High Behavioral Approach System (BAS) sensitivity, reward responsiveness, and goal-striving predict first onset of bipolar spectrum disorders: A prospective behavioral high-risk design

Alloy, Lauren B.; Bender, Rachel E.; Whitehouse, Wayne G.; Wagner, Clara A.; Liu, Richard T.; Grant, David A.; Jager-Hyman, Shari; Molz, Ashleigh; Choi, James Y.; Harmon-Jones, Eddie; Abramson, Lyn Y.

doi:10.1037/a0025877

Cited by 203Bipolar Disorder and TreatmentSchizophrenia research and treatmentPersonality Disorders and Psychopathology

High Behavioral Approach System (BAS) sensitivity, reward responsiveness, and goal-striving predict first onset of bipolar spectrum disorders: A prospective behavioral high-risk design

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Alloy, Lauren B., Bender, Rachel E., Whitehouse, Wayne G., Wagner, Clara A., Liu, Richard T., Grant, David A., Jager-Hyman, Shari, Molz, Ashleigh +3 more·2012·Journal of Abnormal Psychology

DOI 10.1037/a0025877PMC PMC3403678

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Abstract

A prospective, behavioral high-risk design provided a theoretically guided examination of vulnerability to first onset of bipolar spectrum disorder based on the Behavioral Approach System (BAS) model. Adolescents (ages 14-19) at an "age of risk" for bipolar disorder onset were screened on BAS sensitivity by interviewers blind to current symptoms, lifetime history, and family history of psychopathology. Participants were selected with high versus moderate levels of BAS sensitivity and administered a lifetime diagnostic interview. Those with a bipolar spectrum disorder, psychosis, or hypomanic episode with onset prior to the BAS sensitivity assessment were excluded. High BAS (n = 171) and moderate BAS (n = 119) sensitivity participants in the final sample completed baseline measures of symptoms, goal-setting, and reward responsiveness and were followed prospectively with semistructured diagnostic interviews every 6 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. High reward responsiveness on a behavioral task and ambitious goal-striving for popular fame and financial success (but not impulsivity) also predicted first onset of bipolar spectrum disorder controlling for the covariates and BAS risk group, and ambitious goal-striving partially mediated the BAS risk group effect. We discuss implications of the findings for the BAS model of bipolar disorder and early intervention efforts.

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Bipolar spectrum disorders are characterized by hyperactive behavioral tendencies reflecting reward and goal systems without regard for threat and danger cues.
“bipolar spectrum disorders are characterized by hyperactive behavioral tendencies reflective of reward and goal systems without regard for contextual cues to threat and danger”
From United we stand: emphasizing commonalities across cognitive-behavioral therapies. (2013) · cites this paper as Alloy et al., 2012
The “Behavioral Approach System (BAS) Model: Theory and Evidence” section describes heightened sensitivity to reward and goal cues and excessive goal-striving in people with bipolar spectrum disorders. It does not say they disregard contextual cues to threat or danger; that part of the claim is unsupported by the passages in our copy. (LLM, conf=0.86)
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Eisner, L. R., Johnson, S. L., & Carver, C. S. (2008) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.117.1.154 · Cited by 115 · see citing works
Psychological processes in bipolar affective disorder: negative cognitive style and reward processing
van der Gucht, E., Morriss, R. K., Lancaster, G., Kinderman, P., & Bentall, R. P. (2009) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.107.047894 · Cited by 113 · see citing works
Behavioral Approach System (BAS) Sensitivity and Bipolar Spectrum Disorders: A Retrospective and Concurrent Behavioral High-Risk Design
Alloy, L. B., Abramson, L. Y., Walshaw, P. D., Cogswell, A., Smith, J. M., Neeren, A. M., Hughes, M. E., Iacoviello, B. M., Gerstein, R. K., Keyser, J. D., et al. (2006) · Motivation and Emotion · doi:10.1007/s11031-006-9003-3 · Cited by 102 · see citing works
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Tendencies Toward Mania and Tendencies Toward Depression Have Distinct Motivational, Affective, and Cognitive Correlates
Carver, C. S., & Johnson, S. L. (2008) · Cognitive Therapy and Research · doi:10.1007/s10608-008-9213-y · Cited by 99 · see citing works
Severity of bipolar disorder is associated with impairment of response inhibition
Swann, A. C., Lijffijt, M., Lane, S. D., Steinberg, J. L., & Moeller, F. G. (2008) · Journal of Affective Disorders · doi:10.1016/j.jad.2008.10.022 · Cited by 98 · see citing works
A double-blind placebo controlled experimental study of nicotine: I—effects on incentive motivation
Dawkins, L., Powell, J. H., West, R., Powell, J., & Pickering, A. (2006) · Psychopharmacology · doi:10.1007/s00213-006-0588-8 · Cited by 97 · see citing works
Positive Emotional Traits and Ambitious Goals among People at Risk for Mania: The Need for Specificity
Gruber, J., & Johnson, S. L. (2009) · International Journal of Cognitive Therapy · doi:10.1521/ijct.2009.2.2.176 · Cited by 91 · see citing works
A cognitive vulnerability–stress perspective on bipolar spectrum disorders in a normative adolescent brain, cognitive, and emotional development context
Alloy, L. B., Abramson, L. Y., Walshaw, P. D., Keyser, J. D., & Gerstein, R. K. (2006) · Development and Psychopathology · doi:10.1017/s0954579406060524 · Cited by 90 · see citing works
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Motivational deficits after brain injury: A neuropsychological approach using new assessment techniques.
Al‐Adawi, S., Powell, J. H., & Greenwood, R. (1998) · Neuropsychology · doi:10.1037//0894-4105.12.1.115 · Cited by 88 · see citing works
Reactivity to Alcohol-Related Cues: Relationship Among Cue Type, Motivational Processes, and Personality.
Kambouropoulos, N., & Staiger, P. K. (2004) · Psychology of Addictive Behaviors · doi:10.1037/0893-164x.18.3.275 · Cited by 86 · see citing works
Clinical and Economic Effects of Unrecognized or Inadequately Treated Bipolar Disorder
Keck, P. E., Kessler, R. C., & ROSS, R. W. (2008) · Journal of Psychiatric Practice · doi:10.1097/01.pra.0000320124.91799.2a · Cited by 83 · see citing works
The functioning of the Behavioral Activation and Inhibition Systems in bipolar I euthymic patients and its influence in subsequent episodes over an eighteen-month period
Salavert, J., Caseras, X., Torrúbia, R., Furest, S., Arranz, B., Dueñas, R., & San, L. (2006) · Personality and Individual Differences · doi:10.1016/j.paid.2006.10.010 · Cited by 76 · see citing works
A multimethod investigation of the Behavioral Activation System in bipolar disorder.
Hayden, E. P., Bodkins, M., Brenner, C. A., Shekhar, A., Nürnberger, J. I., O’Donnell, B. F., & Hetrick, W. P. (2008) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.117.1.164 · Cited by 71 · see citing works
The topographical features of EEGs in patients with affective disorders
Kano, K., Nakamura, M., Matsuoka, T., Iida, H., & Nakajima, T. (1992) · Electroencephalography and Clinical Neurophysiology · doi:10.1016/0013-4694(92)90025-d · Cited by 70 · see citing works
Longitudinal predictors of bipolar spectrum disorders: A behavioral approach system perspective.
