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23-01-2014 | Mental health | Article

Attentional biases toward emotion help characterize bipolar disorder


Free abstract

medwireNews: Attentional biases toward emotional images are a key feature of bipolar disorder and may contribute to increased vulnerability and continued maintenance of the condition, researchers report.

They found that 66 patients with bipolar disorder had a general bias toward threatening stimuli, regardless of mood state, relative to 20 mentally healthy individuals, and an “anhedonic bias” to positive stimuli when depressed.

Each participant simultaneously viewed four pictures depicting happy, neutral, sad, or threatening emotions for 20 seconds.

Eye-tracking technology showed that the 23 euthymic patients spent 24% of the time looking at threatening images, the 23 manic patients 25% of the time, and the 20 depressed patients 26% of the time, compared with 18% of the time for the mentally healthy controls.

“[T]he attentional preference toward threatening stimuli would increase the [bipolar disorder] patients’ emotional reactivity and would contribute to the onset or exacerbation of an affective episode,” says the team, led by Ana García-Blanco (Universitat de València, Spain).

“This bias toward threatening information is in accordance with accounts that emphasize the influence of these pathogenic attentional biases on reactivity to stressful events for [bipolar disorder] patients, even in asymptomatic patients and high-risk relatives,” they add.

The bipolar patients with depression also differed significantly from controls in terms of the time spent looking at happy images, at just 27% of the time compared with 38%, respectively.

The two groups did not differ significantly with regard to the percentage of time looking at sad images, however, leading the researchers to suggest that the emotional bias was due to a lack of motivation to focus attention on positive images, rather than a higher attention to sad images.

“[T]he avoidance of positive stimuli in the depressive state may disturb emotional self-regulation and may be an important maintenance factor for [bipolar disorder],” the researchers write in Psychiatry Research.

Therefore, training of biases toward mood-relevant information “may constitute a novel treatment for symptomatic [bipolar disorder] episodes,” they suggest.

The team also comments that if bias toward threatening images is confirmed as a vulnerability marker for bipolar disorder, it will be important to investigate whether potential preventive strategies can be used particularly in high-risk individuals.

medwireNews ( is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2014

By Lucy Piper, Senior medwireNews Reporter

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