The impact of reward, punishment, and frustration on attention in pediatric bipolar disorder.
BACKGROUND
Theories in affective neuroscience suggest that mood disorders involve perturbations in attention-emotion interactions. We tested the hypothesis that frustration adversely impacts attention and behavior in children with bipolar disorder (BPD).


METHODS
Thirty-five children with BPD and 26 normal control subjects completed: 1) a Posner attention task with feedback but no contingencies; 2) an affective Posner with contingencies; and 3) an affective Posner that used rigged feedback to induce frustration. Reaction time (RT) and event-related potential (ERP) data were collected.


RESULTS
At baseline (task 1), there were no between-group differences in behavior or ERPs. Children with BPD exhibited reduced parietal P3 amplitude on task 3 only. On trials occurring after negative feedback, control subjects showed decreased RT when contingencies were introduced (task 2), whereas BPD subjects did not.


CONCLUSIONS
The introduction of contingencies was associated with impaired performance of children with BPD, suggesting deficits in their ability to adapt to changing contingencies. In addition, frustration was associated with disrupted attention allocation in children with BPD. We hypothesize that children with BPD inappropriately deployed attention to their internal frustration rather than to the task, causing impaired performance.
Rich
Brendan A
BA
Pediatrics and Developmental Neuropsychiatry Branch, Mood and Anxiety Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD 20892-1255, USA. brendanrich@mail.nih.gov
Schmajuk
Mariana
M
Perez-Edgar
Koraly E
KE
Pine
Daniel S
DS
Fox
Nathan A
NA
Leibenluft
Ellen
E
D000293:Adolescent; D000339:Affect / Q000502:physiology; D018692:Antimanic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001288:Attention / Q000502:physiology*; D001714:Bipolar Disorder / Q000150:complications / Q000188:drug therapy / Q000523:psychology*; D002648:Child; D004569:Electroencephalography; D004644:Emotions / Q000502:physiology; D005071:Evoked Potentials / Q000502:physiology; D005260:Female; D005639:Frustration; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales; D011597:Psychomotor Performance / Q000502:physiology; D011678:Punishment; D011930:Reaction Time / Q000502:physiology; D015203:Reproducibility of Results; D012201:Reward
D018692:Antimanic Agents