University, Tianjin 300387, China
- Key Research Base of Humanities and Social Sciences of the Ministry of Education, Academy of Psychology and Behavior, Tianjin Normal University, Tianjin 300387, China
- Tianjin Social Science Laboratory of Students’ Mental Development and Learning, Tianjin 300387, China
| | - He Wang
- Institute of Biomedical Engineering, Chinese Academy of Medical Science & Peking Union Medical College, Tianjin 300192, China
| | - Qiang Wang
- Faculty of Psychology, Tianjin Normal University, Tianjin 300387, China
- Key Research Base of Humanities and Social Sciences of the Ministry of Education, Academy of Psychology and Behavior, Tianjin Normal University, Tianjin 300387, China
- Tianjin Social Science Laboratory of Students’ Mental Development and Learning, Tianjin 300387, China
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Aidelbaum R, Shakeel MK, Goghari V. A self-report and behavioural assessment of impulsivity in bipolar disorder: Evidence of elevated trait but not behavioural facets. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021. [DOI: 10.1016/j.jadr.2021.100279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Wang H, Lesh TA, Maddock RJ, Fassbender C, Carter CS. Delay discounting abnormalities are seen in first-episode schizophrenia but not in bipolar disorder. Schizophr Res 2020; 216:200-206. [PMID: 31902558 PMCID: PMC7239725 DOI: 10.1016/j.schres.2019.11.063] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 10/27/2019] [Accepted: 11/30/2019] [Indexed: 01/08/2023]
Abstract
Delay discounting (DD) is the phenomenon of individuals discounting future rewards as a function of time. It has been studied extensively in chronic schizophrenia (SZ) and the results of these studies have been variable. Comorbidity in chronic samples could be one reason for the mixed findings and studies in first-episode (FE) samples are surprisingly lacking. Bipolar disorder (BP) which shares some genetic and symptom features with SZ could serve as an interesting comparison group for DD but has been underexplored. Here we present the first study that combines FE SZ, FE BP with psychotic features, as well as healthy controls and study DD with two versions of the task. We found that SZ showed steeper discounting than HC and BP on the well-validated Kirby DD task. SZ showed no difference than HC on a separate DD task with smaller rewards presented with decimal places and shorter delays. As a preliminary finding, DD was found to be positively related to positive symptoms in FE SZ, while no relationship was found between negative symptoms and DD. In addition, we found comparable DD in BP compared to HC. Ultimately, our data may help elucidate the psychopathology in SZ and BP during intertemporal decision making.
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Affiliation(s)
- Huan Wang
- Department of Psychiatry, University of California, Davis, Davis, CA, USA.
| | - Tyler A. Lesh
- Department of Psychiatry, University of California, Davis, Davis, California, USA
| | - Richard J. Maddock
- Department of Psychiatry, University of California, Davis, Davis, California, USA
| | - Catherine Fassbender
- Department of Psychiatry, University of California, Davis, Davis, California, USA
| | - Cameron S. Carter
- Department of Psychiatry, University of California, Davis, Davis, California, USA,Corresponding author: Huan Wang () or Cameron S. Carter ()
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Reich R, Gilbert A, Clari R, Burdick KE, Szeszko PR. A preliminary investigation of impulsivity, aggression and white matter in patients with bipolar disorder and a suicide attempt history. J Affect Disord 2019; 247:88-96. [PMID: 30658245 DOI: 10.1016/j.jad.2019.01.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 10/24/2018] [Accepted: 01/02/2019] [Indexed: 01/20/2023]
Abstract
BACKGROUND Impulsivity and aggression may be associated with suicide attempts in bipolar disorder (BD), but findings have been inconsistent. Abnormalities in anterior white matter tracts that project to the frontal lobes mediate top-down regulation of emotion and may contribute to this clinical phenomenology. METHODS We assessed white matter (i.e., fractional anisotropy) in anterior and posterior brain regions using diffusion tensor imaging in 18 patients with BD and no prior suicide attempt (BD-S), 12 patients with BD and a prior suicide attempt (BD+S), and 12 healthy volunteers. Patients completed the Urgency, Premeditation, Perseverance, Sensation Seeking, Positive Urgency (UPPS-P) Impulsive Behavior Scale and Impulsive Premeditated Aggression Scale (IPAS). All individuals completed the Barratt Impulsiveness Scale (BIS-11). RESULTS Patients with BD+S had higher overall impulsivity (assessed using both the UPPS-P Impulsive Behavior Scale and BIS-11) and premeditated aggression compared to patients with BD-S. There were no significant group differences on measures of fractional anisotropy (FA). In patients with BD+S, however, higher FA in the anterior (but not the posterior) brain regions correlated with greater overall impulsivity on the UPPS-P Impulsive Behavior Scale. There were no significant correlations between either anterior or posterior brain regions with clinical measures in patients with BD-S. LIMITATIONS Cross-sectional study, sample size and possible contribution of psychotropic medications. CONCLUSION Impulsivity and aggression may be risk factors for a suicide attempt in BD. White matter in the anterior limb of the internal capsule and anterior corona radiata may play a role in this phenomenology.
