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Smith LT, Bishop OC, Nusslock R, Alloy LB. The path from mood symptoms to substance use: A longitudinal examination in individuals with and at risk for bipolar spectrum disorders. J Affect Disord 2024; 360:33-41. [PMID: 38815758 PMCID: PMC11185173 DOI: 10.1016/j.jad.2024.05.146] [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: 01/12/2024] [Revised: 05/02/2024] [Accepted: 05/27/2024] [Indexed: 06/01/2024]
Abstract
BACKGROUND Adolescent substance use poses a critical public health challenge, intertwined with risk-taking behavior, criminality, functional impairment, and comorbid mental and physical health issues. Adolescents with bipolar spectrum disorders (BSD) exhibit heightened susceptibility to substance use, necessitating a nuanced exploration of the bipolar-substance use relationship. METHODS This study addressed gaps in the literature by employing a prospective, longitudinal design with 443 Philadelphia-area adolescents, tracking BSD symptoms and substance use. We predicted that BSD symptoms would be associated with increases in substance use, and that these effects would be more pronounced for individuals with a BSD and those with high reward sensitivity. RESULTS Hypomanic symptoms predicted subsequent substance use, with a stronger association observed in individuals diagnosed with BSD. Contrary to expectations, depressive symptoms did not exhibit a similar relationship. Although the hypothesized moderating role of reward sensitivity was not supported, higher reward sensitivity predicted increased substance use. LIMITATIONS Symptoms and substance use are only captured for the month prior to each session due to the assessment timeline. This highlights the benefits of frequent assessments over a shorter time frame to monitor real-time changes. Alternative classification methods for reward sensitivity, such as brain or behavior-based assessments, might yield different results. CONCLUSIONS This study's contributions include evaluating substance use broadly, utilizing a longitudinal design for temporal clarity, and shifting the focus from substance use predicting mood symptoms to the inverse. The findings underscore the need for continued exploration of mood symptom predictors of substance use, emphasizing the role of reward sensitivity.
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Affiliation(s)
- Logan T Smith
- Department of Psychology and Neuroscience, Temple University, United States of America
| | - Olivia C Bishop
- Department of Psychology and Neuroscience, Temple University, United States of America
| | - Robin Nusslock
- Department of Psychology, Northwestern University, United States of America
| | - Lauren B Alloy
- Department of Psychology and Neuroscience, Temple University, United States of America.
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2
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Macoveanu J, Kjærstad HL, Halvorsen KS, Fisher PM, Vinberg M, Kessing LV, Miskowiak KW. Trajectory of reward-related abnormalities in unaffected relatives of patients with bipolar disorder - A longitudinal fMRI study. J Psychiatr Res 2024; 170:217-224. [PMID: 38157669 DOI: 10.1016/j.jpsychires.2023.12.035] [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: 04/20/2023] [Revised: 11/14/2023] [Accepted: 12/20/2023] [Indexed: 01/03/2024]
Abstract
First-degree relatives of patients with bipolar disorder are at heightened risk of mood episodes, which may be attributed to the existence of endophenotypes i.e., heritable (neuro)biological changes present in patients and their unaffected relatives (UR). In this longitudinal MRI study, we aim to investigate the trajectories of aberrant reward-related functional changes identified in UR vs healthy controls (HC). Sixty-eight UR and 65 HC of similar age and gender distribution underwent MRI at baseline while performing a card guessing task. Of these, 29 UR and 36 HC were investigated with the same protocol following a 16-month period in average. We first identified brain regions showing group differences in the neural response to expected value (EV) and reward prediction error (PE) at baseline and analyzed how the reward-related response in these regions changed over time in UR vs HC. Relative to HC at baseline, UR showed lower EV signal in the right ventrolateral prefrontal cortex (vlPFC) and paracingulate gyrus and lower PE signal in the left vlPFC and dorsomedial PFC. The trajectories of these abnormalities in UR showed a normalization of the prefrontal EV signals, whereas the PE signals which correlated with depressive symptoms remained stable over time. While the UR showed both blunted EV and PE signals, none of these abnormalities increased over time, which is consistent with the observed stable mood symptoms.
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Affiliation(s)
- Julian Macoveanu
- Neurocognition and Emotion in Affective Disorders (NEAD) Centre, Psychiatric Centre Copenhagen, Frederiksberg Hospital, Mental Health Services, Capital Region of Denmark, Denmark; Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Frederiksberg Hospital, Mental Health Services, Capital Region of Denmark, Denmark.
| | - Hanne Lie Kjærstad
- Neurocognition and Emotion in Affective Disorders (NEAD) Centre, Psychiatric Centre Copenhagen, Frederiksberg Hospital, Mental Health Services, Capital Region of Denmark, Denmark; Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Frederiksberg Hospital, Mental Health Services, Capital Region of Denmark, Denmark
| | - Kaja Sofie Halvorsen
- Neurocognition and Emotion in Affective Disorders (NEAD) Centre, Psychiatric Centre Copenhagen, Frederiksberg Hospital, Mental Health Services, Capital Region of Denmark, Denmark
| | - Patrick M Fisher
- Neurobiology Research Unit, Department of Drug Design and Pharmacology, University of Copenhagen, Denmark
| | - Maj Vinberg
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Frederiksberg Hospital, Mental Health Services, Capital Region of Denmark, Denmark; Psychiatric Research Unit, Psychiatric Centre North Zealand, Hillerød, Denmark; Department of Clinical Medicine, University of Copenhagen, Denmark
| | - Lars Vedel Kessing
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Frederiksberg Hospital, Mental Health Services, Capital Region of Denmark, Denmark; Department of Clinical Medicine, University of Copenhagen, Denmark
| | - Kamilla Woznica Miskowiak
- Neurocognition and Emotion in Affective Disorders (NEAD) Centre, Psychiatric Centre Copenhagen, Frederiksberg Hospital, Mental Health Services, Capital Region of Denmark, Denmark; Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Frederiksberg Hospital, Mental Health Services, Capital Region of Denmark, Denmark; Department of Psychology, University of Copenhagen, Denmark