Alloy, L. B., Abramson, L. Y., Urošević, S., Bender, R. E., & Wagner, C. A. (2009) · Clinical Psychology Science and Practice · doi:10.1111/j.1468-2850.2009.01160.x · Cited by 69 · see citing works
Self-citation
Elevated expectancies among persons diagnosed with bipolar disorder
Johnson, S. L., Eisner, L. R., & Carver, C. S. (2009) · British Journal of Clinical Psychology · doi:10.1348/014466509x414655 · Cited by 67 · see citing works
The influence of smoking on reward responsiveness and cognitive functions: a natural experiment
Al‐Adawi, S., & Powell, J. E. (1997) · Addiction · doi:10.1111/j.1360-0443.1997.tb02897.x · Cited by 63 · see citing works
Behavioral phenotypes of impulsivity related to the ANKK1 gene are independent of an acute stressor
White, M. J., Morris, C. P., Lawford, B. R., & Young, R. (2008) · Behavioral and Brain Functions · doi:10.1186/1744-9081-4-54 · Cited by 61 · see citing works
A study of age at onset and affective temperaments in a Norwegian sample of patients with mood disorders
Oedegaard, K. J., Syrstad, V. E. G., Morken, G., Akiskal, H. S., & Fasmer, O. B. (2009) · Journal of Affective Disorders · doi:10.1016/j.jad.2009.01.030 · Cited by 48 · see citing works
Is the Behavioural Inhibition System the core vulnerability for cluster C personality disorders?
Caseras, X., Torrúbia, R., & Farré, J. M. (2001) · Personality and Individual Differences · doi:10.1016/s0191-8869(00)00141-0 · Cited by 22 · see citing works
Impairment in the achievement domain in bipolar spectrum disorders: role of behavioral approach system hypersensitivity and impulsivity.
Nusslock, R., Alloy, L. B., Ly, A., Harmon‐Jones, E., & Me, H. (2008) · PubMed · Cited by 22 · see citing works
Self-citation
Testing New Diagnostic Criteria for Hypomania
Benazzi, F. (2007) · Annals of Clinical Psychiatry · doi:10.1080/10401230701338219 · Cited by 16 · see citing works
Factor structure of the Barratt impulsiveness scale
Patton, J. H., Stanford, M. S., & Barratt, E. S. (1995) · Journal of Clinical Psychology · doi:10.1002/1097-4679(199511)51:6

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A Critical Appraisal of Neuroimaging Studies of Bipolar Disorder: Toward a New Conceptualization of Underlying Neural Circuitry and a Road Map for Future Research
Phillips, M. L., & Swartz, H. A. (2014) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2014.13081008 · Cited by 636 · see citing works
“Theme 4: Abnormalities in reward processing neural circuitry—In addition to emotional over-reactivity, and emotion dysregulation, another feature of bipolar disorder is heightened reward sensitivity, indicated by behavioral and event-related potential studies(29-31).”
Reward processing and mood-related symptoms: An RDoC and translational neuroscience perspective
Nusslock, R., & Alloy, L. B. (2017) · Journal of Affective Disorders · doi:10.1016/j.jad.2017.02.001 · Cited by 322 · see citing works
“…of hypo/manic episodes (Alloy et al., 2008), an increase in manic symptoms among recovered individuals with bipolar I disorder (Meyer et al., 2001), and a greater likelihood of progressing to a more severe bipolar diagnosis among those with milder bipolar spectrum diagnoses (Alloy et al., 2012b).”
BackgroundSelf-citation
Age at onset and clinical correlates in body dysmorphic disorder
Bjornsson, A. S., Didie, E. R., Grant, J. E., Menard, W., Stalker, E., & Phillips, K. A. (2013) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2013.03.019 · Cited by 245 · see citing works
“Prospective, longitudinal studies in high-risk samples are needed to address this limitation in the age at onset literature (see eg [80] for a study involving a prospective, high-risk design).”
Background
The Behavioral Activation System and Mania
Johnson, S. L., Edge, M. D., Holmes, M. K., & Carver, C. S. (2012) · Annual Review of Clinical Psychology · doi:10.1146/annurev-clinpsy-032511-143148 · Cited by 230 · see citing works
United we stand: emphasizing commonalities across cognitive-behavioral therapies.
Mennin, D. S., Ellard, K. K., Fresco, D. M., & Gross, J. J. (2013) · Behavior Therapy · doi:10.1016/j.beth.2013.02.004 · Cited by 172 · see citing works
“By contrast, bipolar spectrum disorders are characterized by hyperactive behavioral tendencies reflective of reward and goal systems without regard for contextual cues to threat and danger (Alloy et al., 2012).”
Background
Role of Reward Sensitivity and Processing in Major Depressive and Bipolar Spectrum Disorders
Alloy, L. B., Olino, T. M., Freed, R. D., & Nusslock, R. (2016) · Behavior Therapy · doi:10.1016/j.beth.2016.02.014 · Cited by 169 · see citing works
Self-citation
Circadian Rhythm Dysregulation in Bipolar Spectrum Disorders
Alloy, L. B., Ng, T. H., Titone, M. K., & Boland, E. M. (2017) · Current Psychiatry Reports · doi:10.1007/s11920-017-0772-z · Cited by 167 · see citing works
Self-citation
The Development and Course of Bipolar Spectrum Disorders: An Integrated Reward and Circadian Rhythm Dysregulation Model
Alloy, L. B., Nusslock, R., & Boland, E. M. (2015) · Annual Review of Clinical Psychology · doi:10.1146/annurev-clinpsy-032814-112902 · Cited by 135 · see citing works
“In line with the BAS/reward model of BSD, functional MRI (fMRI) research indicates that BSD is associated with an excessive increase in fronto-striatal reward-related neural activation to positive or approach-related stimuli.”
BackgroundInfluentialSelf-citation
Rumination interacts with life stress to predict depressive symptoms: An ecological momentary assessment study
Connolly, S. L., & Alloy, L. B. (2017) · Behaviour Research and Therapy · doi:10.1016/j.brat.2017.07.006 · Cited by 114 · see citing works
“The current study utilized the depression module of the expanded version of the SADS-L semistructured diagnostic interview (exp-SADS-L; see Alloy et al., 2012).”
Method
Non-suicidal self-injury prospectively predicts interpersonal stressful life events and depressive symptoms among adolescent girls
Burke, T. A., Hamilton, J. L., Abramson, L. Y., & Alloy, L. B. (2015) · Psychiatry Research · doi:10.1016/j.psychres.2015.06.021 · Cited by 103 · see citing works
“…(ages 14–19) were drawn from a behavioral high-risk study investigating the differences between individuals at low and high risk for a first onset bipolar spectrum disorder based on exhibiting high versus moderate Behavioral Approach System (BAS)/reward sensitivity (see Alloy et al., 2012).”
Self-citation
Asymmetrical frontal cortical activity associated with differential risk for mood and anxiety disorder symptoms: An RDoC perspective
Nusslock, R., Walden, K., & Harmon-Jones, E. (2015) · International Journal of Psychophysiology · doi:10.1016/j.ijpsycho.2015.06.004 · Cited by 95 · see citing works
“…hypomanic/manic episodes (Alloy et al., 2008), an increase in manic symptoms among recovered individuals with bipolar I disorder (Meyer et al., 2001), and a greater likelihood of progressing to a more severe bipolar diagnosis among those with milder bipolar spectrum diagnoses (Alloy et al., 2012b).”
BackgroundInfluentialSelf-citation
A pathway linking reward circuitry, impulsive sensation-seeking and risky decision-making in young adults: identifying neural markers for new interventions
Chase, H. W., Fournier, J. C. J., Bertocci, M. A., Greenberg, T., Aslam, H. A., Stiffler, R. S., Lockovich, J., Graur, S., Bebko, G. M., Forbes, E. E., et al. (2017) · Translational Psychiatry · doi:10.1038/tp.2017.60 · Cited by 92 · see citing works
Transdiagnostic approaches to psychopathology measurement: Recommendations for measure selection, data analysis, and participant recruitment.
