THE LONG-TERM COURSE OF BIPOLAR SPECTRUM DISORDER: APPLICATIONS OF THE BEHAVIORAL APPROACH SYSTEM (BAS) MODEL

Abstract

In this study, I tested predictions of the Behavioral Approach System (BAS) model as applied to the course of bipolar spectrum disorders. In this model, when a vulnerable individual experiences a BAS activation-relevant event, the weak regulatory strength of the BAS interacts with pre-event BAS state and is likely to lead to hypomania/mania. In contrast, when a vulnerable individual experiences a BAS deactivation-relevant event, the weak regulatory strength of the BAS interacts with pre- event BAS state and is likely to lead to depression. A secondary goal of this study involved comparing the BAS model to the cognitive-vulnerability stress model of bipolar disorder. Toward this end, data from a sample of 217 individuals (112 individuals with a diagnosis in the bipolar spectrum and 105 demographically similar, normal controls) participating in the Longitudinal Investigation of Bipolar Spectrum Disorders (LIBS) Project, a two-site prospective examination of the role of BAS, cognitive styles, and life events in the course of bipolar disorders among college students, were analyzed. The results of this study suggest that there is some support for both the BAS model and the cognitive-vulnerability stress model. Specifically, BAS-relevant cognitive styles, in interaction with congruent positive life events, predicted hypomanic episodes. There was less support for either model in the prediction of depression. There was some support for BAS sensitivity and BAS-relevant events each predicting the course of bipolar disorder. However, there was no support for the interaction of BAS sensitivity and BAS-relevant events predicting the type and number of mood episodes. As such, this study found more support for a BAS-related cognitive vulnerability-stress model, as compared to the "pure" BAS model, as applied to bipolar spectrum disorders. Following a review of the results, strengths and limitations, as well as clinical implications and potential future research directions are discussed.