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Kaiser RH, Moser AD, Neilson C, Jones J, Peterson EC, Ruzic L, Rosenberg BM, Hough CM, Sandman C, Schneck CD, Miklowitz DJ. Neurocognitive risk phenotyping to predict mood symptoms in adolescence. JOURNAL OF PSYCHOPATHOLOGY AND CLINICAL SCIENCE 2024; 133:90-102. [PMID: 38059934 PMCID: PMC10752243 DOI: 10.1037/abn0000866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/08/2023]
Abstract
Predicting mood disorders in adolescence is a challenge that motivates research to identify neurocognitive predictors of symptom expression and clinical profiles. This study used machine learning to test whether neurocognitive variables predicted future manic or anhedonic symptoms in two adolescent samples risk-enriched for lifetime mood disorders (Sample 1, n = 73, ages = 13-25, M [SD] = 19.22 [2.49] years, 68% lifetime mood disorder) or familial mood disorders (Sample 2, n = 154, ages = 13-21, M [SD] = 16.46 [1.95] years, 62% first-degree family history of mood disorder). Participants completed cognitive testing and functional magnetic resonance imaging at baseline, for behavioral and neural measures of reward processing and executive functioning. Next, participants completed a daily diary procedure for 8-16 weeks. Penalized mixed-effects models identified neurocognitive predictors of future mood symptoms and stress-reactive changes in mood symptoms. Results included the following. In both samples, adolescents showing ventral corticostriatal reward hyposensitivity and lower reward performance reported more severe stress-reactive anhedonia. Poorer executive functioning behavior was associated with heightened anhedonia overall in Sample 1, but lower stress-reactive anhedonia in both samples. In Sample 1, adolescents showing ventral corticostriatal reward hypersensitivity and poorer executive functioning reported more severe stress-reactive manic symptoms. Clustering analyses identified, and replicated, five neurocognitive subgroups. Adolescents characterized by neural or behavioral reward hyposensitivities together with average-to-poor executive functioning reported unipolar symptom profiles. Adolescents showing neural reward hypersensitivity together with poor behavioral executive functioning reported a bipolar symptom profile (Sample 1 only). Together, neurocognitive phenotypes may hold value for predicting symptom expression and profiles of mood pathology. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Roselinde H Kaiser
- Research on Affective Disorders and Development (RADD) Lab, Department of Psychology and Neuroscience, University of Colorado Boulder
| | - Amelia D Moser
- Research on Affective Disorders and Development (RADD) Lab, Department of Psychology and Neuroscience, University of Colorado Boulder
| | - Chiara Neilson
- Institute of Cognitive Science, University of Colorado Boulder
| | - Jenna Jones
- Institute of Cognitive Science, University of Colorado Boulder
| | - Elena C Peterson
- Research on Affective Disorders and Development (RADD) Lab, Department of Psychology and Neuroscience, University of Colorado Boulder
| | - Luke Ruzic
- Institute of Cognitive Science, University of Colorado Boulder
| | | | | | | | | | - David J Miklowitz
- Department of Psychiatry, Semel Institute, University of California, Los Angeles
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Walsh RFL, Klugman J, Moriarity DP, Titone MK, Ng TH, Goel N, Alloy LB. Reward sensitivity and social rhythms during goal-striving: An ecological momentary assessment investigation of bipolar spectrum disorders. J Affect Disord 2024; 344:510-518. [PMID: 37852584 PMCID: PMC10842638 DOI: 10.1016/j.jad.2023.10.114] [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: 06/29/2023] [Revised: 10/12/2023] [Accepted: 10/15/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND The reward/circadian rhythm model of bipolar spectrum disorders (BSDs) posits that when individuals with hypersensitive reward systems encounter reward-relevant events, they experience social and circadian rhythm disruption, leading to mood symptoms. The aim of the current study is to test an element of this theoretical model by investigating changes in social rhythms during and after an ecologically-valid reward-relevant event and evaluating whether the strength of these associations differ by trait reward sensitivity and BSD diagnostic group. METHODS Young adults from three groups (low BSD risk with moderate reward sensitivity [MRew], high BSD risk with high reward sensitivity [HRew], and high reward sensitivity with BSD [HRew+BSD]) completed a reward responsiveness task and 20-day ecological momentary assessment study structured around a participant-specific goal occurring on day 15. Social rhythm disruption (SRD) and social rhythm regularity (SRR) were assessed daily. Multilevel models examined whether reward sensitivity and group moderated associations between study phase (baseline [days 1-5], goal-striving [days 16-20], or outcome [days 16-20]) and social rhythms. RESULTS Participants experienced greater SRD after the goal-striving event during the outcome phase, compared to the baseline phase. The HRew+BSD group had significant decreases in SRR during the outcome phase, and this pattern differed significantly from the low-risk and high-risk groups. Greater task reward responsiveness also was associated with significant decreases in SRR during the outcome phase. LIMITATIONS This study did not test whether social rhythm irregularity was associated with subsequent mood change. CONCLUSIONS Participants exhibited social rhythm changes over the course of this ecologically valid goal-striving period, providing evidence for the interplay between reward-activating events and social rhythms. The HRew+BSD group showed a distinct pattern in which their social rhythms were more irregular after completing reward-relevant goal-striving that was not observed for the low-BSD risk or high-BSD risk groups. These findings provide additional support for Interpersonal and Social Rhythms Therapy.
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Affiliation(s)
- Rachel F L Walsh
- Department of Psychology and Neuroscience, Temple University, United States of America
| | - Joshua Klugman
- Department of Psychology and Neuroscience, Temple University, United States of America; Department of Sociology, Temple University, United States of America
| | - Daniel P Moriarity
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, United States of America
| | - Madison K Titone
- VA San Diego Healthcare System, United States of America; University of California San Diego, United States of America
| | - Tommy H Ng
- Department of Psychiatry, Weill Cornell Medicine College, United States of America
| | - Namni Goel
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, United States of America
| | - Lauren B Alloy
- Department of Psychology and Neuroscience, Temple University, United States of America.
