Exploring Behavioral Activation and Inhibition Sensitivities Among College Students at Risk for Bipolar Spectrum Symptomatology

We explored cross-sectionally the roles in bipolar spectrum symptomatology of two broad motivational systems that are thought to control levels of responsiveness to cues of threat and reward, the Behavioral Inhibition System (BIS) and the Behavioral Activation System (BAS). Undergraduate students (n = 357) completed questionnaires regarding (a) bipolar spectrum disorders [the General Behavior Inventory (GBI), a well-established clinical screening measure], (b) current depression and mania symptoms (the Internal State Scale; ISS), and (c) BIS/BAS sensitivities (the BIS/BAS scales). Validated cutoff scores on the GBI were used to identify individuals at risk for a mood disorder. It was hypothesized that, among at-risk respondents, high BAS and low BIS levels would be associated with high current mania ratings, whereas low BAS and high BIS would be associated with high current depression ratings. Multiple regression analyses indicated that, among at-risk individuals (n = 63), BAS accounted for 27% of current mania symptoms but BIS did not contribute. For these individuals, BAS and BIS were both significant and together accounted for 44% of current depressive symptoms.     

Reward Dysregulation and Mood Symptoms in an Adolescent Outpatient Sample

Research on bipolar spectrum disorders (BPSD) in adolescence has burgeoned in the last decade, but continued work is needed to identify endophenotypic markers associated with illness onset and course. The present study examined reward dysregulation—measured via the behavioral activation system (BAS)—as one putative marker of BPSD in adolescence. A diverse group of 425 outpatient adolescents between 11 and 17 years of age (52 % male) completed the Behavioral Inhibition and Activation Scale (BIS-BAS) scale to measure reward dysregulation. Semi-structured interviews determined diagnoses and severity of mood symptoms. Parent-reported BAS was associated with increased symptoms of mania, and parent and adolescent-reported BAS were associated with symptoms of depression. Parent-reported BIS scores were associated with increased symptoms of mania. Results held independent of diagnostic status. Furthermore, parent BIS/BAS reports were stronger predictors for manic symptoms compared to adolescent-reports. Results extend work in adults with BPSD, suggesting a transdiagnostic association between reward dysregulation and mood symptom severity in adolescence.     

Progression along the bipolar spectrum: a longitudinal study of predictors of conversion from bipolar spectrum conditions to bipolar I and II disorders

Little longitudinal research has examined progression to more severe bipolar disorders in individuals with "soft" bipolar spectrum conditions. We examine rates and predictors of progression to bipolar I and II diagnoses in a nonpatient sample of college-age participants (n = 201) with high General Behavior Inventory scores and childhood or adolescent onset of "soft" bipolar spectrum disorders followed longitudinally for 4.5 years from the Longitudinal Investigation of Bipolar Spectrum (LIBS) project. Of 57 individuals with initial cyclothymia or bipolar disorder not otherwise specified (BiNOS) diagnoses, 42.1% progressed to a bipolar II diagnosis and 10.5% progressed to a bipolar I diagnosis. Of 144 individuals with initial bipolar II diagnoses, 17.4% progressed to a bipolar I diagnosis. Consistent with hypotheses derived from the clinical literature and the Behavioral Approach System (BAS) model of bipolar disorder, and controlling for relevant variables (length of follow-up, initial depressive and hypomanic symptoms, treatment-seeking, and family history), high BAS sensitivity (especially BAS Fun Seeking) predicted a greater likelihood of progression to bipolar II disorder, whereas early age of onset and high impulsivity predicted a greater likelihood of progression to bipolar I (high BAS sensitivity and Fun-Seeking also predicted progression to bipolar I when family history was not controlled). The interaction of high BAS and high Behavioral Inhibition System (BIS) sensitivities also predicted greater likelihood of progression to bipolar I. We discuss implications of the findings for the bipolar spectrum concept, the BAS model of bipolar disorder, and early intervention efforts.     