Stanton, K. J., McDonnell, C. G., Hayden, E. P., & Watson, D. (2019) · Journal of Abnormal Psychology · doi:10.1037/abn0000464 · Cited by 91 · see citing works
At-risk studies and clinical antecedents of psychosis, bipolar disorder and depression: a scoping review in the context of clinical staging
Hartmann, J., Nelson, B., Ratheesh, A., Treen, D., & McGorry, P. D. (2018) · Psychological Medicine · doi:10.1017/s0033291718001435 · Cited by 79 · see citing works
“Based on high sensitivity of the behavioural approach system in university students (Alloy et al., 2012a), a study in a ‘behavioural high risk’ sample found that higher scores on the fun-seeking sub-scale of the Behavioural Activation Scale (Alloy et al., 2012b) and low social rhythm (i.e. patterns…”
BackgroundInfluential
The prevalence and co-occurrence of psychiatric conditions among entrepreneurs and their families
Freeman, M. A., Staudenmaier, P. J., Zisser, M., & Andresen, L. A. (2018) · Small Business Economics · doi:10.1007/s11187-018-0059-8 · Cited by 80 · see citing works
“Risk propensity and impulsivity are associated with ADHD (Bakhshani 2013; Drechsler et al. 2008; Shoham et al. 2016), bipolar spectrum conditions (Alloy et al. 2012; Reddy et al. 2014; Strakowski et al. 2010; Swann et al. 2001), substance use disorders (Birkley and Smith 2011; Feldstein and Miller…”
Background
Elevated reward-related neural activation as a unique biological marker of bipolar disorder: Assessment and treatment implications
Nusslock, R., Young, C. B., & Damme, K. S. F. (2014) · Behaviour Research and Therapy · doi:10.1016/j.brat.2014.08.011 · Cited by 79 · see citing works
A brief review of exercise, bipolar disorder, and mechanistic pathways
Thomson, D., Turner, A., Lauder, S., Gigler, M. E., Berk, L., Singh, A., Pasco, J. A., Berk, M., & Sylvia, L. G. (2015) · Frontiers in Psychology · doi:10.3389/fpsyg.2015.00147 · Cited by 79 · see citing works
“The aggravation of manic symptoms could be mediated by direct effects on mood or indirectly on excessive goal striving, which has been hypothesized to be a psychological risk pathway in the disorder (Nusslock et al., 2007; Alloy et al., 2012).”
Background
Future Directions for Understanding Adolescent Bipolar Spectrum Disorders: A Reward Hypersensitivity Perspective
Alloy, L. B., & Nusslock, R. (2019) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2019.1567347 · Cited by 73 · see citing works
Self-citation
Disturbed Anterior Prefrontal Control of the Mesolimbic Reward System and Increased Impulsivity in Bipolar Disorder
Trost, S., Diekhof, E. K., Zvonik, K., Lewandowski, M., Usher, J., Keil, M., Zilles‐Wegner, D., Falkai, P., Dechent, P., & Gruber, O. (2014) · Neuropsychopharmacology · doi:10.1038/npp.2014.39 · Cited by 72 · see citing works
“Both depressive and manic mood states have been associated with dysfunctions of the brain reward system (Alloy et al, 2012; Hasler, 2006; Johnson et al, 2012b).”
Elevated left mid-frontal cortical activity prospectively predicts conversion to bipolar I disorder.
Nusslock, R., Harmon‐Jones, E., Alloy, L. B., Urošević, S., Goldstein, K. E., & Abramson, L. Y. (2012) · Journal of Abnormal Psychology · doi:10.1037/a0028973 · Cited by 73 · see citing works
Self-citation
Moving Forward with the BAS
Krupıć, D., & Corr, P. J. (2017) · Psihologijske teme · doi:10.31820/pt.26.1.2 · Cited by 72 · see citing works
“Deficits in the BAS are related to bipolar disorder (e.g. Alloy et al., 2012), mania (Carver & Johnson, 2009), drug abuse (Hundt, Kimbrel, Mitchell, & Nelson-Gray, 2008), and other problems similar to the dysfunctions of the RDS (see above).”
Background
The clinical trajectory of emerging bipolar disorder among the high-risk offspring of bipolar parents: current understanding and future considerations
Duffy, A. C., Vandeleur, C. L., Heffer, N., & Preisig, M. (2017) · International Journal of Bipolar Disorders · doi:10.1186/s40345-017-0106-4 · Cited by 69 · see citing works
“2006b) and that young people with abnormal sensitivity to reward and goal-striving are at elevated risk of developing BD symptoms (Alloy et al. 2012).”
Background
Elevated striatal reactivity across monetary and social rewards in bipolar I disorder.
Dutra, S. J., Cunningham, W. A., Hedy Kober, A., & Gruber, J. (2015) · Journal of Abnormal Psychology · doi:10.1037/abn0000092 · Cited by 68 · see citing works
“In addition, this finding is generally consistent with theoretical models emphasizing hypersensitivity to rewards as a central process implicated in BD (e.g., Alloy et al., 2009, 2012; Nusslock et al., 2012; Urosevic et al., 2008).”
Result
A 3-year longitudinal study of risk for bipolar spectrum psychopathology.
Walsh, M. A., DeGeorge, D. P., Barrantes‐Vidal, N., & Kwapil, T. R. (2015) · Journal of Abnormal Psychology · doi:10.1037/abn0000045 · Cited by 63 · see citing works
Low social rhythm regularity predicts first onset of bipolar spectrum disorders among at-risk individuals with reward hypersensitivity.
Alloy, L. B., Boland, E. M., Ng, T. H., Whitehouse, W. G., & Abramson, L. Y. (2015) · Journal of Abnormal Psychology · doi:10.1037/abn0000107 · Cited by 63 · see citing works
“Consistent with the reward model, Alloy et al. (2012) previously demonstrated that controlling for baseline hypomanic and depressive symptoms and family history of bipolar disorder, adolescents who exhibited high levels of reward sensitivity at baseline, but had no prior history of BSD, were…”
BackgroundMethodResultInfluentialSelf-citation
Kindling of life stress in bipolar disorder: comparison of sensitization and autonomy models
Weiss, R. B., Stange, J. P., Boland, E. M., Black, S. K., LaBelle, D. R., Abramson, L. Y., & Alloy, L. B. (2015) · Journal of Abnormal Psychology · doi:10.1037/abn0000014 · Cited by 62 · see citing works
“The original SADS-L was expanded for the LIBS project to include DSM-IV criteria and to increase reliability and accuracy in diagnosing BSDs (see Alloy et al., 2008, 2012 for details of the expansion and interviewer training and supervision).”
Self-citation
Candidate Risks Indicators for Bipolar Disorder: Early Intervention Opportunities in High-Risk Youth
Duffy, A. C., Jones, S. H., Goodday, S., & Bentall, R. P. (2015) · The International Journal of Neuropsychopharmacology · doi:10.1093/ijnp/pyv071 · Cited by 61 · see citing works
Disrupted cortico‐limbic connectivity during reward processing in remitted bipolar I disorder
Dutra, S. J., Man, V. Y., Hedy Kober, A., Cunningham, W. A., & Gruber, J. (2017) · Bipolar Disorders · doi:10.1111/bdi.12560 · Cited by 57 · see citing works
Life events and social rhythms in bipolar spectrum disorders: An examination of social rhythm sensitivity
Boland, E. M., Bender, R. E., Alloy, L. B., Conner, B. T., LaBelle, D. R., & Abramson, L. Y. (2012) · Journal of Affective Disorders · doi:10.1016/j.jad.2012.01.038 · Cited by 53 · see citing works
“…disorders (BSD) warrant additional investigation because individuals with these spectrum conditions, particularly youth and adolescents, are at increased risk to develop bipolar I disorder (Alloy et al., 2012; Birmaher et al., 2006; Birmaher et al., 2009; Cassano, et al., 1999; Shen et al., 2008).”