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5
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Soehner AM, Wallace ML, Edmiston K, Chase HW, Lockovich J, Aslam H, Stiffler R, Graur S, Skeba A, Bebko G, Benjamin OE, Wang Y, Phillips ML. Neurobehavioral Reward and Sleep-Circadian Profiles Predict Present and Next-Year Mania/Hypomania Symptoms. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2023; 8:1251-1261. [PMID: 37230386 PMCID: PMC10665544 DOI: 10.1016/j.bpsc.2023.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 04/21/2023] [Accepted: 04/22/2023] [Indexed: 05/27/2023]
Abstract
BACKGROUND Heightened reward sensitivity/impulsivity, related neural activity, and sleep-circadian disruption are important risk factors for bipolar spectrum disorders, the defining feature of which is mania/hypomania. Our goal was to identify neurobehavioral profiles based on reward and sleep-circadian features and examine their specificity to mania/hypomania versus depression vulnerability. METHODS At baseline, a transdiagnostic sample of 324 adults (18-25 years) completed trait measures of reward sensitivity (Behavioral Activation Scale), impulsivity (UPPS-P-Negative Urgency), and a functional magnetic resonance imaging card-guessing reward task (left ventrolateral prefrontal activity to reward expectancy, a neural correlate of reward motivation and impulsivity, was extracted). At baseline, 6-month follow-up, and 12-month follow-up, the Mood Spectrum Self-Report Measure - Lifetime Version assessed lifetime predisposition to subthreshold-syndromal mania/hypomania, depression, and sleep-circadian disturbances (insomnia, sleepiness, reduced sleep need, rhythm disruption). Mixture models derived profiles from baseline reward, impulsivity, and sleep-circadian variables. RESULTS Three profiles were identified: 1) healthy (no reward or sleep-circadian disruption; n = 162); 2) moderate-risk (moderate reward and sleep-circadian disruption; n = 109); and 3) high-risk (high impulsivity and sleep-circadian disruption; n = 53). At baseline, the high-risk group had significantly higher mania/hypomania scores than the other groups but did not differ from the moderate-risk group in depression scores. Over the follow-up period, the high-risk and moderate-risk groups exhibited elevated mania/hypomania scores, whereas depression scores increased at a faster rate in the healthy group than in the other groups. CONCLUSIONS Cross-sectional and next-year predisposition to mania/hypomania is associated with a combination of heightened reward sensitivity and impulsivity, related reward circuitry activity, and sleep-circadian disturbances. These measures can be used to detect mania/hypomania risk and provide targets to guide and monitor interventions.
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Affiliation(s)
- Adriane M Soehner
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
| | - Meredith L Wallace
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Kale Edmiston
- Department of Psychiatry, University of Massachusetts Chan Medical School, Worcester, Massachusetts
| | - Henry W Chase
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Jeannette Lockovich
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Haris Aslam
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Richelle Stiffler
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Simona Graur
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Alex Skeba
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Genna Bebko
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Osasumwen E Benjamin
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Yiming Wang
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Mary L Phillips
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Department of Biostatistics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Department of Statistics, University of Pittsburgh, Pittsburgh, Pennsylvania
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6
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Smith LT, Walsh RFL, Goel N, Alloy LB. Social jetlag and trajectories of mood symptoms and reward responsiveness in individuals at low-risk, high-risk, and with bipolar spectrum disorders: An ecological momentary assessment study. Psychiatry Res 2023; 329:115499. [PMID: 37774444 PMCID: PMC10841532 DOI: 10.1016/j.psychres.2023.115499] [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: 02/09/2023] [Revised: 08/22/2023] [Accepted: 09/25/2023] [Indexed: 10/01/2023]
Abstract
A specific type of sleep disruption, social jetlag, involves an incongruence of sleep time between weekends and weekdays. This study investigated relationships between social jetlag and mood symptom lability and trajectories of daily reward responsiveness and mood symptoms. Participants (N = 130) from three groups (moderate reward sensitivity, high reward sensitivity, and high reward sensitivity with a diagnosed bipolar spectrum disorder [BSD]) were recruited from an ongoing longitudinal study based on their self-reported reward sensitivity and a diagnostic interview. For this study, they completed 20 days of ecological momentary assessment (EMA) of reward responsiveness and mood symptoms and a daily sleep diary. Social jetlag was significantly associated with differences in trajectories of depressive symptoms between groups. Specifically, greater social jetlag was associated with a greater increase in depressive symptoms over the 20 days for participants in the high reward sensitivity and BSD groups compared to the moderate reward sensitivity group. Social jetlag also was significantly associated with depressive symptom lability during the EMA period, but this finding was reduced to a trend toward significance when controlling for self-reported sleep duration. The study adds to the literature with methodological strengths including the EMA design and assessment of symptom and reward responsiveness trajectories.
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Affiliation(s)
- Logan T Smith
- Department of Psychology and Neuroscience, Temple University, Weiss Hall, 1701 N 13th St, Philadelphia, PA 19122, United States
| | - Rachel F L Walsh
- Department of Psychology and Neuroscience, Temple University, Weiss Hall, 1701 N 13th St, Philadelphia, PA 19122, United States
| | - Namni Goel
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States
| | - Lauren B Alloy
- Department of Psychology and Neuroscience, Temple University, Weiss Hall, 1701 N 13th St, Philadelphia, PA 19122, United States.
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Pouchon A, Vinckier F, Dondé C, Gueguen MC, Polosan M, Bastin J. Reward and punishment learning deficits among bipolar disorder subtypes. J Affect Disord 2023; 340:694-702. [PMID: 37591352 DOI: 10.1016/j.jad.2023.08.075] [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: 01/24/2023] [Revised: 07/24/2023] [Accepted: 08/14/2023] [Indexed: 08/19/2023]
Abstract
BACKGROUND Reward sensitivity is an essential dimension related to mood fluctuations in bipolar disorder (BD), but there is currently a debate around hypersensitivity or hyposensitivity hypotheses to reward in BD during remission, probably related to a heterogeneous population within the BD spectrum and a lack of reward bias evaluation. Here, we examine reward maximization vs. punishment avoidance learning within the BD spectrum during remission. METHODS Patients with BD-I (n = 45), BD-II (n = 34) and matched (n = 30) healthy controls (HC) were included. They performed an instrumental learning task designed to dissociate reward-based from punishment-based reinforcement learning. Computational modeling was used to identify the mechanisms underlying reinforcement learning performances. RESULTS Behavioral results showed a significant reward learning deficit across BD subtypes compared to HC, captured at the computational level by a lower sensitivity to rewards compared to punishments in both BD subtypes. Computational modeling also revealed a higher choice randomness in BD-II compared to BD-I that reflected a tendency of BD-I to perform better during punishment avoidance learning than BD-II. LIMITATIONS Our patients were not naive to antipsychotic treatment and were not euthymic (but in syndromic remission) according to the International Society for Bipolar Disorder definition. CONCLUSIONS Our results are consistent with the reward hyposensitivity theory in BD. Computational modeling suggests distinct underlying mechanisms that produce similar observable behaviors, making it a useful tool for distinguishing how symptoms interact in BD versus other disorders. In the long run, a better understanding of these processes could contribute to better prevention and management of BD.