Gray's Reinforcement Sensitivity Model and Child Psychopathology: Laboratory and Questionnaire Assessment of the BAS and BIS

The Behavioral Approach System (BAS) and Behavioral Inhibition System (BIS) are widely studied components of Gray's sensitivity to reinforcement model. There is growing interest in integrating the BAS and BIS into models of risk for psychopathology, however, few measures assess BAS and BIS functioning in children. We adapted a questionnaire measure and reaction time task from adult studies to assess the BAS and BIS in a sample of 9-12 year olds (N = 63; 42% female). A continuous performance task was also administered to assess physiological correlates of the BAS and BIS. Factor analysis supported 3 subdimensions of the BAS (Drive, Reward Responsivity, and Impulsivity/Fun seeking), and one dimension of the BIS (sensitivity to punishment). Results supported the utility of the questionnaire measures and reaction time task as assessments of BAS and BIS functioning. Moreover, these measures were associated with internalizing and externalizing problem behavior as expected. High levels of impulsivity/fun seeking, but not drive or reward responsivity, were associated with high levels of externalizing problems, whereas high levels of sensitivity to punishment were associated with high levels of internalizing behavior problems. The relation between physiological indices and caregiver reports of the BAS, BIS, and problem behavior were complex and not consistent with expectation.     

Self appraisal and behavioural activation in the prediction of hypomanic personality and depressive symptoms

Hypomanic personality is characterised by increased positive mood and energy but also more depression and greater risk of bipolar disorder. It is linked with positive self-appraisals for hypomania-relevant events and Behavioural Activation System (BAS) sensitivity such that hypomanic individuals tend preferentially towards goal-related activities. This study investigated relationships between positive and negative self-appraisal and BAS functioning and hypomanic personality and depressive symptoms. Participants (N = 231) completed measures of hypomanic personality, mood symptoms, dysfunctional attitudes, self-appraisal and behavioural activation/inhibition.Positive but not negative self-appraisal contributed to prediction of hypomanic personality as did higher BAS fun seeking and lower Behavioural Inhibition System (BIS) scores. Conversely, negative self-appraisal was positively predictive of current depressive mood, whilst BAS reward responsiveness was negatively predictive. There are specific relationships between positive and negative appraisal styles and hypomanic personality and depressive mood, respectively. The findings of complimentary contributions from appraisal style, BAS and BIS to prediction of hypomanic personality are relevant to developing a better understanding of risk factors for bipolar disorder.     

Coping mediates relationships between reinforcement sensitivity and symptoms of psychopathology

Limited research has evaluated whether coping strategies mediate the relationships between reinforcement sensitivity theory (RST) and symptoms of psychopathology. Undergraduates (n = 293) completed questionnaires assessing RST, coping, and symptoms of psychopathology. Consistent with our hypotheses, bootstrapping analyses indicated that emotion- and avoidance-focused coping mediated the relationship between high Behavioral Inhibition System (BIS) and depression, anxiety, and worry. Less problem-focused coping mediated the relationship between low Behavioral Approach System (BAS) and depression. Avoidance-focused coping mediated the effects of high BIS on drug and alcohol use whereas high BAS directly predicted alcohol and drug use. Unexpectedly, emotion-focused coping mediated the relationship between BAS and anxiety and worry. These results provide support for the hypothesis that personality variables are associated with psychopathology partially through coping.     

