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Pina IG, Timmer-Murillo SC, Larson CL, deRoon-Cassini TA, Tomas CW. Trajectories of Anhedonia Symptoms after Traumatic Injury. EUROPEAN JOURNAL OF TRAUMA & DISSOCIATION 2024; 8:100408. [PMID: 38799039 PMCID: PMC11113075 DOI: 10.1016/j.ejtd.2024.100408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
Anhedonia describes the inability or difficulty of experiencing or seeking pleasure. Previous research has demonstrated a relationship between posttraumatic stress disorder (PTSD) or experiencing trauma and anhedonia symptoms; however, little to no work has been done to understand the evolution of anhedonia symptoms after trauma. We aimed to identify anhedonia trajectories following traumatic injury. One hundred ninety-five participants were recruited from the emergency department of a Level-1 Trauma Center after experiencing a traumatic injury. To measure anhedonia symptoms, participants completed the Snaith-Hamilton Pleasure Scale (SHAPS) at 2-weeks, 3-months, and 6-months post-injury. Using latent class mixture modeling, we ran a trajectory analysis with three timepoints of SHAPS scores and compared mental and physical health outcomes across trajectories. Most of the sample fell in the resilient trajectory (85%), while the remainder were in a remitting trajectory (7%) where symptoms decreased over time, and a delayed (6%) trajectory where symptoms did not emerge until 3-months after injury. In the resilient trajectory, there was consistently low levels of PTSD, pain, depression, and anxiety relative to the other trajectories. In the delayed trajectory, depression and PTSD were chronically elevated and pain levels were consistent but mild. In the remitting trajectory, PTSD and depression symptoms decreased over time. Identified anhedonia trajectories mirrored trajectories commonly reported for PTSD symptoms after injury. Evaluating anhedonia trajectories and how they relate to mental health outcomes may inform targeted interventions for traumatic injury patients.
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Affiliation(s)
- Isela G. Pina
- Department of Surgery, Division of Trauma & Acute Care Surgery, Medical College of Wisconsin, Milwaukee, WI
| | - Sydney C. Timmer-Murillo
- Department of Surgery, Division of Trauma & Acute Care Surgery, Medical College of Wisconsin, Milwaukee, WI
| | | | - Terri A. deRoon-Cassini
- Department of Surgery, Division of Trauma & Acute Care Surgery, Medical College of Wisconsin, Milwaukee, WI
- Comprehensive Injury Center, Medical College of Wisconsin, Milwaukee, WI
| | - Carissa W. Tomas
- Comprehensive Injury Center, Medical College of Wisconsin, Milwaukee, WI
- Division of Epidemiology and Social Sciences, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI
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Qiu Y, Dou H, Wang J, Zhang H, Zhang S, Shen D, Li H, Lei Y. Reduced generalization of reward among individuals with subthreshold depression: Behavioral and EEG evidence. Int J Psychophysiol 2024; 200:112339. [PMID: 38554769 DOI: 10.1016/j.ijpsycho.2024.112339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 02/19/2024] [Accepted: 03/27/2024] [Indexed: 04/02/2024]
Abstract
Altered stimulus generalization has been well-documented in anxiety disorders; however, there is a paucity of research investigating this phenomenon in the context of depression. Depression is characterized by impaired reward processing and heightened attention to negative stimuli. It is hypothesized that individuals with depression exhibit reduced generalization of reward stimuli and enhanced generalization of loss stimuli. Nevertheless, no study has examined this process and its underlying neural mechanisms. In the present study, we recruited 25 participants with subthreshold depression (SD group) and 24 age-matched healthy controls (HC group). Participants completed an acquisition task, in which they learned to associate three distinct pure tones (conditioned stimuli, CSs) with a reward, a loss, or no outcome. Subsequently, a generalization session was conducted, during which similar tones (generalization stimuli, GSs) were presented, and participants were required to classify them as a reward tone, a loss tone, or neither. The results revealed that the SD group exhibited reduced generalization errors in the early phase of generalization, suggesting a diminished ability to generalize reward-related stimuli. The event-related potential (ERP) results indicated that the SD group exhibited decreased generalization of positive valence to reward-related GSs and heightened generalization of negative valence to loss-related GSs, as reflected by the N1 and P2 components. However, the late positive potential (LPP) was not modulated by depression in reward generalization or loss generalization. These findings suggested that individuals with subthreshold depression may have a blunted or reduced ability to generalize reward stimuli, shedding light on potential treatment strategies targeting this particular process.
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Affiliation(s)
- Yiwen Qiu
- College of Psychology, Shenzhen University, Shenzhen 518060, China; Center for Neurogenetics, Shenzhen Institute of Neuroscience, Shenzhen 518057, China
| | - Haoran Dou
- Institution for Brain and Psychological Science, Sichuan Normal University, Chengdu 610066, China; Center for Neurogenetics, Shenzhen Institute of Neuroscience, Shenzhen 518057, China
| | - Jinxia Wang
- Institution for Brain and Psychological Science, Sichuan Normal University, Chengdu 610066, China; Center for Neurogenetics, Shenzhen Institute of Neuroscience, Shenzhen 518057, China; Faculty of Education and Psychology, University of Jyväskylä, Jyväskylä 40014, Finland
| | - Huoyin Zhang
- College of Psychology, Shenzhen University, Shenzhen 518060, China; Center for Neurogenetics, Shenzhen Institute of Neuroscience, Shenzhen 518057, China
| | - Shiyunmeng Zhang
- College of Psychology, Shenzhen University, Shenzhen 518060, China; Center for Neurogenetics, Shenzhen Institute of Neuroscience, Shenzhen 518057, China
| | - Die Shen
- College of Psychology, Shenzhen University, Shenzhen 518060, China; Center for Neurogenetics, Shenzhen Institute of Neuroscience, Shenzhen 518057, China
| | - Hong Li
- College of Psychology, Shenzhen University, Shenzhen 518060, China; Center for studies of Psychological Applications Guangdong Key Laboratory of Mental Health and Cognitive Science Key Laboratory of Brain Cognition and Educational Science, Ministry of Education School of Psychology, South China Normal University, Guangzhou 510631, China; Center for Neurogenetics, Shenzhen Institute of Neuroscience, Shenzhen 518057, China.
| | - Yi Lei
- Institution for Brain and Psychological Science, Sichuan Normal University, Chengdu 610066, China; Center for Neurogenetics, Shenzhen Institute of Neuroscience, Shenzhen 518057, China.
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Dillon DG, Belleau EL, Origlio J, McKee M, Jahan A, Meyer A, Souther MK, Brunner D, Kuhn M, Ang YS, Cusin C, Fava M, Pizzagalli DA. Using Drift Diffusion and RL Models to Disentangle Effects of Depression On Decision-Making vs. Learning in the Probabilistic Reward Task. COMPUTATIONAL PSYCHIATRY (CAMBRIDGE, MASS.) 2024; 8:46-69. [PMID: 38774430 PMCID: PMC11104335 DOI: 10.5334/cpsy.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 04/08/2024] [Indexed: 05/24/2024]
Abstract
The Probabilistic Reward Task (PRT) is widely used to investigate the impact of Major Depressive Disorder (MDD) on reinforcement learning (RL), and recent studies have used it to provide insight into decision-making mechanisms affected by MDD. The current project used PRT data from unmedicated, treatment-seeking adults with MDD to extend these efforts by: (1) providing a more detailed analysis of standard PRT metrics-response bias and discriminability-to better understand how the task is performed; (2) analyzing the data with two computational models and providing psychometric analyses of both; and (3) determining whether response bias, discriminability, or model parameters predicted responses to treatment with placebo or the atypical antidepressant bupropion. Analysis of standard metrics replicated recent work by demonstrating a dependency between response bias and response time (RT), and by showing that reward totals in the PRT are governed by discriminability. Behavior was well-captured by the Hierarchical Drift Diffusion Model (HDDM), which models decision-making processes; the HDDM showed excellent internal consistency and acceptable retest reliability. A separate "belief" model reproduced the evolution of response bias over time better than the HDDM, but its psychometric properties were weaker. Finally, the predictive utility of the PRT was limited by small samples; nevertheless, depressed adults who responded to bupropion showed larger pre-treatment starting point biases in the HDDM than non-responders, indicating greater sensitivity to the PRT's asymmetric reinforcement contingencies. Together, these findings enhance our understanding of reward and decision-making mechanisms that are implicated in MDD and probed by the PRT.
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Affiliation(s)
- Daniel G. Dillon
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont MA, USA
- Harvard Medical School, Boston MA, USA
| | - Emily L. Belleau
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont MA, USA
- Harvard Medical School, Boston MA, USA
| | - Julianne Origlio
- Depression Clinical and Research Program, Massachusetts General Hospital, Boston MA, USA
| | - Madison McKee
- Depression Clinical and Research Program, Massachusetts General Hospital, Boston MA, USA
| | - Aava Jahan
- Depression Clinical and Research Program, Massachusetts General Hospital, Boston MA, USA
| | - Ashley Meyer
- Depression Clinical and Research Program, Massachusetts General Hospital, Boston MA, USA
| | - Min Kang Souther
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont MA, USA
| | - Devon Brunner
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont MA, USA
| | - Manuel Kuhn
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont MA, USA
- Depression Clinical and Research Program, Massachusetts General Hospital, Boston MA, USA
| | - Yuen Siang Ang
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont MA, USA
| | - Cristina Cusin
- Harvard Medical School, Boston MA, USA
- Depression Clinical and Research Program, Massachusetts General Hospital, Boston MA, USA
| | - Maurizio Fava
- Harvard Medical School, Boston MA, USA
- Depression Clinical and Research Program, Massachusetts General Hospital, Boston MA, USA
| | - Diego A. Pizzagalli
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont MA, USA
- Depression Clinical and Research Program, Massachusetts General Hospital, Boston MA, USA
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Du X, Yao L, Sun L, Chen X, Jiang J. Neural mechanisms of social comparison in subthreshold depression. Cereb Cortex 2024; 34:bhae222. [PMID: 38813967 DOI: 10.1093/cercor/bhae222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 04/28/2024] [Accepted: 05/14/2024] [Indexed: 05/31/2024] Open
Abstract
Social comparison is a common phenomenon in our daily life, through which people get to know themselves, and plays an important role in depression. In this study, event-related potential (ERP) was used to explore the temporal course of social comparison processing in the subthreshold depression group. Electrophysiological recordings were acquired from 30 subthreshold depressed individuals and 31 healthy individuals while they conducted the adapted dot estimation task. The ERP results revealed that there was a significant difference of feedback-related negativity (FRN) in the process of social comparison. Especially only in the subthreshold depression, the FRN amplitudes of worse off than some, better off than many comparisons were larger than those of upward comparisons and downward comparisons. Our results suggested that the abnormal reward sensitivity for worse off than some, better off than many comparisons might be prodromal symptoms in the subthreshold depression.
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Affiliation(s)
- Xue Du
- College of Educational Science, Chongqing Normal University, Chongqing, China
- Key Laboratory of Applied Psychology, Chongqing Normal University, Chongqing, China
| | - Li Yao
- College of Educational Science, Chongqing Normal University, Chongqing, China
- Key Laboratory of Applied Psychology, Chongqing Normal University, Chongqing, China
- Chongqing Tsinghua High School, Chongqing, China
| | - Le Sun
- College of Educational Science, Chongqing Normal University, Chongqing, China
- Key Laboratory of Applied Psychology, Chongqing Normal University, Chongqing, China
| | - Xiaoyi Chen
- College of Educational Science, Chongqing Normal University, Chongqing, China
- Key Laboratory of Applied Psychology, Chongqing Normal University, Chongqing, China
| | - Jun Jiang
- Department of Basic Psychology, School of Psychology, Third Military Medical University, Chongqing, China
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Lloyd A, Roiser JP, Skeen S, Freeman Z, Badalova A, Agunbiade A, Busakhwe C, DeFlorio C, Marcu A, Pirie H, Saleh R, Snyder T, Fearon P, Viding E. Reviewing explore/exploit decision-making as a transdiagnostic target for psychosis, depression, and anxiety. COGNITIVE, AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2024:10.3758/s13415-024-01186-9. [PMID: 38653937 DOI: 10.3758/s13415-024-01186-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/27/2024] [Indexed: 04/25/2024]
Abstract
In many everyday decisions, individuals choose between trialling something novel or something they know well. Deciding when to try a new option or stick with an option that is already known to you, known as the "explore/exploit" dilemma, is an important feature of cognition that characterises a range of decision-making contexts encountered by humans. Recent evidence has suggested preferences in explore/exploit biases are associated with psychopathology, although this has typically been examined within individual disorders. The current review examined whether explore/exploit decision-making represents a promising transdiagnostic target for psychosis, depression, and anxiety. A systematic search of academic databases was conducted, yielding a total of 29 studies. Studies examining psychosis were mostly consistent in showing that individuals with psychosis explored more compared with individuals without psychosis. The literature on anxiety and depression was more heterogenous; some studies found that anxiety and depression were associated with more exploration, whereas other studies demonstrated reduced exploration in anxiety and depression. However, examining a subset of studies that employed case-control methods, there was some evidence that both anxiety and depression also were associated with increased exploration. Due to the heterogeneity across the literature, we suggest that there is insufficient evidence to conclude whether explore/exploit decision-making is a transdiagnostic target for psychosis, depression, and anxiety. However, alongside our advisory groups of lived experience advisors, we suggest that this context of decision-making is a promising candidate that merits further investigation using well-powered, longitudinal designs. Such work also should examine whether biases in explore/exploit choices are amenable to intervention.
