Associations Between Early Adolescent Reward Functioning And Later Psychopathology

Reward functioning refers to how individuals process and respond to rewards, including anticipation, motivation, and pleasure derived from positive experiences.

This system plays a crucial role in behavior and decision-making. Alterations in reward functioning have been linked to various forms of psychopathology, such as depression (reduced reward sensitivity) and substance use disorders (heightened reward seeking).

Understanding these relationships may provide insights into the development and maintenance of mental health disorders.

Mattoni, M., Pegg, S., Kujawa, A., Klein, D. N., & Olino, T. M. (2024). Prospective associations between early adolescent reward functioning and later dimensions of psychopathology. Journal of Psychopathology and Clinical Science, 133(8), 630–637. https://doi.org/10.1037/abn0000942

Key Points

• The study examined prospective associations between early adolescent reward functioning (at age 12) and different dimensions of psychopathology later in adolescence (at age 18).
• A hierarchical model of psychopathology was used, including individual disorders, internalizing and externalizing dimensions, and a general factor of psychopathology.
• Multiple measures of reward functioning were examined, including self-report questionnaires and event-related potentials (ERPs) in response to monetary and social rewards.
• Overall, the study found modest results for prospective associations between reward functioning and psychopathology dimensions.
• After correcting for multiple comparisons, only two significant associations remained – between social anhedonia and the residuals of specific phobia and alcohol use disorder.
• The study highlights the importance of examining dimension-specific associations between reward functioning and psychopathology, but more research is needed to better understand these relationships.
• Limitations included the largely White, middle-class sample and low reliability of some ERP measures.

Rationale

Adolescent reward functioning has been associated with various forms of psychopathology, but it remains unclear whether these relationships are disorder-specific or better explained by transdiagnostic factors.

Previous research has found links between reward functioning and depression (Forbes & Dahl, 2012), substance use disorders (Bart et al., 2021), anxiety disorders (Auerbach et al., 2022), and behavioral disorders (Hawes et al., 2021).

However, high rates of comorbidity between disorders (Kessler et al., 2005) make it difficult to determine if individual disorders have distinct relationships with reward functioning or if these relationships are better explained by transdiagnostic dimensions of psychopathology.

To address this gap, the current study aimed to examine prospective associations between early adolescent reward functioning and different levels of a hierarchical model of psychopathology measured later in adolescence.

This approach allows for testing whether associations are specific to one or more hierarchical levels of psychopathology, potentially improving our understanding of risk factors and informing clinical translation efforts.

Method

The study used a longitudinal design, examining reward functioning measures at age 12 and psychopathology outcomes at age 18.

A hierarchical model of psychopathology was constructed, and associations between reward measures and different levels of the hierarchy were tested.

Procedure

Participants completed self-report measures of reward functioning and two ERP tasks (monetary and social reward) at age 12.

At age 18, participants and their parents were interviewed to assess clinical diagnoses.

A hierarchical model of psychopathology was constructed using these diagnoses, and associations with earlier reward measures were examined.

Sample

The final sample included 418 participants from the Stony Brook Temperament Study.

The sample was 47% female, 92% White, and predominantly middle-class.

Measures

• Reward Responsiveness Scale (self-report and parent-report): A measure assessing approach motivation and reward responsiveness, with items related to how individuals respond to potential rewards.
• Anticipatory and Consummatory Interpersonal Pleasure Scale (ACIPS) for social anhedonia: A self-report measure assessing hedonic capacity for social reward and interpersonal interactions, with higher scores indicating greater social anhedonia (inability to experience pleasure).
• Monetary reward task (ERP measure): A simple guessing task where participants could win or lose money, used to elicit event-related potentials (ERPs) in response to monetary feedback.
• Social feedback task (ERP measure): A task where participants received acceptance or rejection feedback from simulated peers, used to elicit ERPs sensitive to social reward.
• Schedule of Affective Disorders and Schizophrenia for School-Age Children (K-SADS-PL) for clinical diagnoses: A semi-structured diagnostic interview used to assess current and lifetime psychopathology in children and adolescents according to DSM criteria.

Statistical measures:

• Confirmatory factor analysis to construct the hierarchical psychopathology model
• Structural equation modeling to examine associations between reward measures and psychopathology dimensions
• False Discovery Rate (FDR) correction for multiple comparisons

Results

Hypothesis 1: Most relationships with reward functioning would be at a higher-order dimensional level.

Result: This hypothesis was not supported. After FDR correction, no significant associations were found between reward measures and higher-order dimensions (internalizing, externalizing, or general factor).

Hypothesis 2: There would be additional relationships specific to the residuals of depression and substance use disorder.

Result: This hypothesis was partially supported. After FDR correction, significant associations were found between social anhedonia and the residuals of specific phobia and alcohol use disorder. However, no significant associations were found with depression residuals.

Additional findings:

• Before FDR correction, several other associations were significant but did not survive correction.
• The hierarchical model of psychopathology showed good fit and expected factor loadings.

Insight

The study’s key finding is that early adolescent social anhedonia was prospectively associated with later specific phobia and alcohol use disorder, even after accounting for shared variance with other disorders and higher-order dimensions.

This suggests that social anhedonia may be a specific risk factor for these disorders, rather than for broader internalizing or externalizing problems.

The largely null results after correction for multiple comparisons highlight the challenges in identifying robust prospective associations between reward functioning and psychopathology.

This contrasts with some previous research finding stronger links, such as Nelson et al. (2016), who found that blunted reward positivity predicted first-onset depressive disorder in adolescent girls.