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Affiliation(s)
- Arnaud Pouchon
- Univ. Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Grenoble Institut Neurosciences, 38000 Grenoble, France; Department of Psychiatry, CHU Grenoble Alpes, 38000 Grenoble, France.
| | - Fabien Vinckier
- Motivation, Brain & Behavior (MBB) lab, Institut du Cerveau (ICM), Hôpital Pitié-Salpêtrière, F-75013 Paris, France; Université Paris Cité, F-75006 Paris, France; Department of Psychiatry, Service Hospitalo-Universitaire, GHU Paris Psychiatrie & Neurosciences, F-75014 Paris, France
| | - Clément Dondé
- Univ. Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Grenoble Institut Neurosciences, 38000 Grenoble, France; Department of Psychiatry, CHU Grenoble Alpes, 38000 Grenoble, France; Department of Psychiatry, CH Alpes-Isère, 38000 Saint-Egrève, France
| | - Maëlle Cm Gueguen
- Department of Psychiatry, University Behavioral Health Care & the Brain Health Institute, Rutgers University-New Brunswick, Piscataway, USA; Laureate Institute for Brain Research, Tulsa, OK 74136 USA
| | - Mircea Polosan
- Univ. Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Grenoble Institut Neurosciences, 38000 Grenoble, France; Department of Psychiatry, CHU Grenoble Alpes, 38000 Grenoble, France
| | - Julien Bastin
- Univ. Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, 38000 Grenoble, France.
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Alloy LB, Walsh RFL, Smith LT, Maddox MA, Olino TM, Zee PC, Nusslock R. Circadian, Reward, and Emotion Systems in Teens prospective longitudinal study: protocol overview of an integrative reward-circadian rhythm model of first onset of bipolar spectrum disorder in adolescence. BMC Psychiatry 2023; 23:602. [PMID: 37592214 PMCID: PMC10436678 DOI: 10.1186/s12888-023-05094-z] [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: 06/22/2023] [Accepted: 08/08/2023] [Indexed: 08/19/2023] Open
Abstract
BACKGROUND Bipolar spectrum disorders (BSDs) are associated with a heightened sensitivity to rewards and elevated reward-related brain function in cortico-striatal circuitry. A separate literature documents social and circadian rhythm disruption in BSDs. Recently, integrated reward-circadian models of BSDs have been proposed. These models draw on work indicating that the two systems influence each other and interact to affect mood functioning. When dysregulated, reward and circadian system signaling may combine to form a positive feedback loop, whereby dysregulation in one system exacerbates dysregulation in the other. Project CREST (Circadian, Reward, and Emotion Systems in Teens) provides a first systematic test of reward-circadian dysregulation as a synergistic and dynamic vulnerability for first onset of BSD and increases in bipolar symptoms during adolescence. METHODS This NIMH-funded R01 study is a 3-year prospective, longitudinal investigation of approximately 320 community adolescents from the broader Philadelphia area, United States of America. Eligible participants must be 13-16 years old, fluent in English, and without a prior BSD or hypomanic episode. They are being selected along the entire dimension of self-reported reward responsiveness, with oversampling at the high tail of the dimension in order to increase the likelihood of BSD onsets. At Times 1-6, every 6 months, participants will complete assessments of reward-relevant and social rhythm disruption life events and self-report and diagnostic assessments of bipolar symptoms and episodes. Yearly, at Times 1, 3, and 5, participants also will complete self-report measures of circadian chronotype (morningness-eveningness) and social rhythm regularity, a salivary dim light melatonin onset (DLMO) procedure to assess circadian phase, self-report, behavioral, and neural (fMRI) assessments of monetary and social reward responsiveness, and a 7-day ecological momentary assessment (EMA) period. During each EMA period, participants will complete continuous measures of sleep/wake and activity (actigraphy), a daily sleep diary, and three within-day (morning, afternoon, evening) measures of life events coded for reward-relevance and social rhythm disruption, monetary and social reward responsiveness, positive and negative affect, and hypo/manic and depressive symptoms. The fMRI scan will occur on the day before and the DLMO procedure will occur on the first evening of the 7-day EMA period. DISCUSSION This study is an innovative integration of research on multi-organ systems involved in reward and circadian signaling in understanding first onset of BSD in adolescence. It has the potential to facilitate novel pharmacological, neural, and behavioral interventions to treat, and ideally prevent, bipolar conditions.
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Affiliation(s)
- Lauren B Alloy
- Department of Psychology and Neuroscience, Temple University, Philadelphia, USA.
| | - Rachel F L Walsh
- Department of Psychology and Neuroscience, Temple University, Philadelphia, USA
| | - Logan T Smith
- Department of Psychology and Neuroscience, Temple University, Philadelphia, USA
| | - Mackenzie A Maddox
- Department of Psychology and Neuroscience, Temple University, Philadelphia, USA
| | - Thomas M Olino
- Department of Psychology and Neuroscience, Temple University, Philadelphia, USA
| | - Phyllis C Zee
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Evanston, USA
| | - Robin Nusslock
- Department of Psychology, Northwestern University, Evanston, USA
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9
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Burani K, Brush CJ, Shields GS, Klein DN, Nelson B, Slavich GM, Hajcak G. Cumulative lifetime acute stressor exposure interacts with reward responsiveness to predict longitudinal increases in depression severity in adolescence. Psychol Med 2023; 53:4507-4516. [PMID: 37698514 PMCID: PMC10388334 DOI: 10.1017/s0033291722001386] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 04/11/2022] [Accepted: 04/27/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND Life stress and blunted reward processing each have been associated with the onset and maintenance of major depressive disorder. However, much of this work has been cross-sectional, conducted in separate lines of inquiry, and focused on recent life stressor exposure, despite the fact that theories of depression posit that stressors can have cumulative effects over the lifespan. To address these limitations, we investigated whether acute and chronic stressors occurring over the lifespan interacted with blunted reward processing to predict increases in depression over time in healthy youth. METHOD Participants were 245 adolescent girls aged 8-14 years old (Mage = 12.4, s.d. = 1.8) who were evaluated at baseline and two years later. The reward positivity (RewP), an event-related potential measure of reward responsiveness, was assessed at baseline using the doors task. Cumulative lifetime exposure to acute and chronic stressors was assessed two years later using the Stress and Adversity Inventory for Adolescents (Adolescent STRAIN). Finally, depressive symptoms were assessed at both baseline and follow-up using the Children's Depression Inventory. RESULTS As hypothesized, greater lifetime acute stressor exposure predicted increases in depressive symptoms over two years, but only for youth exhibiting a blunted RewP. This interaction, however, was not found for chronic stressors. CONCLUSIONS Lifetime acute stressor exposure may be particularly depressogenic for youth exhibiting a blunted RewP. Conversely, a robust RewP may be protective in the presence of greater acute lifetime stressor exposure.
