Reduced Stress-Sensitivity or Increased Reward Experience: The Psychological Mechanism of Response to Antidepressant Medication

Wichers, M C; Barge-Schaapveld, D Q C M; Nicolson, N A; Peeters, F; de Vries, M; Mengelers, R; van Os, J

doi:10.1038/npp.2008.66

Cited by 139Treatment of Major DepressionAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesNeurotransmitter Receptor Influence on Behavior

Reduced Stress-Sensitivity or Increased Reward Experience: The Psychological Mechanism of Response to Antidepressant Medication

Wichers, M C, Barge-Schaapveld, D Q C M, Nicolson, N A, Peeters, F, de Vries, M, Mengelers, R, van Os, J·2009·Neuropsychopharmacology

DOI 10.1038/npp.2008.66

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Abstract

Depression has often been associated with increased negative affect reactivity to stress (Stress-Sensitivity) and reduced capacity to experience pleasure or positive affect (Reward Experience). To date, no studies have prospectively examined changes in Stress-Sensitivity and Reward Experience following antidepressant treatment. The sample included 83 depressed patients and 22 healthy controls. A randomized controlled trial was carried out with patients receiving either imipramine or placebo for 6 weeks. At baseline and 6 weeks, patients and controls participated in an Experience Sampling procedure, prospectively measuring ecologically valid daily life appraisals of activities and mood states. The course of depression was assessed with the Hamilton Depression Rating Scale (HDRS). Multilevel linear regression analyses showed that patients had higher negative and lower positive appraisals of activities than controls. In addition, patients showed increased Stress-Sensitivity (negative affect reactivity to negatively appraised activities). Treatment with imipramine decreased Stress-Sensitivity and increased Reward Experience (positive affect reactivity to positively appraised activities). Changes in Stress-Sensitivity and Reward Experience were in part reducible to changes in the process of activity appraisal itself. However, increase in Reward Experience, but not decrease in Stress-Sensitivity, discriminated between patients who responded and those who did not, independent of changes in the process of activity appraisal itself. Response to treatment in depression may be conditional on restoration of hedonic capacity, the cerebral substrate of which requires further study in relation to antidepressant response. A search for (synergistic) antidepressant therapies specifically targeting ability to experience reward may be warranted.

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Authors: Wichers, M. C., Barge-Schaapveld, D. Q. C. M., Nicolson, N. A., Peeters, F., de Vries, M., Mengelers, R., & van Os, J.
Affiliations: Maastricht University (NL)
Corresponding author: Wichers, M C
ORCID: Wichers, M C
Nicolson, N A
Peeters, F
Venue: Neuropsychopharmacology
Publisher: Springer Science and Business Media LLC
Published: 2008-05-21
Volume: 34
Issue: 4
Pages: 923-931
ISSN: 0893-133X (ISSN-L)
1740-634X
DOI: 10.1038/npp.2008.66
OpenAlex: W1965872363
Cited by: 139
References: 69
Citations by year: 2026: 2 · 2025: 5 · 2024: 3 · 2023: 5 · 2022: 7 · 2021: 5 · 2020: 7 · 2019: 8 · 2018: 8 · 2017: 13 · 2016: 9 · 2015: 16 · 2014: 11 · 2013: 6 · 2012: 8
FWCI: 6.07
Type: journal article
Language: en
Open access: closed
Licence: www.springer.com/tdm (tdm)
Locations: Neuropsychopharmacology (publishedVersion)
PubMed (publishedVersion)
Data Archiving and Networked Services (DANS) (submittedVersion)
Pure Amsterdam UMC (submittedVersion)
Topics: Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
Keywords: depression, antidepressant response, imipramine, stress sensitivity, hedonic capacity, treatment response prediction, ecological momentary assessment
MeSH terms: Adolescent, Adult, Aged, Analysis of Variance, Antidepressive Agents, Major Depressive Disorder, Female, Humans, Imipramine, Male, Middle Aged, Neuropsychological Tests, Regression Analysis, Reward, Stress, Psychological, Young Adult

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Reduced Stress-Sensitivity or Increased Reward Experience: The Psychological Mechanism of Response to Antidepressant Medication

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