Social and Non-social Reward Processing and Depressive Symptoms Among Sexual Minority Adolescents

Abstract

Sexual minority adolescents (SMA) are more likely to suffer from depression, putatively through experiences of social stress and victimization interfering with processing of social reward. Alterations in neural reward networks, which develop during adolescence, confer risk for the development of depression. Employing both social and monetary reward fMRI tasks, this is the first neuroimaging study to examine function in reward circuitry as a potential mechanism of mental health disparities between SMA and heterosexual adolescents. Eight SMA and 38 heterosexual typically developing adolescents completed self-report measures of depression and victimization, and underwent fMRI during monetary and peer social reward tasks in which they received positive monetary or social feedback, respectively. Compared with heterosexual adolescents, SMA had greater interpersonal depressive symptoms and exhibited blunted neural responses to social, but not monetary, reward in socioaffective processing regions that are associated with depressive symptoms. Specifically, compared with heterosexual adolescents, SMA exhibited decreased activation in the right medial prefrontal cortex, left anterior insula (AI), and right temporoparietal junction (TPJ) in response to being liked. Lower response in the right TPJ was associated with greater interpersonal depressive symptoms. These results suggest that interpersonal difficulties and the underlying substrates of response to social reward (perhaps more so than response to monetary reward) may confer risk for development of depressive symptoms in SMA.

A systematic review of the neural correlates of sexual minority stress: towards an intersectional minority mosaic framework with implications for a future research agenda

“…The current systematic review revealed a significant void in the current minority stress neuroimaging knowledge base. Only 1 of the 13 studies meeting inclusion criteria for this review (see Tables 2 and 3 ) directly report on levels of minority stress (Eckstrand et al, 2019 ), whereas the remaining 12 studies focus on investigating the neurobiological basis of sexual orientation. Eckstrand et al ( 2019 ) found that victimization was associated with higher interpersonal depressive symptoms among male and female sexual minority and heterosexual adolescents.…”

“…Only 1 of the 13 studies meeting inclusion criteria for this review (see Tables 2 and 3 ) directly report on levels of minority stress (Eckstrand et al, 2019 ), whereas the remaining 12 studies focus on investigating the neurobiological basis of sexual orientation. Eckstrand et al ( 2019 ) found that victimization was associated with higher interpersonal depressive symptoms among male and female sexual minority and heterosexual adolescents. Here, as compared to heterosexual adolescents, sexual minority adolescents had decreased neural responses to social rewards among areas contained within the dorsal default-mode network (DMN), salience network , and social processing regions that are associated with depressive symptoms (Eckstrand et al, 2019 ).…”

“…Eckstrand et al ( 2019 ) found that victimization was associated with higher interpersonal depressive symptoms among male and female sexual minority and heterosexual adolescents. Here, as compared to heterosexual adolescents, sexual minority adolescents had decreased neural responses to social rewards among areas contained within the dorsal default-mode network (DMN), salience network , and social processing regions that are associated with depressive symptoms (Eckstrand et al, 2019 ). Specifically, as compared with heterosexual adolescents, sexual minority adolescents exhibited decreased activation in the right medial prefrontal cortex (mPFC), the left anterior insula, and the right temporoparietal junction (TPJ) in response to being liked.…”

“… 3. Eckstrand et al ( 2019 ) USA 1/7 50% White 25% Black/African American 25% Multiracial 18/20 68% White; 24% Black/African American; 8% Multiracial Adolescent Serious medical illness or history of psychiatric disorders/treatment Attraction (equivalent to National Longitudinal Study on Adolescent Health); grouped into sexual minority or heterosexual Victimization Youth Risk Behaviour Survey (YRBS) 2009 (Eaton et al, 2010 ) Experiencing victimization was positively associated with interpersonal depressive symptoms, but groups did not differ on rates of victimization 4. Folkierska-Żukowska et al ( 2020 ) Poland 46/0 23 classified as gender-conforming; 23 as gender non-conforming in childhood 100% white 22/22 100% white Adult Sell Assessment of Sexual Orientation (Polish Adaptation) Predominantly heterosexual and homosexual groups defined by combination of attraction/behaviour/identity n.a.…”

“…Burke et al ( 2017 ) MRI/DTI 2 Fractional anisotropy HoM & HoF vs. HeM & HeF ns 3. Eckstrand et al ( 2019 ) fMRI 1 Brain activation during social reward task (perception of being liked) Sexual minorities < heterosexuals (positive > neutral feedback) R Medial prefrontal cortex L Anterior insula R Temporoparietal junction Brain activation during monetary reward Sexual minorities vs. heterosexuals (reward anticipation > neutral) ns Negative correlation between depression scores and brain activation during social reward task Sexual minorities < heterosexuals (positive > neutral feedback) R Temporoparietal junction Positive correlation between depression scores and brain activation during social reward task Sexual minorities < heterosexuals (positive > neutral feedback) L Anterior insula 4. Folkierska-Żukowska et al ( 2020 ) fMRI 1 ROI activation (mental rotation task vs. baseline) GC HoM vs. GC HeM ns GNC HoM < GC HeM R Angular gyrus R Middle temporal gyrus L Middle temporal gyrus <...>…”