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Reinforcement sensitivity, depression and anxiety: A meta-analysis and meta-analytic structural equation model

Katz, Benjamin A., Matanky, Kathryn, Aviram, Gidi, Yovel, Iftah·2020·Clinical Psychology Review

DOI 10.1016/j.cpr.2020.101842

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Abstract

Reinforcement Sensitivity Theory (RST) posits that individual differences in reward and punishment processing predict differences in cognition, behavior, and psychopathology. We performed a quantitative review of the relationships between reinforcement sensitivity, depression and anxiety, in two separate sets of analyses. First, we reviewed 204 studies that reported either correlations between reinforcement sensitivity and self-reported symptom severity or differences in reinforcement sensitivity between diagnosed and healthy participants, yielding 483 effect sizes. Both depression (Hedges' g = .99) and anxiety (g = 1.21) were found to be high on punishment sensitivity. Reward sensitivity negatively predicted only depressive disorders (g = -.21). More severe clinical states (e.g., acute vs remission) predicted larger effect sizes for depression but not anxiety. Next, we reviewed an additional 39 studies that reported correlations between reinforcement sensitivity and both depression and anxiety, yielding 156 effect sizes. We then performed meta-analytic structural equation modeling to simultaneously estimate all covariances and control for comorbidity. Again we found punishment sensitivity to predict depression (β = .37) and anxiety (β = .35), with reward sensitivity only predicting depression (β = -.07). The transdiagnostic role of punishment sensitivity and the discriminatory role of reward sensitivity support a hierarchical approach to RST and psychopathology.

