Extreme Goal Setting and Vulnerability to Mania Among Undiagnosed Young Adults

Abstract

During euthymia people with bipolar disorder and their unaffected family members accomplish more than the general population. People with bipolar disorder, or those who are at risk for it, also set higher goals in laboratory tasks than other people. The work reported here examines whether persons vulnerable to mania set elevated goals in their lives. In two studies, a measure of lifetime vulnerability to mania was related to traits bearing on incentive sensitivity, and also to endorsement of high ambitions for fame, wealth, and political influence (assessed by a new measure). Relations were weaker to ambitions for other kinds of extreme goals. The effects were independent of current symptoms of mania and depression and lifetime depression. There was also evidence that incentive sensitivity and elevated aspirations made independent contributions to variance in the measure of manic risk. Discussion focuses on the implications of high goal setting for understanding goal dysregulation and mania. KeywordsAmbition; Mania; Cognition; High risk Bipolar I disorder, defined by the occurrence of a single lifetime episode of mania, is one of the most severe of psychiatric illnesses. It accounts for nearly half the inpatient mental health care costs in the United States (Kent, Fogartee, & Yellowless, 1995). The rate of suicide in bipolar I disorder is 12-15 times that of the general population (Angst, Stausen, Clayton, & Angst, 2002). Given these human costs, a better understanding of the dynamics of this disorder is clearly needed.There is no question that mania is deeply rooted in biology. Heritability estimates for an initial manic episode fall between 80 and 85% (McGuffin et al., 2003;Vehmanen, Kaprio, & Loennqvist, 1995). On the other hand, biological variables do not account well for variations in the course of the disorder (cf. Keller et al., 1992). This has led to interest in psychosocial variables that may help predict manic symptoms (for a review see .In this article we consider one class of psychological variable that seems relevant to mania: ambitious goal-setting. Several sorts of evidence lead us to examine this variable. For one, bipolar disorder has been linked for many years to above-average attainment. In 1913, Stern noted that patients with affective psychosis (or their fathers) were more likely to be professionals than were patients with schizophrenia (or their fathers). In nine epidemiological © Springer Science+Business Media, Inc. 2006 Correspondence to: Sheri L. Johnson, Sjohnson@miami.edu. NIH Public Access Author ManuscriptCognit Ther Res. Author manuscript; available in PMC 2010 March 1. This pattern, which is in sharp contrast to that seen with most psychiatric disorders (cf. Weissman & Myers, 1978), is surprising, because many factors work against achievement in people with mania. People with mania tend to remain unemployed for long periods after episodes (Harrow, Goldberg, Grossman, & Meltzer, 1990). Early onset of the illness may interfere with on-schedule completion of college (Lewi...

Elevated ambitions for fame among persons diagnosed with bipolar I disorder.

“…Correlations among subscales ranged from .22 to .59. In previous research, persons at risk for mania and those diagnosed with bipolar spectrum disorder have endorsed high aspirations on the Popular Fame and Financial Success subscales Johnson & Carver, 2006;Fulford, Johnson, & Carver, 2008;Gruber & Johnson, 2009;Johnson & Jones, 2009). …”

“…To examine this issue further, Johnson and Carver (2006) developed the Willingly Approached Set of Statistically Unlikely Pursuits (WASSUP), a self-report measure of extremely ambitious (difficult to achieve) life goals, such as becoming the focus of books and TV shows, or becoming the best-loved parent of all time. The WASSUP was designed to include goals related to extrinsic recognition, such as achieving fame, wealth, or political influence, as well as goals that are more intrinsically motivated, such as family and friendship goals.…”

Do current beliefs predict hypomanic symptoms beyond personality style? Factor analysis of the hypomanic attitudes and positive predictions inventory (HAPPI) and its association with hypomanic symptoms in a student population

“…A further specific scale is the Willingly Approached Set of Statistically Unlikely Pursuits Scale (WASSUP; Johnson & Carver, 2006), which assesses ambitions for fame, wealth, and political influence. Within a sample of undiagnosed young adults, individuals scoring higher on the hypomanic personality scale made higher endorsements on the WASSUP scale, independent of current symptoms of mania or depression.…”

Bipolar disorder: What can psychotherapists learn from the cognitive research?

“…Items were designed to cover highly improbable life goals such as making more than 10 million dollars, becoming famous, ruling a country, and having 50 or more lovers. In two initial validation studies (Johnson & Carver, 2006), risk of hypomania was correlated with endorsing higher life ambitions, particularly for highly extrinsic goals such as wealth and popular fame. Highly ambitious life goals appeared to be present even after controlling for baseline subsyndromal mood symptoms.…”