Decision‐making and risk in bipolar disorder:A quantitative study using fuzzy trace theory

Objectives: This study characterizes risk-taking behaviours in a group of people with a self-reported diagnosis of BD using fuzzy trace theory (FTT). FTT hypothesizes that risk-taking is a ‘reasoned’ (but sometimes faulty) action, rather than an impulsive act associated with mood fluctuations. Design: We tested whether measures of FTT (verbatim and gist-based thinking) were predictive of risk-taking intentions in BD, after controlling for mood and impulsivity. We hypothesized that FTT scales would be significant predictors of risk-taking intentions even after accounting for mood and impulsivity. Methods: Fifty-eight participants with BD (age range 21–78, 68% female) completed a series of online questionnaires assessing risk intentions, mood, impulsivity, and FTT. Results: Fuzzy trace theory scales significantly predicted risk-taking intentions (medium effect sizes), after controlling for mood and impulsivity consistent with FTT (part range.26 to.49). Participants with BD did not show any statistically significant tendency towards verbatim-based thinking. Conclusions: Fuzzy trace theory gist and verbatim representations were both independent predictors of risk-taking intentions, even after controlling for mood and impulsivity. The results offer an innovative conceptualization of the mechanisms behind risk-taking in BD. Practitioner points: Risk-taking behaviour in bipolar disorder is not just a consequence of impulsivity. Measures of fuzzy trace theory help to understand risk-taking in bipolar disorder. FTT measures predict risk-taking intentions, after controlling for mood and impulsivity