Valence specific response reversal deficits and risk for mania

Response reversal deficits are well documented in bipolar disorder (BD). Although frequently construed as an index of reward processing abnormalities, these response reversal deficits might simply result from more general cognitive inflexibility. Given that both are implicated in BD, our goal was to more carefully test whether reversal learning deficits are specific to reward processing or reflect more general cognitive inflexibility. To more carefully assess deficits, a novel variant of the response reversal task was used to separate responses to in reward versus punishment feedback. In addition, while response reversal deficits are well documented in BD, it is still unknown if these deficits are observable in people at risk for the disorder, whose performance would be unconfounded by medication use and illness course. To assess the presence of premorbid response reversal deficits, we tested students at risk for developing BD, as defined by the well-validated Hypomanic Personality Scale. Undergraduates (n?=?99) were randomly assigned to complete either a reward only or a punishment only version of a response reversal task. Mania risk was related to difficulty reversing responses following reward, but not punishment feedback. Findings suggest that a deficit in response reversal may be an index of reward dysregulation in BD, and that this deficit can be observed even in those at high risk for the development of BD.