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Affiliation(s)
- Rachel Reich
- Yeshiva University, Ferkauf Graduate School of Psychology, Bronx, NY, USA
| | - Alison Gilbert
- Feinstein Institute for Medical Research, Manhasset, NY, USA
| | - Rosarito Clari
- Icahn School of Medicine at Mount Sinai, Department of Psychiatry, New York, NY, USA
| | - Katherine E Burdick
- Brigham and Women's Hospital, Harvard Medical School, Department of Psychiatry, Boston MA, USA; James J. Peters VA Medical Center, Mental Health Patient Care Center and Mental Illness Research Education Clinical Center (MIRECC), Bronx, NY, USA
| | - Philip R Szeszko
- Icahn School of Medicine at Mount Sinai, Department of Psychiatry, New York, NY, USA; James J. Peters VA Medical Center, Mental Health Patient Care Center and Mental Illness Research Education Clinical Center (MIRECC), Bronx, NY, USA.
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Um M, Hershberger AR, Whitt ZT, Cyders MA. Recommendations for applying a multi-dimensional model of impulsive personality to diagnosis and treatment. Borderline Personal Disord Emot Dysregul 2018; 5:6. [PMID: 29619225 PMCID: PMC5879935 DOI: 10.1186/s40479-018-0084-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 03/13/2018] [Indexed: 01/10/2023] Open
Abstract
The UPPS-P Model of Impulsive Personality, a prominent model of impulsive personality derived from the Five Factor Model of Personality, is a multi-dimensional model of impulsive personality that consists of negative urgency, lack of premeditation, lack of perseveration, sensation seeking, and positive urgency. The UPPS-P model has highlighted the importance of separating multidimensional traits due to the specificity of these traits corresponding to different risk behaviors. The goal of the current review paper is to make recommendations on how to apply the UPPS-P Model of Impulsive Personality, to diagnosis of and treatment for psychopathology. However, despite impulsivity being one of the most frequently used criteria for a number of clinical disorders, our review of the Diagnostic and Statistical Manual for Mental Disorders-5 found that the UPPS-P traits are not well represented in the diagnostic criteria, which we propose limits inferences about etiology and treatment targets. Additionally, research has largely focused on the importance of these traits for risk models; our review of the literature applying the UPPS-P traits to treatment processes and outcomes concluded that this area is not yet well studied. Here, we propose the specific application of the UPPS-P model to improve diagnosis and increase treatment effectiveness.
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Affiliation(s)
- Miji Um
- Department of Psychology, Indiana University - Purdue University Indianapolis, 402 N Blackford St, LD 124, Indianapolis, IN 46202 USA
| | - Alexandra R Hershberger
- Department of Psychology, Indiana University - Purdue University Indianapolis, 402 N Blackford St, LD 124, Indianapolis, IN 46202 USA
| | - Zachary T Whitt
- Department of Psychology, Indiana University - Purdue University Indianapolis, 402 N Blackford St, LD 124, Indianapolis, IN 46202 USA
| | - Melissa A Cyders
- Department of Psychology, Indiana University - Purdue University Indianapolis, 402 N Blackford St, LD 124, Indianapolis, IN 46202 USA
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Raucher-Chéné D, Terrien S, Gobin P, Gierski F, Kaladjian A, Besche-Richard C. Modulation of the N400 component in relation to hypomanic personality traits in a word meaning ambiguity resolution task. Psychiatry Clin Neurosci 2017; 71:637-646. [PMID: 28457018 DOI: 10.1111/pcn.12534] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 03/11/2017] [Accepted: 04/25/2017] [Indexed: 01/07/2023]
Abstract
AIM High levels of hypomanic personality traits have been associated with an increased risk of developing bipolar disorder (BD). Changes in semantic content, impaired verbal associations, abnormal prosody, and abnormal speed of language are core features of BD, and are thought to be related to semantic processing abnormalities. In the present study, we used event-related potentials to investigate the relation between semantic processing (N400 component) and hypomanic personality traits. METHODS We assessed 65 healthy young adults on the Hypomanic Personality Scale (HPS). Event-related potentials were recorded during a semantic ambiguity resolution task exploring semantic ambiguity (polysemous word ending a sentence) and congruency (target word semantically related to the sentence). RESULTS As expected, semantic ambiguity and congruency both elicited an N400 effect across our sample. Correlation analyses showed a significant positive relationship between the Social Vitality subscore of the HPS and N400 modulation in the frontal region of interest in the incongruent unambiguous condition, and in the frontocentral region of interest in the incongruent ambiguous condition. CONCLUSION We found differences in semantic processing (i.e., detection of incongruence and semantic inhibition) in individuals with higher Social Vitality subscores. In the light of the literature, we discuss the notion that a semantic processing impairment could be a potential marker of vulnerability to BD, and one that needs to be explored further in this clinical population.