BackgroundSelf-citation
Latent classes of trait affect and cognitive affective regulation strategies are associated with depression, non-suicidal self-injury, and well-being
Burke, T. A., McArthur, B. A., Daryanani, I., Abramson, L. Y., & Alloy, L. B. (2017) · Journal of Affective Disorders · doi:10.1016/j.jad.2017.08.015 · Cited by 53 · see citing works
“Adolescent participants were recruited for Project TEAM, a longitudinal, multiwave, behavioral high-risk study that investigates vulnerability for bipolar spectrum disorder (BSD) onset (see Alloy et al., 2012).”
Self-citation
The Double‐Edged Sword of Goal Engagement: Consequences of Goal Pursuit in Bipolar Disorder
Johnson, S. L., Fulford, D., & Carver, C. S. (2012) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.1801 · Cited by 52 · see citing works
“…spectrum diagnoses among college students at risk for the disorder (Alloy et al., 2010), the onset of bipolar I disorder among those diagnosed with bipolar II disorder (Alloy et al., 2012b) and the onset of bipolar II disorder among those diagnosed with cyclothymic disorder (Alloy et al., 2012a).”
Impulsivity: present during euthymia in bipolar disorder? - a systematic review
Newman, A. L., & Meyer, T. D. (2014) · International Journal of Bipolar Disorders · doi:10.1186/2194-7511-2-2 · Cited by 52 · see citing works
Personal recovery in bipolar disorder: Systematic review and “best fit” framework synthesis of qualitative evidence – a POETIC adaptation of CHIME
Jagfeld, G., Lobban, F. A., Marshall, P., & Jones, S. H. (2021) · Journal of Affective Disorders · doi:10.1016/j.jad.2021.05.051 · Cited by 52 · see citing works
“There is some evidence that people with a high behavioural activation system sensitivity, resulting in increased goal directed behaviour, may be more vulnerable to develop bipolar disorder symptoms (Alloy et al., 2012; Dempsey et al., 2017; Depue and Iacono, 1989).”
Background
Baseline and follow-up activity and functional connectivity in reward neural circuitries in offspring at risk for bipolar disorder
Acuff, H. E., Versace, A., Bertocci, M. A., Ladouceur, C. D., Hanford, L. C., Manelis, A., Monk, K., Bonar, L. K., Mccaffrey, A., Goldstein, B. I., et al. (2019) · Neuropsychopharmacology · doi:10.1038/s41386-019-0339-2 · Cited by 50 · see citing works
Linking Cognitive Measures of Response Inhibition and Reward Sensitivity to Trait Impulsivity
Zinkunegi, A. J., Kessler, K., & Hassel, S. (2018) · Frontiers in Psychology · doi:10.3389/fpsyg.2018.02306 · Cited by 50 · see citing works
Neural correlates of delay discount alterations in addiction and psychiatric disorders: A systematic review of magnetic resonance imaging studies
Noda, Y., Barr, M. S., ElSalhy, M., Masuda, F., Tarumi, R., Ogyu, K., Wada, M., Tsugawa, S., Miyazaki, T., Nakajima, S., et al. (2019) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2019.109822 · Cited by 47 · see citing works
Cognitive and Emotion‐Regulatory Mediators of the Relationship Between Behavioral Approach System Sensitivity and Nonsuicidal Self‐Injury Frequency
Burke, T. A., Stange, J. P., Hamilton, J. L., Cohen, J. N., O’Garro-Moore, J. K., Daryanani, I., Abramson, L. Y., & Alloy, L. B. (2014) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12145 · Cited by 47 · see citing works
“A random subset of adolescents screened in Phase I who met inclusion criteria for the HBAS or MBAS groups participated in Phase II of screening (see Alloy et al., 2012, for further details regarding study recruitment and eligibility).”
BackgroundMethodSelf-citation
The dominance behavioral system and manic temperament: Motivation for dominance, self-perceptions of power, and socially dominant behaviors
Johnson, S. L., & Carver, C. (2012) · Journal of Affective Disorders · doi:10.1016/j.jad.2012.05.015 · Cited by 45 · see citing works
“Heightened ambitions for extrinsic recognition have also been found to predict both the onset of bipolar disorder (Alloy et al., 2011) and a more severe course of mania (Johnson et al., in press).”
Childhood abuse and stress generation: The mediational effect of depressogenic cognitive styles
Liu, R. T., Choi, J. Y., Boland, E. M., Mastin, B. M., & Alloy, L. B. (2012) · Psychiatry Research · doi:10.1016/j.psychres.2012.12.001 · Cited by 44 · see citing works
“As detailed in Alloy et al. (2000, 2012), the SADS-L was modified to allow for the assessment of DSM-IV-TR (American Psychiatric Association, 2000) diagnoses of major and minor depression.”
MethodSelf-citation
Evaluating endophenotypes for bipolar disorder
Guglielmo, R., Miskowiak, K. W., & Hasler, G. (2021) · International Journal of Bipolar Disorders · doi:10.1186/s40345-021-00220-w · Cited by 44 · see citing works
“A prospective study also found that adolescents with no prior history of BD who exhibited an ambitious goal-striving cognitive style at baseline had a greater likelihood and shorter time to first lifetime onset of BD than those without this cognitive style (Alloy et al. 2012).”
Background
Affective Disruption From Social Rhythm and Behavioral Approach System (BAS) Sensitivities
Boland, E. M., Stange, J. P., LaBelle, D. R., Shapero, B. G., Weiss, R. B., Abramson, L. Y., & Alloy, L. B. (2015) · Clinical Psychological Science · doi:10.1177/2167702615603368 · Cited by 42 · see citing works
Self-citation
Altered functioning of reward circuitry in youth offspring of parents with bipolar disorder
Manelis, A., Ladouceur, C. D., Graur, S., Monk, K., Bonar, L. K., Hickey, M. B., Dwojak, A., Axelson, D., Goldstein, B., Goldstein, T. R., et al. (2015) · Psychological Medicine · doi:10.1017/s003329171500166x · Cited by 40 · see citing works
“One such information processing domain is reward processing, as an increasing number of studies reported abnormally heightened reward sensitivity in individuals with BD (Alloy et al. 2012; Ibanez et al. 2012; Mason et al. 2012).”
Background
An integrative study of motivation and goal regulation processes in subclinical anxiety, depression and hypomania
Dickson, J. M., Johnson, S. L., Huntley, C. D., Peckham, A., & Taylor, P. J. (2017) · Psychiatry Research · doi:10.1016/j.psychres.2017.06.002 · Cited by 39 · see citing works
“to note that our findings are consistent with those observed in clinically diagnosed samples (Alloy et al., 2012; Carver et al., 2013; Shankman et al., 2013), and recent studies document that rates of psychopathology among current college students are equivalent to those in the general population (Ibrahim et al.”
