Reward Dysregulation and Mood Symptoms in an Adolescent Outpatient Sample

Gruber, June; Gilbert, Kirsten; Youngstrom, Eric A.; Youngstrom, Jennifer Kogos; Feeny, Norah C.; Findling, Robert L.

doi:10.1007/s10802-013-9746-8

Cited by 15 publications

(12 citation statements)

References 67 publications

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“…With respect to joy, these findings dovetail with a growing literature suggesting mania symptoms involve a heightened focus on the pursuit of rewards and ambitious goals (Alloy & Abramson, 2010; Johnson, 2005; Meyer, Johnson, & Winters, 2001). Importantly in the emerging adolescent literature, these findings are consistent with work among outpatient adolescents suggesting that reward-relevant positive emotions were concurrently associated with increased manic symptom severity (Gruber et al, 2013). This work also is also consistent with research in adults with BPSD suggesting that increased reward sensitivity is concurrently associated with increased manic symptoms, providing encouraging support for developmental continuity in positive associations between reward-relevant emotions and mania symptoms (Alloy & Abramson, 2010; Johnson, 2005; Meyer et al, 2001; Urosevic et al, 2008).…”

Section: Discussionsupporting

confidence: 84%

“…Moreover, adolescents at risk for or with depression demonstrate blunted reward responding that is associated with lower levels of daily positive emotion (Forbes et al, 2009) while decreased happiness predicts the onset of depressive symptoms (Neumann, Lier, Frijns, Meeus, & Koot, 2011). Similar to adult literature, adolescent BPSDs are characterized by dysregulated reward learning (Dickstein et al, 2009) and increased reward sensitivity and approach-motivated behaviors being associated with elevated manic symptoms (Gruber et al, 2013). Taken together, elevated reward-seeking positive emotions (such as joy) and increased goal approach-motivated emotions (including anger) appear to be linked to manic and depressive symptoms in adolescents.…”

Section: Positive Emotion and Adolescent Mood Disturbancementioning

confidence: 88%

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Positive Emotion Specificity and Mood Symptoms in an Adolescent Outpatient Sample

et al. 2016

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Research on positive emotion disturbance has gained increasing attention, yet it is not clear which specific positive emotions are affected by mood symptoms, particularly during the critical period of adolescence. This is especially pertinent for identifying potential endophenotypic markers associated with mood disorder onset and course. The present study examined self-reported discrete positive and negative emotions in association with clinician-rated manic and depressive mood symptoms in a clinically and demographically diverse group of 401 outpatient adolescents between 11–18 years of age. Results indicated that higher self reported joy and contempt were associated with increased symptoms of mania, after controlling for symptoms of depression. Low levels of joy and high sadness uniquely predicted symptoms of depression, after controlling for symptoms of mania. Results were independent of age, ethnicity, gender and bipolar diagnosis. These findings extend work on specific emotions implicated in mood pathology in adulthood, and provide insights into associations between emotions associated with goal driven behavior with manic and depressive mood symptom severity in adolescence. In particular, joy was the only emotion associated with both depressive and manic symptoms across adolescent psychopathology, highlighting the importance of understanding positive emotion disturbance during adolescent development.

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Section: Discussionsupporting

confidence: 84%

Section: Positive Emotion and Adolescent Mood Disturbancementioning

confidence: 88%

Positive Emotion Specificity and Mood Symptoms in an Adolescent Outpatient Sample

et al. 2016

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“…Self-reported high BAS sensitivity also distinguishes BSD patients from those with unipolar depression (Quilty, Mackew, & Bagby, 2014). Similarly, Gruber et al (2013) found that parents’ reports of their adolescent offspring’s BAS sensitivity were associated with both manic and depressive symptoms of those offspring. Thus, BSDs are associated with elevated self-reported reward sensitivity and reward-relevant personality traits.…”

Section: Reward Hypersensitivity In Bipolar Spectrum Disorders: Theormentioning

confidence: 87%

Role of Reward Sensitivity and Processing in Major Depressive and Bipolar Spectrum Disorders

et al. 2016

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Since Costello’s (1972) seminal Behavior Therapy article on loss of reinforcers or reinforcer effectiveness in depression, the role of reward sensitivity and processing in both depression and bipolar disorder has become a central area of investigation. In this article, we review the evidence for a model of reward sensitivity in mood disorders, with unipolar depression characterized by reward hyposensitivity and bipolar disorders by reward hypersensitivity. We address whether aberrant reward sensitivity and processing are correlates of, mood-independent traits of, vulnerabilities for, and/or predictors of the course of depression and bipolar spectrum disorders, covering evidence from self-report, behavioral, neurophysiological, and neural levels of analysis. We conclude that substantial evidence documents that blunted reward sensitivity and processing are involved in unipolar depression and heightened reward sensitivity and processing are characteristic of hypomania/mania. We further conclude that aberrant reward sensitivity has a trait component, but more research is needed to clearly demonstrate that reward hyposensitivity and hypersensitivity are vulnerabilities for depression and bipolar disorder, respectively. Moreover, additional research is needed to determine whether bipolar depression is similar to unipolar depression and characterized by reward hyposensitivity, or whether like bipolar hypomania/mania, it involves reward hypersensitivity.

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“…Higher BAS sensitivity also distinguished patients with BSD from patients with unipolar depression (Quilty et al, 2014). In addition, parent reports of BAS sensitivity were associated with both manic and depressive symptoms in an outpatient sample of adolescents (Gruber et al, 2013). Even in a euthymic state, individuals with BSDs exhibit higher self-reported BAS sensitivity (Alloy et al, 2008; Salavert et al, 2007), suggesting that the high reward sensitivity may be independent of mood-related report biases.…”

Section: Reward Hypersensitivity Model Of Bipolar Spectrum Disorders:mentioning

confidence: 99%

The Development and Course of Bipolar Spectrum Disorders: An Integrated Reward and Circadian Rhythm Dysregulation Model

Alloy

Nusslock

Boland

2015

Annu. Rev. Clin. Psychol.

116

162

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In this article, we present and review the evidence for two major biopsychosocial theories of the onset and course of bipolar spectrum disorders (BSDs) that integrate behavioral, environmental, and neurobiological mechanisms: the reward hypersensitivity and the social and circadian rhythm disruption models. We describe the clinical features, spectrum, age of onset, and course of BSDs. We then discuss research designs relevant to demonstrating whether a hypothesized mechanism represents a correlate, vulnerability, or predictor of the course of BSDs, as well as important methodological issues. We next present the reward hypersensitivity model of BSD, followed by the social/circadian rhythm disruption model of BSD. For each model, we review evidence regarding whether the proposed underlying mechanism is associated with BSDs, provides vulnerability to the onset of BSDs, and predicts the course of BSDs. We then present a new integrated reward/circadian rhythm (RCR) dysregulation model of BSD and discuss how the RCR model explains the symptoms, onset, and course of BSDs. We end with recommendations for future research directions.

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Reward Dysregulation and Mood Symptoms in an Adolescent Outpatient Sample

Cited by 15 publications

References 67 publications

Positive Emotion Specificity and Mood Symptoms in an Adolescent Outpatient Sample

Positive Emotion Specificity and Mood Symptoms in an Adolescent Outpatient Sample

Role of Reward Sensitivity and Processing in Major Depressive and Bipolar Spectrum Disorders

The Development and Course of Bipolar Spectrum Disorders: An Integrated Reward and Circadian Rhythm Dysregulation Model

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