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Performance monitoring and executive control of attention in euthymic bipolar disorder: Employing the CPT-AX paradigm

Lookup NU author(s): Dr Lucy Robinson, Jill Thompson, Dr Peter GallagherORCiD, Dr John Gray, Professor Allan Young, Emeritus Professor Nicol Ferrier


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Reduced cognitive test performance has been demonstrated in patients with bipolar disorder (BD), even when euthymic. Several studies have explored aspects of attention, including sustained attention, and reported patients show lower accuracy compared to controls. It is necessary to modify existing attentional paradigms to fully characterise such deficits. The present study sought to examine if there are changes in the profile of performance and error-types during a sustained attention task in BD. Twenty-two euthymic patients with DSM-IV diagnosed BD and 21 healthy controls were recruited. Participants completed a modified CPT-AX paradigm with a high proportion of target trials (70%) with cues and probes presented at continuous intervals. This modification increases the demands on response inhibition and permits the deconstruction of attentional/executive deficits previously described. Overall, BD patients showed significantly poorer target discriminability compared to controls. In block one (first quarter) of the task, patients showed no significant differences to controls, but by the final fourth block (last quarter) they made significantly fewer hits and more errors (both 'AX' misses and 'BX' false alarms). BD patients completed initial stages of the task similarly to controls, but as demands on the attentional system continued difficulties emerged, consistent with problems in context-maintenance.

Publication metadata

Author(s): Robinson LJ, Thompson JM, Gallagher P, Gray JM, Young AH, Ferrier IN

Publication type: Article

Publication status: Published

Journal: Psychiatry Research

Year: 2013

Volume: 210

Issue: 2

Pages: 457-464

Print publication date: 15/12/2013

Online publication date: 20/07/2013

Acceptance date: 23/06/2013

ISSN (print): 0165-1781

ISSN (electronic): 1872-7123

Publisher: Elsevier Ireland Ltd


DOI: 10.1016/j.psychres.2013.06.039

PubMed id: 23880481


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