The study extends previous research by using a hierarchical modeling approach, allowing for examination of both disorder-specific and transdiagnostic associations.

This approach can help disentangle complex relationships between reward functioning and psychopathology, potentially leading to more precise understanding of risk factors.

Future research should consider using more specific symptom measures rather than broad diagnostic categories, as the meaning of residual variance for disorders is unclear.

Additionally, investigating potential moderators or contextual factors (e.g., stress) that may influence the relationship between reward functioning and psychopathology could be fruitful.

Implications

The findings suggest that early adolescent social anhedonia may be a specific risk factor for later specific phobia and alcohol use disorder.

This could inform targeted prevention efforts, focusing on improving social reward experiences for adolescents at risk for these disorders.

The largely null results for other reward measures and psychopathology dimensions highlight the need for more nuanced approaches to studying these relationships.

Clinicians and researchers should be cautious about assuming strong, direct links between early reward functioning and later psychopathology.

The study demonstrates the utility of hierarchical modeling approaches in psychopathology research.

Future studies should continue to use and refine these methods to better understand the specificity of risk factors across different levels of psychopathology.

Strengths

This study had several methodological strengths, including:

• Longitudinal design with a 6-year follow-up period
• Moderately large sample size (N = 418)
• Use of multiple measures of reward functioning (self-report, parent-report, and ERP)
• Application of a hierarchical model of psychopathology
• Examination of both disorder-specific and transdiagnostic associations
• Use of FDR correction to control for multiple comparisons

Limitations

This study also had several methodological limitations, including:

• The sample was predominantly White and middle-class, limiting generalizability to more diverse populations.
• Low reliability of some ERP measures, particularly difference scores, led to the use of separate condition scores rather than more commonly used difference or residual scores.
• The hierarchical model was limited by the number of available indicators, particularly for externalizing disorders.
• The meaning of residual variance for broad diagnostic categories is unclear, making interpretation of some findings challenging.
• The study focused on DSM-5 diagnoses, which may not capture the full range of psychopathology experiences.

These limitations suggest that the findings may not generalize to all populations and that the measurement of both reward functioning and psychopathology could be improved in future studies.

The use of more specific symptom measures and a wider range of psychopathology indicators could provide clearer insights into the relationships between reward functioning and mental health outcomes.

References

Primary reference

Mattoni, M., Pegg, S., Kujawa, A., Klein, D. N., & Olino, T. M. (2024). Prospective associations between early adolescent reward functioning and later dimensions of psychopathology. Journal of Psychopathology and Clinical Science, 133(8), 630–637. https://doi.org/10.1037/abn0000942

Other references

Auerbach, R. P., Pagliaccio, D., Hubbard, N. A., Frosch, I., Kremens, R., Cosby, E., … & Pizzagalli, D. A. (2022). Reward-related neural circuitry in depressed and anxious adolescents: a human connectome project. Journal of the American Academy of Child & Adolescent Psychiatry, 61(2), 308-320. https://doi.org/10.1016/j.jaac.2021.04.014

Bart, C. P., Nusslock, R., Ng, T. H., Titone, M. K., Carroll, A. L., Damme, K. S., … & Alloy, L. B. (2021). Decreased reward-related brain function prospectively predicts increased substance use. Journal of abnormal psychology, 130(8), 886. https://doi.org/10.1037/abn0000711

Forbes, E. E., & Dahl, R. E. (2012). Altered reward function in adolescent depression: What, when and how? Journal of Child Psychology and Psychiatry, 53(1), 3-15. https://doi.org/10.1111/j
.1469-7610.2011.02477.x

Hawes, S. W., Waller, R., Byrd, A. L., Bjork, J. M., Dick, A. S., Sutherland, M. T., … & Gonzalez, R. (2021). Reward processing in children with disruptive behavior disorders and callous-unemotional traits in the ABCD study. American Journal of Psychiatry, 178(4), 333-342. https://doi.org/10.1176/appi.ajp.2020.19101092

Kessler, R. C., Chiu, W. T., Demler, O., & Walters, E. E. (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of general psychiatry, 62(6), 617-627.

Nelson, B. D., Perlman, G., Klein, D. N., Kotov, R., & Hajcak, G. (2016). Blunted neural response to rewards as a prospective predictor of the development of depression in adolescent girls. American Journal of Psychiatry, 173(12), 1223-1230. https://doi.org/10.1176/appi.ajp.2016.15121524

Keep Learning

Socratic questions for a college class to discuss this paper:

1. How might the use of a hierarchical model of psychopathology provide insights that traditional approaches to studying mental disorders cannot?
2. What are the potential implications of finding specific associations between social anhedonia and later specific phobia and alcohol use disorder? How might this inform prevention or intervention efforts?
3. Why do you think the study found mostly null results after correcting for multiple comparisons? What factors might contribute to the difficulty in identifying robust prospective associations between reward functioning and psychopathology?
4. How could future studies improve upon the measurement of reward functioning and psychopathology to better understand their relationships?
5. What are the ethical considerations in conducting longitudinal studies with adolescents, particularly when examining risk factors for psychopathology?
6. How might the findings of this study be different if conducted with a more diverse sample? What cultural factors might influence the relationship between reward functioning and psychopathology?
7. Given the limitations of broad diagnostic categories, how could researchers better capture the complexity of mental health experiences in future studies?
8. What role might developmental factors play in the relationship between early adolescent reward functioning and later psychopathology? How could future studies better account for these factors?