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Affiliation(s)
- Kreshnik Burani
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - C. J. Brush
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Grant S. Shields
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA
| | - Daniel N. Klein
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Brady Nelson
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - George M. Slavich
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Greg Hajcak
- Department of Psychology, Florida State University, Tallahassee, FL, USA
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10
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Kaiser RH, Moser AD, Neilson C, Peterson EC, Jones J, Hough CM, Rosenberg BM, Sandman CF, Schneck CD, Miklowitz DJ, Friedman NP. Mood Symptom Dimensions and Developmental Differences in Neurocognition in Adolescence. Clin Psychol Sci 2023; 11:308-325. [PMID: 37309523 PMCID: PMC10259862 DOI: 10.1177/21677026221111389] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
Adolescence is critical period of neurocognitive development as well as increased prevalence of mood pathology. This cross-sectional study replicated developmental patterns of neurocognition and tested whether mood symptoms moderated developmental effects. Participants were 419 adolescents (n=246 with current mood disorders) who completed reward learning and executive functioning tasks, and reported on age, puberty, and mood symptoms. Structural equation modeling revealed a quadratic relationship between puberty and reward learning performance that was moderated by symptom severity: in early puberty, adolescents reporting higher manic symptoms exhibited heightened reward learning performance (better maximizing of rewards on learning tasks), whereas adolescents reporting elevated anhedonia showed blunted reward learning performance. Models also showed a linear relationship between age and executive functioning that was moderated by manic symptoms: adolescents reporting higher mania showed poorer executive functioning at older ages. Findings suggest neurocognitive development is altered in adolescents with mood pathology and suggest directions for longitudinal studies.
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Affiliation(s)
- Roselinde H Kaiser
- Department of Psychology and Neuroscience, University of Colorado Boulder
- Institute of Cognitive Science, University of Colorado Boulder
- Renée Crown Wellness Institute, University of Colorado Boulder
| | - Amelia D Moser
- Department of Psychology and Neuroscience, University of Colorado Boulder
- Institute of Cognitive Science, University of Colorado Boulder
| | - Chiara Neilson
- Department of Psychology and Neuroscience, University of Colorado Boulder
- Institute of Cognitive Science, University of Colorado Boulder
| | - Elena C Peterson
- Department of Psychology and Neuroscience, University of Colorado Boulder
| | - Jenna Jones
- Department of Psychology and Neuroscience, University of Colorado Boulder
- Institute of Cognitive Science, University of Colorado Boulder
| | | | | | | | | | | | - Naomi P Friedman
- Department of Psychology and Neuroscience, University of Colorado Boulder
- Institute of Cognitive Science, University of Colorado Boulder
- Institute of Behavioral Genetics, University of Colorado Boulder
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11
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Walsh RFL, Smith LT, Klugman J, Titone MK, Ng TH, Goel N, Alloy LB. An examination of bidirectional associations between physical activity and mood symptoms among individuals diagnosed and at risk for bipolar spectrum disorders. Behav Res Ther 2023; 161:104255. [PMID: 36682182 PMCID: PMC9909602 DOI: 10.1016/j.brat.2023.104255] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 09/19/2022] [Accepted: 01/15/2023] [Indexed: 01/19/2023]
Abstract
OBJECTIVES Activation, a construct including energy and activity, is a central feature of Bipolar Spectrum Disorders (BSDs). Prior research found motor activity is associated with affect, and this relationship may be stronger for individuals with BSDs. The aims of this study were to investigate bidirectional relationships between physical activity and mood and evaluate whether bipolar risk status moderated potential associations. METHODS Young adults at low-risk, high-risk, and diagnosed with BSD participated in a 20-day EMA study in which they wore an actiwatch to measure physical activity and sleep/wake cycles. They also reported depressive and hypo/manic symptoms three times daily. Multilevel linear models were estimated to examine how bipolar risk group moderated bidirectional relationships between physical activity and mood symptoms at within-day and between-day timescales. RESULTS Physical activity was significantly associated with subsequent mood symptoms at the within-day level. The relationship between physical activity and depressive symptoms was moderated by BSD risk group. An increase in physical activity resulted in a greater reduction of depressive symptoms for the BSD group compared to the low-risk and high-risk groups. CONCLUSIONS Interventions targeting activity like behavioral activation may improve residual inter-episode mood symptoms.
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Affiliation(s)
- Rachel F L Walsh
- Department of Psychology and Neuroscience, Temple University, USA
| | - Logan T Smith
- Department of Psychology and Neuroscience, Temple University, USA
| | - Joshua Klugman
- Department of Psychology and Neuroscience, Temple University, USA; Department of Sociology, Temple University, USA
| | - Madison K Titone
- VA San Diego Healthcare System, USA; University of California San Diego, USA
| | - Tommy H Ng
- Department of Psychiatry, Weill Cornell Medicine College, USA
| | - Namni Goel
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, USA
| | - Lauren B Alloy
- Department of Psychology and Neuroscience, Temple University, USA.
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12
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Carroll AL, Damme KS, Alloy LB, Bart CP, Ng TH, Titone MK, Chein J, Cichocki AC, Armstrong CC, Nusslock R. Risk for bipolar spectrum disorders associated with positive urgency and orbitofrontal cortical grey matter volume. Neuroimage Clin 2022; 36:103225. [PMID: 36242853 PMCID: PMC9668630 DOI: 10.1016/j.nicl.2022.103225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 10/03/2022] [Accepted: 10/08/2022] [Indexed: 11/07/2022]
Abstract
Bipolar spectrum disorders (BSDs) are associated with reward hypersensitivity, impulsivity, and structural abnormalities within the brain's reward system. Using a behavioral high-risk study design based on reward sensitivity, this paper had two primary objectives: 1) investigate whether elevated positive urgency, the tendency to act rashly when experiencing extreme positive affect, is a risk for or correlate of BSDs, and 2) examine the nature of the relationship between positive urgency and grey matter volume in fronto-striatal reward regions, among individuals at differential risk for BSD. Young adults (ages 18-28) screened to be moderately reward sensitive (MReward; N = 42), highly reward sensitive (HReward; N = 48), or highly reward sensitive with a lifetime BSD (HReward + BSD; N = 32) completed a structural MRI scan and the positive urgency subscale of the UPPS-P scale. Positive urgency scores varied with BSD risk (MReward < HReward < HReward + BSD; ps≤0.05), and positive urgency interacted with BSD risk group in predicting lateral OFC volume (p <.001). Specifically, the MReward group showed a negative relationship between positive urgency and lateral OFC volume. By contrast, there was no relationship between positive urgency and lateral OFC grey matter volume among the HReward and HReward + BSD groups. The results suggest that heightened trait positive urgency is a pre-existing vulnerability for BSD that worsens with illness onset, and there is a distinct relationship between positive urgency and lateral OFC volume among individuals at high versus low risk for BSD. These findings have implications for understanding the expression and development of impulsivity in BSDs.
