Electrocortical Reactivity during Self-Referential Processing Predicts the Development of Depression across Adolescence

BACKGROUND

Negative attentional biases and self-schemas have been implicated in the development of depression. Research has indicated that a larger late positive potential (LPP) to negative self-referential words is associated with depression-as well as a maternal history of depression, an indicator of risk. However, it is unclear whether the LPP to self-referential words predicts the actual development of depression. The present study examined whether electrocortical reactivity during self-referential processing predicts the development of depression across adolescence.

METHODS

The sample consisted of 165 8 to 14-year-old girls with no lifetime history of a depressive disorder who completed the self-referential encoding task (SRET) while electroencephalography was recorded at a baseline assessment. Participants and their parent completed the Kiddie Schedule for Affective Disorders and Schizophrenia for School Aged Children at the baseline, 2-year, 4-year, and 6-year follow-up assessments.

RESULTS

Results indicated that a larger LPP to negative self-referential words at baseline predicted an increased likelihood of developing chronic-intermittent depression (i.e., persistent and/or recurrent), but not non-chronic, single episode depression, across adolescence. In contrast, neither SRET recall biases nor the LPP to positive self-referential words predicted the development of either type of depression.

CONCLUSIONS

The present study suggests that electrocortical reactivity associated with a negative self-schema in late childhood predicts the development of a more pernicious subtype of depression across adolescence. Moreover, the present study highlights the importance of considering clinical course in the examination of biomarkers of risk for depression.

College student interest in teletherapy and self-guided mental health supports during the COVID-19 pandemic

Objective The COVID-19 pandemic has worsened college students' mental health while simultaneously creating new barriers to traditional in-person care. Teletherapy and online self-guided mental health supports are two potential avenues for addressing unmet mental health needs when face-to-face services are less accessible, but little is known about factors that shape interest in these supports. Participants: 1,224 U.S. undergraduate students (mean age = 20.7; 73% female; 40% White) participated. Methods: Students completed an online questionnaire assessing interest in teletherapy and self-guided supports. Predictors included age, sex, race/ethnicity, sexual minority status, and anxiety and depression symptomatology. Results: Interest rates were 20% and 25% for at-cost supports (teletherapy and online self-help, respectively) and 70% and 72% for free supports (teletherapy and online self-help, respectively). Patterns emerged by age, anxiety symptom severity, and race/ethnicity. Conclusions: Results may inform universities' efforts to optimize students' engagement with nontraditional, digital mental health supports, including teletherapy and self-guided programs.

The SARS-CoV2 (COVID-19) pandemic has taken a severe toll on public health, with effects reaching far beyond unprecedented illness and mortality. Levels of mental health difficulties appear to be rising broadly as the pandemic has progressed, both in the general U.S. population and among college students specifically.1,2 The COVID-19 pandemic and its repercussions may undermine college student mental health in myriad ways.2 Concurrently, students now face the potential for serious illness, loss of loved ones, financial strain, social isolation, loss of on-campus resources, and sudden disruption of routines-creating a "perfect storm" for the emergence or exacerbation of psychological distress.

Neural response to monetary and social rewards and familial risk for psychopathology in adolescent females

BACKGROUND

Adolescence is a key developmental period for the emergence of psychopathology. Reward-related brain activity increases across adolescence and has been identified as a potential neurobiological mechanism of risk for different forms of psychopathology. The reward positivity (RewP) is an event-related potential component that indexes reward system activation and has been associated with both concurrent and family history of psychopathology. However, it is unclear whether the RewP is also associated with higher-order psychopathology subfactors and whether this relationship is present across different types of reward.

METHODS

In a sample of 193 adolescent females and a biological parent, the present study examined the association between adolescent and parental psychopathology subfactors and adolescent RewP to monetary and social reward.

RESULTS

Results indicated that the adolescent and parental distress subfactors were negatively associated with the adolescent domain-general RewP. The adolescent and parental positive mood subfactors were negatively associated with the adolescent domain-general and domain-specific monetary RewP, respectively. Conversely, the adolescent and parental fear/obsessions subfactors were positively associated with the adolescent domain-general RewP. The associations between parental and adolescent psychopathology subfactors and the adolescent RewP were independent of each other.

CONCLUSIONS

The RewP in adolescent females is associated with both concurrent and parental psychopathology symptoms, suggesting that it indexes both severity and risk for higher-order subfactors.

Social feedback biases emerge during recall but not prediction and shift across the development of social anxiety

Memory is a reconstructive process that can result in events being recalled as more positive or negative than they actually were. While positive recall biases may contribute to well-being, negative recall biases may promote internalizing symptoms, such as social anxiety. Adolescence is characterized by increased salience of peers and peak incidence of social anxiety. Symptoms often wax and wane before becoming more intractable during adulthood. Open questions remain regarding how and when biases for social feedback are expressed and how individual differences in biases may contribute to social anxiety across development. Two studies used a social feedback and cued response task to assess biases about being liked or disliked when retrieving memories vs. making predictions. Findings revealed a robust positivity bias about memories for social feedback, regardless of whether memories were true or false. Moreover, memory bias was associated with social anxiety in a developmentally sensitive way. Among adults (study 1), more severe symptoms of social anxiety were associated with a negativity bias. During the transition from adolescence to adulthood (study 2), age strengthened the positivity bias in those with less severe symptoms and strengthened the negativity bias in those with more severe symptoms. These patterns of bias were isolated to perceived memory retrieval and did not generalize to predictions about social feedback. These results provide initial support for a model by which schemas may infiltrate perceptions of memory for past, but not predictions of future, social events, shaping susceptibility for social anxiety, particularly during the transition into adulthood.

Predicting internalizing symptoms with machine learning: identifying individuals that need care

Objective The current project aims to identify individuals in urgent need of mental health care, using a machine learning algorithm (random forest). Comparison/contrast with conventional regression analyses is discussed. Participants: A total of 2,409 participants were recruited from an anonymous university, including undergraduate and graduate students, faculty, and staff. Methods: Answers to a COVID-19 impact survey, the Patient Health Questionnaire-9 (PHQ-9), and the Generalized Anxiety Disorder-7 (GAD-7) were collected. The total scores of PHQ-9 and GAD-7 were regressed on six composites that were created from the questionnaire items, based on their topics. A random forest was trained and validated. Results: Results indicate that the random forest model was able to make accurate, prospective predictions (R2 = .429 on average) and we review variables that were deemed predictively relevant. Conclusions: Overall, the study suggests that predictive models can be clinically useful in identifying individuals with internalizing symptoms based on daily life disruption experiences.

Examining Blunted Initial Response to Reward and Recent Suicidal Ideation in Children and Adolescents Using Event-Related Potentials: Failure to Conceptually Replicate Across Two Independent Samples

A recent study by Tsypes and colleagues (2019) found that children with recent suicidal ideation had blunted neural reward processing, as measured by the reward positivity (RewP), compared to matched controls, and that this difference was driven by reduced neural responses to monetary loss, rather than to reward. Here, we aimed to conceptually replicate and extend these findings in two samples (n = 264, 27 with suicidal ideation; and n = 314, 49 with suicidal ideation at baseline) of children and adolescents (11 to 15 years and 8 to 15 years, respectively). Results from both samples showed no evidence that children and adolescents with suicidal ideation have abnormal reward or loss processing, nor that reward processing predicts suicidal ideation two years later. The results highlight the need for greater statistical power, as well as continued research examining the neural underpinnings of suicidal thoughts and behaviors.