Result
Trait Affect, Emotion Regulation, and the Generation of Negative and Positive Interpersonal Events
Hamilton, J. L., Burke, T. A., Stange, J. P., Kleiman, E. M., Rubenstein, L. M., Scopelliti, K. A., Abramson, L. Y., & Alloy, L. B. (2017) · Behavior Therapy · doi:10.1016/j.beth.2017.01.006 · Cited by 38 · see citing works
Self-citation
Negative Event Recall as a Vulnerability for Depression: Relationship between Momentary Stress-Reactive Rumination and Memory for Daily Life Stress
Connolly, S. L., & Alloy, L. (2017) · Clinical psychological science : a journal of the Association for Psychological Science · doi:10.1177/2167702617729487 · Cited by 33 · see citing works
Self-citation
The interaction of affective states and cognitive vulnerabilities in the prediction of non-suicidal self-injury
Cohen, J. N., Stange, J. P., Hamilton, J. L., Burke, T. A., Jenkins, A., Ong, M.-L., Heimberg, R. G., Abramson, L. Y., & Alloy, L. B. (2014) · Cognition & Emotion · doi:10.1080/02699931.2014.918872 · Cited by 38 · see citing works
“…colleges (ages 14–19) were selected for participation in a behavioural high-risk study designed to evaluate characteristics of individuals hypothesised to be at high versus low risk for a first onset of bipolar disorder based on Behavioral Approach System (BAS) sensitivity (see Alloy et al., 2012).”
Self-citation
Improving early recognition and intervention in people at increased risk for the development of bipolar disorder: study protocol of a prospective-longitudinal, naturalistic cohort study (Early-BipoLife)
Pfennig, A., Leopold, K., Martini, J., Boehme, A., Lambert, M., Stamm, T. J., Bermpohl, F., Reif, A., Kittel‐Schneider, S., Juckel, G., et al. (2020) · International Journal of Bipolar Disorders · doi:10.1186/s40345-020-00183-4 · Cited by 38 · see citing works
Emotion regulation characteristics and cognitive vulnerabilities interact to predict depressive symptoms in individuals at risk for bipolar disorder: A prospective behavioural high-risk study
Stange, J. P., Boccia, A. S., Shapero, B. G., Adams, A. M., Flynn, M. E., Matt, L. M., Abramson, L. Y., & Alloy, L. B. (2012) · Cognition & Emotion · doi:10.1080/02699931.2012.689758 · Cited by 36 · see citing works
Self-citation
Reward Responsiveness in the Adolescent Brain Cognitive Development (ABCD) Study: African Americans’ Diminished Returns of Parental Education
Assari, S., Boyce, S., Akhlaghipour, G., Bazargan, M., & Caldwell, C. H. (2020) · Brain Sciences · doi:10.3390/brainsci10060391 · Cited by 35 · see citing works
“Many investigators have found evidence linking the RR trait to a wide range of health and behavioral outcomes in clinical [22,25,26] as well as community [27] samples.”
Background
Identity in bipolar disorder: Self‐worth and achievement
Ironside, M. L., Johnson, S. L., & Carver, C. S. (2019) · Journal of Personality · doi:10.1111/jopy.12461 · Cited by 34 · see citing works
“WASSUP elevations appear to function as a double-edged sword, with some positive and some negative outcomes related to WASSUP elevations.”
BackgroundInfluential
Exploring the Relationship between Reward and Punishment Sensitivity and Gambling Disorder in a Clinical Sample: A Path Modeling Analysis
Jiménez-Murcia, S., Fernández-Aranda, F., Mestre-Bach, G., Granero, R., Tarrega, S., Torrubia, R., Aymamí, N., Gómez-Peña, M., Soriano-Mas, C., Steward, T., et al. (2017) · Journal of Gambling Studies · doi:10.1007/s10899-016-9631-9 · Cited by 33 · see citing works
“2015), bipolar spectrum disorder (Alloy et al. 2012), eating disorders (Farmer et al.”
Background
Behavioral Approach System (BAS)-Relevant Cognitive Styles in Individuals with High Versus Moderate BAS Sensitivity: A Behavioral High-Risk Design
Stange, J. P., Shapero, B. G., Jager‐Hyman, S., Grant, D. A., Abramson, L. Y., & Alloy, L. B. (2012) · Cognitive Therapy and Research · doi:10.1007/s10608-012-9443-x · Cited by 33 · see citing works
Self-citation
What is bipolar disorder? A disease model of dysregulated energy expenditure
Mansur, R. B., Lee, Y. L., McIntyre, R. S., & Brietzke, E. M. (2020) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2020.04.006 · Cited by 33 · see citing works
Elucidating the relation between childhood emotional abuse and depressive symptoms in adulthood: The mediating role of maladaptive interpersonal processes
Massing‐Schaffer, M., Liu, R. T., Kraines, M. A., Choi, J. Y., & Alloy, L. B. (2014) · Personality and Individual Differences · doi:10.1016/j.paid.2014.09.045 · Cited by 33 · see citing works
“The original version was modified for the current study to meet DSM-IV-TR (American Psychiatric Association, 2000) criteria for major and minor depression (for details, see Alloy et al., 2012).”
MethodSelf-citation
Spontaneous Eye-Blink Rate as an Index of Reward Responsivity
Peckham, A., & Johnson, S. L. (2015) · Clinical Psychological Science · doi:10.1177/2167702615594999 · Cited by 30 · see citing works
“…for wealth, e.g., “You will have 20 million dollars or more”), as these two subscales have been found to be elevated in bipolar I disorder ( Johnson et al., 2009) and to predict symptoms of mania ( Johnson, Carver, et al., 2012) and onset of bipolar spectrum disorders (Alloy et al., 2012).”
Background
Elevated nucleus accumbens structural connectivity associated with proneness to hypomania: a reward hypersensitivity perspective
Damme, K. S. F., Young, C. B., & Nusslock, R. (2017) · Social Cognitive and Affective Neuroscience · doi:10.1093/scan/nsx017 · Cited by 32 · see citing works
“Furthermore, elevated reward sensitivity has been shown to prospectively predict onset of first bipolar episode (Alloy et al., 2012a) and, among individuals with a bipolar spectrum disorder, predict a worsening of course (i.e. conversion from cyclothymia/bipolar II disorder to bipolar I; Alloy et…”
BackgroundInfluential
Decreased reward-related brain function prospectively predicts increased substance use.
Bart, C. P., Nusslock, R., Ng, T. H., Titone, M. K., Carroll, A., Damme, K. S. F., Young, C. B., Armstrong, C. C., Chein, J. M., & Alloy, L. B. (2021) · Journal of Abnormal Psychology · doi:10.1037/abn0000711 · Cited by 34 · see citing works
“Participants were selected from a larger longitudinal study (Project TEAM; Alloy et al., 2012) examining adolescent risk for bipolar disorders.”
InfluentialSelf-citation
Mania risk and creativity: A multi-method study of the role of motivation
Ruiter, M., & Johnson, S. L. (2014) · Journal of Affective Disorders · doi:10.1016/j.jad.2014.08.049 · Cited by 30 · see citing works
Associations of age with reward delay discounting and response inhibition in adolescents with bipolar disorders
Urošević, S., Youngstrom, E. A., Collins, P. F., Jensen, J. B., & Luciana, M. M. (2015) · Journal of Affective Disorders · doi:10.1016/j.jad.2015.11.005 · Cited by 30 · see citing works
“A uthor M anuscript A uthor M anuscript A uthor M anuscript A uthor M anuscript five-year interval (Alloy et al., 2012a).”
BackgroundInfluential
Shared and distinct reward neural mechanisms among patients with schizophrenia, major depressive disorder, and bipolar disorder: an effort-based functional imaging study
Wang, Y., Wang, Y., Huang, J., Sun, X., Wang, X., Zhang, S., Zhu, G., Lui, S. S. Y., Cheung, E. F. C., Sun, H., et al. (2022) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-021-01376-3 · Cited by 29 · see citing works
“Many previous studies using the Behavioural Activation Scale found patients with BD exhibiting reward hyper-sensitivity [1, 2, 32].”
