Background: Bipolar Disorder (BD) is a disease characterized by abnormal emotional regulation (ER). Determining how distinct ER strategies in such patients interact with ER trends observed in normal aging may be crucial to predicting clinically relevant functional outcomes in aging populations with BD and providing them with adequate treatments.
Methods: Participants completed the Cambridge Neuropsychological Test Automated Battery (CANTAB) Emotion Recognition Task (ERT), which measures the ability to identify both negative (sad) and positive (happy) facial expressions. Results from the Brief Coping Orientation to Problems Experienced (B-COPE) scale allowed us to characterize the habitual use of both adaptive and maladaptive coping strategies.
Results: 203 BD patients and 47 HCs were comprehensively characterized. The sample was divided into three age cohorts to represent early (20-40 years), mid- (41-50 years), and late life (51-65 years). (1) In an analysis examining ER and attentional bias, there was a significant diagnosis by age interaction (p<0.05); HCs reported a higher ‘positivity effect’ with age (p<.05) – a pattern not observed in the BD group. (2) Further, the Brief COPE scale revealed a shift toward adaptive coping styles in older adults (F=4.12; p<.02), however, the age-related shift toward the use of adaptive ER strategies was not seen in BD patients (F=3.2; p<05). (3) Lastly, we found that emotional dysregulation predicts social disability, where performance on the SAS Social Leisure model was significant (F=27.2; p<0.001), with an adjusted R-squared of 0.29.
Conclusions: Overall, these data demonstrate significant differences of ER across the lifespan for patients with BD vs. HCs.