Family study of the startle reflex and event-related potentials in anticipation of predictable and unpredictable threat in adolescents and their parents

A heightened sensitivity to unpredictable threat has been identified as a potential transdiagnostic mechanism of psychopathology. The majority of supporting research has been conducted in adults, and it is unclear whether psychophysiological indicators of sensitivity to unpredictable threat are comparable in youth during developmental periods associated with increased risk for psychopathology. In addition, no studies have examined whether sensitivity to unpredictable threat is correlated between parents and their offspring. The present study examined defensive motivation (startle reflex) and attentional engagement (probe N100, P300) in anticipation of predictable and unpredictable threat in a sample of 15-year-old adolescents (N = 395) and a biological parent (N = 379). Adolescents, compared to their parents, demonstrated greater startle potentiation and probe N100 enhancement in anticipation of unpredictable threat. In addition, overall startle potentiation in anticipation of threat was correlated between the adolescents and their parents. Adolescence is a key developmental period characterized by heightened defensive motivation and attentional engagement in anticipation of both predictable and unpredictable threat. Sensitivity to threat might index is one mechanism of vulnerability that is at least partially shared between parents and their offspring.

Neurobiological sensitivity to unpredictable threat and familial risk for the internalizing and externalizing spectra in adolescents

BACKGROUND

Adolescence is a key developmental period for the emergence of psychiatric disorders. However, there is still no consensus on the core mechanisms of dysfunction in youth. Neurobiological sensitivity to unpredictable threat has been associated with several psychiatric disorders in adults. The present study examined adolescent defensive motivation (startle reflex) and attention (event-related potentials) in anticipation of unpredictable threat in relation to both adolescent and maternal (i.e. familial risk) internalizing and externalizing spectra.

METHODS

The sample included 395 15-year-old adolescents and their biological mothers. Adolescent startle potentiation and probe P300 suppression (indicating increased attention to threat) were measured in anticipation of predictable and unpredictable threat. Adolescent and maternal lifetime history of psychiatric disorders were assessed via semi-structured diagnostic interviews, and confirmatory factor analysis was used to model internalizing and externalizing spectra.

RESULTS

The adolescent internalizing spectrum was positively associated with adolescent startle potentiation and probe P300 suppression to unpredictable threat. Conversely, the adolescent externalizing spectrum was negatively associated with adolescent P300 suppression to unpredictable threat. The maternal internalizing spectrum was positively associated with adolescent startle potentiation to unpredictable threat and P300 suppression to both predictable and unpredictable threat. The maternal externalizing spectrum was negatively associated with adolescent startle potentiation to unpredictable threat and P300 suppression to both predictable and unpredictable threat. Adolescent and maternal internalizing and externalizing spectra were independently related to adolescent startle potentiation and P300 suppression.

CONCLUSIONS

Adolescent neurobiological sensitivity to unpredictable threat is associated with both personal history and familial risk for the internalizing and externalizing spectra.

Loss of mental health support among college students during the COVID-19 pandemic

Objective: The COVID-19 pandemic has simultaneously exacerbated mental health concerns among college students and made it more challenging for many students to access mental health support. However, little is known about the extent of mental health support loss among college students, or which students have lost support. Participants: 415 undergraduate students who reported receiving mental health support prior to the pandemic participated. Methods: Students completed an online questionnaire between March and May of 2020. Researchers examined the extent of support loss and how support loss differed by demographic and mental health variables. Methods pre-registered at https://osf.io/m83hz. Results: 62% of respondents reported loss of mental health support. Loss of support was associated with more severe depressive symptoms (p < .001), more severe anxiety symptoms (p < .001), suicidal ideation (p < .001), and sexual minority identity (p = .017). Conclusions: Loss of support was common, especially among more vulnerable students.

Longitudinal Associations Between Reward Responsiveness and Depression Across Adolescence

OBJECTIVE

Lower neural response to reward predicts subsequent depression during adolescence. Both pubertal development and biological sex have important effects on reward system development and depression during this period. However, relations among these variables across the transition from childhood to adolescence are not well characterized.

METHOD

Depressive symptoms, pubertal status, and the reward positivity (RewP) event-related potential component, a neural indicator of reward responsivity, were assessed in 609 community-recruited youth at 9, 12, and 15 years of age. Structural equation modeling was used to examine concurrent and prospective relations within and between depression and reward responsiveness as well as the influence of pubertal status and biological sex on these variables across assessments.

RESULTS

Stability paths for depression, the RewP, and pubertal status were significant across assessments. Compared with male participants, female participants reported more advanced pubertal status at all assessments, a smaller RewP at age 9, and higher levels of depression at age 15. More advanced pubertal status was associated with a larger RewP at age 15. Most importantly, there were bidirectional prospective effects between the RewP and depression from ages 12 to 15; a lower RewP at age 12 predicted increases in depression at age 15, whereas increased depression at age 12 predicted a lower RewP at age 15.

CONCLUSION

These findings indicate that there are bidirectional prospective effects between reward responsiveness and depression that emerge between ages 12 and 15. This may be a crucial time for studying bidirectional reward responsiveness-depression associations across time.

Gender and Racial/Ethnic Disparities in Undergraduate and Graduate Students' Mental Health and Treatment Use Amid the COVID-19 Pandemic

The COVID-19 pandemic has negatively impacted numerous people?s mental health and created new barriers to services. To address the unknown effects of the pandemic on accessibility and equality issues in mental health care, this study aimed to investigate gender and racial/ethnic disparities in mental health and treatment use in undergraduate and graduate students amid the COVID-19 pandemic. The study was conducted based on a largescale online survey (N = 1,415) administered during the weeks following a pandemic-related university-wide campus closure in March 2020. We focused on the gender and racial disparities in current internalizing symptomatology and treatment use. Our results showed that in the initial period of the pandemic, students identified as cis women (p < .001), non-binary/genderqueer (p < .001), or Hispanic/Latinx (p = .002) reported higher internalizing problem severity (aggregated from depression, generalized anxiety, intolerance of uncertainty, and COVID-19-related stress symptoms) compared to their privileged counterparts. Additionally, Asian (p < .001) and multiracial students (p = .002) reported less treatment use than White students while controlling for internalizing problem severity. Further, internalizing problem severity was associated with increased treatment use only in cisgender, non-Hispanic/Latinx White students (pcis man = 0.040, pcis woman < 0.001). However, this relationship was negative in cis-gender Asian students (pcis man = 0.025, pcis woman = 0.016) and nonsignificant in other marginalized demographic groups. The findings revealed unique mental health challenges faced by different demographic groups and served as a call that specific actions to enhance mental health equity, such as continued mental health support for students with marginalized gender identities, additional COVID-related mental and practical support for Hispanic/Latinx students and promotion of mental health awareness, access, and trust in non-White, especially Asian, students are desperately needed.