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Affiliation(s)
- Alex Lloyd
- Clinical, Educational and Health Psychology, Psychology and Language Sciences, University College London, 26 Bedford Way, London, WC1H 0AP, UK.
| | - Jonathan P Roiser
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - Sarah Skeen
- Institute for Life Course Health Research, Stellenbosch University, Stellenbosch, South Africa
| | - Ze Freeman
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Aygun Badalova
- Institute of Neurology, University College London, London, UK
| | | | | | | | - Anna Marcu
- Young People's Advisor Group, London, UK
| | | | | | | | - Pasco Fearon
- Clinical, Educational and Health Psychology, Psychology and Language Sciences, University College London, 26 Bedford Way, London, WC1H 0AP, UK
- Centre for Family Research, Department of Psychology, University of Cambridge, Cambridge, UK
| | - Essi Viding
- Clinical, Educational and Health Psychology, Psychology and Language Sciences, University College London, 26 Bedford Way, London, WC1H 0AP, UK
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Esfand SM, Null KE, Duda JM, de Leeuw J, Pizzagalli DA. Lifetime history of major depressive disorder is associated with decreased reward learning: Evidence from a novel online version of the probabilistic reward task. J Affect Disord 2024; 350:1007-1015. [PMID: 38278332 DOI: 10.1016/j.jad.2024.01.133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 12/31/2023] [Accepted: 01/14/2024] [Indexed: 01/28/2024]
Abstract
BACKGROUND The Probabilistic Reward Task (PRT) is a signal detection task that assesses reward learning. In laboratory versions of the task, individuals with current or past major depressive disorder (MDD) were characterized by reduced response bias towards a more frequently rewarded stimuli, compared to controls. Our main goal was to develop and validate a novel online version of the PRT, and, in exploratory analyses, evaluate whether lifetime history of depression was associated with blunted reward learning. METHODS 429 participants recruited via CloudResearch completed questionnaires assessing psychiatric history and an online PRT featuring visually appealing stimuli. 108 participants reported either current or past diagnosis of MDD (lifetime MDD group), and were compared to 321 without lifetime MDD. RESULTS Participants showed overall increase in response bias, validating the online PRT. Females with lifetime MDD (N = 43), compared to females without prior history of MDD (N = 173), exhibited blunted response bias towards the more frequently rewarded stimulus (i.e., reduced reward learning). LIMITATIONS Participants did not undergo a structured clinical interview, thus we cannot confirm whether they met full diagnostic criteria for depression. CONCLUSIONS The online PRT yielded similar psychometric properties as laboratory versions of the task. In exploratory analyses, females with lifetime MDD showed a lower propensity to modulate behavior as a function of rewards, which might contribute to heightened vulnerability for developing MDD in females. Future studies should consider social, cultural, and neurobiological factors contributing to sex differences in reward responsiveness and how factors may relate to disease prognosis and treatment outcomes.
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Affiliation(s)
- Shiba M Esfand
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA
| | - Kaylee E Null
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA
| | - Jessica M Duda
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA
| | | | - Diego A Pizzagalli
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA; Harvard Medical School, Boston, MA, USA; McLean Imaging Center, McLean Hospital, Belmont, MA, USA.
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Gupta T, Eckstrand KL, Lenniger CJ, Haas GL, Silk JS, Ryan ND, Phillips ML, Flores LE, Pizzagalli DA, Forbes EE. Anhedonia in adolescents at transdiagnostic familial risk for severe mental illness: Clustering by symptoms and mechanisms of association with behavior. J Affect Disord 2024; 347:249-261. [PMID: 37995926 PMCID: PMC10843785 DOI: 10.1016/j.jad.2023.11.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 11/07/2023] [Accepted: 11/17/2023] [Indexed: 11/25/2023]
Abstract
BACKGROUND Anhedonia is a transdiagnostic symptom of severe mental illness (SMI) and emerges during adolescence. Possible subphenotypes and neural mechanisms of anhedonia in adolescents at risk for SMI are understudied. METHODS Adolescents at familial risk for SMI (N = 81) completed anhedonia (e.g., consummatory, anticipatory, social), demographic, and clinical measures and one year prior, a subsample (N = 46) completed fMRI scanning during a monetary reward task. Profiles were identified using k-means clustering of anhedonia type and differences in demographics, suicidal ideation, impulsivity, and emotional processes were examined. Moderation analyses were conducted to investigate whether levels of brain activation of reward regions moderated the relationships between anhedonia type and behaviors. RESULTS Two-clusters emerged: a high anhedonia profile (high-anhedonia), characterized by high levels of all types of anhedonia, (N = 32) and a low anhedonia profile (low-anhedonia), characterized by low levels of anhedonia types (N = 49). Adolescents in the high-anhedonia profile reported more suicidal ideation and negative affect, and less positive affect and desire for emotional closeness than low-anhedonia profile. Furthermore, more suicidal ideation, less positive affect, and less desire for emotional closeness differentiated the familial high-risk, high-anhedonia profile adolescents from the familial high-risk, low-anhedonia profile adolescents. Across anhedonia profiles, moderation analyses revealed that adolescents with high dmPFC neural activation in response to reward had positive relationships between social, anticipatory, and consummatory anhedonia and suicidal ideation. LIMITATIONS Small subsample with fMRI data. CONCLUSION Profiles of anhedonia emerge transdiagnostically and vary on clinical features. Anhedonia severity and activation in frontostriatal reward areas have value for clinically important outcomes such as suicidal ideation.
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Affiliation(s)
- T Gupta
- University of Pittsburgh, Department of Psychiatry, Pittsburgh, PA, USA.
| | - K L Eckstrand
- University of Pittsburgh, Department of Psychiatry, Pittsburgh, PA, USA
| | - C J Lenniger
- University of Pittsburgh, Department of Psychology, Pittsburgh, PA, USA
| | - G L Haas
- University of Pittsburgh, Department of Psychiatry, Pittsburgh, PA, USA; University of Pittsburgh, Department of Psychology, Pittsburgh, PA, USA; VA Pittsburgh Healthcare System, Pittsburgh, PA, USA
| | - J S Silk
- University of Pittsburgh, Department of Psychiatry, Pittsburgh, PA, USA; University of Pittsburgh, Department of Psychology, Pittsburgh, PA, USA
| | - N D Ryan
- University of Pittsburgh, Department of Psychiatry, Pittsburgh, PA, USA
| | - M L Phillips
- University of Pittsburgh, Department of Psychiatry, Pittsburgh, PA, USA
| | - L E Flores
- Queens University, Department of Psychology, Kingston, Ontario, CA, USA
| | - D A Pizzagalli
- Harvard Medical School and McLean Hospital, Department of Psychiatry, Boston, MA, USA
| | - E E Forbes
- University of Pittsburgh, Department of Psychiatry, Pittsburgh, PA, USA; University of Pittsburgh, Department of Psychology, Pittsburgh, PA, USA; University of Pittsburgh, Department of Pediatrics, Pittsburgh, PA, USA; University of Pittsburgh, Department of Clinical and Translational Science, Pittsburgh, PA, USA
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8
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Landaeta-Díaz L, Durán-Agüero S, González-Medina G. Exploring food intake networks and anhedonia symptoms in a Chilean Adults sample. Appetite 2023; 190:107042. [PMID: 37704006 DOI: 10.1016/j.appet.2023.107042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 09/08/2023] [Accepted: 09/10/2023] [Indexed: 09/15/2023]
Abstract
INTRODUCTION high-calorie and sugar-sweetened food is considered more pleasant food. People with anhedonia symptoms have difficulties experiencing pleasure in daily activities. However, is still unclear if anhedonia symptomatology increases palatable food consumption in the Chilean Adults sample. OBJECTIVE to explore food networks in the Chilean Adults sample and in people with anhedonia symptom. METHODS the sample was recruited through digital platforms. Pregnant or lactating women and subjects under pharmacological treatment or psychotherapy were excluded. A total of 1242 subjects, 76.6% women, with a mean age of 30.7 (SD 9.3) and who were highly educated, participated in the study. Data were collected through an online survey. A questionnaire on food consumption based on daily and weekly frequency was used, as well as the Snaith-Hamilton Pleasure Scale to measure anhedonia symptoms. We employed the Gaussian graph model (GGM) to analyze food consumption as networks. We started with the total sample, and then we repeated the analysis on a subsample with anhedonia symptoms, and next on a subsample with exclusively food-related anhedonia. RESULTS in the total sample, a positive and strong relationship was observed between fruits and vegetables, as well as a negative association with the triad of sugar-sweetened beverages, fast food, and fried food. The network in anhedonic subjects shows that "pasta, rice & potatoes" and "bread" have a stronger association and a more central place in the network compared those without anhedonia symptoms. CONCLUSIONS Subjects with anhedonia symptoms have a more central consumption of foods with a high or medium glycemic index compared to subjects without anhedonia symptoms, which could trigger the development of chronic diet-related diseases.
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Affiliation(s)
- Leslie Landaeta-Díaz
- Escuela de Nutrición y Dietética, Facultad de Salud y Ciencias Sociales, Universidad de Las Américas, Chile.
| | - Samuel Durán-Agüero
- Escuela de Nutrición y Dietética, Facultad de Ciencias para el Cuidado de la Salud, Universidad San Sebastián, Los Leones, Santiago, Chile.
| | - Gabriel González-Medina
- Escuela de Medicina, Departamento de Salud Pública, Pontificia Universidad Católica de Chile, Santiago, Chile.
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Sailer U, Wurm F, Pfabigan DM. Social and non-social feedback stimuli lead to comparable levels of reward learning and reward responsiveness in an online probabilistic reward task. Behav Res Methods 2023:10.3758/s13428-023-02255-6. [PMID: 37845425 DOI: 10.3758/s13428-023-02255-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2023] [Indexed: 10/18/2023]
Abstract
Social stimuli seem to be processed more easily and efficiently than non-social stimuli. The current study tested whether social feedback stimuli improve reward learning in a probabilistic reward task (PRT), in which one response option is usually rewarded more often than the other via presentation of non-social reward stimuli. In a pre-registered online study with 305 participants, 75 participants were presented with a non-social feedback stimulus (a star) and information about gains, which is typically used in published PRT studies. Three other groups (with 73-82 participants each) were presented with one of three social feedback stimuli: verbal praise, an attractive happy face, or a "thumbs up"-picture. The data were analysed based on classical signal detection theory, drift diffusion modelling, and Bayesian analyses of null effects. All PRT variants yielded the expected behavioural preference for the more frequently rewarded response. There was no processing advantage of social over non-social feedback stimuli. Bayesian analyses further supported the observation that social feedback stimuli neither increased nor decreased behavioural preferences in the PRT. The current findings suggest that the PRT is a robust experimental paradigm independent of the applied feedback stimuli. They also suggest that the occurrence of a processing advantage for social feedback stimuli is dependent on the experimental task and design.
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Affiliation(s)
- Uta Sailer
- Department of Behavioural Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Sognsvannsveien 9, 0372, Oslo, Norway
| | - Franz Wurm
- Department of Psychology, Leiden University, Leiden, 2333 AK, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden, 2333 AK, The Netherlands
| | - Daniela M Pfabigan
- Department of Behavioural Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Sognsvannsveien 9, 0372, Oslo, Norway.
- Department of Biological and Medical Psychology, Faculty of Psychology, University of Bergen, Jonas Lies vei 91, 5009, Bergen, Norway.
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10
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Boyle CC, Bower JE, Eisenberger NI, Irwin MR. Stress to inflammation and anhedonia: Mechanistic insights from preclinical and clinical models. Neurosci Biobehav Rev 2023; 152:105307. [PMID: 37419230 DOI: 10.1016/j.neubiorev.2023.105307] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 06/30/2023] [Accepted: 07/04/2023] [Indexed: 07/09/2023]
Abstract
Anhedonia, as evidenced by impaired pleasurable response to reward, reduced reward motivation, and/or deficits in reward-related learning, is a common feature of depression. Such deficits in reward processing are also an important clinical target as a risk factor for depression onset. Unfortunately, reward-related deficits remain difficult to treat. To address this gap and inform the development of effective prevention and treatment strategies, it is critical to understand the mechanisms that drive impairments in reward function. Stress-induced inflammation is a plausible mechanism of reward deficits. The purpose of this paper is to review evidence for two components of this psychobiological pathway: 1) the effects of stress on reward function; and 2) the effects of inflammation on reward function. Within these two areas, we draw upon preclinical and clinical models, distinguish between acute and chronic effects of stress and inflammation, and address specific domains of reward dysregulation. By addressing these contextual factors, the review reveals a nuanced literature which might be targeted for additional scientific inquiry to inform the development of precise interventions.
