Processing of differentially valued rewards and punishments in youths with bipolar disorder or severe mood dysregulation.

BACKGROUND

Youths with chronic irritability and hyperarousal (i.e., severe mood dysregulation, SMD) have reward- and punishment-processing deficits distinct from those exhibited by children with episodic symptoms of mania (i.e., narrow-phenotype bipolar disorder, BD). Additionally, youths with SMD, like those with psychopathy, have prominent reactive aggression. Therefore, we hypothesized that SMD, but not BD, youths would be impaired on a decision-making task that has identified reward- and punishment-processing deficits in individuals with psychopathy.

METHODS

A decision-making task was used in which BD (n = 23), SMD (n = 37), and control subjects (n = 31) were asked to choose between two images associated with different levels of reward or punishment.

RESULTS

No between-group differences in task performance were found.

CONCLUSION

These results suggest that BD, SMD, and normal youths do not differ in their ability to select between rewards and punishments of different value. Effect-size analyses suggest that this finding is not secondary to a type II error. Unlike individuals with psychopathy, neither SMD subjects nor those with BD differ from controls in their ability to select between differentially valued rewards and punishments.