This article is more than 5 years old. Information may no longer be current.

Reduced neural response may be useful screening target for adolescent depression

Reduced reward positivity predicted first-onset depressive disorder among adolescent girls, suggesting blunted neural response may be an important target for screening and prevention.

“Adolescence is a high-risk period for the emergence of depression. Prospective studies show a marked increase in rates of depression from childhood through adolescence, and epidemiological studies indicate that the lifetime prevalence of depression in adolescence is approximately 11% to 14%,” Brady D. Nelson, PhD, of Stony Brook University, New York, and colleagues wrote. “Adolescence provides a unique opportunity to examine risk factors for depression before the marked increase in disorder incidence and symptoms, especially in girls, who exhibit the sharpest rise in risk.”

To determine if reward positivity predicts development of depression 18 months later in adolescent girls, researchers assessed 444 girls aged 13.5 to 15.5 years with no lifetime history of depressive disorder in addition to a biological parent of each girl. At baseline, adolescents’ reward positivity was measured using a monetary guessing task and current depressive symptoms were assessed via self-reports. Parents’ lifetime histories were assessed via diagnostic interviews. Interviews and self-reports were administered to adolescents 18 months later.

Reduced reward positivity at baseline predicted first-onset depressive disorder and greater depressive symptom scores 18 months later.

Reward positivity also significantly predicted later depression regardless of other prominent risk factors, including baseline depressive symptoms and adolescent and parental lifetime psychiatric history.

Together, reduced reward positivity and greater depressive symptom scores at baseline were the strongest predictors of later depressive disorder.

“These results suggest that a blunted neural response to rewards indexes a distinct vulnerability from other well-established psychosocial risk factors. In addition, the reward positivity provided a nearly twofold increase in positive predictive value of first-onset depressive disorder when combined in series with baseline dysphoria symptoms,” the researchers wrote. “In a clinical or research setting, the temporal ordering of these screening measures could be conducted in a cost-effective manner. For example, all patients might initially complete a self-report measure of dysphoria symptoms, and those with elevated symptoms would receive the secondary assessment of reward system functioning.” – by Amanda Oldt

Disclosure: The researchers report no relevant financial disclosures.