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Motivational dysregulation is a prominent feature of bipolar disorder. Mania is accompanied by excessive sensitivity to incentive motivation and compulsivity toward positive cues despite their negative consequences, and depression is characterized by lack of interest. In previous research, manic, depressed, and euthymic bipolar patients were found to commit more errors than others when contingencies change. These deficits are paralleled by findings of abnormal orbitofrontal activation in bipolar patients.
Conjecturing that neural systems regulating motivation might harbor endophenotypes for bipolar I disorder, these investigators compared ability to shift choices with rapidly shifting rewards and concurrent findings on functional magnetic re…