BackgroundResult
Impulsivity predicts the onset of DSM-IV-TR or RDC hypomanic and manic episodes in adolescents and young adults with high or moderate reward sensitivity
Ng, T. H., Stange, J. P., Black, C. L., Titone, M. K., Weiss, R. B., Abramson, L. Y., & Alloy, L. B. (2016) · Journal of Affective Disorders · doi:10.1016/j.jad.2016.03.045 · Cited by 31 · see citing works
“…to mediate the association between BD and substance use problems (Alloy et al., 2009b), predict a longer time to recovery among inpatients with bipolar I disorder (Dawson et al., 2014) and an increased likelihood of conversion from milder forms of BD to bipolar I disorder (Alloy et al., 2012b).”
InfluentialSelf-citation
Reward anticipation revisited- evidence from an fMRI study in euthymic bipolar I patients and healthy first-degree relatives
Kollmann, B., Scholz, V., Linke, J. O., Kirsch, P., & Wessa, M. (2017) · Journal of Affective Disorders · doi:10.1016/j.jad.2017.04.044 · Cited by 29 · see citing works
A genetic analysis of the validity of the Hypomanic Personality Scale
Johnson, S. L., Carver, C. S., Joormann, J., & Cuccaro, M. L. (2014) · Bipolar Disorders · doi:10.1111/bdi.12251 · Cited by 28 · see citing works
“Such work would build on several recent examples suggesting that biological and psychological parameters may help predict the conversion from at-risk to diagnosed status (64, 65).”
Background
The roles of behavioural activation and inhibition among young adults engaging in self‐injury
Jenkins, A. L., Seelbach, A. C., Conner, B. T., & Alloy, L. B. (2012) · Personality and Mental Health · doi:10.1002/pmh.1200 · Cited by 27 · see citing works
Self-citation
Is “early intervention” in bipolar disorder what it claims to be?
Malhi, G. S., Morris, G., Hamilton, A., Outhred, T., & Mannie, Z. N. (2017) · Bipolar Disorders · doi:10.1111/bdi.12576 · Cited by 26 · see citing works
Mania Symptoms and HIV-Risk Behavior Among Adolescents in Mental Health Treatment
Stewart, A. J., Theodore‐Oklota, C., Hadley, W. S., Brown, L. K., Donenberg, G. R., DiClemente, R. J., & Project Style Study Group (2012) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2012.675569 · Cited by 26 · see citing works
“Adolescents with more sensitive behavioral approach systems are more vulnerable to developing bipolar spectrum disorders (Alloy et al., 2011).”
Longitudinal changes in the antecedent and early manifest course of bipolar disorder—A narrative review of prospective studies
Pfennig, A., Leopold, K., Ritter, P. S., Böhme, A., Severus, E., & Bauer, M. (2017) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/0004867417700730 · Cited by 25 · see citing works
“…BAS-activating, and anger-evoking life events over a period of up to 4.5 years as a function of levels of aggression and impulsivity in a sample of 104 individuals with BSD and 96 healthy controls from the Longitudinal Investigation of Bipolar Spectrum Disorders Project (LIBS; Alloy et al., 2012b).”
BackgroundInfluential
Bipolar disorder and leadership - a total population study
Kyaga, S., Lichtenstein, P., Boman, M., & Landén, M. (2014) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.12304 · Cited by 24 · see citing works
“Essentially, people with bipolar traits seem to want more intensively than do others, continue to want even after attaining a reward, and consequently endorse highly ambitious life goals (41, 42).”
Background
Neural reward circuit dysfunction as a risk factor for bipolar spectrum disorders and substance use disorders: A review and integration
Bart, C. P., Titone, M. K., Ng, T. H., Nusslock, R., & Alloy, L. B. (2021) · Clinical Psychology Review · doi:10.1016/j.cpr.2021.102035 · Cited by 25 · see citing works
“…and responsiveness towards goals and rewards, is associated with the onset and course of bipolar spectrum disorders (BSDs; Alloy et al., 2012; Alloy et al., 2012; Nusslock et al., 2012) and substance use disorders (SUDs; Alloy et al., 2009; Dawe, Gullo, & Loxton, 2004; Dawe & Loxton, 2004).”
Self-citation
Age associations with neural processing of reward anticipation in adolescents with bipolar disorders
Urošević, S., Luciana, M. M., Jensen, J. B., Youngstrom, E. A., & Thomas, K. M. (2016) · NeuroImage Clinical · doi:10.1016/j.nicl.2016.03.013 · Cited by 23 · see citing works
Reward Responsiveness and Ruminative Styles Interact to Predict Inflammation and Mood Symptomatology
Moriarity, D. P., Ng, T. H., Titone, M. K., Chat, I. K.-Y., Nusslock, R., Miller, G. E., & Alloy, L. B. (2019) · Behavior Therapy · doi:10.1016/j.beth.2019.11.007 · Cited by 22 · see citing works
Self-citation
Positive overgeneralization and Behavioral Approach System (BAS) sensitivity interact to predict prospective increases in hypomanic symptoms: A behavioral high-risk design
Stange, J. P., Adams, A. M., Black, C. L., Shapero, B. G., Bacelli, J. M., Abramson, L. Y., & Alloy, L. B. (2012) · Behaviour Research and Therapy · doi:10.1016/j.brat.2012.01.003 · Cited by 22 · see citing works
Self-citation
Impulsivity and sleep and circadian rhythm disturbance predict next-day mood symptoms in a sample at high risk for or with recent-onset bipolar spectrum disorder: An ecological momentary assessment study
Titone, M. K., Goel, N., Ng, T. H., MacMullen, L. E., & Alloy, L. B. (2021) · Journal of Affective Disorders · doi:10.1016/j.jad.2021.08.155 · Cited by 21 · see citing works
Self-citation
Differentiating bipolar disorder from unipolar depression and ADHD: The utility of the General Behavior Inventory.
Pendergast, L. L., Youngstrom, E. A., Merkitch, K. G., Moore, K. A., Black, C. L., Abramson, L. Y., & Alloy, L. B. (2013) · Psychological Assessment · doi:10.1037/a0035138 · Cited by 21 · see citing works
“Notably, although data from participants with a history of (hypo)mania that started prior to enrolling in Project TEAM were excluded from the main study (see Alloy et al., 2012a), data from TEAM participants with a history of BD were included in this study.”
BackgroundMethodInfluentialSelf-citation
Basic dimensions defining mania risk: A structural approach.
Stanton, K. J., Gruber, J., & Watson, D. (2016) · Psychological Assessment · doi:10.1037/pas0000337 · Cited by 20 · see citing works
“…al us e of th e in di vi du al us er an d is no t to be di ss em in at ed br oa dl y. constructs related to the positive affective system (i.e., achievement motivation) that are implicated in BD (Alloy et al., 2008, 2012; Gruber 2011a; Johnson, Leedom, et al., 2012; Quilty, De Young et al., 2014).”
BackgroundResult
Behavioral Approach System Sensitivity and Risk Taking Interact to Predict Left-Frontal EEG Asymmetry
Black, C. L., Goldstein, K. E., LaBelle, D. R., Brown, C. W., Harmon‐Jones, E., Abramson, L. Y., & Alloy, L. B. (2014) · Behavior Therapy · doi:10.1016/j.beth.2014.01.006 · Cited by 20 · see citing works
Self-citation
Goal-striving tendencies moderate the relationship between reward-related brain function and peripheral inflammation
Chat, I. K.-Y., Nusslock, R., Moriarity, D. P., Bart, C. P., Giollabhui, N. M., Damme, K. S. F., Carroll, A., Miller, G. E., & Alloy, L. B. (2021) · Brain Behavior and Immunity · doi:10.1016/j.bbi.2021.03.006 · Cited by 19 · see citing works
“Participants were drawn from the Teen Emotion and Motivation (TEAM) Project (Alloy et al., 2012), a large longitudinal study examining the relationship between reward responsivity, motivation, and risk for mood disorders.”