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Affiliation(s)
- Delphine Raucher-Chéné
- Psychiatry Department, University Hospital, Reims, France.,Cognition, Health & Socialization (C2S EA6291) Laboratory, University of Reims Champagne-Ardenne, Reims, France
| | - Sarah Terrien
- Cognition, Health & Socialization (C2S EA6291) Laboratory, University of Reims Champagne-Ardenne, Reims, France
| | - Pamela Gobin
- Cognition, Health & Socialization (C2S EA6291) Laboratory, University of Reims Champagne-Ardenne, Reims, France
| | - Fabien Gierski
- Cognition, Health & Socialization (C2S EA6291) Laboratory, University of Reims Champagne-Ardenne, Reims, France
| | - Arthur Kaladjian
- Psychiatry Department, University Hospital, Reims, France.,Cognition, Health & Socialization (C2S EA6291) Laboratory, University of Reims Champagne-Ardenne, Reims, France.,Faculty of Medicine, University of Reims Champagne-Ardenne, Reims, France
| | - Chrystel Besche-Richard
- Cognition, Health & Socialization (C2S EA6291) Laboratory, University of Reims Champagne-Ardenne, Reims, France
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Bauer IE, Meyer TD, Sanches M, Spiker D, Zunta-Soares G, Soares JC. Are self-rated and behavioural measures of impulsivity in bipolar disorder mainly related to comorbid substance use problems? Cogn Neuropsychiatry 2017; 22:298-314. [PMID: 28490234 DOI: 10.1080/13546805.2017.1324951] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Impulsivity is a multidimensional feature observed in bipolar disorder (BD) and substance use disorder (SUD). We previously found a relationship between SUD and risk taking in BD. It is still unclear whether self-rated and behavioral impulsivity measures differ between BD with and without comorbid SUD, or are specific to BD. METHODS 93 adults with BD with comorbid SUD, 91 BD without SUD, and 93 healthy controls (HC) were administered the Barratt Impulsivity Scale (BIS), the Behavioral Inhibition/Behavioral Activation System Scale (BIS/BAS), and the Cambridge Neuropsychological Test Automated Battery. Analyses compared impulsivity measures across groups controlling for age. Discriminant function analyses (DFA) assessed the combination of variables effectively predicting group membership. RESULTS BD displayed increased BIS, BIS/BAS scores, reduced performance on the Cambridge Gambling and Rapid Visual Processing, and Affective Go/No-Go tasks compared to HC. Comparisons between BD with and without SUD showed increased BIS Motor impulsiveness. The overall predictive power of DFA was weak. CONCLUSIONS Some facets of impulsivity are a core trait of BD and are partially independent from the presence of SUD. Motor impulsiveness may be distinctive of BD+SUD. More research is needed to understand the role of impulsive behaviors as risk factors for relapse in SUD.
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Affiliation(s)
- Isabelle E Bauer
- a Department of Psychiatry and Behavioral Sciences , McGovern Medical School, University of Texas Health Science Center at Houston , Houston , TX , USA
| | - Thomas D Meyer
- a Department of Psychiatry and Behavioral Sciences , McGovern Medical School, University of Texas Health Science Center at Houston , Houston , TX , USA
| | - Marsal Sanches
- a Department of Psychiatry and Behavioral Sciences , McGovern Medical School, University of Texas Health Science Center at Houston , Houston , TX , USA.,b Archway Mental Health Services , Bismarck , ND , USA
| | - Danielle Spiker
- a Department of Psychiatry and Behavioral Sciences , McGovern Medical School, University of Texas Health Science Center at Houston , Houston , TX , USA
| | - Giovana Zunta-Soares
- a Department of Psychiatry and Behavioral Sciences , McGovern Medical School, University of Texas Health Science Center at Houston , Houston , TX , USA
| | - Jair C Soares
- a Department of Psychiatry and Behavioral Sciences , McGovern Medical School, University of Texas Health Science Center at Houston , Houston , TX , USA
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