High Behavioral Approach System (BAS) sensitivity, reward responsiveness, and goal-striving predict first onset of bipolar spectrum disorders: a prospective behavioral high-risk design

A prospective, behavioral high-risk design provided a theoretically guided examination of vulnerability to first onset of bipolar spectrum disorder based on the Behavioral Approach System (BAS) model. Adolescents (ages 14-19) at an "age of risk" for bipolar disorder onset were screened on BAS sensitivity by interviewers blind to current symptoms, lifetime history, and family history of psychopathology. Participants were selected with high versus moderate levels of BAS sensitivity and administered a lifetime diagnostic interview. Those with a bipolar spectrum disorder, psychosis, or hypomanic episode with onset prior to the BAS sensitivity assessment were excluded. High BAS (n = 171) and moderate BAS (n = 119) sensitivity participants in the final sample completed baseline measures of symptoms, goal-setting, and reward responsiveness and were followed prospectively with semistructured diagnostic interviews every 6 months. Consistent with the vulnerability hypothesis of the BAS model of bipolar disorder, high BAS participants had a greater likelihood, and shorter time to onset, of bipolar spectrum disorder than moderate BAS participants across an average of 12.8 months of follow-up (12.9% vs. 4.2%), controlling for baseline depressive and hypomanic symptoms, and family history of bipolar disorder. High reward responsiveness on a behavioral task and ambitious goal-striving for popular fame and financial success (but not impulsivity) also predicted first onset of bipolar spectrum disorder controlling for the covariates and BAS risk group, and ambitious goal-striving partially mediated the BAS risk group effect. We discuss implications of the findings for the BAS model of bipolar disorder and early intervention efforts.     

Behavioral Approach System Sensitivity and Risk Taking Interact to Predict Left-Frontal EEG Asymmetry

The Behavioral Approach System (BAS) hypersensitivity theory of bipolar disorder (BD; Alloy & Abramson, 2010; Depue & Iacono, 1989) suggests that hyperreactivity in the BAS results in the extreme fluctuations of mood characteristic of BD. In addition to risk conferred by BAS hypersensitivity, cognitive and personality variables may play a role in determining risk. We evaluated relationships among BAS sensitivity, risk taking, and an electrophysiological correlate of approach motivation, relative left-frontal electroencephalography (EEG) asymmetry. BAS sensitivity moderated the relationship between risk taking and EEG asymmetry. More specifically, individuals who were high in BAS sensitivity showed left-frontal EEG asymmetry regardless of their level of risk-taking behavior. However, among individuals who were moderate in BAS sensitivity, risk taking was positively associated with asymmetry. These findings suggest that cognitive and personality correlates of bipolar risk may evidence unique contributions to a neural measure of trait-approach motivation. Clinical implications of these findings are discussed.     

Impulsivity and Behavior-Dependent Life Events Mediate the Relationship of Reward Sensitivity and Depression,but Not Hypomania,Among at-Risk Adolescents

Both reward sensitivity and impulsivity are related to the development and course of bipolar spectrum disorders (BSDs) and have been implicated in other disorders and negative functional outcomes such as substance abuse, obesity, suicidal behaviors, and risk-taking. Furthermore, according to the transactional component of the Behavioral Approach System (BAS)/reward hypersensitivity theory of BSDs, people with reward hypersensitivity should experience more BAS-relevant events, and thus, are more vulnerable to mood symptoms and episodes via stress generation. Impulsivity may exacerbate stress generation in individuals at risk for BSDs based on exhibiting reward hypersensitivity. The current study examined whether impulsivity explained the generation of stress and subsequent mood symptoms beyond what is explained by reward sensitivity alone. Participants were 131 Moderate BAS and 216 High BAS sensitivity adolescents (M = 18.43 years, SD = 1.40), who completed baseline measures of reward sensitivity and impulsivity, as well as follow-up measures of life events and mood symptoms. Results from linear regression analyses indicated that higher baseline impulsivity predicted behavior-dependent, but not behavior-independent, life events. Furthermore, path analyses suggested that the effect of BAS group on depression symptoms at next follow-up was partly explained via the indirect effect of impulsivity and negative behavior-dependent life events. We did not find these effects for behavior-independent or positive-dependent events or for prediction of hypomanic symptoms. The findings suggest that impulsivity may account for stress generation of negative events that precede depression.     

