Muhtadie, L., Johnson, S. L., Carver, C. S., Gotlib, I. H., & Ketter, T. A. (2014). A profile approach to impulsivity in bipolar disorder: The key role of strong emotions. Acta Psychiatrica Scandinavica, 129, 100-108. DOI: 10.1111/acps.12136

Objective: Bipolar disorder has been associated with elevated impulsivity - a complex construct subsuming multiple facets. We aimed to compare specific facets of impulsivity in bipolar disorder, including those related to key psychological correlates of the illness: reward sensitivity and strong emotion.

Method: 91 individuals diagnosed with bipolar I disorder (inter-episode period) and 80 controls completed several well-validated impulsivity measures, including those relevant to reward (Fun-seeking subscale of the Behavioral Approach System scale) and emotion (Positive Urgency and Negative Urgency scales).

Results: Bipolar participants reported higher impulsivity scores than did controls on all of the impulsivity measures, except BAS Fun-seeking. Positive Urgency-a measure assessing the tendency to act impulsively when experiencing strong positive emotion-yielded the largest group differences: F(1,170) = 78.69, p <.001, partial 2 = .316. Positive Urgency was also associated with poorer psychosocial functioning in the bipolar group: R2 = 0.24, b = .45, p< .001

Conclusions: Findings suggest that individuals with bipolar I disorder are at particular risk for impulsive behavior when experiencing strong positive emotion, and provide an important first step toward developing a more refined understanding of impulsivity in bipolar disorder with the potential to inform targeted interventions.

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