title: The behavioral activation system and mania.
abstract: For over two decades, theorists have suggested that mania relates to heightened sensitivity of the behavioral activation system (BAS). In this article, we review a burgeoning empirical literature on this model, drawing on both cross-sectional and prospective studies. As evidence has emerged for this model, we argue that it is time to consider more specific aspects of BAS sensitivity in this disorder. We review evidence that bipolar disorder relates to an increased willingness to expend effort toward reward and to increases in energy and goal pursuit after an initial reward. We conclude by considering the strengths and weaknesses of this literature, with an eye toward future directions and implications for treatment.
authors.affiliation: Department of Psychology, University of California, Berkeley, Berkeley, California 94720, USA. sljohnson@berkeley.edu
authors.forename: Sheri L
authors.initials: SL
authors.lastname: Johnson
authors.forename: Michael D
authors.initials: MD
authors.lastname: Edge
authors.forename: M Kathleen
authors.initials: MK
authors.lastname: Holmes
authors.forename: Charles S
authors.initials: CS
authors.lastname: Carver
mesh_terms: D001519:Behavior; D001714:Bipolar Disorder / Q000523:psychology*; D003430:Cross-Sectional Studies; D006040:Goals; D006801:Humans; D009042:Motivation; D011446:Prospective Studies; D012201:Reward
references.citation: Br J Psychiatry. 2010 Feb;196(2):109-15
references.pmid: 20118454
references.citation: J Abnorm Psychol. 2007 May;116(2):313-28
references.pmid: 17516764
references.citation: J Neurosci. 2006 May 10;26(19):5160-6
references.pmid: 16687507
references.citation: Int J Cogn Ther. 2009;2(4):313-324
references.pmid: 22518204
references.citation: J Abnorm Psychol. 2002 Nov;111(4):589-97
references.pmid: 12428772
references.citation: J Abnorm Psychol. 2012 Aug;121(3):602-609
references.pmid: 22103804
references.citation: J Pers Soc Psychol. 2002 Apr;82(4):610-8
references.pmid: 11999927
references.citation: Neuropharmacology. 2009;56 Suppl 1:139-48
references.pmid: 18619474
references.citation: Bipolar Disord. 2006 Aug;8(4):382-99
references.pmid: 16879139
references.citation: J Neurosci. 2011 Mar 23;31(12):4466-74
references.pmid: 21430147
references.citation: Philos Trans R Soc Lond B Biol Sci. 2008 Oct 12;363(1507):3191-200
references.pmid: 18640912
references.citation: Neuropsychopharmacology. 2008 Aug;33(9):2217-27
references.pmid: 17987058
references.citation: Psychol Med. 2009 Feb;39(2):211-8
references.pmid: 18507876
references.citation: Am J Psychiatry. 2005 Oct;162(10):1975-7
references.pmid: 16199850
references.citation: Psychol Bull. 2011 May;137(3):421-42
references.pmid: 21401218
references.citation: Trends Genet. 2009 Feb;25(2):99-105
references.pmid: 19144440
references.citation: Eur Psychiatry. 2007 Oct;22(7):455-61
references.pmid: 17764910
references.citation: Psychol Med. 2001 Nov;31(8):1397-402
references.pmid: 11722154
references.citation: Neuropharmacology. 2009;56 Suppl 1:122-32
references.pmid: 18675281
references.citation: Am J Psychiatry. 2001 Oct;158(10):1605-11
references.pmid: 11578991
references.citation: Biol Psychiatry. 1996 Nov 1;40(9):872-80
references.pmid: 8896773
references.citation: Pharmacol Biochem Behav. 2010 Jul;96(1):7-15
references.pmid: 20363246
references.citation: Psychol Sci. 2010 Jul;21(7):1021-7
references.pmid: 20519486
references.citation: Bipolar Disord. 2008 Mar;10(2):310-22
references.pmid: 18271911
references.citation: J Abnorm Psychol. 2009 Aug;118(3):459-71
references.pmid: 19685944
references.citation: Annu Rev Neurosci. 2007;30:31-56
references.pmid: 17417936
references.citation: J Neurosci. 2001 Oct 1;21(19):7831-40
references.pmid: 11567074
references.citation: Pharmacopsychiatria. 1982 Jan;15(1):31-9
references.pmid: 7038719
