Abstract
BackgroundIndividuals with bipolar disorder show mood instability, including heightened anger and impulsivity. The Ultimatum Game (UG) is a tool used to evaluate emotional and social decision‐making strategies. We investigated behavioral and electrophysiological responses to subjectively fair or unfair offers in the UG in patients with bipolar I disorder.MethodsTwenty‐four manic patients, 20 euthymic patients, and 30 healthy controls participated in this study. We analyzed their behaviors and collected electroencephalography data with which to analyze feedback‐related negativity (FRN) as they played in the UG as responders.ResultsManic patients exhibited significantly higher rejection rates for unfair offers than euthymic patients and healthy controls. Healthy individuals exhibited a greater (i.e., more negative) FRN amplitude in response to unfair offers than to fair offers, whereas euthymic patients exhibited a greater FRN amplitude in response to fair offers compared with unfair offers. Manic patients exhibited no difference in FRN amplitudes between fair and unfair offers.ConclusionsThe current data suggest that different behavioral responses and FRN amplitude patterns can be associated with characteristic manifestations of mood instability in manic bipolar patients. In addition, electrophysiological alterations in response to unfair offers may be a trait abnormality independent of mood state.
Highlights
Bipolar disorder is characterized by mood instability, anger, and aggressive behavior (Bonsall et al, 2012; Perroud et al, 2008 )
A twoway fairness × group analysis of variance (ANOVA) revealed a significant main effect of fairness (F(2,142) = 17.0, p < 0.001) and a significant fairness × group interaction (F(4,142) = 23.1, p < 0.001), but no main effect of group (F(2,71) = 1.87, p = 0.16). We further explored this interaction in two ways as described above for rejection rate (Figure 4)
Our current findings suggest that there is no correlation between mood symptom severity and rejection rates or feedback-related negativity (FRN) amplitude, that behavioral responses to unfair offers may be mood state-dependent whereas electrophysiological alteration may be a trait abnormality
Summary
Bipolar disorder is characterized by mood instability, anger, and aggressive behavior (Bonsall et al, 2012; Perroud et al, 2008 ). Aggression based on anger is an important characteristic of patients with bipolar disorder (Ballester et al, 2014) This characteristic is related to symptom severity, but is relatively high even during stable mood states. Methods: Twenty-four manic patients, 20 euthymic patients, and 30 healthy controls participated in this study. We analyzed their behaviors and collected electroencephalography data with which to analyze feedback-related negativity (FRN) as they played in the UG as responders. Results: Manic patients exhibited significantly higher rejection rates for unfair offers than euthymic patients and healthy controls. Conclusions: The current data suggest that different behavioral responses and FRN amplitude patterns can be associated with characteristic manifestations of mood instability in manic bipolar patients. Electrophysiological alterations in response to unfair offers may be a trait abnormality independent of mood state
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