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“A large meta-analysis by Katz et al. (2020) also showed that hypersensitivity to low reinforcement and sensitivity to high punishment predict depression.”
BackgroundResultInfluential
Relations Between Behavioral Inhibition/Activation Systems and Self-Esteem: Two Multiple Mediation Models With Social Relationships
Jiang, D., Yin, J., Zhai, S.-Y., & He, J. (2024) · Emerging Adulthood · doi:10.1177/21676968241254417 · Cited by 1
“To illustrate, researchers have found that individuals with higher BIS sensitivity are more likely to show emotion regulation dif ﬁ culties, depression, and stress symptoms, while individuals with high BAS sensitivity are the opposite (Katz et al., 2020; Markarian et al., 2013; Ran et al., 2018).”
Neural and psychosocial signatures of the comorbidity between pain and affective symptoms
Scarlatti, F., Dormegny-Jeanjean, L. C., Schefzik, R., Foucher, J., Banaschewski, T., Bokde, A. L. W., Brühl, R., Desrivières, S., Garavan, H., Gowland, P. A., et al. (2025) · PAIN Reports · doi:10.1097/pr9.0000000000001353 · Cited by 1
“7,25 The MID task used in the IMAGEN study did not involve explicit punishments, which may be essential for revealing the components of instrumental learning associated with anxiety.”
Approach and avoidance behaviors in motivational conflicts are driven by magnitude of potential outcomes and relate to anxiety levels
Feldman, S. B.-Z., Dayan, O., Somerville, Y., Kao, C.-H., Cohen, S., Glickman, O., Ruiz, S. G., Newsome, P., Linke, J. O., Shechner, T., et al. (2026) · Scientific Reports · doi:10.1038/s41598-026-46946-4 · Cited by 1
Internet addiction from a computational model: the predictive value of reinforcement learning parameters and behavioral inhibition systems
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“Prior studies have substantiated the role of the BIS/BAS sensitivity in predicting certain psychiatric disorders, including depression, anxiety (Katz et al., 2020), and substance addiction (Jacobs et al., 2022).”
Construct and Concurrent Validity of two Scales Designed to Measure Reinforcement Sensitivity
Rull, M. A. P., Aristegui, T., Gutiérrez, A., Mariñelarena, V., Parra, F., & Pascual, M. (2023) · Revista Argentina de Ciencias del Comportamiento ( RACC ) · doi:10.32348/1852.4206.v15.n1.30901 · Cited by 1
Reinforcement sensitivity, depression and anxiety: A meta-analysis and meta-analytic structural equation modelPreprint
Katz, B. A., Matanky, K., Aviram, G., Yovel, I., & Yovel, C. A. P. L. I. (2019) · doi:10.31234/osf.io/xw7sh · Cited by 1
Self-citation
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A Study on Reward and Punishment Learning Using A Data-Driven Approach
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“Katz et al. [12] proposed a framework to perform a quantitative analysis on the relationship between reinforcement sensitivity, anxiety, and depression using a meta-analysis and meta-analytic structural equation approach.”
Background
Reinforcement sensitivity theory and clinical psychology
Sasaki, Y. (2023) · The Japanese journal of psychology · doi:10.4992/jjpsy.94.22404
Relationship Between Supply Chain Management and Competitor Intensity in The Food Business: A Structural Equation Model
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“…is developed as a system and coordination of strategies from traditional business functions, which is a tactic of all businesses in an organization and all companies in the supply chain to improve the long-term performance of individual organizations and supply chains (Xi, 2020)(Katz, 2020).”
Background
(In)Harmonious transition from an intent to an action: emotional correlates of susceptibility to control and authorship
Adamska, K., Jurek, P., & Pedynkowska, J. (2024) · Current Psychology · doi:10.1007/s12144-024-06882-w
“As anxiety (as well as neuroticism) is associated with sen - sitivity to punishment signals (Katz et al., 2020), the real or imagined presence of others may contribute negatively to the link between intention and action, reinforcing a ten - dency towards social anxiety and embarrassment.”
Cognitive styles and behavioral systems: Linking looming cognitive style and reinforcement sensitivity
Atalay, A. A., Gökdağ, C., & King, N. (2025) · Personality and Individual Differences · doi:10.1016/j.paid.2025.113152
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“…disorders, and individual differences in sensitivity toward reward versus punishment are often assumed to contribute to vulnerability to addiction (Martin-Soelch et al. 2007), including addictive behaviors (Brand et al. 2019), or anxiety disorders and depression (Katz et al. 2020), respectively.”
Exploring the Link Between a Prior Belief for Active Avoidance and Apathy, Anhedonia, and Depression: A Network Analysis
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Interrelationship of childhood abuse, BIS/BAS, and stressful life events in predicting depression: A structural equation modeling study
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“24,50 This lack of association in our study may be owing to the fact that our sample consisted of a nonclinical adult population, which did not include individuals with severe depression.”
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Mrkonja, L., Feng, Z., Marchant, N. J., Vries, T. J. D., Leganes‐Fonteneau, M., & Wiers, R. W. H. J. (2026) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2026.102086
Contribution of Reward Sensitivity Towards Anhedonia Among College Students
Mahakud, G. C., Sharma, A., & Chakraborty, S. (2026) · Indian Journal of Health Studies · doi:10.56490/ijhs.2026.8101
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Sutcliffe, K., Tashjian, S. M., & Dam, N. T. V. (2026) · Journal of Experimental Psychopathology · doi:10.1177/20438087261429311
“This heightened attentiveness to potential loss information may be especially pronounced in individuals with affective distress symptoms given that heightened sensitivity to punishment is characteristic of both anxiety and depression (Katz et al., 2020).”
Mesocorticolimbic connectivity and motivational sensitivity: sex-specific effects of puberty in early adolescence
Ojha, A., Henry, T. R., Jones, N. P., Shirtcliff, E. A., & Ladouceur, C. D. (2026) · Neuropsychopharmacology · doi:10.1038/s41386-026-02378-2
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Anhedonia and Anxious Arousal Are Associated With Distinct Expectations About the Statistics of a Volatile Environment
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“…findings are consistent with research showing asymmetric recruitment of neural systems that control responsiveness to volatility across positive and negative contexts [e.g., norepinephrine (28)] and with findings of valence-specific learning alterations in internalizing disorders (31,32,70,71).”
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“Higher behavioral inhibition system was associated not only with more severe depressive symptoms (Masuyama et al., 2022), but also with worry and avoidance (Katz et al., 2020).”
The Causal Model of Depression in Women with Multiple Sclerosis Based on Behavioral Brain Systems with the Mediator Role of Cognitive Emotion Regulation Strategies
Haddadi, S., Mousavi, S. M., & Khanzadeh, A. A. H. (2025) · Rooyesh Psychological Journal · doi:10.66224/rooyesh.14.10.151

Authors: Katz, B. A., Matanky, K., Aviram, G., & Yovel, I.
Affiliations: Hebrew University of Jerusalem (IL)
Corresponding author: Katz, Benjamin A.
ORCID: Katz, Benjamin A.
Yovel, Iftah
Venue: Clinical Psychology Review
Publisher: Elsevier BV
Published: 2020-04
Volume: 77
Pages: 101842
ISSN: 0272-7358 (ISSN-L)
DOI: 10.1016/j.cpr.2020.101842
OpenAlex: W3009760869
Cited by: 109
References: 410
Citations by year: 2026: 18 · 2025: 20 · 2024: 15 · 2023: 16 · 2022: 16 · 2021: 14 · 2020: 9
FWCI: 2.01
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: Clinical Psychology Review (publishedVersion)
PubMed (publishedVersion)
Funders: Israel Science Foundation (886/18)
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
Keywords: Reinforcement Sensitivity Theory, punishment sensitivity, reward sensitivity, depression, anxiety, psychopathology, transdiagnostic mechanisms, comorbidities, symptom severity, remission
MeSH terms: Latent Class Analysis, Anxiety, Depression, Humans, Punishment, Reward

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Reinforcement sensitivity, depression and anxiety: A meta-analysis and meta-analytic structural equation model

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