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Affiliation(s)
- Ann L. Carroll
- Department of Psychology, Northwestern University, Evanston IL, United States,Corresponding author at: Northwestern University, Department of Psychology, Swift Hall, 2029 Sheridan Road, Evanston, IL 60208, United States.
| | - Katherine S.F. Damme
- Department of Psychology, Northwestern University, Evanston IL, United States,Institute for Innovation in Developmental Sciences, Chicago IL, United States
| | - Lauren B. Alloy
- Department of Psychology and Neuroscience, Temple University, Philadelphia PA, United States
| | - Corinne P. Bart
- Department of Psychology and Neuroscience, Temple University, Philadelphia PA, United States
| | - Tommy H. Ng
- Department of Psychology and Neuroscience, Temple University, Philadelphia PA, United States
| | - Madison K. Titone
- Department of Psychology and Neuroscience, Temple University, Philadelphia PA, United States
| | - Jason Chein
- Department of Psychology and Neuroscience, Temple University, Philadelphia PA, United States
| | - Anna C. Cichocki
- Department of Psychology, Northwestern University, Evanston IL, United States
| | - Casey C. Armstrong
- Department of Psychology, Northwestern University, Evanston IL, United States
| | - Robin Nusslock
- Department of Psychology, Northwestern University, Evanston IL, United States,Institute for Policy Research, Northwestern University, Evanston IL, United States
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13
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Chat IKY, Dunning EE, Bart CP, Carroll AL, Grehl MM, Damme KS, Abramson LY, Nusslock R, Alloy LB. The Interplay between Reward-Relevant Life Events and Trait Reward Sensitivity in Neural Responses to Reward Cues. Clin Psychol Sci 2022; 10:869-884. [PMID: 36381350 PMCID: PMC9662616 DOI: 10.1177/21677026211056627] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/01/2023]
Abstract
The reward hypersensitivity model posits that trait reward hypersensitivity should elicit hyper/hypo approach motivation following exposure to recent life events that activate (goal-striving and goal-attainment) or deactivate (goal-failure) the reward system, respectively. To test these hypotheses, eighty-seven young adults with high (HRew) versus moderate (MRew) trait reward sensitivity reported frequency of life events via the Life Event Interview. Brain activation was assessed during the fMRI Monetary Incentive Delay task. Greater exposure to goal-striving events was associated with higher nucleus accumbens (NAc) reward anticipation among HRew participants and lower orbitofrontal cortex (OFC) reward anticipation among MRew participants. Greater exposure to goal-failure events was associated with higher NAc and OFC reward anticipation only among HRew participants. This study demonstrated different neural reward anticipation (but not outcome) following reward-relevant events for HRew versus MRew individuals. Trait reward sensitivity and reward-relevant life events may jointly modulate reward-related brain function, with implications for understanding psychopathology.
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Affiliation(s)
- Iris Ka-Yi Chat
- Department of Psychology, Temple University, Philadelphia, Pennsylvania
| | - Erin E. Dunning
- Department of Psychology, Temple University, Philadelphia, Pennsylvania
| | - Corinne P. Bart
- Department of Psychology, Temple University, Philadelphia, Pennsylvania
| | - Ann L. Carroll
- Department of Psychology, Northwestern University, Evanston, Illinois
| | - Mora M. Grehl
- Department of Psychology, Temple University, Philadelphia, Pennsylvania
| | | | | | - Robin Nusslock
- Department of Psychology, Northwestern University, Evanston, Illinois
| | - Lauren B. Alloy
- Department of Psychology, Temple University, Philadelphia, Pennsylvania
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14
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Yan M, Hodgdon EA, Yang R, Yu Q, Inagaki TK, Wiggins JL. Neural correlates of attachment in adolescents with trauma: a preliminary study on frustrative non-reward. Soc Cogn Affect Neurosci 2022; 17:1091-1100. [PMID: 35587099 PMCID: PMC9714423 DOI: 10.1093/scan/nsac038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 04/14/2022] [Accepted: 05/18/2022] [Indexed: 01/12/2023] Open
Abstract
Despite the proposed early life origins of attachment style and its implications for risk for psychopathology, little is known about its neurodevelopmental course. Adolescence represents a key transition period when neural substrates of emotion regulation and reward undergo dramatic maturational shifts. Thus, maladaptive coping strategies associated with insecure attachment styles may have an exaggerated effect during adolescence. The current study, therefore, examined the neural correlates of insecure attachment in a diverse sample of adolescents using a frustrative non-reward task (i.e. repeatedly being denied an expected reward). Although there were no significant interactions in the whole-brain activation averaged over the course of the task, the use of complementary analytic approaches (connectivity, change in activation over the course of the task) revealed widespread alterations associated with avoidant attachment during the immediate reaction to, and ensuing recovery from, being denied a reward. Most strikingly, increased avoidant attachment, adjusting for anxious attachment, predicted functional connectivity and change in activity over time in amygdala-prefrontal and frontostriatal networks to reward blocked vs received trials. These patterns were in the opposite direction compared to those exhibited by adolescents lower in avoidant attachment. The findings suggest that negative emotional experiences, such as receiving frustrating feedback, may be uniquely aversive internal experiences for avoidantly attached adolescents and provide preliminary evidence that early coping strategies may persist into adolescence in the form of altered emotion- and reward-related neural patterns.
