DelDonno Sophie R, Weldon Anne L, Crane Natania A, Passarotti Alessandra M, Pruitt Patrick J, Gabriel Laura B, Yau Wendy, Meyers Kortni K, Hsu David T, Taylor Stephen F, Heitzeg Mary M, Herbener Ellen, Shankman Stewart A, Mickey Brian J, Zubieta Jon-Kar, Langenecker Scott A
Department of Psychiatry, University of Illinois - Chicago, Chicago, IL, USA.
Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA.
Psychiatry Res. 2015 Nov 30;230(1):56-64. doi: 10.1016/j.psychres.2015.08.011. Epub 2015 Aug 11.
Anhedonia, the diminished anticipation and pursuit of reward, is a core symptom of major depressive disorder (MDD). Trait behavioral activation (BA), as a proxy for anhedonia, and behavioral inhibition (BI) may moderate the relationship between MDD and reward-seeking. The present studies probed for reward learning deficits, potentially due to aberrant BA and/or BI, in active or remitted MDD individuals compared to healthy controls (HC). Active MDD (Study 1) and remitted MDD (Study 2) participants completed the modified monetary incentive delay task (mMIDT), a behavioral reward-seeking task whose response window parameters were individually titrated to theoretically elicit equivalent accuracy between groups. Participants completed the BI Scale and BA Reward-Responsiveness and Drive Scales. Despite individual titration, active MDD participants won significantly less money than HCs. Higher Reward-Responsiveness scores predicted more won; Drive and BI were not predictive. Remitted MDD participants' performance did not differ from controls', and trait BA and BI measures did not predict r-MDD performance. These results suggest that diminished reward-responsiveness may contribute to decreased motivation and reward pursuit during active MDD, but that reward learning is intact in remission. Understanding individual reward processing deficits in MDD may inform personalized intervention addressing anhedonia and motivation deficits in select MDD patients.
快感缺失，即对奖励的预期和追求减少，是重度抑郁症（MDD）的核心症状。特质行为激活（BA）作为快感缺失的替代指标，以及行为抑制（BI）可能会调节MDD与寻求奖励之间的关系。本研究探究了与健康对照组（HC）相比，处于活动期或缓解期的MDD个体中可能由于异常BA和/或BI导致的奖励学习缺陷。活动期MDD（研究1）和缓解期MDD（研究2）参与者完成了改良的金钱激励延迟任务（mMIDT），这是一项行为性寻求奖励任务，其反应窗口参数经过个体调整，理论上可使各组之间的准确性相当。参与者完成了BI量表以及BA奖励反应性和驱动力量表。尽管进行了个体调整，但活动期MDD参与者赢得的钱明显少于HC组。较高的奖励反应性得分预示着赢得更多的钱；驱动力和BI没有预测作用。缓解期MDD参与者的表现与对照组没有差异，特质BA和BI测量指标也不能预测缓解期MDD的表现。这些结果表明，奖励反应性降低可能导致活动期MDD期间动机和奖励追求减少，但缓解期的奖励学习是完整的。了解MDD中个体奖励处理缺陷可能有助于为针对特定MDD患者的快感缺失和动机缺陷的个性化干预提供信息。
