Neural and self-reported reward responsiveness are associated with dispositional affectivity and emotion dysregulation in adolescents with evidence for convergent and incremental validity

Electrophysiological indices of reward anticipation as ADHD risk and prognostic biomarkers

The attention-deficit/hyperactivity disorder (ADHD) clinical phenotype has limitations for deciphering ADHD etiology and predicting prognosis. Although relative to the clinical phenotype, intermediate phenotypes may have better explanatory and prognostic power, the extent to which ADHD intermediate phenotypes are associated with ADHD risk and prognosis is unknown. The aim of this study was to evaluate evidence for event-related potential (ERP) measures of reward anticipation as ADHD risk and prognostic biomarkers. We examined, whether (1) in a sample of adolescents (N = 304; Mage = 15.78 years, SD = 1.08; 39.5% female), accounting for the effects of age, sex, ADHD severity and depression, ERPs are associated with ADHD polygenic risk scores (PRSs) (ADHD risk) and (2) in a sample of adolescents at-risk for ADHD (n = 99; Mage = 15.78 years, SD = 1.08; 39.5% female), accounting for the effects of age, sex, ADHD severity, depression, and baseline outcome values, ERPs are associated, prospectively, with alcohol misuse (ADHD prognosis). In adolescents, greater ADHD PRSs were associated with lower electrophysiological anticipatory attention to motivationally relevant feedback (b = -0.115, p = .046 95%CI [-0.228; -0.002]). The predictors accounted for 5% of the variance in the outcome. In adolescents at-risk for ADHD, at 18-month follow-up, lower electrophysiological anticipatory attention to motivationally relevant feedback was associated with greater alcohol consumption (b = -7.454, p = .007, 95%CI [-12.873; -2.034]). The predictors accounted for 31% of the variance in this outcome. These findings were replicated in sensitivity analyses with behavioral performance variables added as covariates. The current findings support the hypothesis that ERP amplitudes of reward anticipation may be ADHD risk and prognostic biomarkers and suggest that intermediate phenotypes may confer advantages over the ADHD clinical phenotype in delineating etiology and predicting prognosis.

Incremental validity of ERP correlates of self-referential processing in predicting emerging depressive symptoms in late childhood: Evidence from a community-dwelling sample

Depressogenic self-referential processing (e.g., self-schemas reflecting shallower processing of positive, and deeper processing of negative, self-descriptive words) is an established cognitive vulnerability to depression. Alterations of event-related potentials (ERPs) during self-referential processing have been observed in adolescents with depression risk or clinical depression. However, no study has examined ERPs associated with self-referential processing in typical-risk youth with emerging depressive symptoms during late childhood, a high-risk period for depression. It is also unclear to what extent ERPs provide incremental validity in predicting symptoms beyond performance on self-referential processing tasks. Sixty-five community-dwelling children (38 girls; mean age/SD = 11.02/1.59 years) completed a self-referent encoding task (SRET) with EEG recorded. Children showed a larger P2 and a larger late positive potential (LPP) in response to positive SRET stimuli versus negative stimuli. Hierarchical regression showed that in the positive condition only, including ERP correlates (P1, P2, LPP) and interactions between the ERPs and positive SRET score increased the explained variation in depressive symptoms beyond behavioral SRET performance. The LPP in response to positive words was associated with lower depressive symptoms. The P1 and P2 in response to positive words interacted with positive SRET score, such that the association between positive SRET score and symptoms was significant in children with greater P1 but smaller P2. We provide novel evidence supporting the incremental validity of ERPs beyond behavioral makers in predicting emerging depressive symptoms in children. Our findings also highlight the moderating role of ERP activity in strengthening the association between behavioral markers of self-schemas and depressive outcomes.

Drinking alcohol by mid-adolescence is related to reduced reward reactivity: Novel evidence of positive valence system alterations in early initiating female youth

Initiation of alcohol use at younger ages is prognostic of later drinking problems. Reward system dysfunction is theorized to contribute to early initiation and escalation of drinking, but existing evidence supports both hyposensitivity and hypersensitivity as risk-markers; research employing effective indices of reward processing is needed for clarification. The reward positivity (RewP) is a well-established neurophysiological index of hedonic "liking," an important aspect of reward processing. Adult research has yielded conflicting findings, with different studies reporting reduced, enhanced, or null associations of RewP with engagement in or risk for harmful alcohol use. No study has examined relations between RewP and multiple indices of drinking in youth. Here, we examined how RewP measured in a gain/loss feedback task related to self-reported drinking initiation and past-month drinking, when accounting for age along with depression and externalizing symptoms, in 250 mid-adolescent females. Analyses showed that (1) compared to not-yet drinkers, adolescents endorsing drinking initiation responded less strongly to monetary gain (RewP) but not loss feedback (FN), and (2) past-month drinking was unrelated to both RewP and FN magnitude. These findings provide evidence for reduced hedonic "liking" as a concomitant of early drinking initiation in adolescent females and warrant further research with mixed-sex adolescent samples exhibiting greater drinking variability.

