1 - (SYM 68) Physical Activity and Mood Symptoms: Bidirectional Associations Among Individuals Diagnosed and At-risk for Bipolar Spectrum Disorders

A growing body of research suggests that activation, a combination of energy and activity, is a central feature of bipolar spectrum disorders (BSD). This is reflected in the DSM-5, where increased energy and activity is a Criterion A symptom of hypo/mania. To improve our understanding of BSD pathophysiology and treatment, it is important to understand how activation interrelates with other key bipolar symptoms, namely mood disturbance, and whether these associations are specific for individuals with BSD. Prior work found motor activity is associated with affect, and this relationship was stronger for individuals with BSDs. The aims of this study were to investigate bidirectional relationships between physical activity (PA) and mood and evaluate whether associations were stronger among individuals diagnosed or at-risk for BSD. A community sample of emerging adults (n=113; 57% White) ages 18-27 at low-risk for BSD due to moderate reward sensitivity, high-risk for BSD due to high reward sensitivity, and diagnosed with BSD participated in a 20-day EMA study in which they continuously wore an actiwatch to measure PA and sleep/wake cycles. Participants also reported depressive and hypo/manic symptoms three times daily (morning, afternoon, evening) via EMA prompt. Multilevel linear models examined whether bipolar risk group moderated bidirectional relationships between PA and mood symptoms at within-day (e.g., morning predicting afternoon) and between-day timescales (i.e., mean levels on day 1 predicting day 2). At the within-day level, an increase in PA was prospectively associated with a decrease in depressive symptoms (B=-.06, SE=.01, p< .01) and increase in hypomanic symptoms (B=.11, SE=.02, p< .00). Increased PA resulted in an even more pronounced decrease in depressive symptoms for the BSD group relative to the low- and high-risk groups (B=-.10, SE=.04, p< .01; B=-.07, SE=.03, p=.04). In addition, depressive symptoms predicted decreased same-day PA (B=-.09, SE=.01, p< .01) and hypomanic symptoms predicted increased same-day PA (B=.13, SE=.01, p< .01). None of the between-day analyses were significant. The bidirectional associations between PA and depressive and hypomanic symptoms and significant moderating effect of BSD diagnosis suggest that PA may be an easily accessible, low-cost treatment target for improving inter-episode mood symptoms, although the effects appear limited to the same day. Findings also provide support for cognitive behavioral interventions targeting activity patterns, like behavioral activation.