Reduced Reward Responsiveness Predicts Change in Depressive Symptoms in Anxious Children and Adolescents Following Treatment

Kujawa, Autumn; Burkhouse, Katie L.; Karich, Shannon R.; Fitzgerald, Kate D.; Monk, Christopher S.; Phan, K. Luan

doi:10.1089/cap.2018.0172

Cited by 41Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesChild and Adolescent Psychosocial and Emotional DevelopmentNeural and Behavioral Psychology Studies

Reduced Reward Responsiveness Predicts Change in Depressive Symptoms in Anxious Children and Adolescents Following Treatment

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Kujawa, Autumn, Burkhouse, Katie L., Karich, Shannon R., Fitzgerald, Kate D., Monk, Christopher S., Phan, K. Luan·2019·Journal of Child and Adolescent Psychopharmacology

DOI 10.1089/cap.2018.0172PMC PMC6585168

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Abstract

Objectives: Reduced reward responsiveness, as measured by the event-related potential (ERP) component, the reward positivity (RewP), has been shown to play a role in the development of internalizing disorders, but implications for treatment remain unclear. In adult patients with anxiety and/or depression, reduced RewP has emerged as a predictor of greater change in symptoms following cognitive behavior therapy (CBT) or selective serotonin reuptake inhibitor (SSRI) treatment. The objectives of this preliminary study were to extend these findings to children and adolescents with anxiety disorders by evaluating RewP to reward as a predictor of change in anxiety severity or depressive symptoms following treatment with CBT or SSRI and to explore whether RewP differentially predicts response to one type of treatment. Methods: Patients (7–19 years old) with social and/or generalized anxiety disorder (N = 27) completed baseline measures of anxiety severity and depressive symptoms, as well as an ERP monetary reward anticipation and feedback task. RewP was measured in response to reward and breaking even feedback. Patients were then randomly assigned to CBT or SSRI treatment, and completed measures of anxiety and depressive symptom severity at the last treatment session. Results: Reduced reward responsiveness, as measured by RewP to rewards, predicted greater change in depressive symptoms following treatment, adjusting for baseline symptoms, age, and RewP to breaking even. RewP was not a significant predictor of change in anxiety symptoms. Although preliminary, exploratory analyses suggested that among anxious youth, RewP specifically predicted change in depressive symptoms following CBT, rather than SSRI. Conclusion: Results provide preliminary support for the utility of ERP measures of reward responsiveness in predicting treatment response in youth. With further research and standardization, ERP assessments could potentially be implemented in clinical settings to inform prognosis and treatment planning for youth with internalizing disorders.

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In individuals with MDD, aerobic exercise is beneficial in ameliorating depressive symptoms, particularly in those with more severe depressive symptoms and a higher baseline RewP.
“In individuals with MDD, aerobic exercise was found to be beneficial in ameliorating depressive symptoms, particularly in those with more severe depressive symptoms and a higher baseline RewP. 325 , 326”
From Major depressive disorder: hypothesis, mechanism, prevention and treatment (2024) · cites this paper as [326]
The Results (page unavailable) report that a reduced—not higher—baseline RewP predicted greater improvement in depressive symptoms. The study examined anxious children and adolescents treated with CBT or SSRIs, not aerobic exercise in individuals with MDD; it also does not establish that those with more severe baseline symptoms benefited more. (LLM, conf=0.82)
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NEURAL REACTIVITY TO REWARD AS A PREDICTOR OF COGNITIVE BEHAVIORAL THERAPY RESPONSE IN ANXIETY AND DEPRESSION
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The role of reward-related brain activity in response to treatment and later depression severity: data from a randomized controlled trial in early adolescents with anxiety disorders
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Authors: Kujawa, A., Burkhouse, K. L., Karich, S. R., Fitzgerald, K. D., Monk, C. S., & Phan, K. L.
Affiliations: Vanderbilt University (US)
University of Illinois Chicago (US)
University of Michigan (US)
Corresponding author: Burkhouse, Katie L.
ORCID: Kujawa, Autumn
Burkhouse, Katie L.
Fitzgerald, Kate D.
Monk, Christopher S.
Phan, K. Luan
Venue: Journal of Child and Adolescent Psychopharmacology
Publisher: SAGE Publications
Published: 2019-06
Volume: 29
Issue: 5
Pages: 378-385
ISSN: 1044-5463 (ISSN-L)
1557-8992
DOI: 10.1089/cap.2018.0172
PMC: PMC6585168
OpenAlex: W2944593621
Cited by: 41
References: 51
Citations by year: 2026: 2 · 2025: 3 · 2024: 7 · 2023: 3 · 2022: 7 · 2021: 5 · 2020: 12 · 2019: 1 · 2018: 1
FWCI: 7.34
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.liebertpub.com/nv/resources-tools/text-and-data-mining-policy/121/ (tdm)
Locations: Journal of Child and Adolescent Psychopharmacology (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: National Institute of Mental Health (R01MH086517, K23-MH113793-01, K23MH113793, MH113793, MH086517)
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
Keywords: reward positivity, reward responsiveness, event-related potentials, depressive symptoms, anxiety disorders, social anxiety disorder, generalized anxiety disorder, cognitive behavioral therapy, selective serotonin reuptake inhibitors, treatment response prediction, children and adolescents, internalizing disorders
MeSH terms: Adolescent, Anxiety Disorders, Depression, Electroencephalography, Evoked Potentials, Female, Humans, Male, Psychiatric Status Rating Scales, Reward, Cognitive Behavioral Therapy, Selective Serotonin Reuptake Inhibitors

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Reduced Reward Responsiveness Predicts Change in Depressive Symptoms in Anxious Children and Adolescents Following Treatment

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