Behavioral activation can normalize neural hypoactivation in subthreshold depression during a monetary incentive delay task
Abstract
Background Late adolescents are under increased risk of developing depressive symptoms. Behavioral activation is an effective treatment for subthreshold depression, which can prevent the development of subthreshold depression into a major depressive disorder. However, the neural mechanisms underlying the efficacy of behavioral activation have not been clearly understood. We investigated neural responses during reward processing by individuals with subthreshold depression to clarify the neural mechanisms of behavioral activation.Methods Late adolescent university students with subthreshold depression (n=15, age 18-19 years) as indicated by a high score on the Beck's Depression Inventory-ll (BDI-ll) and 15 age-matched controls with a low BDI-ll score participated in functional magnetic resonance imaging scanning conducted during a monetary incentive delay task on two occasions. The Individuals in the subthreshold depression group received five, weekly behavioral activation sessions between the two scanning sessions. Moreover, they did not receive any medication until the study was completed.Results Behavioral activation significantly reduced depressive symptoms. Moreover, compared to the changes in brain functions in the control group, the behavioral activation group showed functional changes during loss anticipation in brain structures that mediates cognitive and emotional regulation, including the left ventrolateral prefrontal cortex and angular gyrus.Limitations Replication of the study with a larger sample size is required to increase the generalizability of these results.Conclusions Behavioral activation results in improved functioning of the fronto-parietal region during loss anticipation. These results increase our understanding of the mechanisms underlying specific psychotherapies.
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No interventions yet target subclinical anhedonia or reinforcement-learning deficits in at-risk groups, but evidence suggests they could work.
“To our knowledge, interventions meant to target subclinical anhedonia or impairments in reinforcement learning in at risk populations have yet to be tested, however there is evidence for potential efficacy.”
From The effects of early life stress on reward processing (2018) · cites this paper as Mori et al., 2016
After behavioral activation therapy, people show greater ventromedial PFC activation while anticipating loss on a monetary incentive delay task, which is thought to support continued rewarding activity despite negative mood.
“When individuals who have completed behavioral activation therapy are challenged with a monetary incentive delay task, they demonstrate increased activation of the ventromedial PFC during anticipation of a loss, which is interpreted as allowing for ongoing engagement in rewarding activity despite negative emotions (Mori et al., 2016).”
From The effects of early life stress on reward processing (2018) · cites this paper as Mori et al., 2016
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- Authors
- Mori, A., Okamoto, Y., Okada, G., Takagaki, K., Jinnin, R., Takamura, M., Kobayakawa, M., & Yamawaki, S.
- Affiliations
- Hiroshima University (JP)
- Corresponding author
- Okamoto, Yasumasa
- ORCID
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2016-01
- Volume
- 189
- Pages
- 254-262
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W1862856276
- Cited by
- 49
- References
- 73
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 10 · 2023: 4 · 2021: 6 · 2020: 3 · 2019: 4 · 2018: 6 · 2017: 7 · 2016: 3
- FWCI
- 3.21
- Type
- journal article
- Language
- en
- Update notices
- erratum (2017-01-15)
- Open access
- closed
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Keywords
- behavioral activation, subthreshold depression, late adolescence, monetary incentive delay task, reward processing, loss anticipation, ventrolateral prefrontal cortex, angular gyrus, frontoparietal network, psychotherapy mechanisms
- MeSH terms
- Adolescent, Behavior Therapy, Brain, Brain Mapping, Depression, Emotions, Female, Humans, Magnetic Resonance Imaging, Male, Motivation, Reward, Case-Control Studies, Treatment Outcome, Young Adult
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