Behavioral Approach System Identifies Bipolar in Adolescents

There are many forms of bipolar within the spectrum of bipolar spectrum disorders (BSDs), including Bipolar II, cyclothymia, Bipolar I and bipolar disorder not otherwise specified (BiNOS). “Bipolar spectrum disorders (BSDs) occur in 4.4% of the U.S. population and can be associated with severe personal, social, and economic costs,” said Lauren B. Alloy of the Department of Psychology at Temple University. BSDs often manifest during the emotionally charged years of adolescence, making it difficult to diagnose. “Inasmuch as BSDs frequently emerge during adolescence, the ability to identify at-risk adolescents before the initial onset of a BSD may facilitate early and targeted intervention. In turn, early intervention may prevent disorder expression or improve long-term prognosis,” added Alloy. Most individuals with bipolar have a relative with some form of it, but some do not. “Thus, alternative approaches for identifying at-risk adolescents that do not rely on a genetic risk paradigm would be extremely valuable.”

To fill this void, Alloy and her colleagues employed the Behavioral Approach System (BAS) model of bipolar disorder in their study on adolescents. “The BAS is a bio-behavioral system that regulates approach motivation and goal-directed behavior to attain rewards,” said Alloy. Having an oversensitive or under-reactive BAS can result in symptoms that fall at either end of the manic or depressive end of the bipolar spectrum, thus making the BAS model an ideal tool for identifying the early onset of symptoms. The adolescents were measured at the onset of the study and followed every six months. “Consistent with the vulnerability hypothesis of the BAS model of bipolar disorder, high BAS participants had a greater likelihood, and shorter time to onset, of bipolar spectrum disorder than moderate BAS participants across an average of 12.8 months of follow-up (12.9% vs. 4.2%), controlling for baseline depressive and hypomanic symptoms, and family history of bipolar disorder,” said Alloy. She added, “Our findings support the vulnerability hypothesis of the BAS model and indicate that high BAS sensitivity, ambitious goal-striving, and high reward responsiveness are vulnerabilities for first onset of bipolar spectrum disorders.”

Alloy, L. B., Bender, R. E., Whitehouse, W. G., Wagner, C. A., Liu, R. T., Grant, D. A., Jager-Hyman, S., Molz, A., Choi, J. Y., Harmon-Jones, E., & Abramson, L. Y. (2011, October 17). High Behavioral Approach System (BAS) Sensitivity, Reward Responsiveness, and Goal-Striving Predict First Onset of Bipolar Spectrum Disorders: A Prospective Behavioral High-Risk Design. Journal of Abnormal Psychology. Advance online publication. doi: 10.1037/a0025877

© Copyright 2011 by By Noah Rubinstein, LMFT, LMHC, therapist in Olympia, Washington. All Rights Reserved. Permission to publish granted to

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • jake.o


    October 23rd, 2011 at 5:04 AM

    prevention is always better than cure and this is very true in case of health problems..if we can identify people that are at-risk for bipolar with fair precision then that is just is a tool that can help and save a lot of people and also reduce healthcare such as these need all the support that is required to will save billions of dollars spent on researching new drugs.

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