COVID-19 experiences and psychopathology symptoms in college students at the onset of the pandemic

Objective: The present study examined what specific aspects of the COVID-19 pandemic contributed to psychopathology symptoms among college students during the initial stages of the pandemic. Participants: One thousand and eighty-nine college students (M_age = 20.73, SD_age = 2.93) enrolled at a university in New York participated in the study between March and May 2020. Methods: Participants completed self-report measures assessing pandemic-related experiences and psychopathology symptoms. Results: Results indicated that greater COVID-19-related life changes were uniquely associated with greater depression and post-traumatic stress symptoms. Greater concerns about school, home confinement, and basic needs were uniquely associated with greater depression symptoms. Finally, greater COVID-19 infection concerns were uniquely associated with greater generalized anxiety and post-traumatic stress symptoms. Conclusion: The present study indicates that the COVID-19 pandemic had a multifaceted impact on undergraduate students and that specific COVID-19 experiences contributed to higher rates of psychopathology symptoms.

Relational victimization prospectively predicts increases in error-related brain activity and social anxiety in children and adolescents across two years

Recent research has focused on identifying neural markers associated with risk for anxiety, including the error-related negativity (ERN). An elevated ERN amplitude has been observed in anxious individuals from middle childhood onward and has been shown to predict risk for future increases in anxiety development. The ERN is sensitive to environmental influences during development, including interpersonal stressors. Of note, one particular type of interpersonal stressor, relational victimization, has been related to increases in anxiety in adolescents. We tested whether relational victimization predicts increases in the ERN and social anxiety symptoms across two years in a sample of 152 child and adolescent females (ages 8 - 15). Results indicated that children and adolescents' baseline ERN was positively related to the ERN two years later. Furthermore, greater relational victimization at baseline predicted greater increases in the ERN two years later, controlling for baseline ERN. Moreover, relational victimization at baseline predicted increases in social anxiety, and this relationship was mediated by increases in the ERN. These results suggest that relational victimization impacts the developmental trajectory of the neural response to errors and thereby impacts increases in social anxiety among children and adolescents.

Don't worry, it won't be fine. Contributions of worry and anxious arousal to startle responses and event-related potentials in threat anticipation

A widely shared framework suggests that anxiety maps onto two dimensions: anxious apprehension and anxious arousal. Previous research linked individual differences in these dimensions to differential neural response patterns in neuropsychological, imaging, and physiological studies. Differential effects of the anxiety dimensions might contribute to inconsistencies in prior studies that examined neural processes underlying anxiety, such as hypersensitivity to unpredictable threat. We investigated the association between trait worry (as a key component of anxious apprehension), anxious arousal, and the neural processing of anticipated threat. From a large online community sample (N = 1,603), we invited 136 participants with converging and diverging worry and anxious arousal profiles into the laboratory. Participants underwent the NPU-threat test with alternating phases of unpredictable threat, predictable threat, and safety, while physiological responses (startle reflex and startle probe locked event-related potential components N1 and P3) were recorded. Worry was associated with increased startle responses to unpredictable threat and increased attentional allocation (P3) to startle probes in predictable threat anticipation. Anxious arousal was associated with increased startle and N1 in unpredictable threat anticipation. These results suggest that trait variations in the anxiety dimensions shape the dynamics of neural processing of threat. Specifically, trait worry seems to simultaneously increase automatic defensive preparation during unpredictable threat and increase attentional responding to threat-irrelevant stimuli during predictable threat anticipation. The current study highlights the utility of anxiety dimensions to understand how physiological responses during threat anticipation are altered in anxiety and supports that worry is associated with hypersensitivity to unpredictable, aversive contexts.

Effects of early childhood behavioral inhibition and parental anxiety disorder on adolescents' startle response to predictable and unpredictable threat

Numerous studies in children, adolescents and adults have reported that anxiety disorders and symptoms are associated with greater threat-potentiated startle responses. This suggests that it may also be related to risk factors that have been implicated in the genesis of anxiety disorders. Therefore, we examined the roles of early childhood temperamental behavioral inhibition (BI) and parental history of anxiety disorders in predicting threat-potentiated startle response in a community sample of 346 adolescents. Parental history of anxiety disorders moderated the effects of BI on subsequent startle responses. For both total startle response and unpredictable threat startle potentiation, higher levels of BI at age 3 predicted larger startle responses at age 15, but only among offspring of parents with a history of anxiety disorders. Among offspring of parents with no lifetime history of anxiety disorder, BI was unrelated to startle magnitude. These findings were evident even after adjusting for youth's biological sex, concurrent anxiety symptoms, and lifetime history of anxiety disorders. In contrast, neither BI nor parental anxiety significantly predicted startle potentiation to predictable threat. These findings have implications for tracing pathways to the development of anxiety disorders.

Greater Cumulative Lifetime Stressor Exposure Predicts Blunted Reward Positivity in Adolescent Girls Followed for 2 Years

BACKGROUND

Although research has found that life stress is associated with reward-related brain activity, few studies have examined how cumulative stressors occurring over the entire lifetime affect reward processing during adolescence.

METHODS

To address this issue, we investigated how lifetime stressor exposure related to reward processing, indexed by the reward positivity, in 240 adolescent girls between ages 8 and 14 years (mean age = 12.4). Participants were followed for 2 years. They completed a reward task at baseline and follow-up and the Stress and Adversity Inventory at follow-up.

RESULTS

As hypothesized, greater lifetime stressor exposure was related to a blunted reward positivity at the follow-up session while controlling for baseline age, baseline reward positivity, and time between assessments. Furthermore, this association was evident for acute but not chronic lifetime stressors.

CONCLUSIONS

These data suggest that the development of adaptive reward processing may be adversely affected by experiencing major life stressors. The results may thus have implications for understanding how stressors increase risk for psychopathology, such as major depressive disorder.

Increases in depression and anxiety symptoms in adolescents and young adults during the COVID-19 pandemic

BACKGROUND

The coronavirus [coronavirus disease 2019 (COVID-19)] pandemic has introduced extraordinary life changes and stress, particularly in adolescents and young adults. Initial reports suggest that depression and anxiety are elevated during COVID-19, but no prior study has explored changes at the within-person level. The current study explored changes in depression and anxiety symptoms from before the pandemic to soon after it first peaked in Spring 2020 in a sample of adolescents and young adults (N = 451) living in Long Island, New York, an early epicenter of COVID-19 in the U.S.

METHODS

Depression (Children's Depression Inventory) and anxiety symptoms (Screen for Child Anxiety Related Symptoms) were assessed between December 2014 and July 2019, and, along with COVID-19 experiences, symptoms were re-assessed between March 27th and May 15th, 2020.

RESULTS

Across participants and independent of age, there were increased generalized anxiety and social anxiety symptoms. In females, there were also increased depression and panic/somatic symptoms. Multivariable linear regression indicated that greater COVID-19 school concerns were uniquely associated with increased depression symptoms. Greater COVID-19 home confinement concerns were uniquely associated with increased generalized anxiety symptoms, and decreased social anxiety symptoms, respectively.

CONCLUSIONS

Adolescents and young adults at an early epicenter of the COVID-19 pandemic in the U.S. experienced increased depression and anxiety symptoms, particularly amongst females. School and home confinement concerns related to the pandemic were independently associated with changes in symptoms. Overall, this report suggests that the COVID-19 pandemic is having multifarious adverse effects on the mental health of youth.

