Willingness to Expend Effort Toward Reward and Extreme Ambitions in Bipolar I Disorder

More than a dozen recent studies have shown that bipolar disorder and key outcomes within bipolar disorder are related to heightened willingness to pursue extremely ambitious life goals, as measured by the Willingly Approached Set of Statistically Unlikely Pursuits (WASSUP). Although it has been argued that this willingness to pursue difficult lifetime ambitions in bipolar disorder could reflect willingness to expend effort toward reward, this has not been tested to date. In this study, 50 individuals with bipolar I disorder were followed until they achieved remission. They then completed the Effort Expenditure for Rewards Task (EEfRT) and the WASSUP. Scores on the WASSUP Financial Success subscale, but not the Popular Fame subscale, were significantly associated with decision making on the EEfRT, even after controlling for significant effects of reward magnitude, gender, and age. These two indices appear to measure related facets of reward sensitivity.