Cognitive-emotional impairments in euthymic bipolar disorder-New insights into emotion regulation and cognitive control deficits.

Bipolar disorder (BD) is assumed to be a disorder of emotion regulation (ER), with the most prominent endophenotype being deficient cognitive control (CC). However, the nature of ER and CC deficits and specifically their association in BD has not been adequately examined. Therefore, the present study examines different aspects of ER and CC within n = 32 euthymic patients with BD and n = 32 healthy controls (HCs). Besides self-reported habitual use of ER strategies, we also assessed spontaneous use and success of reappraisal and rumination following different mood inductions (MIs; amusement, sadness) and the ability to use reappraisal when instructed to do so. General and valence-specific CC performance was assessed by a working memory manipulation task. BD patients reported increased habitual use of maladaptive ER strategies alongside decreased use of adaptive strategies in response to negative affect. Regarding positive affect, heightened use of dampening was reported. By contrast, no group differences emerged with respect to spontaneous strategy use following MI. However, when instructed to downregulate amusement using reappraisal, patients reported heightened positive affect reactivity compared to HCs following the MI. Furthermore, patients showed overall but no valence-specific CC deficits. ER deficits in the BD group were partly mediated by reduced CC. Our findings confirm that patients show deviations in their habitual ER strategy use and fail to down-regulate positive emotions when required to do so, indicating both performance and competence deficits. This appears to be partly influenced by impaired CC. (PsycInfo Database Record (c) 2025 APA, all rights reserved).