InfluentialSelf-citation
Reward and Punishment Sensitivity and Emotion Regulation Processes Differentiate Bipolar and Unipolar Depression
Weinstock, L. M., Chou, T., Hoyos, C. C.-D., Miller, I. W., & Gruber, J. (2018) · Cognitive Therapy and Research · doi:10.1007/s10608-018-9945-2 · Cited by 20 · see citing works
Association of behavioral activation system sensitivity to lower level facets of positive affect in daily life
Dornbach‐Bender, A., Ruggero, C. J., Smith, P., Schuler, K. L., Bennett, C. B., Neumann, C. S., & Callahan, J. L. (2019) · Personality and Individual Differences · doi:10.1016/j.paid.2019.109570 · Cited by 20 · see citing works
Goals in bipolar I disorder: Big dreams predict more mania
Tharp, J. A., Johnson, S. L., Sinclair, S., & Kumar, S. (2015) · Motivation and Emotion · doi:10.1007/s11031-015-9519-5 · Cited by 20 · see citing works
“Across studies, persons diagnosed with BD endorse highly ambitious life goals on the WASSUP subscales, particularly for extrinsic goals such as wealth and fame, compared to controls (Alloy et al. 2012a; Johnson et al. 2012).”
Influential
Corticostriatal responses to social reward are linked to trait reward sensitivity and subclinical substance use in young adults
Wyngaarden, J. B., Johnston, C. R., Sazhin, D., Dennison, J. B., Zaff, O., Fareri, D. S., McCloskey, M., Alloy, L. B., Smith, D. V., & Jarcho, J. M. (2024) · Social Cognitive and Affective Neuroscience · doi:10.1093/scan/nsae033 · Cited by 20 · see citing works
“The total BAS reward scale and the Sensitivity to Reward (SR) subscale of SPSRQ are reliable and valid measures of RS (Alloy et al., 2006; Alloy et al., 2012).”
Self-citation
Altered brain activation during reward anticipation in bipolar disorder
Long, X.-P., Wang, X.-L., Tian, F.-F., Cao, Y., Xie, H.-S., & Jia, Z. (2022) · Translational Psychiatry · doi:10.1038/s41398-022-02075-w · Cited by 15 · see citing works
Tracking the Emotional Highs but Missing the Lows: Hypomania Risk is Associated With Positively Biased Empathic Inference
Devlin, H. C., Zaki, J., Ong, D. C., & Gruber, J. (2015) · Cognitive Therapy and Research · doi:10.1007/s10608-015-9720-6 · Cited by 18 · see citing works
“Given prior work on elevations in the Behavioral Activation System (BAS) among individuals at risk for or with a clinical history of mania (Alloy et al. 2012; Johnson 2005; Stange et al. 2013), it seems possible that this heightened sensitivity to others’ positive emotion upshifts could in part…”
Background
Cognitive Styles in Mood Disorders: Discriminative Ability of Unipolar and Bipolar Cognitive Profiles
Shapero, B. G., Stange, J. P., Goldstein, K. E., Black, C. L., Adams, A. M., Hamlat, E. J., Black, S. K., Boccia, A. S., Abramson, L. Y., & Alloy, L. B. (2015) · International Journal of Cognitive Therapy · doi:10.1521/ijct.2015.8.1.35 · Cited by 17 · see citing works
“Previous research has demonstrated associations between elevations in the popular fame, financial success, and political influence domains and risk for bipolar disorder (Alloy et al., 2012; Johnson & Carver, 2006) as well as history of mania and/or hypomania (Johnson et al.”
BackgroundSelf-citation
Adjunctive Behavioral Activation for the Treatment of Bipolar Depression
Weinstock, L. M., Melvin, C., MUNROE, M. K., & Miller, I. W. (2016) · Journal of Psychiatric Practice · doi:10.1097/pra.0000000000000142 · Cited by 17 · see citing works
Is There a Bipolar Prodrome Among Children and Adolescents?
Hunt, J., Schwarz, C. M., Nye, P., & Frazier, E. A. (2016) · Current Psychiatry Reports · doi:10.1007/s11920-016-0676-3 · Cited by 16 · see citing works
Willingness to Expend Effort Toward Reward and Extreme Ambitions in Bipolar I Disorder
Johnson, S. L., Swerdlow, B. A., Treadway, M. T., Tharp, J. A., & Carver, C. S. (2017) · Clinical Psychological Science · doi:10.1177/2167702617718181 · Cited by 16 · see citing works
“The WASSUP subscales have also been found to predict the onset of bipolar disorder (Alloy et al., 2012) and a more severe course of mania over time among those diagnosed with bipolar I disorder 718181 CPXXXX10.”
Background
Sex and race influence objective and self-report sleep and circadian measures in emerging adults independently of risk for bipolar spectrum disorder
Titone, M. K., McArthur, B. A., Ng, T. H., Burke, T. A., McLaughlin, L. E., MacMullen, L. E., Goel, N., & Alloy, L. B. (2020) · Scientific Reports · doi:10.1038/s41598-020-70750-3 · Cited by 16 · see citing works
Self-citation
Creative Cognition and Psychosis Vulnerability: What’s the Difference?
Crabtree, J., & Green, M. J. (2016) · Creativity Research Journal · doi:10.1080/10400419.2015.1030305 · Cited by 16 · see citing works
“…investigation in the context of findings suggesting that those with bipolar disorder have high reward sensitivity but poor outcome motivation (Alloy et al., 2012); schizophrenia populations exhibit even greater deficits in reward processing that may be associated with apathy and poor…”
Background
Risk factors for new-onset bipolar disorder in a community cohort: A five-year follow up study
Bach, S. D. L., Cardoso, T. D. A., Moreira, F. P., Mondin, T. C., Simjanoski, M., Kapczinski, F. P., Frey, B. N., Souza, L. D. D. M., da Silva, R. A., & Jansen, K. (2021) · Psychiatry Research · doi:10.1016/j.psychres.2021.114109 · Cited by 15 · see citing works
Reward Processing in Mood Disorders and Schizophrenia: A Neurodevelopmental Framework
Nusslock, R., Mittal, V. A., & Alloy, L. B. (2025) · Annual Review of Clinical Psychology · doi:10.1146/annurev-clinpsy-080822-041621 · Cited by 15 · see citing works
“…likelihood of having a lifetime bipolar spectrum diagnosis (Alloy et al. 2006), an increased risk of experiencing a first onset of the disorder (Alloy et al. 2012a), shorter intervals between recurrences of hypomanic/manic episodes (Alloy et al. 2008), a rise in manic symptoms among…”
Self-citation
Chronotype is associated with affective temperaments, clinical severity and worse treatment outcomes in bipolar disorders: results from a two-center, cross-sectional study
Menculini, G., Steardo, L., Verdolini, N., D’Angelo, M., Chipi, E., Cirimbilli, F., Orsolini, L., Volpe, U., Fazio, P. D., & Tortorella, A. A. V. (2023) · International Journal of Psychiatry in Clinical Practice · doi:10.1080/13651501.2022.2160763 · Cited by 14 · see citing works
“Moreover, trait impulsiveness tends to be high in bipolar-at-risk individuals and possibly underpins a specific vulnerability for the development of the disorders, similarly to what has been demonstrated for circadian rhythm alterations (Alloy et al., 2012; Ng et al., 2015).”