Intergenerational transmission of depressive and anxiety disorders: Mediation via youth personality

Youth personality is hypothesized to mediate the intergenerational transmission of internalizing disorders. However, this has rarely been examined. We tested whether the intergenerational transmission of depressive and anxiety disorders is mediated by youth neuroticism and extraversion, and how parent personality influenced these relationships. Participants included 550 adolescent girls, aged 13-15 years at baseline (T1), and a coparticipating biological parent. Depressive and anxiety disorders were assessed by interview at T1, and adolescents were reinterviewed every 9 months for 3 years (T2-T5). Parent and youth personality was assessed at T1. Four path models examined direct and indirect effects of parent psychopathology and personality (neuroticism and extraversion) on youth outcomes, with youth neuroticism and extraversion as mediators in separate models. In the model examining the effects of parent psychopathology via T1 youth neuroticism, there were direct effects of parent depression on T2-T5 youth depressive disorders and indirect effects of parent anxiety disorders on T2-T5 youth depressive and anxiety disorders. When parent neuroticism was added, indirect effects of T1 parent anxiety disorders and neuroticism on T2-T5 youth depressive and anxiety disorders via T1 youth neuroticism were significant. In the model examining T1 youth extraversion as a mediator, there were significant direct effects of parent depressive and anxiety disorders on T2-T5 youth depressive and anxiety disorders, respectively. Finally, when adding parent extraversion, indirect effects of parent extraversion on T2-T5 youth depressive and anxiety disorders via youth extraversion were significant. Parent and youth personality play important roles in the intergenerational transmission of depressive and anxiety disorders. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Intolerance of uncertainty and psychophysiological reactivity in anticipation of unpredictable threat in youth

OBJECTIVE

Intolerance of uncertainty (IU) is a key transdiagnostic feature of internalizing psychopathology. An increasing body of research suggests that IU is associated with increased psychophysiological reactivity in anticipation of unpredictable threat. However, most studies examining the psychophysiological correlates of IU have been conducted in adults. There is a critical need to understand the relationship between IU and psychophysiological reactivity in anticipation of unpredictable threat during adolescence, a key developmental period associated with increased exploration of situations with uncertain outcomes. Thus, the present study examined the association between (1) youth IU and (2) parental IU (as an indicator of risk) in relation to youth defensive motivation (startle reflex) and attention (startle probe N100 and P300) in anticipation of unpredictable threat.

METHODS

The sample included 193 13 to 22-year-old (M = 17.33, SD = 1.97) females and a biological parent. Participants and their parent completed a self-report measure of prospective and inhibitory IU. Youth startle potentiation, probe N100 enhancement, and probe P300 suppression (indicating increased attention to threat) were measured in anticipation of predictable and unpredictable threat.

RESULTS

Youth prospective IU and inhibitory IU were not related to youth psychophysiological reactivity to predictable or unpredictable threat. Greater parental prospective IU was associated with greater youth startle potentiation and probe N100 enhancement in anticipation of unpredictable threat.

CONCLUSION

The present study suggests that parental IU, but not concurrent IU, is associated with heightened defensive motivation and attentional engagement in anticipation of unpredictable threat in youth.

The Hierarchical Taxonomy of Psychopathology (HiTOP) in psychiatric practice and research

The Hierarchical Taxonomy of Psychopathology (HiTOP) has emerged out of the quantitative approach to psychiatric nosology. This approach identifies psychopathology constructs based on patterns of co-variation among signs and symptoms. The initial HiTOP model, which was published in 2017, is based on a large literature that spans decades of research. HiTOP is a living model that undergoes revision as new data become available. Here we discuss advantages and practical considerations of using this system in psychiatric practice and research. We especially highlight limitations of HiTOP and ongoing efforts to address them. We describe differences and similarities between HiTOP and existing diagnostic systems. Next, we review the types of evidence that informed development of HiTOP, including populations in which it has been studied and data on its validity. The paper also describes how HiTOP can facilitate research on genetic and environmental causes of psychopathology as well as the search for neurobiologic mechanisms and novel treatments. Furthermore, we consider implications for public health programs and prevention of mental disorders. We also review data on clinical utility and illustrate clinical application of HiTOP. Importantly, the model is based on measures and practices that are already used widely in clinical settings. HiTOP offers a way to organize and formalize these techniques. This model already can contribute to progress in psychiatry and complement traditional nosologies. Moreover, HiTOP seeks to facilitate research on linkages between phenotypes and biological processes, which may enable construction of a system that encompasses both biomarkers and precise clinical description.

Drift-Diffusion Model Reveals Impaired Reward-Based Perceptual Decision-Making Processes Associated with Depression in Late Childhood and Early Adolescent Girls

Adolescent girls are a high-risk stratum for the emergence of depression. Previous research has established that depression is associated with blunted responses to rewards. Research using Drift Diffusion Model (DDM) has found that deficits in accumulating reward-based evidence characterize adult depression. However, little is known about how reduced reward sensitivity is reflected in the computational processes involved in reward-based decision-making in late childhood and early adolescent depression.One hundred and sixty-six 8- to 14-year-old girls completed a probabilistic reward-based decision-making task. Participants were instructed to identify which one of two similar visual stimuli were presented, and correct responses were rewarded with unequal probabilities. Analysis using hierarchical DDM quantified rate of evidence accumulation (i.e., drift rate) and starting point. Depression severity was measured using the Children's Depression Inventory.Across all participants, there was a higher drift rate, indicating faster evidence accumulation, for the more frequently rewarded than the less frequently rewarded decision. In addition, the starting point of the evidence accumulation was closer to the more frequently rewarded decision, indicating a starting point bias. Higher depression severity was associated with a slower drift rate for both types of decisions. Higher depression severity was associated with a smaller starting point bias towards the more frequently rewarded decision.The current study uses computational modeling to reveal that late childhood and early adolescent girls with greater depression demonstrate impairments in the reward-related evidence accumulation process.

Event-related potentials to acoustic startle probes during unpredictable threat are associated with individual differences in intolerance of uncertainty

Individual differences in sensitivity to unpredictable threat may be a critical mechanism for internalizing psychopathology phenotypes. The present study examined whether the startle probe-elicited N100 and P300 during unpredictable threat - two event-related potentials indexing early and elaborative attentional processing of unpredictable threat - may be endophenotypes for internalizing psychopathology, including fear and distress/misery disorders and intolerance of uncertainty (IU), a clinical trait that is transdiagnostically associated with internalizing disorders. A large sample of adult siblings (N = 375) completed the no, predictable, and unpredictable threat task, during which the N100 and P300 were recorded. Relative to the no threat condition, N100 was more strongly enhanced in anticipation of unpredictable than predictable threat while P300 was suppressed to both predictable and unpredictable threat. While neither N100 enhancement nor P300 suppression to unpredictable threat was associated with fear or distress/misery disorders, they were negatively linked to inhibitory IU (a facet of IU). Thus, individuals high in inhibitory IU showed reduced attentional engagement with the threatening context when it was unpredictable. Further, N100 enhancement and, to a lesser degree, P300 suppression to unpredictable threat showed familial aggregation - a key criterion for determining whether a biomarker is an endophenotype. In sum, N100 enhancement and P300 suppression to unpredictable threat may be endophenotypes for dimensional measures of internalizing psychopathology.