references.citation: J Affect Disord. 2006 Jul;93(1-3):19-28
references.pmid: 16503056
references.citation: J Abnorm Psychol. 1986 Aug;95(3):214-22
references.pmid: 3745642
references.citation: Int J Neuropsychopharmacol. 2006 Apr;9(2):155-66
references.pmid: 15896265
references.citation: J Abnorm Psychol. 2012 Feb;121(1):16-27
references.pmid: 21668080
references.citation: Neurosci Biobehav Rev. 2011 Jan;35(3):537-55
references.pmid: 20603146
references.citation: Psychol Med. 2000 Mar;30(2):467-72
references.pmid: 10824667
references.citation: Biol Psychiatry. 2008 Jul 15;64(2):162-8
references.pmid: 18242583
references.citation: Behav Ther. 2009 Jun;40(2):103-13
references.pmid: 19433142
references.citation: Cogn Emot. 2007;21(8):1647
references.pmid: 20126420
references.citation: Psychiatry Res. 1992 Aug;43(2):147-60
references.pmid: 1410070
references.citation: Psychol Med. 2006 Sep;36(9):1213-8
references.pmid: 16707029
references.citation: J Nerv Ment Dis. 2008 Jun;196(6):437-45
references.pmid: 18552620
references.citation: Cognit Ther Res. 2009 Dec;33(6):552-569
references.pmid: 20376291
references.citation: J Affect Disord. 2001 Mar;63(1-3):103-11
references.pmid: 11246086
references.citation: Behav Brain Res. 2010 Feb 11;207(1):78-83
references.pmid: 19815032
references.citation: J Abnorm Psychol. 1997 Feb;106(1):159-63
references.pmid: 9103728
references.citation: J Clin Psychiatry. 2005 Jul;66(7):914-21
references.pmid: 16013908
references.citation: Psychol Med. 2009 May;39(5):785-91
references.pmid: 18713486
references.citation: Proc Natl Acad Sci U S A. 2009 Jan 13;106(2):617-22
references.pmid: 19104049
references.citation: Br J Psychiatry. 2009 Feb;194(2):146-51
references.pmid: 19182176
references.citation: J Pers Assess. 2005 Dec;85(3):318-24
references.pmid: 16318571
references.citation: Nat Rev Neurosci. 2004 Jun;5(6):483-94
references.pmid: 15152198
references.citation: J Abnorm Psychol. 2008 Feb;117(1):164-70
references.pmid: 18266494
references.citation: Neuropsychologia. 2004;42(12):1585-97
references.pmid: 15327927
references.citation: Psychiatry Res. 2008 Nov 30;161(2):142-52
references.pmid: 18848361
references.citation: J Abnorm Psychol. 2010 Aug;119(3):610-5
references.pmid: 20677850
references.citation: J Clin Psychol. 2009 Sep;65(9):891-905
references.pmid: 19455611
references.citation: Br J Psychiatry. 2002 Apr;180:313-9
references.pmid: 11925353
references.citation: Mol Psychiatry. 2004 Nov;9(11):1007-29
references.pmid: 15314610
references.citation: Proc Natl Acad Sci U S A. 1998 Mar 31;95(7):4029-34
references.pmid: 9520487
references.citation: Bipolar Disord. 2009 Feb;11(1):33-40
references.pmid: 19133964
references.citation: Psychiatry Res. 1999 Jun 30;86(3):267-70
references.pmid: 10482346
references.citation: J Clin Psychol. 2008 Apr;64(4):450-65
references.pmid: 18327768
references.citation: Emotion. 2004 Mar;4(1):3-22
references.pmid: 15053723
references.citation: Biol Psychiatry. 1997 Nov 1;42(9):749-55
references.pmid: 9347122
references.citation: J Exp Psychol Appl. 2002 Jun;8(2):75-84
references.pmid: 12075692
references.citation: J Abnorm Psychol. 2008 May;117(2):268-277
references.pmid: 18489203
references.citation: Annu Rev Psychol. 1989;40:457-92
references.pmid: 2648983
references.citation: J Res Pers. 2008 Dec;42(6):1427-1438
references.pmid: 20376289
references.citation: Cognit Ther Res. 2006;30(3):377-395
references.pmid: 20198117
references.citation: Cognition. 1994 Apr-Jun;50(1-3):7-15
references.pmid: 8039375
references.citation: Emotion. 2008 Feb;8(1):23-33
references.pmid: 18266513
references.citation: Neurology. 2002 Nov 12;59(9):1421-4
references.pmid: 12427895
references.citation: J Abnorm Psychol. 2007 Feb;116(1):105-15
references.pmid: 17324021
references.citation: Arch Gen Psychiatry. 2005 Jun;62(6):593-602
references.pmid: 15939837