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Affiliation(s)
- Marvin Yan
- Correspondence should be addressed to Marvin Yan, Department of Psychology, San Diego State University, 6363 Alvarado Ct., Ste 103, San Diego, CA 92120, USA. E-mail:
| | - Elizabeth A Hodgdon
- Department of Psychology, San Diego State University, San Diego, CA 92120, USA
| | - Ruiyu Yang
- Department of Psychology, San Diego State University, San Diego, CA 92120, USA
| | - Qiongru Yu
- San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, CA 92120, USA
| | - Tristen K Inagaki
- Department of Psychology, San Diego State University, San Diego, CA 92120, USA,San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, CA 92120, USA
| | - Jillian L Wiggins
- Department of Psychology, San Diego State University, San Diego, CA 92120, USA,San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, CA 92120, USA
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15
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Ka-Yi Chat I, Gepty AA, Kautz M, Giollabhui NM, Adogli ZV, Coe CL, Abramson LY, Olino TM, Alloy LB. Residence in High-Crime Neighborhoods Moderates the Association between Interleukin-6 and Social and Non-Social Reward Brain Responses. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2022; 2:273-282. [PMID: 35873737 PMCID: PMC9306340 DOI: 10.1016/j.bpsgos.2022.04.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Background Residence in high-crime neighborhoods, especially in childhood, is linked to mental health issues later. Detecting distinct neurobiological processes underlying the effects of this environmental stressor may be critical to identifying prevention and intervention targets. This study examined the relationships of levels of a circulating inflammatory protein with social and monetary reward–related brain function among adolescents who lived in high- versus low-crime neighborhoods during childhood. Methods A total of 70 participants (mean age = 16.3 years; 57% female) completed measures of inflammatory markers, depression history, and health and 2 functional magnetic resonance imaging tasks assessing responsivity to monetary and social rewards. Multivariate linear regression tested whether individuals with higher interleukin 6, an inflammatory cytokine, who also lived in neighborhoods with higher crime had distinct orbitofrontal cortex and nucleus accumbens activation to monetary reward and social acceptance. Results For adolescents who lived in neighborhoods with more crime, higher interleukin 6 was associated with higher nucleus accumbens responses to social acceptance. We did not detect significant moderating effects of neighborhood crime rates on the associations of interleukin 6 with orbitofrontal cortex responses to social acceptance or orbitofrontal cortex/nucleus accumbens activation during monetary reward anticipation or outcome. These results were obtained before and after adjusting for neighborhood income and other covariates. We did not detect significant moderating effects of neighborhood income. Conclusions High-threat residence environment and specific demands of the social context in childhood may have shaped the effect of peripheral immune activation on reward-related neural function in adolescence. The prevailing view that inflammation-associated behaviors are characterized by blunted responsiveness to reward may be oversimplistic.
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16
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Smoking as a Common Modulator of Sensory Gating and Reward Learning in Individuals with Psychotic Disorders. Brain Sci 2021; 11:brainsci11121581. [PMID: 34942883 PMCID: PMC8699526 DOI: 10.3390/brainsci11121581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 11/23/2021] [Accepted: 11/26/2021] [Indexed: 02/07/2023] Open
Abstract
Motivational and perceptual disturbances co-occur in psychosis and have been linked to aberrations in reward learning and sensory gating, respectively. Although traditionally studied independently, when viewed through a predictive coding framework, these processes can both be linked to dysfunction in striatal dopaminergic prediction error signaling. This study examined whether reward learning and sensory gating are correlated in individuals with psychotic disorders, and whether nicotine—a psychostimulant that amplifies phasic striatal dopamine firing—is a common modulator of these two processes. We recruited 183 patients with psychotic disorders (79 schizophrenia, 104 psychotic bipolar disorder) and 129 controls and assessed reward learning (behavioral probabilistic reward task), sensory gating (P50 event-related potential), and smoking history. Reward learning and sensory gating were correlated across the sample. Smoking influenced reward learning and sensory gating in both patient groups; however, the effects were in opposite directions. Specifically, smoking was associated with improved performance in individuals with schizophrenia but impaired performance in individuals with psychotic bipolar disorder. These findings suggest that reward learning and sensory gating are linked and modulated by smoking. However, disorder-specific associations with smoking suggest that nicotine may expose pathophysiological differences in the architecture and function of prediction error circuitry in these overlapping yet distinct psychotic disorders.
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17
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Dimick MK, Hird MA, Fiksenbaum LM, Mitchell RHB, Goldstein BI. Severe anhedonia among adolescents with bipolar disorder is common and associated with increased psychiatric symptom burden. J Psychiatr Res 2021; 134:200-207. [PMID: 33412423 DOI: 10.1016/j.jpsychires.2020.12.031] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 11/06/2020] [Accepted: 12/09/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Anhedonia, a deficit in the ability to experience pleasure, is a cardinal symptom of major depressive episodes. In contrast to adolescent major depressive disorder, there is limited research examining anhedonia in the context of depression among adolescents with bipolar disorder (BD). We therefore examined clinical characteristics of anhedonia in a large sample of adolescents with BD. METHODS Participants were 197 adolescents, aged 13-20 years old, with BD type I, II or not otherwise specified. Diagnoses were determined using a semi-structured interview. Anhedonia severity was rated from one to six on the Depression Rating Scale (DRS). Adolescents were divided into "severe" and "non-severe" anhedonia groups based on the DRS item scoring. The association of anhedonia with clinical and demographic variables was evaluated in univariate analyses followed by logistic regression analyses for variables with p ≤ 0.1. RESULTS Threshold anhedonia was evident among 90.9% during their most severe depressive episode. Significant factors associated with severe most severe lifetime anhedonia ("lifetime anhedonia") included: female sex, lifetime history of self-injurious behavior, physical abuse, affective lability, higher lifetime depression severity, comorbid anxiety disorders, family history of ADHD, and second-generation antipsychotic use. In regression analyses, severe lifetime anhedonia was independently associated with female sex, comorbid anxiety disorders, most severe lifetime mania severity, and lifetime second-generation antipsychotic use. CONCLUSION The vast majority of adolescents with BD experience anhedonia. More severe anhedonia is associated with indicators of greater illness severity. Future research is warranted to evaluate the neurobiological underpinnings of anhedonia among adolescents with BD.
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Affiliation(s)
- Mikaela K Dimick
- Department of Pharmacology, University of Toronto, ON, Canada; Centre for Youth Bipolar Disorder, Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Megan A Hird
- Centre for Youth Bipolar Disorder, Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Department of Medicine, University of Toronto, ON, Canada
| | - Lisa M Fiksenbaum
- Centre for Youth Bipolar Disorder, Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Rachel H B Mitchell
- Centre for Youth Bipolar Disorder, Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Department of Medicine, University of Toronto, ON, Canada
| | - Benjamin I Goldstein
- Department of Pharmacology, University of Toronto, ON, Canada; Centre for Youth Bipolar Disorder, Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Department of Medicine, University of Toronto, ON, Canada.
