Neural Correlates of Reward Processing in Depressed and Healthy Preschool-Age Children.
Neural Correlates of Reward Processing in Depressed and Healthy Preschool-Age Children.
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DOI：
10.1016/j.jaac.2016.09.503
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发表时间：
2016-12
影响因子：
13.3
通讯作者：
Barch, Deanna M.
中科院分区：
文献类型：
--
作者：
Belden, Andy C.;Irvin, Kelsey;Hajcak, Greg;Kappenman, Emily S.;Kelly, Danielle;Karlow, Samantha;Luby, Joan L.;Barch, Deanna M.
患有重度抑郁症（MDD）的成年人和青少年对奖励表现出迟钝的神经反应。抑郁症已在3岁的儿童中得到验证;然而，目前尚不清楚对奖励的迟钝反应是否也是学龄前抑郁症的核心特征。如果是这样，这将进一步验证抑郁症神经相关因素在整个生命周期中的连续性，并将确定幼儿治疗的潜在目标。53名4-7岁抑郁症儿童和25名精神健康的4-7岁儿童完成了一项简单的猜测任务，在每次试验中可以赢得或失去点，同时记录事件相关电位（ERP）。精神病诊断是使用幼儿版的情感障碍和抑郁症的儿童时间表建立的。患有抑郁症的幼儿表现出对收益和损失的反应之间的差异减少，这一发现是由对奖励的迟钝反应（即，奖励积极性[RewP]）。即使在控制了同时发生的注意力缺陷/多动障碍、对立违抗性障碍和广泛性焦虑障碍的情况下，这些发现也是成立的。在抑郁症组内，RewP没有随抑郁症严重程度而变化。与患有抑郁症的成年人和青少年类似，患有抑郁症的学龄前儿童显示出RewP指数所指示的对奖励的反应性降低。这些发现为与抑郁症相关的神经机制在整个生命周期中的连续性提供了进一步的证据，并指出奖励敏感性的改变是干预学龄前抑郁症的早期潜在目标。一项PCIT-ED治疗学龄前抑郁症的随机对照试验; http：//clinicaltrials.gov/; NCT 02076425。
Adults and adolescents with major depressive disorder (MDD) show a blunted neural response to rewards. Depression has been validated in children as young as age 3; however, it remains unclear whether blunted response to reward is also a core feature of preschool-onset depression. If so, this would provide further validation for the continuity of the neural correlates of depression across the life span and would identify a potential target for treatment in young children. Fifty-three 4–7-year-old children with depression and 25 psychiatrically healthy 4–7-year-old children completed a simple guessing task in which points could be won or lost on each trial while event-related potentials (ERPs) were recorded. Psychiatric diagnosis was established using a preschool version of the Kiddie Schedule for Affective Disorders and Depression. Young children with depression showed a reduced differentiation between response to gains and losses, and this finding was driven by a blunted response to reward (i.e., the reward positivity [RewP]). These findings held even when controlling for co-occurring attention-deficit/hyperactivity disorder, oppositional defiant disorder, and generalized anxiety disorder. The RewP did not vary as a function of depression severity within the group with depression. Similar to adults and adolescents with depression, preschoolers with depression display reductions in responsivity to rewards as indexed by the RewP. These findings provide further evidence for continuity in the neural mechanisms associated with depression across the lifespan, and point to altered reward sensitivity as an early-emerging potential target for intervention in preschool-onset depression. A Randomized Controlled Trial of PCIT-ED for Preschool Depression; http://clinicaltrials.gov/; NCT02076425.
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