Stable and state-dependent impulsivity in Bipolar disorder

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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

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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.

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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)
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Impulsivity

• 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).

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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.
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Method

• Participants
• 39 bipolar outpatients
• 38 healthy individuals
• (matched for age, gender and years of education)

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• 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)
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• 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.).

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Example If the picture in front of you is
PLEASANT, press the RED BUTTON on the keyboard AS
FAST AS YOU CAN, other way dont press anything.

Go Go No-Go No-Go Go
800 1000 800 1000 800 1000 800 1000 800
Time (ms) Time (ms) Time (ms) Time (ms) Time (ms) Time (ms) Time (ms) Time (ms) Time (ms) Time (ms)
Instructions
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Reaction times
plt0,05 plt0,01

• Bipolar outpatients had longer reaction times to
  emotional stimuli than healthy individuals.

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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 -2,280 0,026 73
Bipolar outpatiens had less correct answers than
healthy individuals.
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N M SD t df
BIS-11 Attention BD 39 17,64 4,43 2,847 75
controls 38 15,05 3,48 2,847 75
BIS-11 Motor BD 39 21,49 4,94 1,832 75
controls 38 19,63 3,87 1,832 75
BIS-11 Non-planning BD 39 24,87 5,66 2,839 75
controls 38 20,76 6,99 2,839 75
BIS-11 Global score BD 39 64,00 12,83 2,990 75
controls 38 55,45 12,25 2,990 75
plt0,01
Bipolar outpatiens had higher levels of trait
impulsivity than healthy individuals.
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• Bipolar patients with heightened levels of trait
  impulsivity underestimated
• target stimuli with positive valence (r -0,425
  p lt 0,01),
• distractors with negative (r -0,331 p lt 0,05)
  and
• distractors with neutral (r -0,417 plt 0,01)
  emotional valence.

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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.

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Contact

• maja.milavec_at_gmail.com