Bipolar Disorder Psychosis Risk Predicts Cue Discrimination on the AX-Continuous Performance Task Paradigm

Area of Science:

• Neuroscience
• Psychiatry
• Cognitive Psychology

Background:

• Bipolar Disorder (BD) is characterized by mania, affective lability, and psychosis risk, often accompanied by sustained attention deficits.
• The AX-Continuous Performance Test (AX-CPT) reliably identifies impairments in schizophrenia-spectrum psychosis, but its utility in BD is debated.
• Understanding cognitive deficits in BD is crucial for developing targeted interventions.

Purpose of the Study:

• To investigate the association between individual differences in mania/affective lability risk and psychosis risk with AX-CPT performance in BD and at-risk individuals.
• To determine if these risks are associated with specific AX-CPT measures (d'context and A-cue bias).

Main Methods:

• The study utilized the AX-Continuous Performance Test (AX-CPT) to measure sustained attention.
• Standard measures d'context and A-cue bias quantified AX-CPT performance.
• The Mood Spectrum Self Report (MOODS-SR-L) assessed lifetime mania/affective lability and psychosis risk.
• Linear regressions and ANCOVAs were employed to analyze the data.

Main Results:

• Higher psychosis and mania/affective lability risk were associated with reduced target discrimination (d'context) in euthymic BD and at-risk individuals.
• No significant association was found with A-cue bias.
• These associations remained after controlling for depressive symptoms but were attenuated by current mania severity.

Conclusions:

• Target discrimination deficits in BD are dimensionally associated with psychosis and mania/affective lability risk, rather than being solely a categorical feature of the BD diagnosis.
• Dimensional risk models offer a promising framework for understanding sustained attention deficits in BD.
• The findings underscore the importance of considering mania/affective lability and psychosis risk in cognitive assessments of BD.