Result
The Role of Social Reward and Corticostriatal Connectivity in Substance Use
Sazhin, D., Frazier, A. M., Haynes, C. R., Johnston, C. R., Chat, I. K.-Y., Dennison, J. B., Bart, C. P., McCloskey, M., Chein, J. M., Fareri, D. S., et al. (2020) · Journal of Psychiatry and Brain Science · doi:10.20900/jpbs.20200024 · Cited by 14 · see citing works
“The total BAS reward scale and the Sensitivity to Reward (SR) subscale of SPSRQ are reliable and valid measures of reward sensitivity that Co-I Alloy has previously used to select participants with different levels of reward sensitivity [84,85].”
MethodSelf-citation
Trauma Affects Prospective Relationships Between Reward-Related Ventral Striatal and Amygdala Activation and 1-Year Future Hypo/Mania Trajectories
Eckstrand, K., Forbes, E. E., Bertocci, M. A., Chase, H. W., Greenberg, T., Lockovich, J., Stiffler, R., Aslam, H. A., Graur, S., Bebko, G. M., et al. (2020) · Biological Psychiatry · doi:10.1016/j.biopsych.2020.11.017 · Cited by 14 · see citing works
An examination of bidirectional associations between physical activity and mood symptoms among individuals diagnosed and at risk for bipolar spectrum disorders
Walsh, R. F. L., Smith, L. T., Klugman, J., Titone, M. K., Ng, T. H., Goel, N., & Alloy, L. B. (2023) · Behaviour Research and Therapy · doi:10.1016/j.brat.2023.104255 · Cited by 15 · see citing works
Self-citation
Comparison of original and revised reinforcement sensitivity theory in clinically-stable schizophrenia and bipolar disorder patients
Afshari, B., Rasouli‐Azad, M., & Ghoreishi, F. S. (2018) · Personality and Individual Differences · doi:10.1016/j.paid.2018.10.026 · Cited by 14 · see citing works
Emotion–behavior decoupling in individuals with schizophrenia, bipolar disorder, and major depressive disorder.
Wang, Y., Ge, M., Zhu, G., Jiang, N., Wang, G., Lv, S.-X., Zhang, Q., Guo, J.-N., Tian, X. S., Lui, S. S. Y., et al. (2020) · Journal of Abnormal Psychology · doi:10.1037/abn0000499 · Cited by 14 · see citing works
African American Children’s Diminished Returns of Subjective Family Socioeconomic Status on Fun Seeking
Assari, S., Akhlaghipour, G., Boyce, S., Bazargan, M., & Caldwell, C. H. (2020) · Children · doi:10.3390/children7070075 · Cited by 13 · see citing works
Amygdala subnuclei volume in bipolar spectrum disorders: Insights from diffusion‐based subsegmentation and a high‐risk design
Damme, K. S. F., Alloy, L. B., Young, C. B., Kelley, N. J., Chein, J. M., Ng, T. H., Titone, M. K., Black, C. L., & Nusslock, R. (2020) · Human Brain Mapping · doi:10.1002/hbm.25021 · Cited by 13 · see citing works
“…recurrences of hypo/manic episodes (Alloy et al., 2008), an increase in manic symptoms among recovered individuals with bipolar I disorder (Meyer, Johnson, & Winters, 2001), and a greater likelihood of progressing to a more severe bipolar diagnosis among those with milder BSDs (Alloy et al., 2012).”
BackgroundInfluentialSelf-citation
The dual-system theory of bipolar spectrum disorders: A meta-analysis
Katz, B. A., Naftalovich, H., Matanky, K., & Yovel, I. (2020) · Clinical Psychology Review · doi:10.1016/j.cpr.2020.101945 · Cited by 13 · see citing works

Behavioral Approach System (BAS) sensitivity and bipolar spectrum disorders: A retrospective and concurrent behavioral high-risk design. Motivation and Emotion
Alloy, L. B., Bender, R. E., Whitehouse, W. G., Wagner, C. A., Liu, R. T., Grant, D. A., Jager‐Hyman, S., Adams, A. M., Choi, J. Y., Harmon‐Jones, E., et al. (2006)
Self-citation
Behavioral Approach System (BAS) Sensitivity and Bipolar Spectrum Disorders: A Retrospective and Concurrent Behavioral High-Risk Design
Alloy, L. B., Abramson, L. Y., Walshaw, P. D., Cogswell, A., Smith, J. M., Neeren, A. M., Hughes, M. E., Iacoviello, B. M., Gerstein, R. K., Keyser, J. D., et al. (2006) · Motivation and Emotion · doi:10.1007/s11031-006-9003-3 · Cited by 102 · see citing works
Self-citation
Behavioral Approach System and Behavioral Inhibition System sensitivities and bipolar spectrum disorders: prospective prediction of bipolar mood episodes
Alloy, L. B., Abramson, L. Y., Walshaw, P. D., Cogswell, A., Sylvia, L. G., Hughes, M. E., Iacoviello, B. M., Whitehouse, W. G., Urošević, S., Nusslock, R., et al. (2008) · Bipolar Disorders · doi:10.1111/j.1399-5618.2007.00547.x · Cited by 259 · see citing works
Self-citation
The Role of the Behavioral Approach System (BAS) in Bipolar Spectrum Disorders
Alloy, L. B., & Abramson, L. Y. (2010) · Current Directions in Psychological Science · doi:10.1177/0963721410370292 · Cited by 165 · see citing works
Self-citation
Assessment and Treatment of Bipolar Spectrum Disorders in Emerging Adulthood: Applying the Behavioral Approach System Hypersensitivity Model
Hamlat, E. J., O’Garro-Moore, J. K., Alloy, L. B., & Nusslock, R. (2016) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2016.05.001 · Cited by 8 · see citing works
Self-citation

Authors: 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.
Affiliations: University of Wisconsin–Madison (US)
ORCID: Alloy, Lauren B.
Liu, Richard T.
Choi, James Y.
Harmon-Jones, Eddie
Venue: Journal of Abnormal Psychology
Publisher: American Psychological Association (APA)
Published: 2012-05
Volume: 121
Issue: 2
Pages: 339-351
ISSN: 0021-843X (ISSN-L)
1939-1846
DOI: 10.1037/a0025877
PMC: PMC3403678
OpenAlex: W2119325457
Cited by: 203
References: 105
Citations by year: 2026: 10 · 2025: 8 · 2024: 3 · 2023: 12 · 2022: 9 · 2021: 18 · 2020: 19 · 2019: 14 · 2018: 14 · 2017: 25 · 2016: 15 · 2015: 20 · 2014: 15 · 2013: 9 · 2012: 12
FWCI: 7.78
Type: journal article
Language: en
Open access: green
europepmc.org
Locations: Journal of Abnormal Psychology (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: National Institute of Mental Health (Grant MH 77908)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
Keywords: bipolar spectrum disorders, behavioral approach system, reward responsiveness, goal pursuit, vulnerability hypothesis, adolescents, impulsivity, psychosis, early intervention
MeSH terms: Adolescent, Bipolar Disorder, Female, Goals, Humans, Interview, Psychological, Male, Motivation, Pedigree, Prospective Studies, Psychiatric Status Rating Scales, Recurrence, Reward, Risk-Taking, Age of Onset, Early Diagnosis, Young Adult

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High Behavioral Approach System (BAS) sensitivity, reward responsiveness, and goal-striving predict first onset of bipolar spectrum disorders: A prospective behavioral high-risk design

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