Validity and utility of Hierarchical Taxonomy of Psychopathology (HiTOP): III. Emotional dysfunction superspectrum

The Hierarchical Taxonomy of Psychopathology (HiTOP) is a quantitative nosological system that addresses shortcomings of traditional mental disorder diagnoses, including arbitrary boundaries between psychopathology and normality, frequent disorder co-occurrence, substantial heterogeneity within disorders, and diagnostic unreliability over time and across clinicians. This paper reviews evidence on the validity and utility of the internalizing and somatoform spectra of HiTOP, which together provide support for an emotional dysfunction superspectrum. These spectra are composed of homogeneous symptom and maladaptive trait dimensions currently subsumed within multiple diagnostic classes, including depressive, anxiety, trauma-related, eating, bipolar, and somatic symptom disorders, as well as sexual dysfunction and aspects of personality disorders. Dimensions falling within the emotional dysfunction superspectrum are broadly linked to individual differences in negative affect/neuroticism. Extensive evidence establishes that dimensions falling within the superspectrum share genetic diatheses, environmental risk factors, cognitive and affective difficulties, neural substrates and biomarkers, childhood temperamental antecedents, and treatment response. The structure of these validators mirrors the quantitative structure of the superspectrum, with some correlates more specific to internalizing or somatoform conditions, and others common to both, thereby underlining the hierarchical structure of the domain. Compared to traditional diagnoses, the internalizing and somatoform spectra demonstrated substantially improved utility: greater reliability, larger explanatory and predictive power, and greater clinical applicability. Validated measures are currently available to implement the HiTOP system in practice, which can make diagnostic classification more useful, both in research and in the clinic.

A biomarker of maternal vicarious reward processing and its association with parenting behavior

Parenting styles play a critical role in child well-being, yet the neural bases of parenting behaviors remain nebulous. Understanding the neural processes associated with parenting styles can both clarify etiological mechanisms underlying parenting behaviors and point us toward new targets for intervention. A novel electrocortical biomarker called the observational reward positivity (oRewP) that occurs in response to observing another receive a reward has been linked to self-reported authoritarian parenting behavior. The current study sought to replicate associations between the oRewP and self-reported and observationally-coded parenting in a sample of mothers selected to be at elevated risk for problematic parenting. Self-reported authoritarian parenting was associated with observationally-coded problematic discipline, while no other self-reported parenting scales were associated with observationally-coded scores. We replicated the previously reported association between a blunted oRewP and increased self-reported authoritarian parenting. We additionally found that an attenuated oRewP was associated with greater permissive parenting, and that only the relationship with permissive parenting was conserved after adjusting for other parenting styles and other relevant covariates. We did not find significant associations between the oRewP and observationally-coded parenting. The current findings suggest that the neural process indexed by the oRewP are relevant to parenting behavior. Further research is needed to better understand the discrepancy between self-reported and observed parenting.

Reliability of reward- and error-related brain activity in early childhood

Event-related potential (ERP) measures of reward- and error-related brain activity have emerged as potential biomarkers of risk for the development of psychopathology. However, the psychometric properties of reward- and error-related brain activity have been primarily investigated in adolescents and adults. It is critical to also establish the reliability of ERPs in younger children, particularly if they are used as individual difference measures of risk during key developmental periods. The present study examined the reliability of the reward positivity (RewP) and error-related negativity (ERN) among 80 children (M_age  = 6.9 years old; 50% female). Participants completed the doors, flanker, and go/no-go tasks twice, separated by approximately 8 months, while electroencephalography (EEG) was recorded. Results indicated that the RewP demonstrated strong internal consistency and test-retest reliability. The ERN also demonstrated strong internal consistency, but test-retest reliability was only significant for the ERN measured during the flanker task and not the go/no-go task. These results are largely consistent with reported psychometric properties of reward- and error related ERPs in adolescents and adults, suggesting that the ERN and RewP may be appropriate biomarkers of individual differences in populations ranging from early childhood to adulthood.

Neuroticism and respiratory sinus arrhythmia predict increased internalizing symptoms during the COVID-19 pandemic

The coronavirus (COVID-19) pandemic has impacted young adults across a number of different domains. It is critical to establish the degree to which the COVID-19 pandemic has affected mental health and identify predictors of poor outcomes. Neuroticism and (low) respiratory sinus arrhythmia (RSA) are risk factors of internalizing disorders that might predict increased psychopathology symptoms. The present study included 222 undergraduate students from [name removed] in Long Island, NY. Before the COVID-19 pandemic, participants completed self-report measures of neuroticism and internalizing symptoms and an electrocardiogram. Between April 15th to May 30th, 2020, participants again completed the measure of internalizing symptoms and a questionnaire about COVID-19 experiences. The COVID-19 pandemic was associated with increased distress, fear/obsessions, and (low) positive mood symptoms. There was a Neuroticism x RSA interaction in relation to distress symptoms, such that greater pre-COVID-19 neuroticism was associated with increased distress symptoms, but only in the context of low RSA. These findings suggest the COVID-19 pandemic has contributed to increased internalizing symptoms in young adults, and individuals with specific personality and autonomic risk factors may be at heightened risk for developing psychopathology.

Neural Response to Monetary and Social Feedback Demonstrate Differential Associations with Depression and Social Anxiety

An aberrant neural response to rewards has been linked to both depression and social anxiety. Most studies have focused on the neural response to monetary rewards, and few have tested different modalities of reward (e.g. social) that are more salient to particular forms of psychopathology. In addition, most studies contain critical confounds, including contrasting positive and negative feedback and failing to disentangle being correct from obtaining positive feedback. In the present study, 204 participants underwent electroencephalography during monetary and social feedback tasks that were matched in trial structure, timing and feedback stimuli. The reward positivity (RewP) was measured in response to correctly identifying stimuli that resulted in monetary win, monetary loss, social like or social dislike feedback. All monetary and social tasks elicited a RewP, which were positively correlated. Across all tasks, the RewP was negatively associated with depression and positively associated with social anxiety. The RewP to social dislike feedback, independent of monetary and social like feedback, was also associated with social anxiety. The present study suggests that a domain-general neural response to correct feedback demonstrates a differential association with depression and social anxiety, but a domain-specific neural response to social dislike feedback is uniquely associated with social anxiety.

Trajectories of depression, anxiety and pandemic experiences; A longitudinal study of youth in New York during the Spring-Summer of 2020

Initial reports suggest that mental health problems were elevated early in the COVID-19 pandemic. However, few studies have followed-up participants as the pandemic evolved and examined both between and within person predictors of symptom trajectories. In the current study, adolescents and young adults (N=532) in New York were surveyed monthly between March 27^th and July 14^th, 2020, a period spanning the first peak and subsequent decline in COVID-19 infection rates in the region. Surveys assessed symptoms of depression and anxiety using the Child Depression Inventory and the Screen for Child Anxiety Related Disorders, as well as experiences related to the pandemic. Multilevel growth modeling indicated that symptoms of depression and anxiety peaked around late April/early May and then decreased through May-July. Some pandemic experiences followed a similar quadratic trajectory, while others decreased linearly across the study. Specific relationships emerged between some types of pandemic experiences and depression and anxiety symptoms. While symptoms of depression and anxiety in youth may have been elevated early in the pandemic, these findings suggest they subsided across Spring-Summer of 2020, with higher levels of both corresponding to a period of peak infection rates and decreases paralleling the decline in pandemic experiences and COVID-19 infection rates.