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Affiliation(s)
- Chloe C Boyle
- Norman Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, UCLA, USA.
| | - Julienne E Bower
- Norman Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, UCLA, USA; Department of Psychology, UCLA, Los Angeles, CA, USA
| | | | - Michael R Irwin
- Norman Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, UCLA, USA
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11
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Giles MA, Cooper CM, Jha MK, Chin Fatt CR, Pizzagalli DA, Mayes TL, Webb CA, Greer TL, Etkin A, Trombello JM, Chase HW, Phillips ML, McInnis MG, Carmody T, Adams P, Parsey RV, McGrath PJ, Weissman M, Kurian BT, Fava M, Trivedi MH. Reward Behavior Disengagement, a Neuroeconomic Model-Based Objective Measure of Reward Pathology in Depression: Findings from the EMBARC Trial. Behav Sci (Basel) 2023; 13:619. [PMID: 37622759 PMCID: PMC10451479 DOI: 10.3390/bs13080619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 06/28/2023] [Accepted: 07/21/2023] [Indexed: 08/26/2023] Open
Abstract
The probabilistic reward task (PRT) has identified reward learning impairments in those with major depressive disorder (MDD), as well as anhedonia-specific reward learning impairments. However, attempts to validate the anhedonia-specific impairments have produced inconsistent findings. Thus, we seek to determine whether the Reward Behavior Disengagement (RBD), our proposed economic augmentation of PRT, differs between MDD participants and controls, and whether there is a level at which RBD is high enough for depressed participants to be considered objectively disengaged. Data were gathered as part of the Establishing Moderators and Biosignatures of Antidepressant Response in Clinical Care (EMBARC) study, a double-blind, placebo-controlled clinical trial of antidepressant response. Participants included 195 individuals with moderate to severe MDD (Quick Inventory of Depressive Symptomatology (QIDS-SR) score ≥ 15), not in treatment for depression, and with complete PRT data. Healthy controls (n = 40) had no history of psychiatric illness, a QIDS-SR score < 8, and complete PRT data. Participants with MDD were treated with sertraline or placebo for 8 weeks (stage I of the EMBARC trial). RBD was applied to PRT data using discriminant analysis, and classified MDD participants as reward task engaged (n = 137) or reward task disengaged (n = 58), relative to controls. Reward task engaged/disengaged groups were compared on sociodemographic features, reward-behavior, and sertraline/placebo response (Hamilton Depression Rating Scale scores). Reward task disengaged MDD participants responded only to sertraline, whereas those who were reward task engaged responded to sertraline and placebo (F(1293) = 4.33, p = 0.038). Reward task engaged/disengaged groups did not differ otherwise. RBD was predictive of reward impairment in depressed patients and may have clinical utility in identifying patients who will benefit from antidepressants.
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Affiliation(s)
- Michael A. Giles
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Crystal M. Cooper
- Center for Depression Research and Clinical Care, Peter O’Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA (T.L.G.)
- Jane and John Justin Neurosciences Center, Cook Children’s Health Care System, Fort Worth, TX 76104, USA
| | - Manish K. Jha
- Center for Depression Research and Clinical Care, Peter O’Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA (T.L.G.)
| | - Cherise R. Chin Fatt
- Center for Depression Research and Clinical Care, Peter O’Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA (T.L.G.)
| | - Diego A. Pizzagalli
- Department of Psychiatry, Harvard Medical School, Boston, MA 02215, USA
- McLean Hospital, Belmont, MA 02478, USA
| | - Taryn L. Mayes
- Center for Depression Research and Clinical Care, Peter O’Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA (T.L.G.)
| | - Christian A. Webb
- Department of Psychiatry, Harvard Medical School, Boston, MA 02215, USA
- McLean Hospital, Belmont, MA 02478, USA
| | - Tracy L. Greer
- Center for Depression Research and Clinical Care, Peter O’Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA (T.L.G.)
- Department of Psychology, University of Texas at Arlington, Arlington, TX 76019, USA
| | - Amit Etkin
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94305, USA
| | - Joseph M. Trombello
- Center for Depression Research and Clinical Care, Peter O’Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA (T.L.G.)
| | - Henry W. Chase
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - Mary L. Phillips
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - Melvin G. McInnis
- Department of Psychiatry, University of Michigan School of Medicine, Ann Arbor, MI 48109, USA
| | - Thomas Carmody
- Peter O’Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Phillip Adams
- Department of Psychiatry, Columbia University, New York, NY 10032, USA
| | - Ramin V. Parsey
- Department of Psychiatry and Behavioral Health, Stony Brook University Renaissance School of Medicine, Stony Brook, NY 11794, USA
| | | | - Myrna Weissman
- Department of Psychiatry, Columbia University, New York, NY 10032, USA
| | - Benji T. Kurian
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Maurizio Fava
- Department of Psychiatry, Harvard Medical School, Boston, MA 02215, USA
- Massachusetts General Hospital, Boston, MA 02114, USA
| | - Madhukar H. Trivedi
- Center for Depression Research and Clinical Care, Peter O’Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA (T.L.G.)
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12
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Kolobaric A, Mizuno A, Yang X, George CJ, Seidman A, Aizenstein HJ, Kovacs M, Karim HT. History of major depressive disorder is associated with differences in implicit learning of emotional faces. J Psychiatr Res 2023; 161:324-332. [PMID: 36996725 PMCID: PMC10202097 DOI: 10.1016/j.jpsychires.2023.03.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/13/2023] [Accepted: 03/15/2023] [Indexed: 04/01/2023]
Abstract
Major depressive disorder is often associated with worsened reward learning, with blunted reward response persisting after remission. In this study, we developed a probabilistic learning task with social rewards as a learning signal. We examined the impacts of depression on social rewards (facial affect displays) as an implicit learning signal. Fifty-seven participants without a history of depression and sixty-two participants with a history of depression (current or remitted) completed a structured clinical interview and an implicit learning task with social reward. Participants underwent an open-ended interview to evaluate whether they knew the rule consciously. Linear mixed effects models revealed that participants without a history of depression learned faster and showed a stronger preference towards the positive than the negative stimulus when compared to the participants with a history of depression. In contrast, those with a history depression learned slower on average and displayed greater variability in stimulus preference. We did not detect any differences in learning between those with current and remitted depression. The results indicate that on a probabilistic social reward task, people with a history of depression exhibit slower reward learning and greater variability in their learning behavior. Improving our understanding of alterations in social reward learning and their associations with depression and anhedonia may help to develop translatable psychotherapeutic approaches for modification of maladaptive emotion regulation.
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Affiliation(s)
| | - Akiko Mizuno
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Xiao Yang
- Department of Psychology, Old Dominion University, Norfolk, VA, USA
| | | | - Andrew Seidman
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Howard J Aizenstein
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Maria Kovacs
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
| | - Helmet T Karim
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA.
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13
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Kasyanov ED, Pinakhina DV, Rakitko AS, Vergasova EO, Yermakovich DP, Rukavishnikov GV, Malyshko LV, Popov YV, Kovalenko EV, Ilinskaya AY, Kim AA, Plotnikov NA, Neznanov NG, Ilinsky VV, Kibitov AO, Mazo GE. [Anhedonia in mood disorders and somatic diseases: results of exploratory Mendelian randomization analysis]. Zh Nevrol Psikhiatr Im S S Korsakova 2023; 123:65-73. [PMID: 37141131 DOI: 10.17116/jnevro202312304265] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
OBJECTIVE To conduct an exploratory Mendelian randomization analysis of the causal relationships of anhedonia with a wide range of psychiatric and somatic phenotypes based on the genetic data of participants in a population study. MATERIAL AND METHODS This cross-sectional study included 4520 participants, of which 50.4% (n=2280) were female. The mean age was 36.8 (S.D.=9.8) years. Participants were pheno-nailed based on the DSM-5 criteria for anhedonia in the framework of depression. An episode of anhedonia exceeding 2 weeks during life was reported by 57.6% (n=2604) of participants. A genome-wide association study (GWAS) of the anhedonia phenotype was performed, as well as a Mendelian randomization analysis using summary statistics of large-scale GWASs on psychiatric and somatic phenotypes. RESULTS The GWAS on anhedonia did not reveal the variants with genome-wide significant association (p<10-8). The most significant (p=9.71×10-7) was the variant rs296009 (chr5:168513184) in an intron of the slit guidance ligand 3 (SLIT3) gene. Using Mendelian randomization, nominally significant (p<0.05) causal associations of anhedonia with 24 phenotypes were identified, which can be divided into 5 main groups: psychiatric/neurological diseases, inflammatory diseases of the digestive system, respiratory diseases, oncological diseases and metabolic disorders. The most significant causal effects of anhedonia were found for breast cancer (p=0.0004, OR=0.9986, 95% confidence interval (CI) (0.9978-0.999)), minimal depression phenotype (p=0.009, OR=1.004, 95% CI (1.001-1.007)), as well as for apolipoprotein A (p=0.01, OR=0.973, 95% CI (0.952-0.993)) and respiratory diseases (p=0.01, OR=0.9988, 95% CI (0.9980-0.9997)). CONCLUSION The polygenic nature of anhedonia may cause the risks of comorbidity of this phenotype with a wide range of somatic diseases, as well as may be associated with mood disorders.
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Affiliation(s)
- E D Kasyanov
- Bekhterev National Medical Research Center for Psychiatry and Neurology, St. Petersburg, Russia
| | - D V Pinakhina
- Bekhterev National Medical Research Center for Psychiatry and Neurology, St. Petersburg, Russia
- ITMO University, St. Petersburg, Russia
| | - A S Rakitko
- Bekhterev National Medical Research Center for Psychiatry and Neurology, St. Petersburg, Russia
- Genotek Ltd., Moscow, Russia
| | | | | | - G V Rukavishnikov
- Bekhterev National Medical Research Center for Psychiatry and Neurology, St. Petersburg, Russia
| | - L V Malyshko
- Bekhterev National Medical Research Center for Psychiatry and Neurology, St. Petersburg, Russia
| | | | | | | | - A A Kim
- Genotek Ltd., Moscow, Russia
| | | | - N G Neznanov
- Bekhterev National Medical Research Center for Psychiatry and Neurology, St. Petersburg, Russia
- Pavlov First Saint-Petersburg State Medical University, St. Petersburg, Russia
| | - V V Ilinsky
- Bekhterev National Medical Research Center for Psychiatry and Neurology, St. Petersburg, Russia
- Genotek Ltd., Moscow, Russia
| | - A O Kibitov
- Bekhterev National Medical Research Center for Psychiatry and Neurology, St. Petersburg, Russia
| | - G E Mazo
- Bekhterev National Medical Research Center for Psychiatry and Neurology, St. Petersburg, Russia
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14
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Ader L, Schick A, Simons C, Delespaul P, Myin-Germeys I, Vaessen T, Reininghaus U. Positive Affective Recovery in Daily Life as a Momentary Mechanism Across Subclinical and Clinical Stages of Mental Disorder: Experience Sampling Study. JMIR Ment Health 2022; 9:e37394. [PMID: 36416883 PMCID: PMC9730210 DOI: 10.2196/37394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 09/06/2022] [Accepted: 09/06/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Identifying momentary risk and protective mechanisms may enhance our understanding and treatment of mental disorders. Affective stress reactivity is one mechanism that has been reported to be altered in individuals with early and later stages of mental disorder. Additionally, initial evidence suggests individuals with early and enduring psychosis may have an extended recovery period of negative affect in response to daily stressors (ie, a longer duration until affect reaches baseline levels after stress), but evidence on positive affective recovery as a putative protective mechanism remains limited. OBJECTIVE This study aimed to investigate trajectories of positive affect in response to stress across the continuum of mental disorder in a transdiagnostic sample. METHODS Using the Experience Sampling Method, minor activity-, event-, and overall stress and positive affect were assessed 10 times a day, with time points approximately 90 minutes apart on six consecutive days in a pooled data set including 367 individuals with a mental disorder, 217 individuals at risk for a severe mental disorder, and 227 controls. Multilevel analysis and linear contrasts were used to investigate trajectories of positive affect within and between groups. RESULTS Baseline positive affect differed across groups, and we observed stress reactivity in positive affect within each group. We found evidence for positive affective recovery after reporting activity- or overall stress within each group. While controls recovered to baseline positive affect about 90 minutes after stress, patients and at-risk individuals required about 180 minutes to recover. However, between-group differences in the affective recovery period fell short of significance (all P>.05). CONCLUSIONS The results provide first evidence that positive affective recovery may be relevant within transdiagnostic subclinical and clinical stages of mental disorder, suggesting that it may be a potential target for mobile health interventions fostering resilience in daily life.