references.citation: J Abnorm Psychol. 2012 May;121(2):339-351
references.pmid: 22004113
references.citation: J Abnorm Psychol. 2008 Feb;117(1):154-63
references.pmid: 18266493
references.citation: Psychol Med. 2011 Jun;41(6):1319-27
references.pmid: 20860871
references.citation: Front Behav Neurosci. 2009 Sep 07;3:13
references.pmid: 19826615
references.citation: Biol Psychiatry. 2006 Jul 15;60(2):93-105
references.pmid: 16406007
references.citation: Arch Gen Psychiatry. 2011 Mar;68(3):241-51
references.pmid: 21383262
references.citation: Biol Psychiatry. 2011 Aug 15;70(4):357-65
references.pmid: 21429477
references.citation: Psychopharmacology (Berl). 2007 Apr;191(3):391-431
references.pmid: 17072591
references.citation: Biol Psychiatry. 2008 Apr 1;63(7):693-8
references.pmid: 17919457
references.citation: Am J Med Genet B Neuropsychiatr Genet. 2008 Oct 5;147B(7):1047-55
references.pmid: 18228528
references.citation: J Abnorm Psychol. 2008 Nov;117(4):838-848
references.pmid: 19025230
references.citation: J Psychopathol Behav Assess. 2001 Sep 1;23(3):133-143
references.pmid: 21765592
references.citation: Psychol Med. 2005 Jan;35(1):69-77
references.pmid: 15842030
references.citation: J Affect Disord. 2010 Sep;125(1-3):341-4
references.pmid: 20122740
references.citation: Int J Cogn Ther. 2009;2(2):176-187
references.pmid: 20360995
references.citation: J Abnorm Psychol. 2005 Nov;114(4):689-696
references.pmid: 16351389
references.citation: Psychol Med. 2010 Jun;40(6):967-75
references.pmid: 19751541
references.citation: Clin Psychol Rev. 2005 Feb;25(2):241-62
references.pmid: 15642648
references.citation: Am J Psychiatry. 1973 Jan;130(1):79-82
references.pmid: 4682751
references.citation: Curr Opin Pharmacol. 2005 Feb;5(1):34-41
references.pmid: 15661623
references.citation: Eur J Neurosci. 2005 Nov;22(10):2617-34
references.pmid: 16307604
references.citation: Am J Psychiatry. 2000 Jul;157(7):1108-14
references.pmid: 10873919
references.citation: Bipolar Disord. 2006 Aug;8(4):362-72
references.pmid: 16879137
references.citation: Psychol Bull. 2009 Mar;135(2):183-204
references.pmid: 19254075
references.citation: Science. 2004 Dec 10;306(5703):1940-3
references.pmid: 15528409
references.citation: Psychol Med. 2010 Jul;40(7):1089-100
references.pmid: 19818204
references.citation: J Abnorm Psychol. 2000 Nov;109(4):721-7
references.pmid: 11195996
references.citation: J Psychopathol Behav Assess. 1999 Dec 1;21(4):275-292
references.pmid: 21765591
references.citation: Biol Psychiatry. 1999 Apr 15;45(8):972-8
references.pmid: 10386179
references.citation: J Neurosci. 1999 Oct 15;19(20):9029-38
references.pmid: 10516320
references.citation: Arch Gen Psychiatry. 2009 Oct;66(10):1072-80
references.pmid: 19805697
references.citation: Psychophysiology. 1988 Jul;25(4):373-91
references.pmid: 3051073
references.citation: Psychol Med. 2006 May;36(5):629-39
references.pmid: 16420729
references.citation: Clin Neurophysiol. 2010 Jan;121(1):60-76
references.pmid: 19900840
references.citation: Psychopharmacology (Berl). 2010 Feb;208(3):443-54
references.pmid: 20020109
references.citation: Proc Natl Acad Sci U S A. 2007 Apr 10;104(15):6406-11
references.pmid: 17379666
references.citation: J Affect Disord. 2004 Apr;79(1-3):193-9
references.pmid: 15023494
references.citation: Psychiatry Res. 2005 Sep 15;136(2-3):153-62
references.pmid: 16125786
references.citation: J Neurosci. 2008 Aug 20;28(34):8454-61
references.pmid: 18716203
references.citation: Clin Psychol (New York). 2009 Dec 1;16(4):449-469
references.pmid: 20161456
references.citation: Curr Dir Psychol Sci. 2010 Jun 1;19(3):189-194
references.pmid: 20606725
references.citation: Am J Med Genet B Neuropsychiatr Genet. 2009 Mar 5;150B(2):182-90
references.pmid: 19127564
references.citation: J Abnorm Psychol. 1989 May;98(2):117-26
references.pmid: 2708652