Teens With a Reduced Response to Rewards Are More Susceptible to Depression

Novel research shows that a reduced neural response to receiving rewards in teens predicts the first onset of depression, but not anxiety or suicidality. This is independent of pre-existing depressive or anxiety symptoms, as well as age or sex, which are already strong risk factors for depression. The study opens in new tab/window in Biological Psychiatry: Cognitive Neuroscience and Neuroimaging opens in new tab/window, published by Elsevier, is a step toward using brain science to understand and assess mental health risks.

Mood and anxiety disorders among youth are a growing concern and have long-lasting consequences. Very few studies have identified premorbid neural markers that indicate the risk of the onset of these disorders in a teen's life. This is particularly important given that 50% of children who experience one episode of depression or anxiety will go on to experience a second. Among those who have had two episodes, 80% will go on to have a third or more.

Investigators at the University of Calgary, Alberta, Canada, followed a group of 145 teens (64.8% female) with a family history of depressive or anxiety disorders, which put them at very high risk for developing these disorders themselves. Participating families were part of the Calgary Biopsychosocial Risk for Adolescent Internalizing Disorders (CBRAID) study, a longitudinal research program examining premorbid risk factors for first-lifetime onsets of mood and anxiety disorders in adolescence.

Researchers conducted nine- and 18-month follow-ups to assess whether participants had developed a major depressive disorder, anxiety disorder, or suicidal ideation. They found that a blunted response to reward feedback (also known as reward positivity) while playing a game during an EEG scan in which teens were told they either won or lost predicted the first onset of depression, but not anxiety or suicidality. This may suggest that teens who feel less pleasure or satisfaction when receiving rewards are particularly vulnerable to developing depression for the first time in their life.

First author Gia-Huy L. Hoang, second-year master’s student in neuroscience, University of Calgary, adds, "Evidence shows that kids with depressive or anxiety disorders, which often occur at the same time, generally exhibit a blunted response to rewards. Our research suggests that the brain's response to rewards may be a marker that specifically indicates a risk for depression, rather than for anxiety or suicidality, in teens. Using EEG to measure how the brain responds to rewards is a simple and low-cost method to measure this response."

Editor-in-Chief of Biological Psychiatry: Cognitive Neuroscience and Neuroimaging Cameron S. Carter, MD, University of California Irvine, comments, "Depression, anxiety, and suicidality are strongly linked, and are highly disabling and common problems that typically begin during adolescence. Reward processing is closely linked to depression and anxiety. However, little is known about if a blunted response to rewards precedes these conditions and confers risk for depression, anxiety, or suicidality. Research into specific biomarkers that can identify the risk of first-lifetime onsets of these conditions is highly important to understand and assess mental health risks."

Senior investigator Daniel C. Kopala-Sibley, PhD, Hotchkiss Brain Institute, Alberta Children Hospital Research Institute, The Mathison Centre for Mental Health Research & Education, and Department of Psychiatry, Cumming School of Medicine, University of Calgary, concludes, "Our findings are important as we work towards understanding the brain bases of why teens become depressed for the first time in their lives, which may ultimately further our ability to identify those at risk and intervene with them to prevent the onset of these disorders."

Notes for editors

The article is "The Reward Positivity as a Predictor of First Lifetime Onsets of Depression, Anxiety, and Suicidal Ideation in High-Risk Adolescents," by Gia-Huy L. Hoang, BSc, Kent G. Hecker, PhD, Connor Maxey, BSc, Ford Burles, PhD, Olave E. Krigolson, PhD, and Daniel C. Kopala-Sibley, PhD (https://doi.org/10.1016/j.bpsc.2024.10.017 opens in new tab/window). It appears online in advance of volume 10, issue 2 (February 2025) of Biological Psychiatry: Cognitive Neuroscience and Neuroimaging opens in new tab/window, published by Elsevier opens in new tab/window.

The article is openly available at https://www.biologicalpsychiatrycnni.org/article/S2451-9022(24)00334-3/fulltext opens in new tab/window.

Copies of this paper are also available to credentialed journalists upon request; please contact Rhiannon Bugno at [email protected] opens in new tab/window. Journalists wishing to interview the study’s authors should contact Daniel C. Kopala-Sibley, PhD, at [email protected] opens in new tab/window, or Kelly Johnston, Sr. Communications Specialist, Cumming School of Medicine, University of Calgary, at +1 403 617 8691 or [email protected] opens in new tab/window.

The authors’ affiliations and disclosures of financial and conflicts of interest are available in the article.

Cameron S. Carter, MD, is Chair of the Department of Psychiatry & Human Behavior at the University of California, Irvine School of Medicine. His disclosures of financial and conflicts of interest are available here opens in new tab/window.

This research was supported by grants from the Canadian Institutes of Health Research (CIHR), the Brain and Behavior Research Foundation through a Young Investigator Award to Daniel C. Kopala-Sibley, the Hotchkiss Brain Institute, the Mathison Centre for Mental Health Research and Education, and the Alberta Children's Hospital Research Institute.

About Biological Psychiatry: Cognitive Neuroscience and Neuroimaging

Biological Psychiatry: Cognitive Neuroscience and Neuroimaging opens in new tab/window is an official journal of the Society of Biological Psychiatry opens in new tab/window, whose purpose is to promote excellence in scientific research and education in fields that investigate the nature, causes, mechanisms and treatments of disorders of thought, emotion, or behavior. In accord with this mission, this peer-reviewed, rapid-publication, international journal focuses on studies using the tools and constructs of cognitive neuroscience, including the full range of non-invasive neuroimaging and human extra- and intracranial physiological recording methodologies. It publishes both basic and clinical studies, including those that incorporate genetic data, pharmacological challenges, and computational modeling approaches. The 2023 Journal Impact Factor^TM score, from Clarivate, for Biological Psychiatry: Cognitive Neuroscience and Neuroimaging is 5.7. https://www.sobp.org/bpcnni opens in new tab/window

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