Using a generative model of affect to characterize affective variability and its response to treatment in bipolar disorder

The affective variability of bipolar disorder (BD) is thought to qualitatively differ from that of borderline personality disorder (BPD), with changes in affect persisting longer in BD. However, quantitative studies have not been able to confirm this distinction. It has therefore not been possible t...

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Main Authors: Pulcu, E, Saunders, KEA, Harmer, CJ, Harrison, PJ, Goodwin, GM, Geddes, JR, Browning, M
Format: Journal article
Language:English
Published: National Academy of Sciences 2022
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author Pulcu, E
Saunders, KEA
Harmer, CJ
Harrison, PJ
Goodwin, GM
Geddes, JR
Browning, M
author_facet Pulcu, E
Saunders, KEA
Harmer, CJ
Harrison, PJ
Goodwin, GM
Geddes, JR
Browning, M
author_sort Pulcu, E
collection OXFORD
description The affective variability of bipolar disorder (BD) is thought to qualitatively differ from that of borderline personality disorder (BPD), with changes in affect persisting longer in BD. However, quantitative studies have not been able to confirm this distinction. It has therefore not been possible to accurately quantify how treatments like lithium influence affective variability in BD. We assessed the affective variability associated with BD and BPD as well as the effect of lithium using a computational model that defines two subtypes of variability: affective changes that persist (volatility) and changes that do not (noise). We hypothesized that affective volatility would be raised in the BD group, noise would be raised in the BPD group, and that lithium would impact affective volatility. Daily affect ratings were prospectively collected for up to 3 y from patients with BD or BPD and nonclinical controls. In a separate experimental medicine study, patients with BD were randomized to receive lithium or placebo, with affect ratings collected from week −2 to +4. We found a diagnostically specific pattern of affective variability. Affective volatility was raised in patients with BD, whereas affective noise was raised in patients with BPD. Rather than suppressing affective variability, lithium increased the volatility of positive affect in both studies. These results provide a quantitative measure of the affective variability associated with BD and BPD. They suggest a mechanism of action for lithium, whereby periods of persistently low or high affect are avoided by increasing the volatility of affective responses.
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spelling oxford-uuid:342308d3-1e2d-415e-9fe2-74b2cf0fe6ec2022-07-12T12:04:25ZUsing a generative model of affect to characterize affective variability and its response to treatment in bipolar disorderJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:342308d3-1e2d-415e-9fe2-74b2cf0fe6ecEnglishSymplectic ElementsNational Academy of Sciences2022Pulcu, ESaunders, KEAHarmer, CJHarrison, PJGoodwin, GMGeddes, JRBrowning, MThe affective variability of bipolar disorder (BD) is thought to qualitatively differ from that of borderline personality disorder (BPD), with changes in affect persisting longer in BD. However, quantitative studies have not been able to confirm this distinction. It has therefore not been possible to accurately quantify how treatments like lithium influence affective variability in BD. We assessed the affective variability associated with BD and BPD as well as the effect of lithium using a computational model that defines two subtypes of variability: affective changes that persist (volatility) and changes that do not (noise). We hypothesized that affective volatility would be raised in the BD group, noise would be raised in the BPD group, and that lithium would impact affective volatility. Daily affect ratings were prospectively collected for up to 3 y from patients with BD or BPD and nonclinical controls. In a separate experimental medicine study, patients with BD were randomized to receive lithium or placebo, with affect ratings collected from week −2 to +4. We found a diagnostically specific pattern of affective variability. Affective volatility was raised in patients with BD, whereas affective noise was raised in patients with BPD. Rather than suppressing affective variability, lithium increased the volatility of positive affect in both studies. These results provide a quantitative measure of the affective variability associated with BD and BPD. They suggest a mechanism of action for lithium, whereby periods of persistently low or high affect are avoided by increasing the volatility of affective responses.
spellingShingle Pulcu, E
Saunders, KEA
Harmer, CJ
Harrison, PJ
Goodwin, GM
Geddes, JR
Browning, M
Using a generative model of affect to characterize affective variability and its response to treatment in bipolar disorder
title Using a generative model of affect to characterize affective variability and its response to treatment in bipolar disorder
title_full Using a generative model of affect to characterize affective variability and its response to treatment in bipolar disorder
title_fullStr Using a generative model of affect to characterize affective variability and its response to treatment in bipolar disorder
title_full_unstemmed Using a generative model of affect to characterize affective variability and its response to treatment in bipolar disorder
title_short Using a generative model of affect to characterize affective variability and its response to treatment in bipolar disorder
title_sort using a generative model of affect to characterize affective variability and its response to treatment in bipolar disorder
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