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Stable and state-dependent impulsivity in Bipolar disorder. Maja Milavec , psychologist, Ph. D. student Lilijana Šprah , Assistant Professor and Research Fellow Sociomedical Institute at SRC SASA, Ljubljana, Slovenia. Bipolar disorder. - PowerPoint PPT Presentation
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Stable and state-dependent impulsivity in Bipolar disorder
Maja Milavec, psychologist, Ph. D. student
Lilijana Šprah, Assistant Professor and Research Fellow
Sociomedical Institute at SRC SASA, Ljubljana, Slovenia
Bipolar disorder
Any of several mood disorders, usually
characterised by alternating episodes of
depression and mania or by episodes of
depression alternating with mild,
non-psychotic excitement.
Impulsivity
is a predisposition toward
rapid, unplanned reactions to
internal or external stimuli
without regard to the negative
consequences of these reactions to the
impulsive individual or to others.
(Moeller, Barratt, Dougherty, Schmitz and Swann, 2001)
- A prominent aspect of Bipolar disorder;
- manic episode;
- can be present during depression;
- complications: suicide, substance abuse, complications
of manic episodes;
- stable or state-dependent;
- emotional modulation of cognitive control (attentional
bias to positive and negative information).
Impulsivity
Aims
1.) Whether emotional valence of stimulus influences
cognitive control in bipolar patients compared to
healthy individuals.
2.) Whether there is an interaction between stable and
state-dependent aspect of impulsivity in bipolar
disorder.
Method
Participants
- 39 bipolar outpatients
- 38 healthy individuals
(matched for age, gender and years of education)
Instruments
Barratt Impulsiveness Scale 11 (BIS-11)
- Questionnaire designed to measure impulsiveness (stable aspect).
- Three subscales: - attention (intention and cognitive instability), - motor (motor impulsiveness and lack of perseverance),- non-planning (lack of self-control and intolerance of
cognitive complexity).
(Patton, Standford and Barratt, 1995)
Affective Go/No-Go Task
- Computer administered;- pictures of negative, positive and neutral
emotional valence taken from International Affective Picture System (IAPS);
- 6 blocks with all combinations (negative/positive etc.).
Go Go No-Go No-Go Go
800 1000 800 1000 800 1000 800 1000 800
Time (ms)
Example:
“If the picture in front of you is PLEASANT, press the RED BUTTON on the keyboard AS FAST AS YOU CAN, other way don’t press
anything.”
Inst
ruct
ions
Reaction times
Bipolar outpatients had longer reaction times to emotional stimuli than healthy individuals.
0
100
200
300
400
500
600
700
800
900
Negative** Neutral* Positive*
emotional valence of targets (Go)
aver
age
reac
tio
n t
imes
BD
controls
* p<0,05; ** p<0,01
Global score
N M SD t p df
BD 39 136,59 12,79-2,280 0,026 73
controls 36 143,17 12,14
Bipolar outpatiens had less correct answers than healthy individuals.
N M SD t df
BIS-11 Attention BD 39 17,64 4,43
2,847** 75controls 38 15,05 3,48
BIS-11 Motor BD 39 21,49 4,94
1,832** 75controls 38 19,63 3,87
BIS-11 Non-planning
BD 39 24,87 5,66
2,839** 75
controls 38 20,76 6,99
BIS-11 Global score
BD 39 64,00 12,83
2,990** 75
controls 38 55,45 12,25
** p<0,01
Bipolar outpatiens had higher levels of trait impulsivity
than healthy individuals.
Bipolar patients with heightened levels of trait impulsivity
underestimated
- target stimuli with positive valence (r = -0,425; p < 0,01),
- distractors with negative (r = -0,331; p < 0,05) and
- distractors with neutral (r = -0,417; p< 0,01) emotional
valence.
Conclusions
- Poorer control of cognitive inhibition
- increased levels of impulsivity and other associated cognitive
impairments;
- emotional valence of stimulus influences cognitive
control in bipolar patients compared to healthy subjects;
- interaction between stable and state-dependent aspect
of impulsivity in bipolar disorder.
Contact
maja.milavec@gmail.com
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