title: Increased affective reactivity to neutral stimuli and decreased maintenance of affective responses in bipolar disorder.
abstract: BACKGROUND
  Affective dysregulation is a core feature of bipolar disorder (BD) and a significant predictor of clinical and functional outcome. Affective dysregulation can arise from abnormalities in multiple processes. This study addresses the knowledge gap regarding the precise nature of the processes that may be dysregulated in BD and their relationship to the clinical expression of the disorder.
  
  
  METHODS
  Patients with BD (n=45) who were either in remission or in a depressive or manic state and healthy individuals (n=101) were compared in terms of the intensity, duration and physiological response (measured using inter-beat intervals and skin conductance) to affective and neutral pictures during passive viewing and during experiential suppression.
  
  
  RESULTS
  Compared to healthy individuals, patients with BD evidenced increased affective reactivity to neutral pictures and reduced maintenance of subjective affective responses to all pictures. This pattern was present irrespective of clinical state but was more pronounced in symptomatic patients, regardless of polarity. Patients, regardless of symptomatic status, were comparable to healthy individuals in terms of physiological arousal and voluntary control of affective responses.
  
  
  CONCLUSIONS
  Our study demonstrates that increased affective reactivity to neutral stimuli and decreased maintenance of affective responses are key dimensions of affective dysregulation in BD.
authors.affiliation: UMR Inserm U930, University François-Rabelais, Tours, France; CHRU Tours, Department of Child Psychiatry, Tours, France.
authors.forename: M
authors.initials: M
authors.lastname: Lemaire
authors.affiliation: UMR Inserm U930, University François-Rabelais, Tours, France; CHRU Tours, Department of Adult Psychiatry (CPU), Tours, France.
authors.forename: W
authors.initials: W
authors.lastname: El-Hage
authors.affiliation: Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1425 Madison Avenue, New York, USA. Electronic address: sophia.frangou@mssm.edu.
authors.forename: S
authors.initials: S
authors.lastname: Frangou
mesh_terms: D000328:Adult; D001143:Arousal / Q000502:physiology*; D001288:Attention / Q000502:physiology; D001714:Bipolar Disorder / Q000503:physiopathology / Q000523:psychology*; D004644:Emotions / Q000502:physiology; D005260:Female; D005403:Fixation, Ocular / Q000502:physiology; D005712:Galvanic Skin Response / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010364:Pattern Recognition, Visual / Q000502:physiology*; D010775:Photic Stimulation / Q000379:methods; D011930:Reaction Time / Q000502:physiology; D012016:Reference Values
keywords: Affective dysregulation; Arousal; Bipolar disorder; Galvanic skin response; Heart rate