바로가기메뉴

본문 바로가기 주메뉴 바로가기

logo

Behavioral Activation System Sensitivity and Functional Impairment in Undergraduates with Hypomanic Personality: Moderating Role of Impulsivity

Abstract

Bipolar disorder (BD) is characterized by diverse functional impairments as well as recurrent mood fluctuations. Based on the behavioral activation system (BAS) model of BD, we explored the possibility that heightened BAS sensitivity, vulnerability for BD within the model, can also be related to functional indices associated with BD. Among a large undergraduate sample (N=531), we screened a BD high-risk group (n=64) via the Hypomanic Personality Scale and examined the relationship between BAS sensitivity, problematic drinking, and academic maladaptation with impulsivity as a moderator. The results showed that high BAS sensitivity, when combined with high impulsivity, could impair academic achievement in the high-risk group. On the contrary, the main effect of impulsivity was only significant in predicting problematic drinking. The present study suggests that BAS sensitivity is related to not only symptomatic but also functional aspects of BD. Future research should continue to investigate if BAS sensitivity may account for both negative and positive features of adaptation associated with BD.

keywords
행동활성화체계, 경조성 성격, 문제음주, 기능적 장해, 충동성, behavioral activation system, hypomanic personality, problematic drinking, functional impairment, impulsivity

Reference

1.

Aiken, L. S., & West, S. G. (1991). Multiple regression: Testing and interpreting interactions. Newbury Park, CA: Sage.

2.

Alloy, L. B., & Abramson, L. Y. (2010). The role of the behavioral approach system (BAS) in bipolar spectrum disorders. Current Directions in Psychological Science, 19, 189-194.

3.

Alloy, L. B., Bender, R. E., Wagner, C. A., Whitehouse, W. G., Abramson, L. Y., Hogan, M. E., ..., & Harmon-Jones, E. (2009). Bipolar spectrum–substance use co-occurrence: Behavioral approach system (BAS) sensitivity and impulsiveness as shared personality vulnerabilities. Journal of Personality and Social Psychology, 97, 549-565.

4.

Alloy, L. B., Nusslock, R., & Boland, E. M. (2015). The development and course of bipolar spectrum disorders: An integrated reward and circadian rhythm dysregulation model. Annual Review of Clinical Psychology, 11, 213-250.

5.

American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders-5th edition (DSM-5). Washington, DC: Author.

6.

Angst, F., Stassen, H. H., Clayton, P. J., & Angst, J. (2002). Mortality of patients with mood disorders: Follow-up over 34–38 years. Journal of Affective Disorders, 68, 167-181.

7.

Barratt, E. (1985). Impulsive subtraits: Arousal and information processing. In J. T. Spence & C. E. Izard (Eds.). Motivation, emotion and personality (pp. 137-146). North Holland: Elsevier Science Publishers.

8.

Blair, C. (2003). Behavioral inhibition and behavioral activation in young children: Relations with self‐regulation and adaptation to preschool in children attending Head Start. Developmental Psychobiology, 42, 301-311.

9.

Carver, C. S., & White, T. L. (1994). Behavioral inhibition, behavioral activation, and affective responses to impending reward and punishment: The BIS/BAS Scales. Journal of Personality and Social Psychology, 67, 319-333.

10.

Cho, S. H., & Cho, A. R. (2008). Personality characteristics of college women group with bulimic and alcohol abuse problem:Based on individual differences in sensitivity of BAS/BIS. Korean Journal of Health Psychology, 13, 57-72.

11.

Cho, Y. I., Kim, J. H., Han, W. R., & Jo, Y. J. (2015). Differences and combinations of moderational and meditational effects: Definitions and statistical testing. Korean Journal of Clinical Psychology, 34, 1113-1131.

12.

Cohen, J. (1988). Statistical power analysis for the behavioral sciences. Hillsdale, NJ: Lawrence Erlbaum.

13.

Cohen, J., Cohen, P., West, S. G., & Aiken, L. S. (2003). Applied multiple correlation/regression analysis for the behavioral sciences. Mahwah, NJ: Lawrence Erlbaum.

14.

Conway, K. P., Compton, W., Stinson, F. S., & Grant, B. F. (2006). Lifetime comorbidity of DSM-IV mood and anxiety disorders and specific drug use disorders: Results from the National Epidemiologic Survey on Alcohol and related conditions. Journal of Clinical Psychiatry, 67, 247-257.

15.

Depue, R. A., & Collins, P. F. (1999). Neurobiology of the structure of personality: Dopamine, facilitation of incentive motivation, and extraversion. Behavioral and Brain Sciences, 22, 491-517.

16.

Depue, R. A., & Iacono, W. G. (1989). Neurobehavioral aspects of affective disorders. Annual Review of Psychology, 40, 457-492.

17.

Dohrenwend, B. S., & Dohrenwend, B. P. (1967). Field studies of social factors in relation to three types of psychological disorder. Journal of Abnormal Psychology, 72, 369-378.

