An Investigation into the Relationship between Approach-Related Responses and Positive Affect in Bipolar Disorder

Abstract

Background The Behavioural Activation System dysregulation theory of Bipolar Disorder (BD) proposes that (hypo)manic episodes represent prolonged periods of elevated approach-motivation and high-activation positive affect (PA). Excessive goal-setting behaviour and increased engagement in stimulating activities have been found amongst people with BD and may interact with elevated approach-motivation, contributing to an “upward spiral”. Hypotheses were: both i) approach-related behaviours in response to PA; and ii) high-activation PA, will be more common in individuals with BD than those without; iii) individuals with BD will be more likely to respond to high-activation PA than to low-activation PA with approach-related behaviours, compared to individuals without BD.

Method Individuals with BD and a non-clinical control group were tested. Participants completed measures of current hypomanic/depressive symptoms, trait PA, and two versions of two measures of response to PA, asking about low-activation and high-activation PA.

Results The BD group used more approach-related responses to PA, particularly within high-activation mood states, compared to controls. The groups differed in their experience of different types of PA, due to the control group experiencing more low-activation PA.

Limitations It is unclear whether the findings are specific to BD or affective disorders in general, due to a lack of a clinical control group. The groups may also differ in their expectations of PA due to medication use and previous experience of mania.

Conclusions It may be therapeutically beneficial to help individuals with BD use non-approach-related strategies in response to high-activation PA. Further research would identify which strategies are most useful.