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Affiliation(s)
- Leonie Ader
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Anita Schick
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Claudia Simons
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands.,GGzE Institute for Mental Health Care, Eindhoven, Netherlands
| | - Philippe Delespaul
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands.,Department of Adult Psychiatry, Mondriaan Mental Health Trust, Heerlen, Netherlands
| | - Inez Myin-Germeys
- Center for Contextual Psychiatry, Department of Neuroscience, KU Leuven, Leuven, Belgium
| | - Thomas Vaessen
- Center for Contextual Psychiatry, Department of Neuroscience, KU Leuven, Leuven, Belgium.,Faculty of Behavioural, Management and Social Sciences, Psychology, Health & Technology, University of Twente, Enschede, Netherlands
| | - Ulrich Reininghaus
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.,ESRC Centre for Society and Mental Health, King's College London, London, United Kingdom.,Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
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15
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The role of anhedonia in predicting risk-taking behavior in university students. J Psychiatr Res 2022; 155:451-457. [PMID: 36183598 DOI: 10.1016/j.jpsychires.2022.09.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 07/31/2022] [Accepted: 09/16/2022] [Indexed: 11/22/2022]
Abstract
There is a growing interest in understanding symptoms of psychological distress, such as anhedonia, not just as related to individual psychological disorders, but transdiagnostically. This broader focus allows for the investigation of the effects of symptoms across disorders, or in non-clinical samples. Previous work has linked anhedonia and risk-taking behavior in clinical samples, though the exploration of this relationship in healthy adolescents and early adults is still a relatively new area of research. The current study explored the relationship between variability in anhedonia and risk-taking behavior by breaking each into separable parts (i.e. anhedonia into deficits in anticipatory and consummatory pleasure; risk-taking into risk propensity, sub-optimal risky behavior, and response to punishment). A sample of 81 university students completed two Chapman scales of anhedonia, the Temporal Experience of Pleasure Scale (TEPS), and the Balloon Analogue Risk Task (BART). Hierarchical linear regression analyses were completed to assess the predictive power of each anhedonia measure on each outcome measure on the BART. TEPS score significantly negatively predicted all three outcome measures, with anticipatory pleasure having more predictive power than consummatory pleasure. Physical anhedonia was also a significant predictor of sub-optimal risky behavior and response to punishment. These findings present a broader and more complex view of the associations between anhedonia and risk than have previously been reported, and merit further study to continue to elucidate how they are related to one another.
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16
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Morris LS, Grehl MM, Rutter SB, Mehta M, Westwater ML. On what motivates us: a detailed review of intrinsic v. extrinsic motivation. Psychol Med 2022; 52:1801-1816. [PMID: 35796023 PMCID: PMC9340849 DOI: 10.1017/s0033291722001611] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 05/02/2022] [Accepted: 05/12/2022] [Indexed: 12/02/2022]
Abstract
Motivational processes underlie behaviors that enrich the human experience, and impairments in motivation are commonly observed in psychiatric illness. While motivated behavior is often examined with respect to extrinsic reinforcers, not all actions are driven by reactions to external stimuli; some are driven by 'intrinsic' motivation. Intrinsically motivated behaviors are computationally similar to extrinsically motivated behaviors, in that they strive to maximize reward value and minimize punishment. However, our understanding of the neurocognitive mechanisms that underlie intrinsically motivated behavior remains limited. Dysfunction in intrinsic motivation represents an important trans-diagnostic facet of psychiatric symptomology, but due to a lack of clear consensus, the contribution of intrinsic motivation to psychopathology remains poorly understood. This review aims to provide an overview of the conceptualization, measurement, and neurobiology of intrinsic motivation, providing a framework for understanding its potential contributions to psychopathology and its treatment. Distinctions between intrinsic and extrinsic motivation are discussed, including divergence in the types of associated rewards or outcomes that drive behavioral action and choice. A useful framework for understanding intrinsic motivation, and thus separating it from extrinsic motivation, is developed and suggestions for optimization of paradigms to measure intrinsic motivation are proposed.
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Affiliation(s)
- Laurel S. Morris
- Department of Psychiatry, Depression and Anxiety Center for Discovery and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY 10029 USA
| | - Mora M. Grehl
- Department of Psychology, Temple University, Philadelphia, PA 19122 USA
| | - Sarah B. Rutter
- Department of Psychiatry, Depression and Anxiety Center for Discovery and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY 10029 USA
| | - Marishka Mehta
- Department of Psychiatry, Depression and Anxiety Center for Discovery and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY 10029 USA
| | - Margaret L. Westwater
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT 06510 USA
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17
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Dillon DG, Lazarov A, Dolan S, Bar-Haim Y, Pizzagalli DA, Schneier FR. Fast evidence accumulation in social anxiety disorder enhances decision making in a probabilistic reward task. Emotion 2022; 22:1-18. [PMID: 34968142 PMCID: PMC9521281 DOI: 10.1037/emo0001053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Choices and response times in two-alternative decision-making tasks can be modeled by assuming that individuals steadily accrue evidence in favor of each alternative until a response boundary for one of them is crossed, at which point that alternative is chosen. Prior studies have reported that evidence accumulation during decision-making tasks takes longer in adults with psychopathology than in healthy controls, indicating that slow evidence accumulation may be transdiagnostic. However, few studies have examined perceptual decision making in anxiety disorders, where hypervigilance might enhance performance. Therefore, this study used the Hierarchical Drift Diffusion model to investigate evidence accumulation in adults with social anxiety disorder (SAD) and healthy controls as they performed a probabilistic reward task (PRT), in which social rewards were delivered for correct perceptual judgments. Adults with SAD completed the PRT before and after gaze-contingent music reward therapy (GCMRT), which trains attention allocation and has shown efficacy for SAD. Healthy controls also completed the PRT twice. Results revealed excellent performance in adults with SAD, especially after GCMRT: relative to controls, they showed faster evidence accumulation, better discriminability, and earned more rewards. These data highlight a positive effect of attention training on performance in anxious adults and show how a behavioral trait that is typically problematic-hypervigilance in SAD-can nevertheless confer advantages in certain contexts. The data also indicate that, in contrast to other forms of psychopathology, SAD is not characterized by slow evidence accumulation, at least in the context of the social PRT. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Daniel G. Dillon
- McLean Hospital, Belmont, MA, USA,Harvard Medical School, Boston, MA, USA
| | | | - Sarah Dolan
- New York State Psychiatric Institute, New York, NY, USA
| | | | | | - Franklin R. Schneier
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA,New York State Psychiatric Institute, New York, NY, USA
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18
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Kangas BD, Der-Avakian A, Pizzagalli DA. Probabilistic Reinforcement Learning and Anhedonia. Curr Top Behav Neurosci 2022; 58:355-377. [PMID: 35435644 DOI: 10.1007/7854_2022_349] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Despite the prominence of anhedonic symptoms associated with diverse neuropsychiatric conditions, there are currently no approved therapeutics designed to attenuate the loss of responsivity to previously rewarding stimuli. However, the search for improved treatment options for anhedonia has been reinvigorated by a recent reconceptualization of the very construct of anhedonia, including within the Research Domain Criteria (RDoC) initiative. This chapter will focus on the RDoC Positive Valence Systems construct of reward learning generally and sub-construct of probabilistic reinforcement learning specifically. The general framework emphasizes objective measurement of a subject's responsivity to reward via reinforcement learning under asymmetrical probabilistic contingencies as a means to quantify reward learning. Indeed, blunted reward responsiveness and reward learning are central features of anhedonia and have been repeatedly described in major depression. Moreover, these probabilistic reinforcement techniques can also reveal neurobiological mechanisms to aid development of innovative treatment approaches. In this chapter, we describe how investigating reward learning can improve our understanding of anhedonia via the four RDoC-recommended tasks that have been used to probe sensitivity to probabilistic reinforcement contingencies and how such task performance is disrupted in various neuropsychiatric conditions. We also illustrate how reverse translational approaches of probabilistic reinforcement assays in laboratory animals can inform understanding of pharmacological and physiological mechanisms. Next, we briefly summarize the neurobiology of probabilistic reinforcement learning, with a focus on the prefrontal cortex, anterior cingulate cortex, striatum, and amygdala. Finally, we discuss treatment implications and future directions in this burgeoning area.
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Affiliation(s)
- Brian D Kangas
- Harvard Medical School, McLean Hospital, Belmont, MA, USA.
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19
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Bondy E, Bogdan R. Understanding Anhedonia from a Genomic Perspective. Curr Top Behav Neurosci 2022; 58:61-79. [PMID: 35152374 PMCID: PMC9375777 DOI: 10.1007/7854_2021_293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Anhedonia, or the decreased ability to experience pleasure, is a cardinal symptom of major depression that commonly occurs within other forms of psychopathology. Supportive of long-held theory that anhedonia represents a genetically influenced vulnerability marker for depression, evidence from twin studies suggests that it is moderately-largely heritable. However, the genomic sources of this heritability are just beginning to be understood. In this review, we survey what is known about the genomic architecture underlying anhedonia and related constructs. We briefly review twin and initial candidate gene studies before focusing on genome-wide association study (GWAS) and polygenic efforts. As large samples are needed to reliably detect the small effects that typically characterize common genetic variants, the study of anhedonia and related phenotypes conflicts with current genomic research requirements and frameworks that prioritize sample size over precise phenotyping. This has resulted in few and underpowered studies of anhedonia-related constructs that have largely failed to reliably identify individual variants. Nonetheless, the polygenic architecture of anhedonia-related constructs identified in these studies has genetic overlap with depression and schizophrenia as well as related brain structure (e.g., striatal volume), providing important clues to etiology that may usefully guide refinement in nosology. As we await the accumulation of larger samples for more well-powered GWAS of reward-related constructs, novel analytic techniques that leverage GWAS summary statistics (e.g., genomic structural equation modeling) may currently be used to help characterize how the genomic architecture of anhedonia is shared and distinct from that underlying other constructs (e.g., depression, neuroticism, anxiety).
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Affiliation(s)
- Erin Bondy
- Department of Psychological and Brain Sciences, Washington University in Saint Louis, St. Louis, MO, USA
| | - Ryan Bogdan
- Department of Psychological and Brain Sciences, Washington University in Saint Louis, St. Louis, MO, USA.
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20
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Landaeta-Díaz L, Agüero SD, Vinueza-Veloz MF, Arias VC, Cavagnari BM, Ríos-Castillo I, Nava-González EJ, López SC, Ivankovich-Guillén S, Pérez-Armijo P, Bejarano-Roncancio JJ, Núñez-Martínez B, Cordón-Arrivillaga K, Meza-Miranda ER, Ortíz A, Mauricio-Alza S, González-Medina G. Anxiety, Anhedonia, and related food consumption at the beginning of the COVID-19 quarantine in populations of Spanish-speaking Ibero-American countries: An online cross-sectional survey study. SSM Popul Health 2021; 16:100933. [PMID: 34608442 PMCID: PMC8479969 DOI: 10.1016/j.ssmph.2021.100933] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 09/21/2021] [Accepted: 09/27/2021] [Indexed: 12/29/2022] Open
Abstract
In Ibero-American, the anxiety and anhedonia are related to the consumption of food. The anxiety is related to the consumption of palatable foods during confinement. The different type of foods had a different probability of increasing serving size. An increase in average body weight was observed during confinement for COVID-19.
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Affiliation(s)
- Leslie Landaeta-Díaz
- Facultad de Salud y Ciencias sociales, Universidad de Las Américas, Chile
- Corresponding author. Facultad de Salud y Ciencias Sociales, Universidad de Las Américas, Chile. Av. Walker Martínez, 1360, piso 3 Edificio A, La Florida, Santiago, Chile.