The effects of behavioral inhibition/approach system as predictors of Internet addiction in adolescents

This study aimed to determine how the Behavioral Inhibition System (BIS) and the Behavioral Approach System (BAS) affect Internet addiction in adolescents. Two hundred and eleven high school students participated in this study and completed the Young’s Internet Addiction Test (IAT), BIS/BAS scales, and several self-administered questionnaires about depression, anxiety, and impulsivity. Hierarchical regressions showed that BIS and BAS × BIS emerged as significant predictors of IAT; however, only BAS-fun seeking subscale predicted IAT among BAS related subscales. In further analyses, the BAS-fun seeking subscale was mediated by impulsivity and anxiety, and BIS was mediated by anxiety and depression. The current findings imply that BIS and BAS interdependently influence vulnerability to Internet addiction through both shared (anxiety) and different (depression and impulsivity, respectively) pathways.     

Positive overgeneralization and Behavioral Approach System (BAS) sensitivity interact to predict prospective increases in hypomanic symptoms: a behavioral high-risk design

Recent work has identified Behavioral Approach System (BAS) sensitivity as a risk factor for the first onset and recurrence of mood episodes in bipolar disorder, but little work has evaluated risk factors for the prospective development of hypomanic symptoms in individuals at risk for, but without a history of, bipolar disorder. The present study used a prospective behavioral high-risk design to evaluate the impact of positive overgeneralization, a cognitive correlate of risk for hypomania, on hypomanic symptoms in individuals with high vs. moderate BAS sensitivity, but without a history of mood elevation. Hierarchical linear regressions indicated that upward positive overgeneralization and BAS sensitivity interacted to predict increased levels of hypomanic symptoms at follow-up, controlling for initial hypomanic symptoms. The pattern of this interaction was such that positive overgeneralization predicted higher levels of hypomanic symptoms among high-BAS, but not moderate-BAS, individuals. Thus, the self-reported tendency to experience grandiose increases in confidence following success may confer additional risk for mood elevation among individuals already at risk for developing bipolar disorder. Potential implications for prevention and treatment are discussed.     

Assessing the dysregulation of the Behavioral Activation System: the Hypomanic Personality Scale and the BIS-BAS scales

We discuss the Hypomanic Personality Scale (Hyp; Eckblad & Chapman, 1986) and the Behavioral Inhibition System (BIS-BAS; Carver & White, 1994) and Behavioral Activation System (BAS; Gray, 1991) Scales as risk factors for bipolar disorders. The dysregulation of the BAS is considered to be central and results in higher variability in mood. Therefore, we examined how those scales are associated with mood fluctuations. A total of 59 participants completed a diary for at least 17 days. It included a modified Center for Epidemiologic Studies-Depression Scale (Meyer & Hautzinger, 2001) assessing depression and mania and the Positive and Negative Affect Schedule (Watson, Clark, & Tellegen, 1988). Hyp and BAS predicted levels of mania and of positive affect but also fluctuations of mania. Hyp also predicted instability of negative affect. Our data also suggest that mood variability is a trait-like feature. Both scales seem not to be perfect measures of the dysregulation factor. Future research should assess this dysregulation more directly.     

BIS/BAS Levels and Psychiatric Disorder: An Epidemiological Study

Behavioral inhibition and behavioral activation levels have been theorized to relate to a broad range of psychopathologies. To date, however, studies have focused on a single diagnosis, and the measures used to assess different psychopathologies have varied greatly. This study assessed how levels of behavioral inhibition and behavioral activation relate to lifetime diagnoses of depression, anxiety, drug abuse and dependence, alcohol abuseand dependence, attention deficit hyperactivity disorder, and conduct disorder. A representative community sample of 1,803 individuals between the ages of 19 and 21 in the Miami area was surveyed with the Composite International Diagnostic Interview and the Behavioral Inhibition and Behavioral Activation Scales (BIS/BAS; C. S. Carver & T. White, 1994). Results supported the role of BIS as a vulnerability factor for depression and anxiety and of BAS Fun Seeking for drug abuse and noncomorbid alcohol diagnoses. Other models were not supported. Goals in understanding BIS and BAS are described, including the need for prospective studies with a broader array of behavioral indices.     

