OBJECTIVE: Emotion regulation deficits are a key characteristic of bipolar disorder (BD). In the present study, we asked if deficits in emotion regulation are also a vulnerability marker for BD. To this end, we investigated a healthy group of participants at high-risk for developing BD, defined on the basis of a hypomanic personality trait. We examined the neural correlates of two emotion regulation strategies, reappraisal and distraction. METHOD: Twenty-two individuals with higher risk for BD and twenty-four controls were investigated in a functional magnetic resonance imaging paradigm. Participants were presented with negative, positive and neutral pictures and were either required to passively view the images, to down-regulate the emotional response by reappraising the pictures' content, or to perform a distracting arithmetic task. RESULTS: High-risk individuals showed increased emotional reactivity to negative stimuli, indicated by heightened amygdala activation during passive viewing. High-risk participants were also less successful in down-regulating amygdala activity using reappraisal of negative stimuli. During distraction from positive stimuli, high-risk individuals showed heightened task-related activity in the inferior parietal cortex, suggesting increased distractibility by task-irrelevant positive background stimuli. There were no differences in habitual emotion regulation as assessed by a self-report questionnaire. LIMITATIONS: Generalizability of the present results is limited by the age- and education-homogenous sample and the small sample size. CONCLUSIONS: This is the first study to report neural correlates of increased emotional reactivity and deficient emotion regulation in healthy individuals at risk for BD. These findings suggest inefficient emotion regulation through reappraisal and distraction in individuals with high hypomanic personality who are supposed to be at higher risk to develop bipolar disorder.
OBJECTIVE: Emotion regulation deficits are a key characteristic of bipolar disorder (BD). In the present study, we asked if deficits in emotion regulation are also a vulnerability marker for BD. To this end, we investigated a healthy group of participants at high-risk for developing BD, defined on the basis of a hypomanic personality trait. We examined the neural correlates of two emotion regulation strategies, reappraisal and distraction. METHOD: Twenty-two individuals with higher risk for BD and twenty-four controls were investigated in a functional magnetic resonance imaging paradigm. Participants were presented with negative, positive and neutral pictures and were either required to passively view the images, to down-regulate the emotional response by reappraising the pictures' content, or to perform a distracting arithmetic task. RESULTS: High-risk individuals showed increased emotional reactivity to negative stimuli, indicated by heightened amygdala activation during passive viewing. High-risk participants were also less successful in down-regulating amygdala activity using reappraisal of negative stimuli. During distraction from positive stimuli, high-risk individuals showed heightened task-related activity in the inferior parietal cortex, suggesting increased distractibility by task-irrelevant positive background stimuli. There were no differences in habitual emotion regulation as assessed by a self-report questionnaire. LIMITATIONS: Generalizability of the present results is limited by the age- and education-homogenous sample and the small sample size. CONCLUSIONS: This is the first study to report neural correlates of increased emotional reactivity and deficient emotion regulation in healthy individuals at risk for BD. These findings suggest inefficient emotion regulation through reappraisal and distraction in individuals with high hypomanic personality who are supposed to be at higher risk to develop bipolar disorder.
Authors: Kristen K Ellard; Aishwarya K Gosai; Julia M Felicione; Amy T Peters; Conor V Shea; Louisa G Sylvia; Andrew A Nierenberg; Alik S Widge; Darin D Dougherty; Thilo Deckersbach Journal: Bipolar Disord Date: 2018-11-22 Impact factor: 6.744
Authors: Kristen K Ellard; Emily E Bernstein; Casey Hearing; Ji Hyun Baek; Louisa G Sylvia; Andrew A Nierenberg; David H Barlow; Thilo Deckersbach Journal: J Affect Disord Date: 2017-05-10 Impact factor: 4.839
Authors: Marta Migó; Kendra Simpson; Amy Peters; Kristen K Ellard; Tina Chou; Andrew A Nierenberg; Darin D Dougherty; Thilo Deckersbach Journal: Psychiatry Res Date: 2021-11-30 Impact factor: 3.222
Authors: Martina Di Simplicio; Fritz Renner; Simon E Blackwell; Heather Mitchell; Hannah J Stratford; Peter Watson; Nick Myers; Anna C Nobre; Alex Lau-Zhu; Emily A Holmes Journal: Bipolar Disord Date: 2016-12-20 Impact factor: 6.744