Adolescent ADHD and electrophysiological reward responsiveness: A machine learning approach to evaluate classification accuracy and prognosis

We evaluated event-related potential (ERP) indices of reinforcement sensitivity as ADHD biomarkers by examining, in N=306 adolescents (M_age=15.78, SD=1.08), the extent to which ERP amplitude and latency variables measuring reward anticipation and response (1) differentiate, in age- and sex-matched subsamples, (i) youth with vs. without ADHD, (ii) youth at-risk for vs. not at-risk for ADHD, and, in the with ADHD subsample, (iii) youth with the inattentive vs. the hyperactive/impulsive (H/I) and combined presentations. We further examined the extent to which ERP variables (2) predict, in the ADHD subsample, substance use (i) concurrently and (ii) prospectively at 18-month follow-up. Linear support vector machine analyses indicated ERPs weakly differentiate youth with/without (65%) - and at-risk for/not at-risk for (63%) - ADHD but better differentiate ADHD presentations (78%). Regression analyses showed in adolescents with ADHD, ERPs explain a considerable proportion of variance (50%) in concurrent alcohol use and, controlling for concurrent marijuana and tobacco use, explain a considerable proportion of variance (87 and 87%) in, and predict later marijuana and tobacco use. Findings are consistent with the dual-pathway model of ADHD. Results also highlight limitations of a dichotomous, syndromic classification and indicate differences in neural reinforcement sensitivity are a promising ADHD prognostic biomarker.

Maturation-dependent vulnerability of emotion regulation as a response to COVID-19 related stress in adolescents

BACKGROUND

The COVID-19 pandemic created unpredictable circumstances resulting in increased psychological strain. Here we investigate pandemic-related alterations in emotion regulation in adolescents assessed before and during the pandemic. We also take biological age into account in the response to the pandemic.

METHODS

Mann-Whitney U tests were conducted to compare baseline data on the Difficulties in Emotion Regulation Scale (DERS) total scores of a pre-pandemic adolescent cohort (n = 241) with those obtained during the second wave of the pandemic (n = 266). We estimated biological age based on an ultrasonic boneage assessment procedure in a subgroup of males, including grammar school and vocational school students in the 9th and 10th grades, and analyzed their data independently.

FINDINGS

There is a gender difference in the timing of vulnerability for pandemic-related stress in grammar school students: females are affected a year earlier than males. Vocational school male students mature faster than grammar school male students, and the timing of emotional vulnerability also precedes that of the grammar school students'.

DISCUSSION

We interpret our findings within a developmental model suggesting that there might be a window of highest vulnerability in adolescent emotion regulation. The timing of the window is determined by both chronological and biological age, and it is different for females and males.

APPLICATION TO PRACTICE

Defining the exact temporal windows of vulnerability for different adolescent cohorts allows for the timely integration of preventive actions into adolescent care to protect mental health during future chronic stressful situations.

Reliability of reward ERPs in middle-late adolescents using a custom and a standardized preprocessing pipeline

Despite advantage of neuroimaging measures in translational research frameworks, less is known about the psychometric properties thereof, especially in middle-late adolescents. Earlier, we examined evidence of convergent and incremental validity of reward anticipation and response event-related potentials (ERPs) and here we examined, in the same sample of 43 adolescents (M_age  = 15.67 years; SD = 1.01; range: 14-18; 32.6% boys), data quality (signal-to-noise ratio [SNR]), stability (mean amplitude across trials), and internal consistency (Cronbach's α and split-half reliability) of the same ERPs. Further, because observed time course and peak amplitude of ERP grand averages and thus findings on SNR, stability, and internal consistency may depend on preprocessing method, we employed a custom and a standardized preprocessing pipeline and compared findings across those. Using our custom pipeline, reward anticipation components were stable by the 40th trial, achieved acceptable internal consistency by the 19th, and all (but the stimulus-preceding negativity [SPN]) achieved acceptable SNR by the 41st trial. Initial response to reward components were stable by the 20th trial and achieved acceptable internal consistency by the 11th and acceptable SNR by the 45th trial. Difference scores had worse psychometric properties than parent measures. Time course and peak amplitudes of ERPs and thus results on SNR, stability, and internal consistency were comparable across preprocessing pipelines. In case of reward anticipation ERPs examined here, 41 trials (+4 artifacted and removed) and, in case of reward response ERPs, 45 trials (+5 artifacted) yielded stable and internally consistent estimates with acceptable SNR. Results are robust across preprocessing methods.