Behavioral approach system (BAS)–relevant cognitive styles and bipolar spectrum disorders: Concurrent and prospective associations.

Abstract

We examined concurrent and prospective associations of Behavioral Approach System (BAS)-relevant and non-BAS-relevant cognitive styles with bipolar spectrum disorders. Controlling for depressive and hypomanic/manic symptoms, 195 individuals with bipolar spectrum disorders scored higher than 194 demographically matched normal controls on BAS sensitivity and BAS-relevant cognitive dimensions of performance concerns, autonomy, and self-criticism, but not on BIS sensitivity and non-BAS-relevant dimensions of approval-seeking, sociotropy, and dependency. Moreover, group differences on autonomy fully mediated the association between higher BAS sensitivity and bipolar status. In addition, only BAS-related cognitive dimensions predicted the likelihood of onset of depressive and hypomanic/manic episodes among the bipolar individuals over a 3.2-year follow-up, controlling for initial symptoms and past history of mood episodes. Higher autonomy and self-criticism predicted a greater likelihood of hypomanic/manic episodes and higher autonomy predicted a lower likelihood of major depressive episodes. In addition, autonomy mediated Corresponding author: Lauren B. Alloy, Ph.D., Department of Psychology, Temple University, 1701 N. 13 th Street, Philadelphia, PA 19122. Phone: 215-204-7326, Fax: 215-204-5539, lalloy@temple.edu. NIH Public AccessAuthor Manuscript J Abnorm Psychol. Author manuscript; available in PMC 2010 August 1. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript the associations between BAS sensitivity and prospective hypomanic/manic episodes. These findings suggest that individuals with bipolar spectrum disorders may exhibit a unique profile of BAS-relevant cognitive styles that influence the course of their mood episodes. KeywordsBipolar Spectrum Disorder; Behavioral Approach System (BAS); Cognitive Styles Bipolar spectrum disorders are prevalent (4.4% of a nationally representative U.S. sample; Merikangas et al., 2007) and often produce significant impairment such as poorer academic achievement, erratic work history, divorce, suicide, and substance abuse (e.g., Angst, Stassen, Clayton, & Angst, 2002;Conway, Compton, Stinson, & Grant, 2006;Goodwin & Jamison, 1990;Grant et al., 2004;Nusslock, Alloy, Abramson, Harmon-Jones, & Hogan, 2008;Quackenbush, Kutcher, Robertson, Boulos, & Chaban, 1996;Strakowski, DelBello, Fleck, & Arndt, 2000). These disorders appear to form a spectrum of severity from the milder subsyndromal cyclothymia, to bipolar II disorder, to full-blown bipolar I disorder (e.g., Akiskal, Djenderedijian, Rosenthal, & Khani, 1977;Akiskal, Khani, & Scott-Strauss, 1979;Cassano et al., 1999;Depue et al., 1981;Goodwin & Jamison, 1990). Moreover, milder forms of bipolar disorder often progress to the more severe forms (e.g., Akiskal et al., 1977;Shen, Alloy, Abramson, & Grandin, 2008), providing support for the spectrum concept.Recently, there has been increasing interest in psychosocial processes in the onset, course, and treatment of bipolar spectrum disorders (see A...

Elevated ambitions for fame among persons diagnosed with bipolar I disorder.

“…Other findings suggest that overly positive views of the self (Lam, Wright, & Sham, 2005), Behavioral Approach System sensitivity (Meyer, Johnson, & Winters, 2001), beliefs about the importance of goals (Alloy et al, 2009;Francis-Raniere, Alloy, & Abramson, 2006), and goal engagement (Lozano & Johnson, 2001) can predict increases in mania. Evidence across these studies suggests an important role for cognitive and personality variables related to goal dysregulation as predictors of the course of manic symptoms.…”

“…Thus, evidence concerning more specific processes has been sought. People with bipolar disorder appear to value goal pursuit more than do other people (Alloy et al, 2009;Fulford, Johnson, & Tuchman, 2009;Scott, Stanton, Garland, & Ferrier, 2000;Spielberger, Parker, & Becker, 1963;Wright, Lam, & Newsom-Davis, 2005). They report both viewing goal attainment as central to their sense of worth (Lam, Wright, & Sham, 2005;Scott, Stanton, Garland, & Ferrier, 2000) and pursuing their goals in a more effortful and perfectionistic manner (Morrison, 2003;Spielberger, Parker, & Becker, 1963).…”

“…These findings have come from studies of bipolar I disorder (Lam, Wright, & Smith, 2004;Salavert et al, 2007;Van der Gucht, Morriss, Lancaster, Kinderman, & Bentall, 2009; but see Jones, Tai, Evershed, Knowles, & Bentall, 2006 for a nonreplication), bipolar spectrum disorders (Alloy & Abramson, 2010;Alloy et al, 2006Alloy et al, , 2008Alloy et al, , 2009, and samples at risk for disorder by virtue of a history of subsyndromal manic symptoms Fulford, Johnson, & Carver, 2008;Gruber & Johnson, 2009;Johnson & Carver, 2006;Meyer, Beevers, Jonson, & Simmons, 2007;Meyer & Hofmann, 2005;Meyer, Johnson, & Carver, 1999). Most of these studies relied on the self-report Behavioral Approach System scales (Carver & White, 1994) to assess reward sensitivity, but elevations on behavioral and psychophysiological measures of reward sensitivity have also been found among students at risk for mania (Harmon-Jones et al, 2008;Hayden et al, 2008;Sutton & Johnson, 2002).…”

The transdiagnostic process of perfectionism = El proceso transdiagnóstico del perfeccionismo

“…The causal role of perfectionism in the development of depression was demonstrated in two studies where scores on the perfectionism subscale of the Dysfunctional Attitudes Scale (Weissman & Beck, 1978) The role of perfectionism has also been recognised in bipolar disorder where individuals with bipolar disorder have been found to score higher on the perfectionism subscale of the Dysfunctional Attitudes Scale compared to controls (Jones et al, 1995). Perfectionism scores on the Dysfunctional Attitudes Scale have also been found to predict onset of hypomanic and manic episodes (Alloy et al, 2009).…”

Can a Diagnosis Be Epidemic, With Therapeutic Efforts the Catastrophe?

“…This outcome is particularly surprising given the findings on the personality characteristics of those individuals who meet criteria for bipolar II. Alloy et al (2009a) found that college students with bipolar II are more likely to exhibit elevated scores on the Carver and White measure of the behavioral activation system (BAS) (Carver & White, 1994). Moreover, if students are selected for extreme scores on the BAS and compared to those with moderate scores, the former more often meet criteria for bipolar II (Alloy et al 2006).…”