| | - Samuel Durán Agüero
- Escuela de Nutrición y Dietética, Facultad de Ciencias para el Cuidado de la Salud. Universidad San Sebastián, Chile
| | - María Fernanda Vinueza-Veloz
- Grupo de investigación PSICOMED, Escuela de Medicina, Facultad de Salud Pública, Escuela Superior Politécnica de Chimborazo, Riobamba, Ecuador
- Departamento de Neurociencia, Erasmus University Rotterdam, Róterdam, the Netherlands
| | - Valeria Carpio Arias
- Grupo de Investigación en Alimentación y Nutrición Humana (GIANH), Facultad de Salud Pública, Escuela Superior Politécnica de Chimborazo. Riobamba, Ecuador
| | - Brian M. Cavagnari
- Escuela de Nutrición, Facultad de Ciencias Médicas, Pontificia Universidad Católica Argentina, Argentina
| | - Israel Ríos-Castillo
- Organización de las Naciones Unidas para la Alimentación y la Agricultura (FAO). Oficina Subregional de la FAO para Mesoamérica. Ciudad de Panamá, Panama
| | - Edna J. Nava-González
- Facultad de Salud Pública y Nutrición, Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | | | | | - Patricio Pérez-Armijo
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Farmacia, Universidad del País Vasco UPV/EHU, 01006, Vitoria-Gasteiz, Álava, Spain
| | | | | | - Karla Cordón-Arrivillaga
- Unidad de Investigación en Seguridad Alimentaria y Nutricional (UNISAN), Escuela de Nutrición, Facultad de Ciencias Químicas y Farmacia, Universidad de San Carlos de Guatemala, Guatemala
| | | | - Alfonsina Ortíz
- Departamento de Nutrición, Facultad de Ciencias de la Salud, Universidad Católica del Uruguay, Uruguay
| | | | - Gabriel González-Medina
- Pontificia Universidad Católica de Chile. Facultad de Medicina. Departamento de Salud Pública. Santiago de Chile, Chile
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Blain SD, Sassenberg TA, Xi M, Zhao D, DeYoung CG. Extraversion but not depression predicts reward sensitivity: Revisiting the measurement of anhedonic phenotypes. J Pers Soc Psychol 2021; 121:e1-e18. [PMID: 33119388 PMCID: PMC8081762 DOI: 10.1037/pspp0000371] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Recently, increasing efforts have been made to define and measure dimensional phenotypes associated with psychiatric disorders. One example is a probabilistic reward task developed by Pizzagalli, Jahn, and O'Shea (2005) to assess anhedonia, by measuring response to a differential reinforcement schedule. This task has been used in many studies, which have connected blunted reward response in the task to depressive symptoms, across clinical groups and in the general population. The current study attempted to replicate these findings in a large community sample and also investigated possible associations with Extraversion, a personality trait linked to reward sensitivity. Participants (N = 299) completed the probabilistic reward task, as well as the Beck Depression Inventory, Personality Inventory for the DSM-5, Big Five Inventory, and Big Five Aspect Scales. Our direct replication attempts used bivariate correlations and analysis of variance models. Follow-up and extension analyses used structural equation models to assess relations among reward sensitivity, depression, Extraversion, and Neuroticism. No significant associations were found between reward sensitivity and depression, thus failing to replicate previous findings. Reward sensitivity (both modeled as response bias aggregated across blocks and as response bias controlling for baseline) showed positive associations with Extraversion, but not Neuroticism. Findings suggest reward sensitivity as measured by this task may be related primarily to Extraversion and its pathological manifestations, rather than to depression per se, consistent with existing models that conceptualize depressive symptoms as combining features of Neuroticism and low Extraversion. Findings are discussed in broader contexts of dimensional psychopathology frameworks, replicable science, and behavioral task reliability. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Scott D Blain
- Department of Psychology, University of Minnesota, Twin Cities
| | | | - Muchen Xi
- Department of Psychology, University of Minnesota, Twin Cities
| | - Daiqing Zhao
- Department of Psychology, University of Minnesota, Twin Cities
| | - Colin G DeYoung
- Department of Psychology, University of Minnesota, Twin Cities
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Horne SJ, Topp TE, Quigley L. Depression and the willingness to expend cognitive and physical effort for rewards: A systematic review. Clin Psychol Rev 2021; 88:102065. [PMID: 34274800 DOI: 10.1016/j.cpr.2021.102065] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 04/26/2021] [Accepted: 06/29/2021] [Indexed: 11/29/2022]
Abstract
Depression is associated with reduced motivation to engage in previously enjoyed activities. In particular, anhedonia has been linked to reduced motivation, though other depressive symptoms may also play a role. The purposes of this systematic review were to 1) examine the relationship between depression and motivation, as operationalized by a willingness to expend effort for rewards, 2) examine the relationship between anhedonia and motivation, and 3) examine potential methodological moderators of these relationships. Forty-three articles met our inclusion criteria for the review. Our review found that individuals with depression and anhedonia demonstrate reduced willingness to expend cognitive and physical effort for rewards, though the effect has been more robustly demonstrated for physical effort expenditure. Task design impacted the strength of these relationships, with stronger effects for tasks that used indices of decision-making and accuracy rather than response time. These findings have clinical implications for behavioral activation, which seeks to improve depressive symptoms by encouraging individuals to increase their activity level. Future research should examine the determinants of motivation in individuals with depression and anhedonia, to ultimately help these individuals become more active and hopefully improve their quality of life as a result.
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Affiliation(s)
- Sarah J Horne
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, United States of America.
| | - Tzippora E Topp
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, United States of America
| | - Leanne Quigley
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, United States of America
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Macoveanu J, Meluken I, Chase HW, Phillips ML, Kessing LV, Siebner HR, Vinberg M, Miskowiak KW. Reduced frontostriatal response to expected value and reward prediction error in remitted monozygotic twins with mood disorders and their unaffected high-risk co-twins. Psychol Med 2021; 51:1637-1646. [PMID: 32115012 DOI: 10.1017/s0033291720000367] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Depressive episodes experienced in unipolar (UD) and bipolar (BD) disorders are characterized by anhedonia and have been associated with abnormalities in reward processes related to reward valuation and error prediction. It remains however unclear whether these deficits are associated with familial vulnerability to mood disorders. METHODS In a functional magnetic resonance imaging study, we evaluated differences in the expected value (EV) and reward prediction error (RPE) signals in ventral striatum (VS) and prefrontal cortex between three groups of monozygotic twins: affected twins in remission for either UD or BD (n = 53), their high-risk unaffected co-twins (n = 34), and low-risk twins with no family history of mood disorders (n = 25). RESULTS Compared to low-risk twins, affected twins showed lower EV signal bilaterally in the frontal poles and lower RPE signal bilaterally in the VS, left frontal pole and superior frontal gyrus. The high-risk group did not show a significant change in the EV or RPE signals in frontostriatal regions, yet both reward signals were consistently lower compared with low-risk twins in all regions where the affected twins showed significant reductions. CONCLUSION Our findings strengthen the notion that reduced valuation of expected rewards and reduced error-dependent reward learning may underpin core symptom of depression such as loss of interest in rewarding activities. The trend reduction in reward-related signals in unaffected co-twins warrants further investigation of this effect in larger samples and prospective follow-up to confirm possible association with increased familial vulnerability to mood disorders.
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Affiliation(s)
- Julian Macoveanu
- Copenhagen Affective Disorder Research Center (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Iselin Meluken
- Copenhagen Affective Disorder Research Center (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Henry W Chase
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Mary L Phillips
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Lars Vedel Kessing
- Copenhagen Affective Disorder Research Center (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Hartwig Roman Siebner
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
- Department of Neurology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
- Faculty of Medical and Health Sciences, Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Maj Vinberg
- Copenhagen Affective Disorder Research Center (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Kamilla W Miskowiak
- Copenhagen Affective Disorder Research Center (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
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Frey AL, Frank MJ, McCabe C. Social reinforcement learning as a predictor of real-life experiences in individuals with high and low depressive symptomatology. Psychol Med 2021; 51:408-415. [PMID: 31831095 PMCID: PMC7958481 DOI: 10.1017/s0033291719003222] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 09/27/2019] [Accepted: 10/22/2019] [Indexed: 01/24/2023]
Abstract
BACKGROUND Several studies have reported diminished learning from non-social outcomes in depressed individuals. However, it is not clear how depression impacts learning from social feedback. Notably, mood disorders are commonly associated with deficits in social functioning, which raises the possibility that potential impairments in social learning may negatively affect real-life social experiences in depressed subjects. METHODS Ninety-two participants with high (HD; N = 40) and low (LD; N = 52) depression scores were recruited. Subjects performed a learning task, during which they received monetary outcomes or social feedback which they were told came from other people. Additionally, participants answered questions about their everyday social experiences. Computational models were fit to the data and model parameters were related to social experience measures. RESULTS HD subjects reported a reduced quality and quantity of social experiences compared to LD controls, including an increase in the amount of time spent in negative social situations. Moreover, HD participants showed lower learning rates than LD subjects in the social condition of the task. Interestingly, across all participants, reduced social learning rates predicted higher amounts of time spent in negative social situations, even when depression scores were controlled for. CONCLUSION These findings indicate that deficits in social learning may affect the quality of everyday social experiences. Specifically, the impaired ability to use social feedback to appropriately update future actions, which was observed in HD subjects, may lead to suboptimal interpersonal behavior in real life. This, in turn, may evoke negative feedback from others, thus bringing about more unpleasant social encounters.
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Affiliation(s)
- Anna-Lena Frey
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Michael J. Frank
- Department of Cognitive, Linguistic and Psychological Sciences, Brown Institute for Brain Science, Brown University, Providence, RI, USA
| | - Ciara McCabe
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
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Sazhin D, Frazier AM, Haynes CR, Johnston CR, Chat IKY, Dennison JB, Bart CP, McCloskey ME, Chein JM, Fareri DS, Alloy LB, Jarcho JM, Smith DV. The Role of Social Reward and Corticostriatal Connectivity in Substance Use. JOURNAL OF PSYCHIATRY AND BRAIN SCIENCE 2020; 5:e200024. [PMID: 33215046 PMCID: PMC7673297 DOI: 10.20900/jpbs.20200024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This report describes an ongoing R03 grant that explores the links between trait reward sensitivity, substance use, and neural responses to social and nonsocial reward. Although previous research has shown that trait reward sensitivity and neural responses to reward are linked to substance use, whether this relationship is impacted by how people process social stimuli remains unclear. We are investigating these questions via a neuroimaging study with college-aged participants, using individual difference measures that examine the relation between substance use, social context, and trait reward sensitivity with tasks that measure reward anticipation, strategic behavior, social reward consumption, and the influence of social context on reward processing. We predict that substance use will be tied to distinct patterns of striatal dysfunction. Specifically, reward hyposensitive individuals will exhibit blunted striatal responses to social and non-social reward and enhanced connectivity with the orbitofrontal cortex; in contrast, reward hypersensitive individuals will exhibit enhanced striatal responses to social and non-social reward and blunted connectivity with the orbitofrontal cortex. We also will examine the relation between self-reported reward sensitivity, substance use, and striatal responses to social reward and social context. We predict that individuals reporting the highest levels of substance use will show exaggerated striatal responses to social reward and social context, independent of self-reported reward sensitivity. Examining corticostriatal responses to reward processing will help characterize the relation between reward sensitivity, social context and substance use while providing a foundation for understanding risk factors and isolating neurocognitive mechanisms that may be targeted to increase the efficacy of interventions.
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Affiliation(s)
- Daniel Sazhin
- Department of Psychology, Temple University, Philadelphia, PA 19122, USA
| | | | - Caleb R. Haynes
- Department of Psychology, Temple University, Philadelphia, PA 19122, USA
| | | | - Iris Ka-Yi Chat
- Department of Psychology, Temple University, Philadelphia, PA 19122, USA
| | | | - Corinne P. Bart
- Department of Psychology, Temple University, Philadelphia, PA 19122, USA
| | | | - Jason M. Chein
- Department of Psychology, Temple University, Philadelphia, PA 19122, USA
| | - Dominic S. Fareri
- Gordon F. Derner School of Psychology, Adelphi University, Garden City, NY 11530, USA
| | - Lauren B. Alloy
- Department of Psychology, Temple University, Philadelphia, PA 19122, USA
| | - Johanna M. Jarcho
- Department of Psychology, Temple University, Philadelphia, PA 19122, USA
| | - David V. Smith
- Department of Psychology, Temple University, Philadelphia, PA 19122, USA
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Reward Functioning Abnormalities in Adolescents at High Familial Risk for Depressive Disorders. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2020; 6:270-279. [PMID: 33160881 DOI: 10.1016/j.bpsc.2020.08.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 08/14/2020] [Accepted: 08/31/2020] [Indexed: 01/26/2023]
Abstract
BACKGROUND A parental history of major depressive disorder (MDD) is an established risk factor for MDD in youth, and clarifying the mechanisms related to familial risk transmission is critical. Aberrant reward processing is a promising biomarker of MDD risk; accordingly, the aim of this study was to test behavioral measures of reward responsiveness and underlying frontostriatal resting activity in healthy adolescents both with (high-risk) and without (low-risk) a maternal history of MDD. METHODS Low-risk and high-risk 12- to 14-year-old adolescents completed a probabilistic reward task (n = 74 low-risk, n = 27 high-risk) and a resting-state functional magnetic resonance imaging scan (n = 61 low-risk, n = 25 high-risk). Group differences in response bias toward reward and resting ventral striatal and medial prefrontal cortex (mPFC) fractional amplitude of low-frequency fluctuations (fALFFs) were examined. Computational modeling was applied to dissociate reward sensitivity from learning rate. RESULTS High-risk adolescents showed a blunted response bias compared with low-risk adolescents. Computational modeling analyses revealed that relative to low-risk adolescents, high-risk adolescents exhibited reduced reward sensitivity but similar learning rate. Although there were no group differences in ventral striatal and mPFC fALFFs, groups differed in their relationships between mPFC fALFFs and response bias. Specifically, among high-risk adolescents, higher mPFC fALFFs correlated with a blunted response bias, whereas there was no fALFFs-response bias relationship among low-risk youths. CONCLUSIONS High-risk adolescents exhibit reward functioning impairments, which are associated with mPFC fALFFs. The blunted response bias-mPFC fALFFs association may reflect an excessive mPFC-mediated suppression of reward-driven behavior, which may potentiate MDD risk.