18.

Eckblad, M., & Chapman, L. J. (1986). Development and validation of a scale for hypomanic personality. Journal of Abnormal Psychology, 95, 214-222.

19.

Evenden, J. L. (1999). Varieties of impulsivity. Psychopharmacology, 146, 348-361.

20.

Fowles, D. C. (1987). Application of a behavioral theory of motivation to the concepts of anxiety and impulsivity. Journal of Research in Personality, 21, 417-435.

21.

Franken, I. H., Muris, P., & Georgieva, I. (2006). Gray’s model of personality and addiction. Addictive Behaviors, 31, 399-403.

22.

Gray, J. A. (1970). The psychophysiological basis of introversionextraversion. Behaviour Research and Therapy, 8, 249-266.

23.

Hantouche, E. G., Angst, J., & Akiskal, H. S. (2003). Factor structure of hypomania: Interrelationships with cyclothymia and the soft bipolar spectrum. Journal of Affective Disorders, 73, 39-47.

24.

Heo, S. Y., Oh, J. Y., & Kim, J. H. (2012). The Korean version of the Barratt Impulsiveness Scale, 11th version: Its reliability and validity. Korean Journal of Psychology: General, 31, 769-782.

25.

Hofmann, B. U., & Meyer, T. D. (2006). Mood fluctuations in people putatively at risk for bipolar disorders. British Journal of Clinical Psychology, 45, 105-110.

26.

Johnson, S. L. (2005a). Mania and dysregulation in goal pursuit: A review. Clinical Psychology Review, 25, 241-262.

27.

Johnson, S. L. (2005b). Life events in bipolar disorder: Towards more specific models. Clinical Psychology Review, 25, 1008-1027.

28.

Johnson, S. L., Carver, C. S., Joormann, J., & Cuccaro, M. (2015). A genetic analysis of the validity of the Hypomanic Personality Scale. Bipolar Disorders, 17, 331-339.

29.

Johnson, S. L., Edge, M. D., Holmes, M. K., & Carver, C. S. (2012). The behavioral activation system and mania. Annual Review of Clinical Psychology, 8, 243-267.

30.

Johnson, S. L., Murray, G., Fredrickson, B., Youngstrom, E. A., Hinshaw, S., Bass, J. M., ..., & Salloum, I. (2012). Creativity and bipolar disorder: Touched by fire or burning with questions? Clinical Psychology Review, 32, 1-12.

31.

Kim, B. N., & Kwon, S. M. (2016). Behavioral activation system hypersensitivity among Korean undergraduates with hypomanic personality: Perspective from the BAS model of bipolar disorder. Korean Journal of Clinical Psychology, 35, 703-710.

32.

Kim, J. Y., & Chung, B. K. (2011). The relationship between BAS/BIS, ego-resiliency, and well-being. Korean Journal of Health Psychology, 16, 313-327.

33.

Kim, K. H., & Kim, W. S. (2001). Korean-BAS/BIS Scale. Korean Journal of Health Psychology, 6, 18-37.

34.

Kim, Y. A., & Oh, K. J. (1996). Psychological characteristics of hypomanic tendency as a risk factor for bipolar disorder. Korean Journal of Clinical Psychology, 15, 103-115.

35.

Kim, J. S., Oh, M. K., Park, B. K., Lee, M. K., & Kim, G. J. (1999). Screening criteria of alcoholism by Alcohol Use Disorders Identification Test (AUDIT) in Korea. Journal of Korean Academy of Family Medicine, 20, 1152-1159.

36.

Klein, D. N., Lewinsohn, P. M., & Seeley, J. R. (1996). Hypomanic personality traits in a community sample of adolescents. Journal of Affective Disorders, 38, 135-143.

37.

Krumm-Merabet, C., & Meyer, T. D. (2005). Leisure activities, alcohol, and nicotine consumption in people with a hypomanic/hyperthymic temperament. Personality and Individual Differences, 38, 701-712.

38.

Kwapil, T. R., Miller, M. B., Zinser, M. C., Chapman, L. J., Chapman, J., & Eckblad, M. (2000). A longitudinal study of high scorers on the Hypomanic Personality Scale. Journal of Abnormal Psychology, 109, 222-226.

39.

Lee, E. K., & Kwon, J. H. (2003). A study of social problem-solving of hypomania and a hypomanic case. Duksung Women’s University Students’ Life Research, 19, 115-143.

40.

Lee, H. S. (1992). Impulsivity Test. Seoul: Korea Guidance.

41.

Lee, S. M., & Park, K. W. (2013). The effect of behavioral activation/inhibition system on the binge eating behavior: The mediation role of difficulties in emotional dysregulation. Cognitive Behavior Therapy in Korea, 13, 407-422.

42.

MacCabe, J. H., Lambe, M. P., Cnattingius, S., Sham, P. C., David, A. S., Reichenberg, A., ..., & Hultman, C. M. (2010). Excellent school performance at age 16 and risk of adult bipolar disorder:National cohort study. The British Journal of Psychiatry, 196, 109-115.

