Reward Delay Influences Impulsivity in Individuals with Bipolar and Schizophrenia

Impulsivity and distorted reward valuation is a common symptom in people with both schizophrenia (SZ) and bipolar disorder (BD). Specifically, the manic state of bipolar includes extreme behaviors such as risky sexual activities, substance abuse and overspending, that are exhibited even when a long-range reward for abstaining from such behavior is present. Researchers at the Indiana University School of Medicine recently conducted a study to determine precisely how the time delay in deliverance of rewards, called delay discounting, related to the impulsive behaviors in people with bipolar and schizophrenia.

The team enlisted 21 participants with schizophrenia, 22 with bipolar and 30 healthy participants for their study. They submitted both working memory (WM) and cognitive tests on the participants using a financial scenario for the reward delay discounting task. The individuals were given a choice between receiving $30 immediately or double that amount in 8 months. To follow that up, the researchers provided the participants with the choice between a much larger sum of money immediately or double the amount at six different future points in time, ranging from 2 weeks to 10 years. The study revealed that the healthy participants had lower discounting rates than those with BD or SZ.

The team said, “In each group, working memory or intelligence scores negatively correlated with discounting rate.” They added, “The results suggest that (a) both BD and SZ groups value smaller, immediate rewards more than larger, delayed rewards compared with the healthy group and (b) working memory or intelligence is related to temporal decision-making in individuals with BD or SZ as well as in healthy individuals.” They believe these findings are relevant to therapeutic interventions and added, “Treatment targeting awareness of long-term outcomes of decisions and working memory- WM/IQ composite improvement might enable patients to make more adaptive decisions for their future and improve their quality of life.”

Ahn, W.-Y., Rass, O., Fridberg, D. J., Bishara, A. J., Forsyth, J. K., Breier, A., Busemeyer, J. R., Hetrick, W. P., Bolbecker, A. R., & O’Donnell, B. F. (2011, August 29). Temporal Discounting of Rewards in Patients With Bipolar Disorder and Schizophrenia. Journal of Abnormal Psychology. Advance online publication. doi: 10.1037/a0023333

© 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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  • Irene


    September 6th, 2011 at 3:48 PM

    So working some with them on impulse control could be a huge step for those living with bipolar disorder and schizophrenia.

  • Suzanne Hunt

    Suzanne Hunt

    September 6th, 2011 at 6:41 PM

    I don’t see how they can draw such conclusions with as small a sample group as that. Surely that’s more to do with maturity or not whether they can delay gratification than any condition they may have. We all know any immature person will take the cash on hand instead of waiting patiently.

    And 22 with bipolar, 21 with schizophrenia and 30 healthy? Why too the discrepancy in numbers and not an equivalent number of subjects in each category?

  • regan t

    regan t

    September 6th, 2011 at 11:50 PM

    interesting to see how even the perception of things such as rewards changes with these conditions.

    but what I would like to point out is that the individual’s financial status will also come into play in this kind of a situation.a better question would be “take this gift now or take two of the same at a later date” without revealing what the gift actually is.what say,folks?

  • Brandon


    September 7th, 2011 at 12:59 PM

    This is also a kind of risk-taking,isn’t it?choosing a smaller amount rather than waiting for a bigger one.maybe these disorders influence even the risk-taking ability??



    September 7th, 2011 at 4:46 PM

    Cool article =) I work with a woman who is bipolar but it must be mild or something because she functions well. I honestly did not know that she was bipolar for the LONGEST time. I only found out when she told me. I felt really stupid that I didn’t realize she was bipolar. But now that I know, I’ve been able to notice small things that she does that are different from what most non-bipolar people do. And let me tell you this article is dead on. I don’t know how she manages reward delay with money because I’m not in her close friend circle, but I do know that when it comes to time she is a perfect example of what this article is saying. She always procrastinates on projects which is normal cuz’ I mean we all do it. But I’ve seen her working extra hard on holidays because she put off projects for months. I’ve also noticed they she takes a lunch break super early, before most places even start serving, so she usually winds up eating a second breakfast. I’m pretty sure this is because of her disorder, ya’ know?

  • marcie


    September 7th, 2011 at 7:45 PM

    so ppl like me who just can’t hold ourselves back from a deal and jump on to any offers could have presence of milder versions of these two problems?it could be right..coz everything is related to genes,whether a particular one is present or not…!

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