Predictors of occupational and social functioning in mania: A symptom-regulation model

Most individuals with bipolar disorder do not function well, yet up to 15% in some studies function exceptionally well. Evidence suggests mania interferes more with functioning than depression. Symptoms do not account for all of the variability in functioning, in that functioning varies across even symptom-free individuals. A symptom-regulation model, drawn from self-regulation theory, was proposed for mania. Using existing data gathered from a study of 55 individuals with bipolar disorder, this study tested the following hypotheses: (1) that mania would predict functioning more strongly than depression; (2) that BIS and BAS reward responsiveness would predict insight; (3) that BIS and BAS reward responsiveness would predict functioning; and (4) that insight would predict better functioning when anxiety is low. Although BIS and BAS reward responsiveness predicted insight, BIS and BAS reward responsiveness and the remaining variables---mania, depression, insight, and anxiety---all failed to predict social or occupational functioning. The data suggest important, though unanticipated, relationships involving BAS reward responsiveness, mania, and good social support. Findings also reflect accumulating evidence in the literature relating BIS to bipolar depression and low social support