43.

Meyer, B., Johnson, S. L., & Carver, C. S. (1999). Exploring behavioral activation and inhibition sensitivities among college students at risk for bipolar spectrum symptomatology. Journal of Psychopathology and Behavioral Assessment, 21, 275-292.

44.

Meyer, B., Johnson, S. L., & Winters, R. (2001). Responsiveness to threat and incentive in bipolar disorder: Relations of the BIS/BAS scales with symptoms. Journal of Psychopathology and Behavioral Assessment, 23, 133-143.

45.

Meyer, T. D., & Hautzinger, M. (2003). Screening for bipolar disorders using the Hypomanic Personality Scale. Journal of Affective Disorders, 75, 149-154.

46.

Miklowitz, D. J., & Johnson, S. L. (2006). The psychopathology and treatment of bipolar disorder. Annual Review of Clinical Psychology, 2, 199-235.

47.

Miller, C. J., Johnson, S. L., Kwapil, T. R., & Carver, C. S. (2011). Three studies on self-report scales to detect bipolar disorder. Journal of Affective Disorders, 128, 199-210.

48.

Min, K. H. (2010). Relationship between behavioral activation/behavioral inhibition system and school life adjustment. (Unpublished master’s thesis). Chungnam National University, Daejeon, Korea.

49.

Moeller, F. G., Barratt, E. S., Dougherty, D. M., Schmitz, J. M., & Swann, A. C. (2001). Psychiatric aspects of impulsivity. American Journal of Psychiatry, 158, 1783-1793.

50.

Najt, P., Perez, J., Sanches, M., Peluso, M. A. M., Glahn, D., & Soares, J. C. (2007). Impulsivity and bipolar disorder. European Neuropsychopharmacology, 17, 313-320.

51.

Newman, A. L., & Meyer, T. D. (2014). Impulsivity: Present during euthymia in bipolar disorder?-A systematic review. International Journal of Bipolar Disorders, 2, 2-17.

52.

Nusslock, R., Alloy, L. B., Abramson, L. Y., Harmon-Jones, E., & Hogan, M. E. (2008). Impairment in the achievement domain in bipolar spectrum disorders: Role of behavioral approach system hypersensitivity and impulsivity. Minerva Pediatrica, 60, 41-50.

53.

Quackenbush, D., Kutcher, S., Robertson, H. A., Boulos, C., & Chaban, P. (1996). Premorbid and postmorbid school functioning in bipolar adolescents: Description and suggested academic interventions. The Canadian Journal of Psychiatry, 41, 16-22.

54.

Quilty, L. C., & Oakman, J. M. (2004). The assessment of behavioural activation––the relationship between impulsivity and behavioural activation. Personality and Individual Differences, 37, 429-442.

55.

Smillie, L. D., Jackson, C. J., & Dalgleish, L. I. (2006). Conceptual distinctions among Carver and White’s (1994) BAS scales: A reward-reactivity versus trait impulsivity perspective. Personality and Individual Differences, 40, 1039-1050.

56.

Spinella, M., & Miley, W. M. (2003). Impulsivity and academic achievement in college students. College Student Journal, 37, 545-550.

57.

Swann, A. C., Dougherty, D. M., Pazzaglia, P. J., Pham, M., & Moeller, F. G. (2004). Impulsivity: A link between bipolar disorder and substance abuse. Bipolar Disorders, 6, 204-212.

58.

Swann, A. C., Dougherty, D. M., Pazzaglia, P. J., Pham, M., Steinberg, J. L., & Moeller, F. G. (2005). Increased impulsivity associated with severity of suicide attempt history in patients with bipolar disorder. American Journal of Psychiatry, 162, 1680-1687.

59.

Swann, A. C., Gerard Moeller, F., Steinberg, J. L., Schneider, L., Barratt, E. S., & Dougherty, D. M. (2007). Manic symptoms and impulsivity during bipolar depressive episodes. Bipolar Disorders, 9, 206-212.

60.

Torrubia, R., Avila, C., Moltó, J., & Caseras, X. (2001). The Sensitivity to Punishment and Sensitivity to Reward Questionnaire (SPSRQ)as a measure of Gray’s anxiety and impulsivity dimensions. Personality and Individual Differences, 31, 837-862.

61.

Urošević, S., Abramson, L. Y., Harmon-Jones, E., & Alloy, L. B. (2008). Dysregulation of the behavioral approach system (BAS)in bipolar spectrum disorders: Review of theory and evidence. Clinical Psychology Review, 28, 1188-1205.

62.

Woods, S. W. (2000). The economic burden of bipolar disease. Journal of Clinical Psychiatry, 61, 38-41.

63.

Zinbarg, R. E., & Mohlman, J. (1998). Individual differences in the acquisition of affectively valenced associations. Journal of Personality and Social Psychology, 74, 1024-1040.

logo