The replicability and generalizability of internalizing symptom networks across five samples

The popularity of network analysis in psychopathology research has increased exponentially in recent years. Yet, little research has examined the replicability of cross-sectional psychopathology network models, and those that have used single items for symptoms rather than multiitem scales. The present study therefore examined the replicability and generalizability of regularized partial correlation networks of internalizing symptoms within and across 5 samples (total N = 2,573) using the Inventory for Depression and Anxiety Symptoms, a factor analytically derived measure of individual internalizing symptoms. As different metrics may yield different conclusions about the replicability of network parameters, we examined both global and specific metrics of similarity between networks. Correlations within and between nonclinical samples suggested considerable global similarities in network structure (rss = .53-.87) and centrality strength (rss = .37-.86), but weaker similarities in network structure (rss = .36-.66) and centrality (rss = .04-.54) between clinical and nonclinical samples. Global strength (i.e., connectivity) did not significantly differ across all 5 networks and few edges (0-5.5%) significantly differed between networks. Specific metrics of similarity indicated that, on average, approximately 80% of edges were consistently estimated within and between all 5 samples. The most central symptom (i.e., dysphoria) was consistent within and across samples, but there were few other matches in centrality rank-order. In sum, there were considerable similarities in network structure, the presence and sign of individual edges, and the most central symptom within and across internalizing symptom networks estimated from nonclinical samples, but global metrics suggested network structure and symptom centrality had weak to moderate generalizability from nonclinical to clinical samples. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

I Knew You Weren't Going to Like Me! Neural Response to Accurately Predicting Rejection Is Associated With Anxiety and Depression

Anxiety and depression often emerge in adolescence. A normative increase in the desire for peer acceptance may be one of many contributing factors. These shifts occur during a phase of development in which neural reward networks, including structures such as the ventral striatum, undergo critical changes. Despite the salience of peer feedback during adolescence, neural responses to reward have largely been examined in the monetary domain, leaving many open questions about responses to social rewards. Moreover, most paradigms do not tease apart different aspects of reward processing (e.g., receiving feedback, being correct). Anxiety and depression are also associated with alterations in reward networks; however, little is known about how anxiety and depression in adolescence relate to differences in social vs. non-social reward processing. In this study, adolescents (n = 28) underwent fMRI while completing novel monetary and social feedback tasks, which tease apart reward domain (social/monetary), valence (positive/negative), and outcome (correct/incorrect). Participants were shown a pair of stimuli (doors/age-matched peers) and asked to indicate which stimulus would provide positive (win money/social like) or negative (lose money/social dislike) feedback. Participants then received feedback about the purported accuracy of their response. Region-of-interest analyses showed that left ventral striatum response varied by domain (social/monetary), valence (positive/negative), and outcome (correct/incorrect) of reward. Additionally, unique associations between anxiety, depression, and brain function were observed for correct, but not for incorrect trials, in the social, but not monetary task. Specifically, adolescents with high anxiety symptoms, but low depression, displayed greater left ventral striatum activation when correctly identifying peers who gave dislike (vs. like) feedback. Thus, anxious youth exhibited enhanced activation in a brain region implicated in reward processing when they accurately predicted someone was going to dislike them. Higher levels of both depression and anxiety symptoms were associated with greater striatal activation to correctly identifying peers who gave like (vs. dislike) feedback. These results suggest a neural mechanism by which negative prediction biases may be reinforced in anxious youth.

Time-Frequency Delta Activity to Social Feedback Demonstrates Differential Associations With Depression and Social Anxiety Symptoms

Social feedback is highly salient and particularly relevant when investigating the pathophysiology of depression and social anxiety. A bourgeoning body of research has demonstrated an association between reward-related delta activity and psychopathology. However, a critical limitation is that these findings are derived from neural responses to monetary feedback, and time-frequency representation of social feedback remains unexplored. In addition, no study has isolated the differential/unique associations of positive valence and the intrinsic rewarding experience of being correct with reward-related neural activity. In the present study, 204 participants underwent electroencephalography (EEG) while they completed a novel paradigm comprised of monetary and social feedback tasks that were matched in trial structure, timing, and feedback stimuli. For each task, participants were instructed to correctly identify one of two doors that would provide positive feedback (monetary win behind the door) or one of two peers who would provide positive feedback (social like); or to correctly identify the door or peer that would provide negative feedback (money loss behind the door/social dislike). A principal component analysis (PCA) was conducted on the time-frequency data and revealed two factors in the delta and one factor in the theta frequency ranges. Results indicated that the lower-frequency delta factor (delta-low) was greater to correct vs. incorrect feedback, more so for social vs. monetary tasks, while the higher-frequency delta factor (delta-high) was greater to correct vs. incorrect feedback for social like, social dislike, and monetary win tasks, but not the monetary loss task. In contrast, the theta factor was greater to incorrect relative to correct feedback in negative valence (lose money/social dislike) but not positive valence (win money/social like) tasks. Furthermore, greater delta-high activity for social feedback was associated with greater social anxiety symptoms, whereas lesser delta-high activity for social feedback was associated with greater depressive symptoms. Finally, greater theta activity to monetary feedback was associated with greater depressive symptoms. The present study provides novel evidence demonstrating unique social vs. monetary feedback-related delta and theta activity, and differential associations between delta activity with depression and social anxiety symptoms. These findings highlight the importance of investigating feedback-related neural responses in the social domain.

Neural Response to Rewards, Stress and Sleep Interact to Prospectively Predict Depressive Symptoms in Adolescent Girls

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.

Reward processing and future life stress: Stress generation pathway to depression

Blunted reward sensitivity and life stress are each depressogenic. Additionally, individuals with clinical and psychosocial vulnerabilities are prone to experience or evoke dependent life stressors (e.g., interpersonal conflict) that, in turn, increase depression risk. However, no previous study has investigated the role of neural vulnerability factors in generating life stress. Therefore, the current study investigated whether a neural measure of reward sensitivity prospectively predicts the generation of life stress, which in turn mediates effects of these neural processes on subsequent depression. Participants were 467 never-depressed adolescent girls. Using event-related potentials, neural sensitivity to the difference between monetary reward and loss (the Reward Positivity [RewP]) was assessed at baseline. Negative life events were assessed twice via interview over the ensuing 18 months, yielding an index of total life stress over the follow-up period. A self-report dimensional measure of depression symptoms was administered at baseline and follow-up. After accounting for baseline age, depression, and race, a blunted RewP predicted greater dependent, but not independent, life stress over the follow-up. Mediation analyses revealed a significant indirect effect of the RewP on follow-up depression through dependent, but not independent, life stress. Our results suggest that neural processing reward and loss plays a crucial role in depressogenic stress generation. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Age-typical changes in neural reward response are moderated by maternal anhedonia

