title: I want it now! Neural correlates of hypersensitivity to immediate reward in hypomania.
abstract: BACKGROUND
  Hypomania is associated with impulsive decision making and risk taking, characteristics that may arise from hypersensitivity to reward. To date, the neural dynamics underlying intertemporal reward processing have neither been characterized clinically nor in the general population. Taking vulnerability to hypomania as a surrogate model of impulsivity, we utilized event-related potentials to study the neural mechanisms of delay discounting.
  
  
  METHODS
  In the first experiment, 32 participants completed an established Two Choice Impulsivity Paradigm in which free choice between immediate and delayed rewards was used to quantify impulsivity behaviorally. In the second experiment, electroencephalography was recorded while 32 separately recruited participants completed a speeded response task involving gains and losses of monetary incentives to be paid at three different delays after the experiment.
  
  
  RESULTS
  In the first experiment, the hypomania-prone group made significantly more immediate choices than the control group. In the second experiment, the hypomania-prone group evidenced greater differentiation between delayed and immediate outcomes in early attention-sensitive (N1) and later reward-sensitive (feedback-related negativity) components. Proneness to hypomania was also associated with greater N1 amplitude to rewards per se.
  
  
  CONCLUSIONS
  These results indicate steeper delay discounting in hypomania at multiple stages of information processing. The N1 modulation by valence and delay suggests an attentional bias to immediate rewards, which may drive subsequent cognitive appraisal of outcomes (feedback-related negativity). These results highlight the early influence of attention on reward processing and provide support for reward dysregulation accounts of bipolar disorder. Potential implications for mindfulness training and other therapeutic interventions are highlighted.
authors: School of Psychological Sciences, University of Manchester, Manchester, United Kingdom. Liam.Mason@manchester.ac.uk
authors: Liam
authors: L
authors: Mason
authors: Noreen
authors: N
authors: O'Sullivan
authors: Marianna
authors: M
authors: Blackburn
authors: Richard
authors: R
authors: Bentall
authors: Wael
authors: W
authors: El-Deredy
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001714:Bipolar Disorder / Q000150:complications / Q000503:physiopathology / Q000523:psychology*; D001921:Brain / Q000503:physiopathology*; D002755:Choice Behavior; D003657:Decision Making; D004569:Electroencephalography; D005071:Evoked Potentials; D005260:Female; D006801:Humans; D007175:Impulsive Behavior / Q000150:complications / Q000523:psychology*; D008297:Male; D009042:Motivation; D012201:Reward; D013334:Students / Q000523:psychology; D013647:Task Performance and Analysis; D055815:Young Adult