Abstract
Motivation is a key neurobehavioral concept underlying adaptive responses to environmental incentives and threats. As such, dysregulation of motivational processes may be critical in the formation of abnormal behavioral patterns/tendencies. According to the long standing model of the Reinforcement Sensitivity Theory (RST), motivation behaviors are driven by three neurobehavioral systems mediating the sensitivity to punishment, reward or goal-conflict. Corresponding to current neurobehavioral theories in psychiatry, this theory links abnormal motivational drives to abnormal behavior; viewing depression and mania as two abnormal extremes of reward driven processes leading to either under or over approach tendencies, respectively. We revisit the RST framework in the context of bipolar disorder (BD) and challenge this concept by suggesting that dysregulated interactions of both punishment and reward related processes better account for the psychological and neural abnormalities observed in BD. We further present an integrative model positing that the three parallel motivation systems currently proposed by the RST model, can be viewed as subsystems in a large-scale neurobehavioral network of motivational decision making.
Highlights
Sensitive Behavioral Inhibition System” (BIS) was found related to proneness toor concurrent depressive symptoms as well (Alloy et al, 2006). This inspires a reconsideration of the Reinforcement Sensitivity Theory (RST) relevance to bipolar disorder (BD) in a broader perspective of two processes, reward and punishment dysregulation. In this context we suggest that dysregulation of the BIS system may result in insensitivity to costs and efforts, a symptomatic phenomenology of the manic state in BD
Manic patients have been shown to display positive cognitive bias (e.g., remembering more positive self-descriptive words than healthy controls (Pavlickova et al, 2013)). Their behavior seems to be guided more by sensitivity to potential rewards than by avoiding dangers (Swann et al, 2004). We suggest that this complex positive cognitive-behavioral bias may reflect impaired generation, or resolution, of goal-conflict processes, which according to RST depends on normal activation of the BIS
Based on a theoretical framework and converging empirical evidence, we suggest that the Behavioral Activation System” (BAS) dysregulation theory has provided a parsimonious and intuitive model for the involvement of motivational processes in BD, a conceptual revision is needed to further adapt these insights to the complexity of human psychopathology
Summary
Moods as ups and downs of the motivation pendulum: revisiting reinforcement sensitivity theory (RST) in bipolar disorder. The term motivation as used in neuroscience refers to the processes which modulate the organism’s responses to environmental reinforcing cues, according to their perceived value (i.e., reward/punishment) (Smillie, 2008) As it is a major determinant of adaptive goal-directed behavior, it may be useful to look at human psychopathological conditions in terms of aberrant neuro-behavioral functioning of motivational processes. Animals tend to approach rewarding and avoid punishing cues, creating the idea of sensitivity to reward and punishment as the main underlying forces of goal-oriented behavior (Corr and Perkins, 2006) Following this view the RST (Gray, 1982) assigned theses sensitivities to three specific neural systems mediating different motivational processes: (1) The “Fight, Flight, Freeze System” (FFFS), sensitive to punishment stimuli and facilitates behavioral responses via activation of the periaquaductal Gray (PAG), medial hypothalamus, central amygdala, and subgenual anterior cingulate cortex (sgACC); (2) The “Behavioral Activation System” (BAS), sensitive to reward stimuli and facilitates behavioral responses via the ventral tegmental area (VTA), nucleus accumbens (NAcc) and dorsomedial prefrontal cortex (dmPFC); and (3) The “Behavioral Inhibition System” (BIS), sensitive to Frontiers in Behavioral Neuroscience www.frontiersin.org
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