Reward response and mood disorders both increase during adolescence. Here, we investigate whether age and gonadal hormone levels relate to neural response to win and loss feedback in 9- to 14-year-old girls and whether such relations are moderated by maternal anhedonia, a factor linked to psychopathology risk and reward response. Psychiatrically healthy daughters of mothers who did not meet criteria for any current DSM-5 disorder or past anxiety/depression diagnosis (N = 69) completed a monetary fMRI guessing task and provided saliva samples for gonadal hormone assay. Voxelwise regressions revealed unique quadratic effects of age and linear effects of gonadal hormones; neither effect was explained by reported puberty. Striatal/insular responses to win/loss feedback peaked between 12 and 13 years, whereas estradiol predicted greater response to wins versus losses within the medial prefrontal cortex, concurrently. Maternal anhedonia specifically moderated the quadratic effect of age within dorsolateral striatum and insula. Daughters of mothers reporting greater anhedonia showed an earlier peak in striatal/insular response to reward and loss feedback. As such, maternal anhedonia predicted blunted striatal/insular response to feedback only in older daughters. A similar pattern was observed for daughters of mothers with lifetime depression in exploratory analyses. These cross-sectional findings suggest that familial anhedonia may relate to altered trajectories of reward responding during adolescence and that these effects are specific to age.

Ventral Striatal Function Interacts With Positive and Negative Life Events to Predict Concurrent Youth Depressive Symptoms

BACKGROUND

Life events and reward-system functioning contribute to resilience and risk for depression. However, interactions between life events and neural responses to reward and loss have not been previously investigated in relation to depression symptoms in child and adolescent populations.

METHODS

An unselected sample (N = 130) of 8- to 14-year-old girls (mean = 12.6 years) completed the Child Depression Inventory and a functional magnetic resonance imaging guessing task in which they won or lost money on each trial. Parents completed a measure of life events experienced by the child. Life events were separated by positive versus negative and whether they were likely related or unrelated to the daughter's behavior (i.e., dependent vs. independent, respectively). Multiple regressions tested whether the interaction between ventral striatal (VS) response to wins or losses and recent life events were associated with child-reported depressive symptoms.

RESULTS

A greater number of dependent positive life events related to decreased total depression symptoms when VS response to wins was robust. Conversely, a greater number of independent negative life events related to increased negative mood depression symptoms when VS response to losses was robust; this relationship was in the opposite direction when VS response to loss was low.

CONCLUSIONS

VS response to reward and loss were independent moderators of the relationship between recent life events (positive and negative, respectively) and depressive symptoms. Findings suggest that targeting neural responses (i.e., increasing responses to winning or decreasing responses to losing) may be important for both improving resilience and reducing risk in different environmental contexts.

Extraversion, neuroticism, and the electrocortical response to monetary rewards in adolescent girls

Affective personality traits, such as extraversion and neuroticism, are associated with individual differences in reward system functioning. The reward positivity (ΔRewP) is an event-related potential (ERP) component that indexes sensitivity to reward, and can be elicited by feedback indicating monetary gains relative to losses. In a sample of 508 adolescent girls, the current study examined the relationship between extraversion, neuroticism, and their respective facets and the ΔRewP. Results indicated an Extraversion × Neuroticism interaction, such that greater extraversion was associated with an increased ΔRewP, but only in the context of low neuroticism. This association was primarily due to the extraversion facet positive emotionality-high levels of positive emotionality were associated with an increased ΔRewP, but only in the context of low neuroticism. In addition, increased neuroticism diminished the age-related increase in the ΔRewP. The current study suggests that both extraversion and neuroticism are associated with reward system function in adolescence.

The effect of panic disorder versus anxiety sensitivity on event-related potentials during anticipation of threat

Attention-related abnormalities are key components of the abnormal defensive responding observed in panic disorder (PD). Although behavioral studies have found aberrant attentional biases towards threat in PD, psychophysiological studies have been mixed. Predictability of threat, an important feature of threat processing, may have contributed to these mixed findings. Additionally, anxiety sensitivity, a dimensional trait associated with PD, may yield stronger associations with cognitive processes than categorical diagnoses of PD. In this study, 171 participants with PD and/or depression and healthy controls completed a task that differentiated anticipation of predictable vs. unpredictable shocks, while startle eyeblink and event-related potentials (ERPs [N100, P300]) were recorded. In all participants, relative to the control condition, probe N100 was enhanced to both predictable and unpredictable threat, whereas P300 suppression was unique to predictable threat. Probe N100, but not P300, was associated with startle eyeblink during both threatening conditions, and was strongest for unpredictable threat. PD was not associated with ERPs, but anxiety sensitivity (physical concerns) was positively associated with probe N100 (indicating reduced responding) in the unpredictable condition independent of PD diagnosis. Vulnerability to panic-related psychopathology may be characterized by aberrant early processing of threat, which may be especially evident during anticipation of unpredictable threats.

A comparison of the electrocortical response to monetary and social reward

Affective science research on reward processing has primarily focused on monetary rewards. There has been a growing interest in evaluating the neural basis of social decision-making and reward processing. The present study employed a within-subject design and compared the reward positivity (RewP), an event-related potential component that is present following favorable feedback and absent or reduced following unfavorable feedback, during monetary and social reward tasks. Specifically, 114 participants (75 females) completed a monetary reward task and a novel social reward task that were matched on trial structure, timing, and feedback stimuli in a counterbalanced order. Results indicated that the monetary and social RewP were of similar magnitude, positively correlated and demonstrated comparable psychometric properties, including reliability and dependability. Across both the monetary and social tasks, women demonstrated a greater RewP compared with men. This study provides a novel methodological approach toward examining the electrocortical response to social reward that is comparable to monetary reward.

Unpredictability increases the error-related negativity in children and adolescents

The error-related negativity (ERN) is a response-locked component in the event-related potential observed asa negative deflection 50-100ms following the commission of an error. An unpredictable context has been shown to potentiate amygdala activity, attentional bias toward threat, and the ERN in adults. However, it is unclear whether the impact of unpredictability on the ERN is also observed in children and adolescents. In a sample of 32 9-17year-old participants, we examined the influence of a task-irrelevant unpredictable context on neural response to errors. Participants completed a flanker task designed to elicit the ERN, while simultaneously being exposed to task-irrelevant tone sequences with either predictable or unpredictable timing. Unpredictable tones were rated as more anxiety provoking compared to the predictable tones. Fewer errors were made during unpredictable relative to predictable tones. Moreover, the ERN-but not the correct response negativity (CRN) or stimulus-locked N200-was potentiated during the unpredictable relative to predictable tones. The current study replicates and extends previous findings by demonstrating that an unpredictable context can increase task performance and selectively potentiate the ERN in children and adolescents. ERN magnitude can be modulated by environmental factors suggesting enhanced error processing in unpredictable contexts.

