Impairment in the achievement domain in bipolar spectrum disorders: Role of behavioral approach system hypersensitivity and impulsivity

Aim. Research indicates that bipolar disorder is characterized by both high levels of impairment and high levels of achievement. A critical, and yet largely unexamined question, is: what psychological mechanisms promote high accomplishment (and low impairment) among bipolar spectrum individuals? The aim of this study was to examine this question. The Authors also conceptually explore how the answer to this question can enhance the development of intervention and prevention strategies for adolescents with a bipolar spectrum condition. Methods. Academic transcript data were obtained for 120 college students who had either a bipolar spectrum disorder (N=54) or no major psychopathology (N=66). Results. Bipolar spectrum individuals obtained a lower cumulative grade point average (GPA, t=-2.9, P=0.005) and dropped more classes (t-2.1, P<0.04) than normal controls. The findings also have relevance to the behavioral approach system (BAS) dysregulation theory of bipolar disorder, as well as research on impulsivity among bipolar individuals. Specifically, follow-up analyses revealed that bipolar individuals exhibiting a combination of high BAS drive and low impulsivity earned higher GPAs than the remaining bipolar individuals. Thus, high BAS sensitivity, when paired with low impulsivity, may not be impairing and may contribute to the high achievement sometimes observed among bipolar individuals. Conclusion. Such information is important for the development of prevention and intervention programs designed adolescents that low-er risk for bipolar impairment without decreasing achievement.