Blunted neural response to rewards prospectively predicts depression in adolescent girls

Motivational and hedonic impairments are core aspects of a variety of types of psychopathology. These impairments cut across diagnostic categories and may be critical to understanding major aspects of the functional impairments accompanying psychopathology. Given the centrality of motivational and hedonic systems to psychopathology, the Research Domain Criteria (RDoC) initiative includes a "positive valence" systems domain that outlines a number of constructs that may be key to understanding the nature and mechanisms of motivational and hedonic impairments in psychopathology. These component constructs include initial responsiveness to reward, reward anticipation or expectancy, incentive or reinforcement learning, effort valuation, and action selection. Here, we review behavioral and neuroimaging studies providing evidence for impairments in these constructs in individuals with psychosis versus in individuals with depressive pathology. There are important differences in the nature of reward-related and hedonic deficits associated with psychosis versus depression that have major implications for our understanding of etiology and treatment development. In particular, the literature strongly suggests the presence of impairments in in-the-moment hedonics or "liking" in individuals with depressive pathology, particularly among those who experience anhedonia. Such deficits may propagate forward and contribute to impairments in other constructs that are dependent on hedonic responses, such as anticipation, learning, effort, and action selection. Such hedonic impairments could reflect alterations in dopamine and/or opioid signaling in the striatum related to depression or specifically to anhedonia in depressed populations. In contrast, the literature points to relatively intact in-the-moment hedonic processing in psychosis, but provides much evidence for impairments in other components involved in translating reward to action selection. Particularly, individuals with schizophrenia exhibit altered reward prediction and associated striatal and prefrontal activation, impaired reward learning, and impaired reward-modulated action selection.

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Theories and research on depression point to reduced responsiveness during reward anticipation and in part also during punishment anticipation. They also suggest weaker affective responses to reward consumption and unchanged affective responses to punishment consumption. However, studies investigating incentive anticipation using effort mobilization and incentive consumption using facial expressions are scarce. The present studies tested reward and punishment responsiveness in a subclinically depressed sample, manipulating a monetary reward (Study 1) and a monetary punishment (Study 2). Effort mobilization was operationalized as cardiovascular reactivity, while facial expressions were measured by facial electromyographic reactivity. Compared to nondysphorics, dysphorics showed reduced preejection period (PEP) reactivity and blunted self-reported wanting during reward anticipation but reduced PEP reactivity and normal self-reported wanting during punishment anticipation.Compared to nondysphorics, dysphorics showed reduced zygomaticus major muscle reactivity and blunted self-reported liking during reward consumption but normal corrugator supercilii muscle reactivity and normal self-reported disliking during punishment consumption.