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Attentional Bias Predicts Increased Reward Salience and Risk Taking in Bipolar Disorder.

Abstract：

BACKGROUND:There is amassing evidence that risky decision-making in bipolar disorder is related to reward-based differences in frontostriatal regions. However, the roles of early attentional and later cognitive processes remain unclear, limiting theoretical understanding and development of targeted interventions. METHODS:Twenty euthymic bipolar disorder and 19 matched control participants played a Roulette task in which they won and lost money. Event-related potentials and source analysis were used to quantify predominantly sensory-attentional (N1), motivational salience (feedback-related negativities [FRN]), and cognitive appraisal (P300) stages of processing. We predicted that the bipolar disorder group would show increased N1, consistent with increased attentional orienting, and reduced FRN, consistent with a bias to perceive outcomes more favorably. RESULTS:As predicted, the bipolar disorder group showed increased N1 and reduced FRN but no differences in P300. N1 amplitude was additionally associated with real-life risk taking, and N1 source activity was reduced in visual cortex but increased activity in precuneus, frontopolar, and premotor cortex, compared to those of controls. CONCLUSIONS:These findings demonstrate an early attentional bias to reward that potentially drives risk taking by priming approach behavior and elevating reward salience in the frontostriatal pathway. Although later cognitive appraisals of these inputs may be relatively intact in remission, interventions targeting attention orienting may also be effective in long-term reduction of relapse.

journal_name

Biol Psychiatry

journal_title

Biological psychiatry

authors

Mason L,Trujillo-Barreto NJ,Bentall RP,El-Deredy W

doi

10.1016/j.biopsych.2015.03.014

subject

Has Abstract

pub_date

2016-02-15 00:00:00

pages

311-9

issue

4

eissn

0006-3223

issn

1873-2402

pii

S0006-3223(15)00228-0

journal_volume

79

pub_type

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