Perfectionism,personality, and affective experiences: New insights from revised Reinforcement Sensitivity Theory

Previous studies have linked perfectionism to differences in reinforcement sensitivity, but findings have been mixed. The present study explored the relationships between three forms of perfectionism (self-oriented, other-oriented, socially prescribed) and components of the revised Reinforcement Sensitivity Theory of personality in relation to the experience of positive and negative affect. In a sample of 388 university students, we found consistent evidence of significant bivariate and semipartial correlations controlling for the overlap between the three forms of perfectionism: self-oriented perfectionism showed positive relationships with the Behavioral Approach System (BAS), the Behavioral Inhibition System (BIS), and the Fight–Flight–Freeze System (FFFS); other-oriented perfectionism showed a negative relationship with the BIS (and was unrelated to the FFFS); and socially prescribed perfectionism showed positive relationships with the BIS and BAS impulsiveness, and a negative relationship with BAS goal-drive persistence (and was unrelated to the FFFS). Furthermore, mediation analyses indicated that the reinforcement sensitivity components (BIS and BAS, but not FFFS) explained differences in how the three forms of perfectionism predicted recent positive and negative affect. These findings open up new empirical avenues in suggesting that fundamental emotion–motivational systems play a key role in the relationship of perfectionism and affective experiences.     

Behavioral activation and inhibition in everyday life

Joint effects of daily events and dispositional sensitivities to cues of reward and punishment on daily positive affect (PA) and negative affect (NA) were examined in 3 diary studies. Study 1 showed that positive events were strongly related to PA but not NA, whereas negative events were strongly related to NA but not PA. Studies 2 and 3 examined how the dispositional sensitivities of independent appetitive and aversive motivational systems, the Behavioral Activation System (BAS) and the Behavioral Inhibition System (BIS), moderated these relationships. Participants in Study 2 with higher BAS sensitivity reported more PA on average; those with more sensitive BIS reported more NA. Also, BIS moderated reactions to negative events, such that higher BIS sensitivity magnified reactions to negative events. Study 3 replicated these findings and showed that BAS predisposed people to experience more positive events. Results demonstrate the value of distinguishing within-person and between-person effects to clarify the functionally independent processes by which dispositional sensitivities influence affect.     

Psychometric evaluation of the behavioral inhibition/behavioral activation scales in a large sample of outpatients with anxiety and mood disorders

The latent structure, reliability, and validity of the Behavioral Inhibition/Behavioral Activation Scales (BIS/BAS; C. L. Carver and T. L. White, 1994) were examined in a large sample of outpatients (N = 1,825) with anxiety and mood disorders. Four subsamples were used for exploratory and confirmatory factor analyses. In addition to generally upholding a latent structure found previously in nonclinical samples, results indicated measurement invariance of the BIS/BAS between genders and a higher order structure of the BAS scales. Convergent and discriminant validity of the BIS/BAS were supported by findings that the subscales correlated most strongly with measures of neighboring personality constructs (e.g., BIS with neuroticism, BAS with positive affect) than with measures of current anxiety and depression symptoms. Overall, the results support the psychometric properties of the BIS/BAS in this clinical sample.     

Mapping Gray’s BIS and BAS constructs onto Factor 1 and Factor 2 of Hare’s Psychopathy Checklist – Revised