Attention bias modification reduces neural correlates of response monitoring

The error-related negativity (ERN) is an electrophysiological response to errors. Individual differences in the ERN have been posited to reflect sensitivity to threat and linked with risk for anxiety disorders. Attention bias modification is a promising computerized intervention that has been shown to decrease threat biases and anxiety symptoms. In the present study, we examined the impact of a single session of attention bias modification, relative to a control task, on the neural correlates of response monitoring, including the ERN, correct response negativity (CRN), and their difference (i.e., the ERN - CRN or ΔERN). The final sample included 60 participants who first completed a flanker task to elicit the ERN and CRN, and were then randomly assigned to attention bias modification (n=30) or a control task (n=30). After completing the attention bias modification or control task, participants completed the same flanker task to again elicit the ERN and CRN. Among participants who completed attention bias modification training, the ERN, CRN, and ΔERN decreased from the pre- to post-training assessment. In contrast, in participants who completed the control task, the CRN, ERN, and ΔERN did not differ between the pre- and post-training assessment. The presents study suggests that a single session of attention bias modification reduces neural correlates of response monitoring, including error-related brain activity. These results also support attention bias modification as a potential mechanistic-based intervention for the prevention and treatment of anxiety pathology.

Time-Frequency Reward-Related Delta Prospectively Predicts the Development of Adolescent-Onset Depression

BACKGROUND

A blunted reward positivity (RewP), an event-related potential elicited by feedback indicating monetary gain relative to loss, was recently shown to prospectively predict the development of adolescent-onset depression. Time-frequency-based representations of this activity (e.g., reward-related delta) have also been associated with depression. This study is a reanalysis of the time-domain RewP investigation to examine the incremental value of time-frequency indices in the prediction of adolescent-onset depression.

METHODS

The sample included 444 13- to 15-year-old girls with no lifetime history of a depressive disorder. At baseline, adolescents completed a monetary guessing task, and both time-domain and time-frequency analyses were conducted on the event-related potential response to gain and loss feedback. Lifetime psychiatric history in the adolescent and a biological parent were evaluated with diagnostic interviews, and adolescents' current depressive symptoms were assessed using a self-report questionnaire. Adolescents were interviewed again approximately 18 months later to identify first-onset depressive disorder.

RESULTS

Blunted reward-related delta predicted first-onset depressive disorder 18 months later, independent of the time-domain RewP and psychosocial risk factors (i.e., adolescent baseline depressive symptoms, adolescent and parental psychiatric history). In contrast, loss-related theta did not predict the development of depression. Reward-related delta increased sensitivity (73.8% to 82.8%) and positive predictive value (45.0% to 70.9%) for first-onset depressive disorder when applied in parallel and in series, respectively, with baseline depressive symptoms and the time-domain RewP.

CONCLUSIONS

This study provides evidence that frequency-based representations of event-related potentials provide incremental value in the prediction of psychiatric disorders.

Depression symptom dimensions and asymmetrical frontal cortical activity while anticipating reward

Unipolar depression has been characterized as involving diminished approach motivation and reward sensitivity. A psychophysiological indicator of approach motivation involves an asymmetry in frontal EEG activity, such that greater left relative to right frontal cortical activity indicates increased approach motivation. Consistent with the perspective of reduced approach motivation tendencies, depression has been associated with decreased relative left frontal cortical activity. To date, supporting research has primarily relied on categorical diagnoses or composite symptom counts. However, given the heterogeneity in depression, it is unclear what specific symptom dimensions relate to decreased relative left frontal cortical activity. The present study examined the association between multiple depression symptom dimensions and asymmetrical frontal cortical activity while anticipating reward in separate undergraduate (n = 75) and clinical samples (current major depressive disorder [n = 68] and never depressed controls [n = 67]). All participants completed the Inventory of Depression and Anxiety Symptoms, a self-report measure of factor-analytically derived symptom dimensions. Frontal cortical activity was assessed during a computerized slot machine task while participants anticipated potential monetary reward or no incentive. In undergraduates with low depression symptoms and never depressed controls, reward trials relative to no-incentive trials elicited greater relative left frontal cortical activity. Furthermore, in both samples across all participants, increased dysphoria and lassitude symptoms were associated with decreased relative left frontal cortical activity while anticipating reward. The present study suggests that depression symptoms consistent with motivational disengagement are associated with decreased relative left frontal cortical activity.

Pubertal development and anxiety risk independently relate to startle habituation during fear conditioning in 8-14 year-old females

Reduced habituation to aversive stimuli has been observed during adolescence and may reflect an underlying mechanism of vulnerability for anxiety disorders. This study examined the startle reflex during a fear-learning task in 54 8-14-year-old girls. We examined the relationship between mean startle, startle habituation, pubertal development, and two measures linked to risk for anxiety: behavioral inhibition system (BIS) and the error-related negativity (ERN). Puberty, BIS, and the ERN were unrelated to mean startle; however, each measure modulated startle habituation. Greater pubertal development was associated with reduced startle habituation across the CS+ and CS-. Higher BIS related to a larger ERN, and both were associated with reduced startle habituation specifically to the CS+. All effects were independent of each other. Findings suggest that puberty alters habituation of defense system activation to both threat and safety cues, and this is independent of risk for anxiety, which uniquely impacts habituation to threat cues.

Defensive motivation and attention in anticipation of different types of predictable and unpredictable threat: A startle and event-related potential investigation

Predictability is an important characteristic of threat that impacts defensive motivation and attentional engagement. Supporting research has primarily focused on actual threat (e.g., shocks), and it is unclear whether the predictability of less intense threat (e.g., unpleasant pictures) similarly affects motivation and attention. The present study utilized a within-subject design and examined defensive motivation (startle reflex and self-reported anxiety) and attention (probe N100 and P300) in anticipation of shocks and unpleasant pictures during a no, predictable, and unpredictable threat task. This study also examined the impact of predictability on the P300 to shocks and late positive potential (LPP) to unpleasant pictures. The startle reflex and self-reported anxiety were increased in anticipation of both types of threat relative to no threat. Furthermore, startle potentiation in anticipation of unpredictable threat was greater for shocks compared to unpleasant pictures, but there was no difference for predictable threat. The probe N100 was enhanced in anticipation of unpredictable threat relative to predictable threat and no threat, and the probe P300 was suppressed in anticipation of predictable and unpredictable threat relative to no threat. These effects did not differ between the shock and unpleasant picture trials. Finally, the P300 and early LPP component were increased in response to unpredictable relative to predictable shocks and unpleasant pictures, respectively. The present study suggests that the unpredictability of unpleasant pictures increases defensive motivation, but to a lesser degree relative to actual threat. Moreover, unpredictability enhances attentional engagement in anticipation of, and in reaction to, both types of threat.

Hurricane Sandy Exposure Alters the Development of Neural Reactivity to Negative Stimuli in Children

This study examined whether exposure to Hurricane Sandy-related stressors altered children's brain response to emotional information. An average of 8 months (M_age  = 9.19) before and 9 months after (M_age  = 10.95) Hurricane Sandy, 77 children experiencing high (n = 37) and low (n = 40) levels of hurricane-related stress exposure completed a task in which the late positive potential, a neural index of emotional reactivity, was measured in response to pleasant and unpleasant, compared to neutral, images. From pre- to post-Hurricane Sandy, children with high stress exposure failed to show the same decrease in emotional reactivity to unpleasant versus neutral stimuli as those with low stress exposure. Results provide compelling evidence that exposure to natural disaster-related stressors alters neural emotional reactivity to negatively valenced information.