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Abstract
BACKGROUND Both acute and chronic pain can disrupt reward processing. Moreover, prolonged prescription opioid use and depressed mood are common in chronic pain samples. Despite the prevalence of these risk factors for anhedonia, little is known about anhedonia in chronic pain populations. METHODS We conducted a large-scale, systematic study of anhedonia in chronic pain, focusing on its relationship with opioid use/misuse, pain severity, and depression. Chronic pain patients across four distinct samples (N = 488) completed the Snaith-Hamilton Pleasure Scale (SHAPS), measures of opioid use, pain severity and depression, as well as the Current Opioid Misuse Measure (COMM). We used a meta-analytic approach to determine reference levels of anhedonia in healthy samples spanning a variety of countries and diverse age groups, extracting SHAPS scores from 58 published studies totaling 2664 psychiatrically healthy participants. RESULTS Compared to healthy samples, chronic pain patients showed higher levels of anhedonia, with ~25% of patients scoring above the standard anhedonia cut-off. This difference was not primarily driven by depression levels, which explained less than 25% of variance in anhedonia scores. Neither opioid use duration, dose, nor pain severity alone was significantly associated with anhedonia. Yet, there was a clear effect of opioid misuse, with opioid misusers (COMM ⩾13) reporting greater anhedonia than non-misusers. Opioid misuse remained a significant predictor of anhedonia even after controlling for pain severity, depression and opioid dose. CONCLUSIONS Study results suggest that both chronic pain and opioid misuse contribute to anhedonia, which may, in turn, drive further pain and misuse.
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Affiliation(s)
- Eric L Garland
- Center on Mindfulness and Integrative Health Intervention Development, University of Utah, Salt Lake City, UT, USA
- College of Social Work, University of Utah, Salt Lake City, UT, USA
| | | | - Marie Eikemo
- Department of Psychology, University of Oslo, Norway
| | - Gernot Ernst
- Department of Psychology, University of Oslo, Norway
- Kongsberg Hospital, Norway
| | - Siri Leknes
- Department of Psychology, University of Oslo, Norway
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Selective kappa-opioid antagonism ameliorates anhedonic behavior: evidence from the Fast-fail Trial in Mood and Anxiety Spectrum Disorders (FAST-MAS). Neuropsychopharmacology 2020; 45:1656-1663. [PMID: 32544925 PMCID: PMC7419512 DOI: 10.1038/s41386-020-0738-4] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 05/22/2020] [Accepted: 06/09/2020] [Indexed: 12/11/2022]
Abstract
Anhedonia remains a major clinical issue for which there is few effective interventions. Untreated or poorly controlled anhedonia has been linked to worse disease course and increased suicidal behavior across disorders. Taking a proof-of-mechanism approach under the auspices of the National Institute of Mental Health FAST-FAIL initiative, we were the first to show that, in a transdiagnostic sample screened for elevated self-reported anhedonia, 8 weeks of treatment with a kappa-opioid receptor (KOR) antagonist resulted in significantly higher reward-related activation in one of the core hubs of the brain reward system (the ventral striatum), better reward learning in the Probabilistic Reward Task (PRT), and lower anhedonic symptoms, relative to 8 weeks of placebo. Here, we performed secondary analyses of the PRT data to investigate the putative effects of KOR antagonism on anhedonic behavior with more precision by using trial-level model-based Bayesian computational modeling and probability analyses. We found that, relative to placebo, KOR antagonism resulted in significantly higher learning rate (i.e., ability to learn from reward feedback) and a more sustained preference toward the more frequently rewarded stimulus, but unaltered reward sensitivity (i.e., the hedonic response to reward feedback). Collectively, these findings provide novel evidence that in a transdiagnostic sample characterized by elevated anhedonia, KOR antagonism improved the ability to modulate behavior as a function of prior rewards. Together with confirmation of target engagement in the primary report (Krystal et al., Nat Med, 2020), the current findings suggest that further transdiagnostic investigation of KOR antagonism for anhedonia is warranted.
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Lawlor VM, Webb CA, Wiecki TV, Frank MJ, Trivedi M, Pizzagalli DA, Dillon DG. Dissecting the impact of depression on decision-making. Psychol Med 2020; 50:1613-1622. [PMID: 31280757 PMCID: PMC6946886 DOI: 10.1017/s0033291719001570] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Cognitive deficits in depressed adults may reflect impaired decision-making. To investigate this possibility, we analyzed data from unmedicated adults with Major Depressive Disorder (MDD) and healthy controls as they performed a probabilistic reward task. The Hierarchical Drift Diffusion Model (HDDM) was used to quantify decision-making mechanisms recruited by the task, to determine if any such mechanism was disrupted by depression. METHODS Data came from two samples (Study 1: 258 MDD, 36 controls; Study 2: 23 MDD, 25 controls). On each trial, participants indicated which of two similar stimuli was presented; correct identifications were rewarded. Quantile-probability plots and the HDDM quantified the impact of MDD on response times (RT), speed of evidence accumulation (drift rate), and the width of decision thresholds, among other parameters. RESULTS RTs were more positively skewed in depressed v. healthy adults, and the HDDM revealed that drift rates were reduced-and decision thresholds were wider-in the MDD groups. This pattern suggests that depressed adults accumulated the evidence needed to make decisions more slowly than controls did. CONCLUSIONS Depressed adults responded slower than controls in both studies, and poorer performance led the MDD group to receive fewer rewards than controls in Study 1. These results did not reflect a sensorimotor deficit but were instead due to sluggish evidence accumulation. Thus, slowed decision-making-not slowed perception or response execution-caused the performance deficit in MDD. If these results generalize to other tasks, they may help explain the broad cognitive deficits seen in depression.
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Affiliation(s)
- Victoria M. Lawlor
- Center for Depression, Anxiety and Stress Research, McLean Hospital/Harvard Medical School
- Emory University
| | - Christian A. Webb
- Center for Depression, Anxiety and Stress Research, McLean Hospital/Harvard Medical School
| | | | | | | | - Diego A. Pizzagalli
- Center for Depression, Anxiety and Stress Research, McLean Hospital/Harvard Medical School
| | - Daniel G. Dillon
- Center for Depression, Anxiety and Stress Research, McLean Hospital/Harvard Medical School
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França AB, Gordon AL, Samra R, Rodolpho Duarte ES, Jacinto AF. Symptoms of mood disorders in family carers of older people with dementia who experience caregiver burden: a network approach. Age Ageing 2020; 49:628-633. [PMID: 32091573 DOI: 10.1093/ageing/afaa008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 12/04/2019] [Accepted: 01/08/2020] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND informal carers of people with dementia are at greater risk of anxiety and depressive disorders if they find caregiving to be a burden. The aim of this study was to use a network analysis of cross-sectional data to investigate the relationships between anxiety and depressive symptoms in family carers of older people with dementia who experience burden. METHODS sixty family carers exhibiting high levels of burden using the Zarit Burden Interview were included in the study. Participants completed the Hospital Anxiety and Depression Scale. The network analysis identified the depression and anxiety symptom network using features including a topological graph, network centrality metrics and community analysis. The network was estimated through the graphical LASSO technique in combination with a walktrap algorithm to obtain the clusters within the network and the connections between the nodes (symptoms). A directed acyclic graph was generated to model symptom interactions. RESULTS the resulting network architecture shows important bridges between depression and anxiety symptoms. Lack of pleasure and loss of enjoyment were identified as potential gateway symptoms to other anxiety and depression symptoms and represent possible therapeutic targets for psychosocial interventions. Fear and loss of optimism were highly central symptoms, indicating their importance as warning signs of more generalised anxiety and depression. CONCLUSIONS this network analysis of depressive and anxiety symptoms in overburdened family carers provides important insights as to what symptoms may be the most important targets for behavioural interventions.
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Affiliation(s)
| | - Adam Lee Gordon
- Division of Medical Sciences and Graduate Entry Medicine, University of Nottingham, Derby, UK
| | - Rajvinder Samra
- School of Health, Wellbeing and Social Care, The Open University, Milton, Keynes, UK
| | | | - Alessandro Ferrari Jacinto
- Medical School, São Paulo State University (UNESP), Botucatu, SP, Brazil
- Geriatrics Discipline, Federal University of São Paulo (UNIFESP), SP, Brazil
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Horne SJ, Bernstein EE, McNally RJ. The Effects of Affective Expectations on Experience in Individuals Varying in Anhedonia. COGNITIVE THERAPY AND RESEARCH 2020. [DOI: 10.1007/s10608-020-10111-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Gaillard C, Guillod M, Ernst M, Federspiel A, Schoebi D, Recabarren RE, Ouyang X, Mueller-Pfeiffer C, Horsch A, Homan P, Wiest R, Hasler G, Martin-Soelch C. Striatal reactivity to reward under threat-of-shock and working memory load in adults at increased familial risk for major depression: A preliminary study. Neuroimage Clin 2020; 26:102193. [PMID: 32036303 PMCID: PMC7011085 DOI: 10.1016/j.nicl.2020.102193] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 12/27/2019] [Accepted: 01/20/2020] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Anhedonia, a core symptom of Major Depressive Disorder (MDD), manifests as a lack or loss of motivation as reflected by decreased reward responsiveness, at both behavioral and neural (i.e., striatum) levels. Exposure to stressful life events is another important risk factor for MDD. However, the mechanisms linking reward-deficit and stress to MDD remain poorly understood. Here, we explore whether the effects of stress exposure on reward processing might differentiate between Healthy Vulnerable adults (HVul, i.e., positive familial MDD) from Healthy Controls (HCon). Furthermore, the well-described reduction in cognitive resources in MDD might facilitate the stress-induced decrease in reward responsiveness in HVul individuals. Accordingly, this study includes a manipulation of cognitive resources to address the latter possibility. METHODS 16 HVul (12 females) and 16 gender- and age-matched HCon completed an fMRI study, during which they performed a working memory reward task. Three factors were manipulated: reward (reward, no-reward), cognitive resources (working memory at low and high load), and stress level (no-shock, unpredictable threat-of-shock). Only the reward anticipation phase was analyzed. Imaging analyses focused on striatal function. RESULTS Compared to HCon, HVul showed lower activation in the caudate nucleus across all conditions. The HVul group also exhibited lower stress-related activation in the nucleus accumbens, but only in the low working memory (WM) load condition. Moreover, while stress potentiated putamen reactivity to reward cues in HVul when the task was more demanding (high WM load), stress blunted putamen reactivity in both groups when no reward was at stake. CONCLUSION Findings suggest that HVul might be at increased risk of developing anhedonic symptoms due to weaker encoding of reward value, higher difficulty to engage in goal-oriented behaviors and increased sensitivity to negative feedback, particularly in stressful contexts. These findings open new avenues for a better understanding of the mechanisms underlying how the complex interaction between the systems of stress and reward responsiveness contribute to the vulnerability to MDD, and how cognitive resources might modulate this interaction.
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Affiliation(s)
- Claudie Gaillard
- IReach Lab, Unit of Clinical and Health Psychology, Department of Psychology, University of Fribourg, Fribourg, Switzerland; Section on Neurobiology of Fear and Anxiety, National Institute of Mental Health, Bethesda, Maryland, USA.
| | - Matthias Guillod
- IReach Lab, Unit of Clinical and Health Psychology, Department of Psychology, University of Fribourg, Fribourg, Switzerland
| | - Monique Ernst
- Section on Neurobiology of Fear and Anxiety, National Institute of Mental Health, Bethesda, Maryland, USA
| | - Andrea Federspiel
- Psychiatric Neuroimaging Unit, Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Dominik Schoebi
- Unit of Clinical Family Psychology, Department of Psychology, University of Fribourg, Fribourg, Switzerland
| | - Romina Evelyn Recabarren
- IReach Lab, Unit of Clinical and Health Psychology, Department of Psychology, University of Fribourg, Fribourg, Switzerland
| | - Xinyi Ouyang
- iBM Lab, Department of Psychology, University of Fribourg, Fribourg, Switzerland
| | - Christoph Mueller-Pfeiffer
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Antje Horsch
- Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland; Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Switzerland
| | - Philipp Homan
- Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, New York, New York, USA
| | - Roland Wiest
- Department of Diagnostic and Interventional Neuroradiology, University Hospital of Bern, Bern, Switzerland
| | - Gregor Hasler
- Unit of Psychiatry Research, University of Fribourg, Fribourg, Switzerland
| | - Chantal Martin-Soelch
- IReach Lab, Unit of Clinical and Health Psychology, Department of Psychology, University of Fribourg, Fribourg, Switzerland
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Guffanti G, Kumar P, Admon R, Treadway MT, Hall MH, Mehta M, Douglas S, Arulpragasam AR, Pizzagalli DA. Depression genetic risk score is associated with anhedonia-related markers across units of analysis. Transl Psychiatry 2019; 9:236. [PMID: 31537779 PMCID: PMC6753161 DOI: 10.1038/s41398-019-0566-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 07/09/2019] [Accepted: 07/30/2019] [Indexed: 12/22/2022] Open
Abstract
Investigations of pathophysiological mechanisms implicated in vulnerability to depression have been negatively impacted by the significant heterogeneity characteristic of psychiatric syndromes. Such challenges are also reflected in numerous null findings emerging from genome-wide association studies (GWAS) of depression. Bolstered by increasing sample sizes, recent GWAS studies have identified genetics variants linked to MDD. Among them, Okbay and colleagues (Nat. Genet. 2016 Jun;48(6):624-33) identified genetic variants associated with three well-validated depression-related phenotypes: subjective well-being, depressive symptoms, and neuroticism. Despite this progress, little is known about psychopathological and neurobiological mechanisms underlying such risk. To fill this gap, a genetic risk score (GRS) was computed from the Okbay's study for a sample of 88 psychiatrically healthy females. Across two sessions, participants underwent two well-validated psychosocial stressors, and performed two separate tasks probing reward learning both before and after stress. Analyses tested whether GRS scores predicted anhedonia-related phenotypes across three units of analyses: self-report (Snaith Hamilton Pleasure Scale), behavior (stress-induced changes in reward learning), and circuits (stress-induced changes in striatal reward prediction error; striatal volume). GRS scores were negatively associated with anhedonia-related phenotypes across all units of analyses but only circuit-level variables were significant. In addition, the amount of explained variance was systematically larger as variables were putatively closer to the effects of genes (self-report < behavior < neural circuitry). Collectively, findings implicate anhedonia-related phenotypes and neurobiological mechanisms in increased depression vulnerability, and highlight the value of focusing on fundamental dimensions of functioning across different units of analyses.
