Strong positive emotions drive impulsivity in bipolar I disorder
By Helen Albert, Senior medwireNews Reporter
02 May 2013
Acta Psychiatr Scand 2013; Advance online publication

medwireNews: Strong positive emotions increase the risk for impulsive behavior in patients with bipolar I disorder, suggest study findings.

In patients with bipolar I disorder "impulsivity is one of the criteria for diagnosing a manic episode… and gives rise to some of the most disruptive behaviors that can occur during manic episodes, such as unrestrained spending, sexual indiscretions, and embarking on risky financial ventures," explain Sheri Johnson (University of California, Berkeley, USA) and colleagues. It can also relate to severity of manic episodes, they add.

Finding predictors of impulsivity could therefore be helpful for regulating potentially disruptive behavior in these patients, say Johnson and team.

They recruited 91 people with bipolar I disorder who were not currently having an episode and 80 controls without the disorder to take part in their study. All participants completed various validated measures of impulsivity including the Fun-seeking

subscale of the Behavioral Activation System scale (relating to reward) and Positive Urgency and Negative Urgency scales (relating to emotion).

When the researchers compared the results obtained for bipolar I disorder patients and controls on the various scales they found that Positive Urgency, a measure of a person's tendency to be impulsive when experiencing strong positive emotion, was the main differentiating factor between them. On univariate testing, the mean score for Positive Urgency was 33.7 in the bipolar I group versus 21.0 in the control group, a statistically significant difference.

Positive Urgency was linked to poorer psychosocial functioning in the patients with bipolar I disorder. Using the Global Assessment of Functioning (GAF) as an assessment tool, the researchers found that 24.2% of the variance in GAF score could be explained by Positive Urgency after controlling for site and comorbid diagnoses. No other impulsivity variables had a significant effect on GAF.

"Our findings provide an important first step toward developing a more refined understanding of impulsivity in bipolar disorder and underscore the pivotal influence of strong positive emotion on impulsive behavior and functioning in this illness," write Johnson et al in Acta Psychiatrica Scandinavica.

"Research corroborating these early self-report findings with multiple methods, including the kinds of laboratory-based and ecological measures outlined above, could lead to more fine-tuned interventions that help to stem self-destructive impulsive behaviors and improve the wellbeing of persons with bipolar disorder," they conclude.

medwireNews (www.medwirenews.com) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2013

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