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18
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De Los Reyes A. (Second) Inaugural Editorial: How the Journal of Clinical Child and Adolescent Psychology Can Nurture Team Science Approaches to Addressing Burning Questions about Mental Health. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2021; 50:1-11. [PMID: 33577356 DOI: 10.1080/15374416.2020.1858839] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- Andres De Los Reyes
- Comprehensive Assessment and Intervention Program, Department of Psychology, University of Maryland
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19
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Mansur RB, Lee Y, McIntyre RS, Brietzke E. What is bipolar disorder? A disease model of dysregulated energy expenditure. Neurosci Biobehav Rev 2020; 113:529-545. [PMID: 32305381 DOI: 10.1016/j.neubiorev.2020.04.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 03/30/2020] [Accepted: 04/05/2020] [Indexed: 12/24/2022]
Abstract
Advances in the understanding and management of bipolar disorder (BD) have been slow to emerge. Despite notable recent developments in neurosciences, our conceptualization of the nature of this mental disorder has not meaningfully progressed. One of the key reasons for this scenario is the continuing lack of a comprehensive disease model. Within the increasing complexity of modern research methods, there is a clear need for an overarching theoretical framework, in which findings are assimilated and predictions are generated. In this review and hypothesis article, we propose such a framework, one in which dysregulated energy expenditure is a primary, sufficient cause for BD. Our proposed model is centered on the disruption of the molecular and cellular network regulating energy production and expenditure, as well its potential secondary adaptations and compensatory mechanisms. We also focus on the putative longitudinal progression of this pathological process, considering its most likely periods for onset, such as critical periods that challenges energy homeostasis (e.g. neurodevelopment, social isolation), and the resulting short and long-term phenotypical manifestations.
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Affiliation(s)
- Rodrigo B Mansur
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
| | - Yena Lee
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Elisa Brietzke
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Kingston General Hospital, Providence Care Hospital, Department of Psychiatry, Queen's University School of Medicine, Kingston, ON, Canada
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20
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Moriarity DP, Ng T, Curley EE, Anne McArthur B, Ellman LM, Coe CL, Abramson LY, Alloy LB. Reward Sensitivity, Cognitive Response Style, and Inflammatory Response to an Acute Stressor in Adolescents. J Youth Adolesc 2020; 49:2149-2159. [PMID: 32141010 DOI: 10.1007/s10964-020-01216-y] [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: 01/07/2020] [Accepted: 02/21/2020] [Indexed: 12/14/2022]
Abstract
Inflammation is gaining support as a biological mediator between stress and many negative outcomes that have heightened risk during adolescence (e.g., mood disorders). Thus, an important line of inquiry is evaluating whether risk factors for mood psychopathology also are associated with heightened inflammatory responses to stress during this developmental period. Two prominent risk factors that interact to predict mood psychopathology are reward sensitivity and perseverative cognitive response styles, which also have been associated with heightened inflammatory proteins. These factors could influence inflammation by synergistically amplifying stress reactivity. Ninety-nine late adolescents (Mage = 18.3 years, range = 15.6-21.9 years) completed measures of reward sensitivity, cognitive response style, and blood draws before and 60-min after a modified Trier Social Stress Task to determine levels of inflammation. Higher reward drive interacted with more perseverative response style ratios (rumination relative to distraction + problem-solving) to predict larger increases in interleukin-6 (a proinflammatory protein). Follow-up analyses found that reward drive interacted with all three components of the ratio to predict change in interleukin-6. Thus, these results suggest that high reward drive and perseverative cognitive response styles are associated with increased inflammatory response to social stress in adolescents, a potential physiological mechanism linking these risk factors to mood psychopathology during this developmental period.
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Affiliation(s)
- Daniel P Moriarity
- Department of Psychology, Temple University, Weiss Hall, 1701 N. 13th St., Philadelphia, PA, 19122, USA
| | - Tommy Ng
- Department of Psychology, Temple University, Weiss Hall, 1701 N. 13th St., Philadelphia, PA, 19122, USA
| | - Erin E Curley
- Department of Psychology, Temple University, Weiss Hall, 1701 N. 13th St., Philadelphia, PA, 19122, USA
| | - Brae Anne McArthur
- Department of Psychology, Temple University, Weiss Hall, 1701 N. 13th St., Philadelphia, PA, 19122, USA
| | - Lauren M Ellman
- Department of Psychology, Temple University, Weiss Hall, 1701 N. 13th St., Philadelphia, PA, 19122, USA
| | | | | | - Lauren B Alloy
- Department of Psychology, Temple University, Weiss Hall, 1701 N. 13th St., Philadelphia, PA, 19122, USA.
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21
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Burani K, Klawohn J, Levinson AR, Klein DN, Nelson BD, Hajcak G. Neural Response to Rewards, Stress and Sleep Interact to Prospectively Predict Depressive Symptoms in Adolescent Girls. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2019; 50:131-140. [PMID: 31328972 DOI: 10.1080/15374416.2019.1630834] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Blunted reward processing both characterizes major depressive disorder and predicts increases in depressive symptoms. However, little is known about the interaction between blunted reward processing and other risk factors in relation to increases in depressive symptoms. Stressful life events and sleep problems are prominent risk factors that contribute to the etiopathogenesis of depression and have been linked to reward dysfunction; these factors may interact with reward dysfunction to predict increased depressive symptoms. In a large sample of 8- to 14-year-old adolescent girls, the current study examined how blunted reward processing, stressful life events, and sleep problems at baseline interacted to predict increases in depressive symptoms 1 year later. Reward processing was indexed by the reward positivity (RewP), an event-related potential elicited during a simple monetary reward paradigm (i.e., Doors task). Two-way interactions confirmed that a blunted RewP predicted increased depressive symptoms at (a) high levels of stress but not average or low levels of stress, and (b) high and average levels of sleep problems but not low levels of sleep problems. Finally, a 3-way interaction confirmed that a blunted RewP predicted increased depressive symptoms at high levels of stress and sleep problems but not average or low levels of stress and sleep problems. Thus, adolescents characterized by low reward response (i.e., blunted RewP) were at an increased risk of developing depressive symptoms if they experienced increased stressful life events or sleep problems; moreover, risk was greatest among adolescents characterized by all 3.
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Affiliation(s)
| | - Julia Klawohn
- Department of Psychology, Florida State University Department of Biomedical Sciences, Florida State University
| | | | | | | | - Greg Hajcak
- Department of Psychology, Florida State University Department of Biomedical Sciences, Florida State University
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