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Affiliation(s)
- Guia Guffanti
- 000000041936754Xgrid.38142.3cDepartment of Psychiatry, Harvard Medical School, Boston, MA 02115 USA ,0000 0000 8795 072Xgrid.240206.2McLean Hospital, Belmont, MA 02478 USA
| | - Poornima Kumar
- 000000041936754Xgrid.38142.3cDepartment of Psychiatry, Harvard Medical School, Boston, MA 02115 USA ,0000 0000 8795 072Xgrid.240206.2McLean Hospital, Belmont, MA 02478 USA
| | - Roee Admon
- 0000 0004 1937 0562grid.18098.38Department of Psychology, University of Haifa, Haifa, Israel
| | - Michael T. Treadway
- 0000 0001 0941 6502grid.189967.8Department of Psychology, Emory University, Atlanta, GA 30322 USA ,0000 0001 0941 6502grid.189967.8Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA 30322 USA
| | - Mei H. Hall
- 000000041936754Xgrid.38142.3cDepartment of Psychiatry, Harvard Medical School, Boston, MA 02115 USA ,0000 0000 8795 072Xgrid.240206.2McLean Hospital, Belmont, MA 02478 USA
| | - Malavika Mehta
- 0000 0000 8795 072Xgrid.240206.2McLean Hospital, Belmont, MA 02478 USA
| | - Samuel Douglas
- 0000 0000 8795 072Xgrid.240206.2McLean Hospital, Belmont, MA 02478 USA
| | - Amanda R. Arulpragasam
- 0000 0001 0941 6502grid.189967.8Department of Psychology, Emory University, Atlanta, GA 30322 USA
| | - Diego A. Pizzagalli
- 000000041936754Xgrid.38142.3cDepartment of Psychiatry, Harvard Medical School, Boston, MA 02115 USA ,0000 0000 8795 072Xgrid.240206.2McLean Hospital, Belmont, MA 02478 USA
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Boyle CC, Kuhlman KR, Dooley LN, Haydon MD, Robles TF, Ang YS, Pizzagalli DA, Bower JE. Inflammation and dimensions of reward processing following exposure to the influenza vaccine. Psychoneuroendocrinology 2019; 102:16-23. [PMID: 30496908 PMCID: PMC6420390 DOI: 10.1016/j.psyneuen.2018.11.024] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 11/15/2018] [Accepted: 11/19/2018] [Indexed: 01/04/2023]
Abstract
BACKGROUND Alterations in reward processing are a central feature of depression and may be influenced by inflammation. Indeed, inflammation is associated with deficits in reward-related processes in animal models and with dysregulation in reward-related neural circuitry in humans. However, the downstream behavioral manifestations of such impairments are rarely examined in humans. METHODS The influenza vaccination was used to elicit a mild inflammatory response in 41 healthy young adults (age range: 18-22, 30 female). Participants provided blood samples and completed behavioral measures of three key aspects of reward-reward motivation, reward learning, and reward sensitivity-before and 1 day after receiving the influenza vaccine. RESULTS The influenza vaccine led to mild but significant increases in circulating levels of the pro-inflammatory cytokine interleukin-6 (IL-6) (p < .001). Consistent with hypotheses, increases in IL-6 predicted lower reward motivation (p = .029). However, contrary to hypotheses, increases in IL-6 predicted increased performance on a reward learning task (p = .043) and were not associated with changes in reward sensitivity (p's > .288). CONCLUSIONS These findings contribute to an emerging literature on the nuanced associations between inflammation and reward and demonstrate that even mild alterations in inflammation are associated with multiple facets of reward processing.
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Affiliation(s)
- Chloe C. Boyle
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Behavior, University of California, Los Angeles, CA 90095,Corresponding Author: Chloe C. Boyle, PhD, Cousins Center for Psychoneuroimmunology, Medical Plaza 300, Los Angeles, CA 90095,
| | - Kate R. Kuhlman
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Behavior, University of California, Los Angeles, CA 90095,School of Social Ecology, University of California, Irvine, CA 92497
| | | | - Marcie D. Haydon
- Department of Psychology, University of California, Los Angeles, CA 90095
| | - Theodore F. Robles
- Department of Psychology, University of California, Los Angeles, CA 90095
| | - Yuen-Siang Ang
- Department of Psychiatry and McLean Hospital, Harvard Medical School, Belmont, MA 02478
| | - Diego A. Pizzagalli
- Department of Psychiatry and McLean Hospital, Harvard Medical School, Belmont, MA 02478
| | - Julienne E. Bower
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Behavior, University of California, Los Angeles, CA 90095,Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA 90095,Department of Psychology, University of California, Los Angeles, CA 90095
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Abstract
The cognitive model of depression was highly stimulating for a better understanding and development of treatment for depression. However, the concept of “cognition” is rather broad and unspecific, and we suggest to focus on the cognitive subset of expectation.
We conducted a narrative review on the role of expectations, and present an expectation-focused model of explaining why depression tends to persist despite the occurrence of positive events.
Several results from basic neuroscience to effects in clinical interventions indicate that expectations play a special role not only for the understanding of the development of mental disorders and the effects of treatment approaches, but especially for an improved understanding of the persistence of mental disorders. If expectations are a major mechanism of depression, the treatment of depression must maximize the violation of dysfunctional expectations. We also introduce the concept of immunization that describes any cognitive or behavioral strategies to reduce the effect of expectation violation experiences, and hereby contributing to expectation maintenance despite expectation contradicting events. We postulate that the development of immunization strategies could help to better understand the transition from episodic to chronic depression.
While in early periods of depression development, a focus on expectation change might be sufficient in treatment, the treatment of patients with chronic depression requires addressing these cognitive and behavioral immunization strategies more intensively. Further implications for treatment and research are outlined that are derived from this balance between expectation violation and cognitive immunization in depression.
A focus on “expectations” helps to better understand the maintenance of depression
We offer a model that explains why depression persists even in the presence of positive experiences.
Many psychological treatments focus on the violation of negative expectations, but cognitive immunization can hinder treatment success.
We suggest strategies on how to improve psychological treatments for depression by maximizing expectation violation, and minimizing cognitive immunization.
A focus on “expectations” helps to better understand the maintenance of depression
We offer a model that explains why depression persists even in the presence of positive experiences.
Many psychological treatments focus on the violation of negative expectations, but cognitive immunization can hinder treatment success.
We suggest strategies on how to improve psychological treatments for depression by maximizing expectation violation, and minimizing cognitive immunization.
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MacKenzie LE, Uher R, Pavlova B. Cognitive Performance in First-Degree Relatives of Individuals With vs Without Major Depressive Disorder: A Meta-analysis. JAMA Psychiatry 2019; 76:297-305. [PMID: 30586133 PMCID: PMC6439825 DOI: 10.1001/jamapsychiatry.2018.3672] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
IMPORTANCE Findings of cognitive impairment in major depressive disorder (MDD), including remitted MDD, raise the question whether impaired cognition is part of preexisting vulnerability rather than a consequence of MDD or its treatment. To our knowledge, no meta-analyses have been published on cognitive impairment in first-degree relatives of individuals with MDD. OBJECTIVE To compare cognitive performance between individuals with and without family history of MDD. DATA SOURCES Medline/PubMed, PsycINFO, and Embase using combinations of search terms for depression, first-degree relatives, and cognition from January 1, 1980, to July 15, 2018. STUDY SELECTION Original articles that reported data on cognition in first-degree relatives of individuals with MDD compared with controls with no family history of major mental illness. DATA EXTRACTION AND SYNTHESIS Means and SDs were extracted, and standardized mean differences (SMD) between relatives and controls were calculated for each measure of cognitive performance. The relative-control differences in overall cognition and in specific cognitive domains were synthesized in random-effects meta-analyses with robust variance estimation that allows including multiple correlated measures of cognition within each study. Heterogeneity was quantified with τ2. Publication bias was assessed with funnel plots and Egger intercept. MAIN OUTCOMES AND MEASURES Performance on cognitive tests. RESULTS Across 284 measures of cognition in 54 nonoverlapping samples including 3246 relatives of people with MDD (mean age 15.38 years, 57.68% females) and 5222 controls (mean age 14.70 years, 55.93% females), relatives of people with MDD performed worse than controls across all measures of cognition (SMD = -0.19; 95% CI, -0.27 to -0.11; P < .001). Domain-specific meta-analyses showed similar size of relative-control difference in most domains of cognition, including Full-Scale IQ (SMD = -0.19), verbal intelligence (SMD = -0.29), perceptual intelligence (SMD = -0.23), memory (SMD = -0.20), academic performance (SMD = -0.40), and language (SMD = -0.29). Study characteristics were not significantly associated with observed between-group differences. There was no evidence of publication bias. CONCLUSIONS AND RELEVANCE A general impairment in cognition is a feature of familial disposition for MDD. Cognition may contribute to early identification of risk for depression and may be examined as potential target for early intervention.
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Affiliation(s)
- Lynn E. MacKenzie
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Rudolf Uher
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada,Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada,Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Barbara Pavlova
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada,Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
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Petrican R, Grady CL. The intrinsic neural architecture of inhibitory control: The role of development and emotional experience. Neuropsychologia 2019; 127:93-105. [PMID: 30822448 DOI: 10.1016/j.neuropsychologia.2019.01.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 11/13/2018] [Accepted: 01/20/2019] [Indexed: 11/25/2022]
Abstract
Inhibitory control is a key determinant of goal-directed behavior. Its susceptibility to reward implies that its variations may not only reflect cognitive ability, but also sensitivity to goal-relevant information. Since cognitive ability and motivational sensitivity vary as a function of age and mood, we hypothesized that their relevance for predicting individual differences in inhibition would similarly vary. Here, we tested this prediction with respect to the brain's intrinsic functional architecture. Specifically, we reasoned that age and affective functioning would both moderate the relationship between inhibition and resting state expression of the dynamic neural organization patterns linked to engaging in cognitive effort versus those involved in manipulating motivationally salient information. First, we used task fMRI data from the Human Connectome Project (N = 359 participants) to identify the brain organization patterns unique to effortful cognitive processing versus manipulation of motivationally relevant information. We then assessed the association between inhibitory control and relative expression of these two neural patterns in an independent resting state dataset from the Nathan Kline Institute-Rockland lifespan sample (N = 247). As hypothesized, the relation between inhibition and intrinsic functional brain architecture varied as a function of age and affective functioning. Among those with superior affective functioning, better inhibitory control in adolescence and early adulthood was associated with stronger resting state expression of the brain pattern that typified processing of motivationally salient information. The opposite effect emerged beyond the age of 49. Among individuals with poorer affective functioning, a significant link between inhibition and brain architecture emerged only before the age of 28. In this group, superior inhibition was associated with stronger resting state expression of the neural pattern that typified effortful cognitive processing. Our results thus imply that motivational relevance makes a unique contribution to superior cognitive functioning during earlier life stages. However, its relevance to higher-order mentation decreases with aging and increased prevalence of mood-related problems, which raises the possibility that patterns of neurobehavioral responsiveness to motivational salience may constitute sensitive markers of successful lifespan development.
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Affiliation(s)
- Raluca Petrican
- Rotman Research Institute, 3560 Bathurst Street, Toronto, Ontario M6A 2E1, Canada.
| | - Cheryl L Grady
- Rotman Research Institute and Departments of Psychology and Psychiatry, University of Toronto, M6A 2E1, Canada
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Liao A, Walker R, Carmody TJ, Cooper C, Shaw MA, Grannemann BD, Adams P, Bruder GE, McInnis MG, Webb CA, Dillon DG, Pizzagalli DA, Phillips ML, Kurian BT, Fava M, Parsey RV, McGrath PJ, Weissman MM, Trivedi MH. Anxiety and anhedonia in depression: Associations with neuroticism and cognitive control. J Affect Disord 2019; 245:1070-1078. [PMID: 30699849 PMCID: PMC9667857 DOI: 10.1016/j.jad.2018.11.072] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 10/10/2018] [Accepted: 11/10/2018] [Indexed: 01/02/2023]
Abstract
BACKGROUND Despite the fact that higher levels of anxiety and anhedonia in Major Depressive Disorder (MDD) are linked to poorer treatment outcomes, mechanisms contributing to these clinical presentations remain unclear. Neuroticism, impaired cognitive control, and blunted reward learning may be critical processes involved in MDD and may help to explain symptoms of anxiety and anhedonia. METHODS Using baseline data from patients with early-onset MDD (N = 296) in the Establishing Moderators and Biosignatures of Antidepressant Response in Clinical Care (EMBARC) trial, we conducted a path analysis to model relationships between neuroticism, cognitive control, and reward learning to levels of anxiety and anhedonia. RESULTS Neuroticism was positively associated with both anhedonia (standardized coefficient = 0.26, p < .001) and anxiety (standardized coefficient = 0.40, p < .001). Cognitive control was negatively associated with anxiety (standardized coefficient = -0.18, p < .05). Reward learning was not significantly associated with either anxiety or anhedonia. LIMITATIONS Extraneous variables not included in the model may have even more influence in explaining symptoms of anxiety and anhedonia. Restricted range in these variables may have attenuated some of the hypothesized relationships. Most important, because this was a cross-sectional analysis in a currently depressed sample, we cannot draw any causal conclusions without experimental and longitudinal data. CONCLUSIONS These cross-sectional findings suggest that neuroticism may contribute to anxiety and anhedonia in patients with early onset and either chronic or recurrent MDD, while enhanced cognitive control may protect against anxiety.
