title: Processing of differentially valued rewards and punishments in youths with bipolar disorder or severe mood dysregulation.
abstract: BACKGROUND
  Youths with chronic irritability and hyperarousal (i.e., severe mood dysregulation, SMD) have reward- and punishment-processing deficits distinct from those exhibited by children with episodic symptoms of mania (i.e., narrow-phenotype bipolar disorder, BD). Additionally, youths with SMD, like those with psychopathy, have prominent reactive aggression. Therefore, we hypothesized that SMD, but not BD, youths would be impaired on a decision-making task that has identified reward- and punishment-processing deficits in individuals with psychopathy.
  
  
  METHODS
  A decision-making task was used in which BD (n = 23), SMD (n = 37), and control subjects (n = 31) were asked to choose between two images associated with different levels of reward or punishment.
  
  
  RESULTS
  No between-group differences in task performance were found.
  
  
  CONCLUSIONS
  These results suggest that BD, SMD, and normal youths do not differ in their ability to select between rewards and punishments of different value. Effect-size analyses suggest that this finding is not secondary to a type II error. Unlike individuals with psychopathy, neither SMD subjects nor those with BD differ from controls in their ability to select between differentially valued rewards and punishments.
authors.affiliation: Mood and Anxiety Program, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland 20892-1289, USA. gmr@duke.edu
authors.forename: Geoff
authors.initials: G
authors.lastname: Rau
authors.forename: Karina S
authors.initials: KS
authors.lastname: Blair
authors.forename: Lisa
authors.initials: L
authors.lastname: Berghorst
authors.forename: Lisa
authors.initials: L
authors.lastname: Knopf
authors.forename: Martha
authors.initials: M
authors.lastname: Skup
authors.forename: David A
authors.initials: DA
authors.lastname: Luckenbaugh
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Pine
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Blair
authors.forename: Ellen
authors.initials: E
authors.lastname: Leibenluft
mesh_terms: D000293:Adolescent; D000374:Aggression / Q000523:psychology*; D000987:Antisocial Personality Disorder / Q000175:diagnosis / Q000523:psychology; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology; D001143:Arousal; D001245:Association Learning; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000523:psychology; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000175:diagnosis / Q000523:psychology; D001714:Bipolar Disorder / Q000175:diagnosis / Q000523:psychology*; D002648:Child; D003210:Concept Formation; D003657:Decision Making; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007508:Irritable Mood; D007600:Judgment; D008297:Male; D019964:Mood Disorders / Q000175:diagnosis / Q000523:psychology*; D009042:Motivation; D011678:Punishment; D012201:Reward