Reinforcement sensitivity theory (RST; Gray, 1987; Gray & McNaughton, 2000) has proven to be a valuable tool for understanding psychopathy (e.g., Fowles, 1980, 1988; Newman & Malterer, 2009; Poythress et al., 2008). Recent research has linked two RST constructs, the Behavioral Inhibition System (BIS) and the Behavioral Activation System (BAS), to individuals with primary psychopathy and secondary psychopathy (Lykken, 1995; Newman, MacCoon, Vaughn, & Sadeh, 2005): Primary psychopaths manifest low BIS reactivity and secondary psychopaths manifest high BAS reactivity. In the present study, we examine the relationships between the BIS/BAS constructs and Factors 1 and 2 of the Psychopathy Checklist – Revised (PCL-R) in a sample of 472 incarcerated male offenders. Paralleling their relationships with primary and secondary psychopathy, the BIS/BAS constructs were differentially related to the two PCL-R factors. Specifically, the influence of the BIS was found to be more prominent than the influence of the BAS for Factor 1, and the influence of the BAS was more prominent than that of the BIS for Factor 2.     

Mapping Gray’s BIS and BAS constructs onto Factor 1 and Factor 2 of Hare’s Psychopathy Checklist – Revised

Reinforcement sensitivity theory (RST; Gray, 1987; Gray & McNaughton, 2000) has proven to be a valuable tool for understanding psychopathy (e.g., Fowles, 1980, 1988; Newman & Malterer, 2009; Poythress et al., 2008). Recent research has linked two RST constructs, the Behavioral Inhibition System (BIS) and the Behavioral Activation System (BAS), to individuals with primary psychopathy and secondary psychopathy (Lykken, 1995; Newman, MacCoon, Vaughn, & Sadeh, 2005): Primary psychopaths manifest low BIS reactivity and secondary psychopaths manifest high BAS reactivity. In the present study, we examine the relationships between the BIS/BAS constructs and Factors 1 and 2 of the Psychopathy Checklist – Revised (PCL-R) in a sample of 472 incarcerated male offenders. Paralleling their relationships with primary and secondary psychopathy, the BIS/BAS constructs were differentially related to the two PCL-R factors. Specifically, the influence of the BIS was found to be more prominent than the influence of the BAS for Factor 1, and the influence of the BAS was more prominent than that of the BIS for Factor 2.     

Behavioral Approach System (BAS) Sensitivity and Bipolar Spectrum Disorders: A Retrospective and Concurrent Behavioral High-Risk Design

In this article, we tested the vulnerability hypothesis of the behavioral approach system (BAS) hypersensitivity model of bipolar disorders. We examined whether self-reported BAS sensitivity predicts lifetime bipolar spectrum diagnoses as well as symptoms and personality characteristics associated with bipolar disorder using a retrospective and concurrent behavioral high-risk design. Participants with high (HBAS; n=28) or moderate (MBAS; n=24) BAS sensitivity were selected and given a lifetime psychiatric diagnostic interview and self-report measures of proneness to bipolar symptoms, current symptoms, and personality characteristics relevant to bipolarity. HBAS participants were significantly and substantially more likely to have a lifetime bipolar spectrum disorder diagnosis than were MBAS participants, but did not differ from MBAS participants in their likelihood of a unipolar depression diagnosis. Also, the HBAS group exhibited higher impulsivity and proneness to hypomanic symptoms than the MBAS group, and BAS-reward responsiveness predicted hypomanic personality characteristics. Finally, high behavioral inhibition system (BIS) sensitivity was associated with proneness to and current depressive symptoms.

Psychometric Properties of the Dutch BIS/BAS Scales

This study examined the reliability, factor structure, and convergent validity of the Dutch version of C. S. Carver and T. L. Whites (1994) Behavioral Approach System and Behavioral Inhibition System Scales (BIS/BAS Scales). For this purpose, the BIS/BAS Scales, a shortened version of the Eysenck Personality Questionnaire (EPQ), and the Dickman Impulsivity Inventory (DII) were administered to 246 undergraduate students in The Netherlands. The internal consistency of the BIS/BAS Scales was sufficient. Further, exploratory and confirmatory factor analysis showed that the Dutch BIS/BAS Scales have a factor structure similar to the English version. Finally, BIS/BAS Scales were found to correlate in a theoretically meaningful way with extraversion, neuroticism, psychoticism, and impulsivity.