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Affiliation(s)
- Allen Liao
- Department of Psychiatry, University of Texas Southwestern Medical Center
| | - Robrina Walker
- Department of Psychiatry, University of Texas Southwestern Medical Center
| | - Thomas J. Carmody
- Department of Psychiatry, University of Texas Southwestern Medical Center
| | - Crystal Cooper
- Department of Psychiatry, University of Texas Southwestern Medical Center
| | | | | | - Phil Adams
- Department of Psychiatry, Columbia University
| | | | | | | | | | | | | | - Benji T. Kurian
- Department of Psychiatry, University of Texas Southwestern Medical Center
| | | | - Ramin V. Parsey
- Department of Psychiatry, Stonybrook University School of Medicine
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Abstract
A lack of motivation and anhedonia represent frequent and pervasive symptoms in depression, although with poor specificity. Historically described as a response bias, reward-related impairments in depression may account for the important aspects of the cognitive impairments associated with diagnosis of major depressive disorder. Reward processing is a broad psychological construct that can be parsed into 3 distinct components known as "reinforcement learning" (learning), "reward responsiveness" (liking), and "motivation to obtain a reward" (wanting). Depressed patients respond hyposensitively to reward and maladaptively to punishment: this pattern is related to a dysfunction in the frontostriatal systems modulated by the monoamine systems; seems to be observed in medicated and unmedicated patients with depression and in healthy individuals with high levels of anhedonia; and could be observed in patients with a history of depression, even when in full remission. Considered to be cognitive impairments, reward-related-impairments may also constitute part of an underlying neurobiological vulnerability to major depressive disorder (MDD). For example, the reward-related impairment is state dependent and, more or less, correlated with symptom severity in some studies but has also been proposed as being trait like, with endophenotype characteristics, possibly contributing to the persistence of the disease or treatment resistance. The 3 core aspects of reward processing have specific neurobiological correlates that involve the ventral and dorsal striatum, lateral habenula, ventral tegmental area, orbitofrontal cortex, anterior cingulate cortex, and ventromedial and dorsolateral prefrontal cortex. These structures underline the important role of the dopaminergic mesolimbic pathway, but glutamate and serotonin could also have an important role, at least in some aspects of reward-related impairments.
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Ren H, Fabbri C, Uher R, Rietschel M, Mors O, Henigsberg N, Hauser J, Zobel A, Maier W, Dernovsek MZ, Souery D, Cattaneo A, Breen G, Craig IW, Farmer AE, McGuffin P, Lewis CM, Aitchison KJ. Genes associated with anhedonia: a new analysis in a large clinical trial (GENDEP). Transl Psychiatry 2018; 8:150. [PMID: 30104601 PMCID: PMC6089928 DOI: 10.1038/s41398-018-0198-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 02/17/2018] [Accepted: 03/26/2018] [Indexed: 12/14/2022] Open
Abstract
A key feature of major depressive disorder (MDD) is anhedonia, which is a predictor of response to antidepressant treatment. In order to shed light on its genetic underpinnings, we conducted a genome-wide association study (GWAS) followed by investigation of biological pathway enrichment using an anhedonia dimension for 759 patients with MDD in the GENDEP study. The GWAS identified 18 SNPs associated at genome-wide significance with the top one being an intronic SNP (rs9392549) in PRPF4B (pre-mRNA processing factor 4B) located on chromosome 6 (P = 2.07 × 10-9) while gene-set enrichment analysis returned one gene ontology term, axon cargo transport (GO: 0008088) with a nominally significant P value (1.15 × 10-5). Furthermore, our exploratory analysis yielded some interesting, albeit not statistically significant genetic correlation with Parkinson's Disease and nucleus accumbens gray matter. In addition, polygenic risk scores (PRSs) generated from our association analysis were found to be able to predict treatment efficacy of the antidepressants in this study. In conclusion, we found some markers significantly associated with anhedonia, and some suggestive findings of related pathways and biological functions, which could be further investigated in other studies.
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Affiliation(s)
- Hongyan Ren
- Psychiatry and Medical Genetics, University of Alberta, Edmonton, AB, Canada
| | - Chiara Fabbri
- MRC Social, Genetic and Developmental Psychiatry Centre, King's College London, London, UK
| | - Rudolf Uher
- Psychiatry Department, Dalhousie University, Halifax, NS, Canada
| | - Marcella Rietschel
- Division of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Mannheim, Germany
| | - Ole Mors
- Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Neven Henigsberg
- Croatian Institute for Brain Research, University of Zagreb, Zagreb, Croatia
| | - Joanna Hauser
- Psychiatry Department, University of Poznan, Poznan, Poland
| | - Astrid Zobel
- Psychiatry Department, University of Bonn, Bonn, Germany
| | - Wolfgang Maier
- Psychiatry Department, University of Bonn, Bonn, Germany
| | - Mojca Z Dernovsek
- University Psychiatric Clinic, University of Ljubliana, Ljubljana, Slovenia
| | - Daniel Souery
- Psychological Medicine, Free University of Brussels, Brussels, Belgium
| | | | - Gerome Breen
- MRC Social, Genetic and Developmental Psychiatry Centre, King's College London, London, UK
| | - Ian W Craig
- MRC Social, Genetic and Developmental Psychiatry Centre, King's College London, London, UK
| | - Anne E Farmer
- MRC Social, Genetic and Developmental Psychiatry Centre, King's College London, London, UK
| | - Peter McGuffin
- MRC Social, Genetic and Developmental Psychiatry Centre, King's College London, London, UK
| | - Cathryn M Lewis
- MRC Social, Genetic and Developmental Psychiatry Centre, King's College London, London, UK
| | - Katherine J Aitchison
- Psychiatry and Medical Genetics, University of Alberta, Edmonton, AB, Canada.
- MRC Social, Genetic and Developmental Psychiatry Centre, King's College London, London, UK.
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Der-Avakian A, Pizzagalli DA. Translational Assessments of Reward and Anhedonia: A Tribute to Athina Markou. Biol Psychiatry 2018; 83:932-939. [PMID: 29615189 PMCID: PMC5953796 DOI: 10.1016/j.biopsych.2018.02.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 01/24/2018] [Accepted: 02/14/2018] [Indexed: 12/18/2022]
Abstract
Loss of pleasure (clinically referred to as anhedonia), impairments in other reward-related processes such as reward learning, motivation, and reward valuation, and blunted affect characterize several mood and other psychiatric disorders. Despite the availability of many therapeutic options for these disorders, reward-related impairments remain challenging to treat and often persist despite alleviation of other symptoms. Lack of animal models of reward-related impairments and affect that have high construct and predictive validity is a key obstacle to developing novel treatments. This review highlights 1) guidelines to consider when developing translatable animal models; and 2) recent efforts to develop new reward-related assessments in humans and nonhuman animals that have been translated or back-translated from one species to another. The procedures described in this review are used to assess aspects of reward learning, motivated behavior, reward valuation, and affect. In several cases, researchers have attempted to implement task parameters that are as identical as possible to the parallel parameters used in existing cross-species tasks, with the goal of improving the translation of preclinical drug discovery findings to the clinic. In this regard, Dr. Athina Markou, who worked tirelessly throughout her career to understand and treat reward-related impairments across several psychiatric disorders, had great influence on conceptualizing the development and use of translational animal models of reward-related processes.
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Affiliation(s)
- Andre Der-Avakian
- Department of Psychiatry, University of California San Diego, La Jolla, California.
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Jordan DG, Winer ES, Salem T, Kilgore J. Longitudinal evaluation of anhedonia as a mediator of fear of positive evaluation and other depressive symptoms. Cogn Emot 2017; 32:1437-1447. [PMID: 28278732 DOI: 10.1080/02699931.2017.1289895] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Fear of positive evaluation (FPE) is experiencing dread during real or potential praise. FPE is associated with social anxiety, but its relation to depressive symptoms is unclear. Anhedonia is a core symptom of depression related to symptoms of anxiety in cross-sectional research. The current study investigated the indirect effect of FPE on depressive symptoms via anhedonia over time. One-hundred ninety-six participants completed three waves of questionnaires over a total timespan of approximately four months via Amazon's Mechanical Turk, including measures of FPE, depressive symptoms, and anticipatory and consummatory anhedonia. Findings indicated that anticipatory anhedonia at Time 2 mediated the relationship between FPE at Time 1 and depressive symptoms at Time 3. Consummatory anhedonia, however, did not. Each model was contextualised by accounting for prospective covarying relationships, such as depressive symptoms predicting the same symptoms at later waves. The constellation of findings is considered within a reward devaluation framework.
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Affiliation(s)
- D Gage Jordan
- a Department of Psychology , Mississippi State University , Starkville , MS , USA
| | - E Samuel Winer
- a Department of Psychology , Mississippi State University , Starkville , MS , USA
| | - Taban Salem
- a Department of Psychology , Mississippi State University , Starkville , MS , USA
| | - Jenna Kilgore
- a Department of Psychology , Mississippi State University , Starkville , MS , USA
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Toward Narrative Theory: Interventions for Reinforcer Pathology in Health Behavior. NEBRASKA SYMPOSIUM ON MOTIVATION 2017. [DOI: 10.1007/978-3-319-51721-6_8] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Yaseen ZS, Galynker II, Briggs J, Freed RD, Gabbay V. Functional domains as correlates of suicidality among psychiatric inpatients. J Affect Disord 2016; 203:77-83. [PMID: 27280966 PMCID: PMC4975988 DOI: 10.1016/j.jad.2016.05.066] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 05/28/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Suicide remains poorly understood and unpredictable. Addressing this challenge, this study examined the independent contributions of several research domain criteria (RDoC) constructs in relation to suicidality in patients hospitalized for acute suicide risk. Specifically, we examined anhedonia, anxiety/entrapment, and attachment disturbances, reflecting disturbances in reward processes, negative valence systems, and social processes, respectively. METHODS Anhedonia, anxiety, entrapment, and fearful attachment, were assessed quantitatively in 135 adults hospitalized for suicidality. Current suicidality and suicidal history were assessed with the Columbia Suicide Severity Rating Scale. Bivariate analyses (with significance threshold of p<.01 to account for multiple comparisons) and multivariate models examined relationships between symptom dimensions and severity of suicidal ideation (SI). We also assessed differences between patients with a history of suicide attempt and those who exhibited only suicidal ideations. RESULTS Using bivariate analyses all symptoms except for fearful attachment correlated robustly with SI (r =.37-0.50, p<.001). However, when using multivariate analyses, only anhedonia (β=.28, p=.01) and entrapment (β=.19, p=.03) were independently associated with SI across the entire sample. No functional domain measures differed between patients with history of suicide attempt versus ideation only. LIMITATIONS The reliance on self-report data and a cross-sectional design. CONCLUSIONS Disturbances in reward and threat processing may represent independent factors in the development of suicidal ideation in this high suicide risk cohort. Future studies should assess their role as risk factors.
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Affiliation(s)
- Zimri S Yaseen
- Icahn School of Medicine at Mount Sinai, Department of Psychiatry, One Gustave L. Levy Place, New York, NY 10029, USA; Mount Sinai Beth Israel, Department of Psychiatry, First Avenue at 16th Street, New York, NY 10003, USA.
| | - Igor I Galynker
- Icahn School of Medicine at Mount Sinai, Department of Psychiatry, One Gustave L. Levy Place, New York, NY 10029, USA; Mount Sinai Beth Israel, Department of Psychiatry, First Avenue at 16th Street, New York, NY 10003, USA
| | - Jessica Briggs
- Mount Sinai Beth Israel, Department of Psychiatry, First Avenue at 16th Street, New York, NY 10003, USA
| | - Rachel D Freed
- Icahn School of Medicine at Mount Sinai, Department of Psychiatry, One Gustave L. Levy Place, New York, NY 10029, USA
| | - Vilma Gabbay
- Icahn School of Medicine at Mount Sinai, Department of Psychiatry, One Gustave L. Levy Place, New York, NY 10029, USA; Nathan S. Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, NY 10962, USA
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