1. Stable and state-dependent impulsivity in Bipolar disorder Maja Milavec, psychologist, Ph. D. student Lilijana Šprah, Assistant Professor and Research Fellow Sociomedical Institute at SRC SASA, Ljubljana, Slovenia

2. Bipolar disorder Any of several mood disorders, usually characterised by alternating episodes of depression and mania or by episodes of depression alternating with mild, non-psychotic excitement.

3. Impulsivity is a predisposition toward rapid, unplanned reactions to internal or external stimuli without regard to the negative consequences of these reactions to the impulsive individual or to others. (Moeller, Barratt, Dougherty, Schmitz and Swann, 2001)

4. -A prominent aspect of Bipolar disorder; -manic episode; -can be present during depression; -complications: suicide, substance abuse, complications of manic episodes; -stable or state-dependent; -emotional modulation of cognitive control (attentional bias to positive and negative information). Impulsivity

5. Aims 1.) Whether emotional valence of stimulus influences cognitive control in bipolar patients compared to healthy individuals. 2.) Whether there is an interaction between stable and state-dependent aspect of impulsivity in bipolar disorder.

6. Method Participants -39 bipolar outpatients -38 healthy individuals (matched for age, gender and years of education)

7. Instruments Barratt Impulsiveness Scale 11 (BIS-11) -Questionnaire designed to measure impulsiveness (stable aspect). -Three subscales: -attention (intention and cognitive instability), -motor (motor impulsiveness and lack of perseverance), -non-planning (lack of self-control and intolerance of cognitive complexity). (Patton, Standford and Barratt, 1995)

8. Affective Go/No-Go Task -Computer administered; -pictures of negative, positive and neutral emotional valence taken from International Affective Picture System (IAPS); -6 blocks with all combinations (negative/positive etc.).

9. Go No-Go Go 8001000800100080010008001000800 Time (ms) Example: “If the picture in front of you is PLEASANT, press the RED BUTTON on the keyboard AS FAST AS YOU CAN, other way don’t press anything.” Instructions

10. Reaction times Bipolar outpatients had longer reaction times to emotional stimuli than healthy individuals. * p<0,05; ** p<0,01

11. Global score NMSDtpdf BDBD39136,5912,79 -2,2800,02673 controls36143,1712,14 Bipolar outpatiens had less correct answers than healthy individuals.

12. NMSDtdf BIS-11 AttentionBDBD3917,644,43 2,847**75 controls3815,053,48 BIS-11 MotorBDBD3921,494,94 1,832**75 controls3819,633,87 BIS-11 Non-planning BDBD3924,875,66 2,839**75 controls3820,766,99 BIS-11 Global score BDBD3964,0012,83 2,990**75 controls3855,4512,25 ** p<0,01 Bipolar outpatiens had higher levels of trait impulsivity than healthy individuals.

13. Bipolar patients with heightened levels of trait impulsivity underestimated -target stimuli with positive valence (r = -0,425; p < 0,01), -distractors with negative (r = -0,331; p < 0,05) and -distractors with neutral (r = -0,417; p< 0,01) emotional valence.

14. Conclusions -Poorer control of cognitive inhibition -increased levels of impulsivity and other associated cognitive impairments; -emotional valence of stimulus influences cognitive control in bipolar patients compared to healthy subjects; -interaction between stable and state-dependent aspect of impulsivity in bipolar disorder.

15. Contact maja.milavec@gmail.com