TY - JOUR
T1 - Neural Indicators of Anhedonia
T2 - Predictors and Mechanisms of Treatment Change in a Randomized Clinical Trial in Early Childhood Depression
AU - Barch, Deanna M.
AU - Whalen, Diana
AU - Gilbert, Kirsten
AU - Kelly, Danielle
AU - Kappenman, Emily S.
AU - Hajcak, Greg
AU - Luby, Joan L.
N1 - Funding Information:
This work was supported by the National Institute of Mental Health (Grant Nos. R01MH098454-04 [to DMB] and K23MH115074-01 [to KG] ). The funding source had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and the decision to submit the manuscript for publication.
Funding Information:
This work was supported by the National Institute of Mental Health (Grant Nos. R01MH098454-04 [to DMB] and K23MH115074-01 [to KG]). The funding source had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and the decision to submit the manuscript for publication. DBM, DW, KG, and JLL had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. JLL, DMB, and GH were responsible for concept and design. DMB, DW, KG, ESK, DK, GH, and JLL were responsible for acquisition, analysis, or interpretation of data. DMB, DW, KG, and DK were responsible for drafting of the manuscript. JLL, ESK, and GH were responsible for critical revision of the manuscript for important intellectual content. DMB, DW, and KG performed statistical analysis. DMB, JLL, and GH obtained funding. DMB, DW, KG, ESK, DK, GH, and JLL provided administrative, technical, or material support. DMB and JLL provided supervision. We thank the families who participated in this study and the staff who helped make the project a success. DMB consults for Pfizer. JLL receives royalties from Guilford Press. All other authors report no biomedical financial interests or potential conflicts of interest. ClinicalTrials.gov: A Randomized Controlled Trial of PCIT-ED for Preschool Depression; https://clinicaltrials.gov/ct2/show/NCT02076425; NCT02076425.
Publisher Copyright:
© 2020 Society of Biological Psychiatry
PY - 2020/12/1
Y1 - 2020/12/1
N2 - Background: Early childhood depression is associated with anhedonia and reduced event-related potential (ERP) responses to rewarding or pleasant stimuli. Whether these neural measures are indicators of target engagement or treatment outcome is not yet known. Methods: We measured ERP responses to win and loss feedback in a guessing task and to pleasant versus neutral pictures in young (4.0–6.9 years of age) depressed children before and after randomization to either 18 weeks of Parent-Child Interaction Therapy–Emotion Development (PCIT-ED) or waitlist. Results: Analyses included reward positivity (RewP) data from 118 children randomly assigned to PCIT-ED (n = 60) or waitlist (n = 58) at baseline and late positive potential (LPP) data from 99 children (44 assigned to PCIT-ED vs. 55 assigned to waitlist) at baseline. Children undergoing PCIT-ED showed a greater reduction in anhedonia (F1,103 = 10.32, p = .002, partial η2 = .09). RewP reward responses increased more (F1,86 = 5.98, p = .02, partial η2 = .07) for PCIT-ED, but a greater change in RewP was not significantly associated with a greater reduction in major depressive disorder symptoms (r = −.12, p > .4). Baseline RewP did not predict treatment change. LPPs to positive pictures did not change across treatment, but greater baseline LPPs to positive pictures predicted a higher likelihood of remission from major depressive disorder in children undergoing PCIT-ED (B = 0.14; SE = 0.07; odds ratio = 1.15; p = .03). Conclusions: The ERP reward response improved in young children with depression during a treatment designed to enhance emotion development, providing evidence of target engagement of the neural systems associated with reward. Further, greater baseline LPP responses to positive pictures was associated with a greater likelihood of depression remission, suggesting that this ERP measure can predict which children are most likely to respond to treatment.
AB - Background: Early childhood depression is associated with anhedonia and reduced event-related potential (ERP) responses to rewarding or pleasant stimuli. Whether these neural measures are indicators of target engagement or treatment outcome is not yet known. Methods: We measured ERP responses to win and loss feedback in a guessing task and to pleasant versus neutral pictures in young (4.0–6.9 years of age) depressed children before and after randomization to either 18 weeks of Parent-Child Interaction Therapy–Emotion Development (PCIT-ED) or waitlist. Results: Analyses included reward positivity (RewP) data from 118 children randomly assigned to PCIT-ED (n = 60) or waitlist (n = 58) at baseline and late positive potential (LPP) data from 99 children (44 assigned to PCIT-ED vs. 55 assigned to waitlist) at baseline. Children undergoing PCIT-ED showed a greater reduction in anhedonia (F1,103 = 10.32, p = .002, partial η2 = .09). RewP reward responses increased more (F1,86 = 5.98, p = .02, partial η2 = .07) for PCIT-ED, but a greater change in RewP was not significantly associated with a greater reduction in major depressive disorder symptoms (r = −.12, p > .4). Baseline RewP did not predict treatment change. LPPs to positive pictures did not change across treatment, but greater baseline LPPs to positive pictures predicted a higher likelihood of remission from major depressive disorder in children undergoing PCIT-ED (B = 0.14; SE = 0.07; odds ratio = 1.15; p = .03). Conclusions: The ERP reward response improved in young children with depression during a treatment designed to enhance emotion development, providing evidence of target engagement of the neural systems associated with reward. Further, greater baseline LPP responses to positive pictures was associated with a greater likelihood of depression remission, suggesting that this ERP measure can predict which children are most likely to respond to treatment.
KW - Anhedonia
KW - Clinical trial
KW - Depression
KW - ERP
KW - Preschool
KW - Reward
UR - http://www.scopus.com/inward/record.url?scp=85093917623&partnerID=8YFLogxK
U2 - 10.1016/j.biopsych.2020.06.032
DO - 10.1016/j.biopsych.2020.06.032
M3 - Article
C2 - 33153527
AN - SCOPUS:85093917623
VL - 88
SP - 879
EP - 887
JO - Biological Psychiatry
JF - Biological Psychiatry
SN - 0006-3223
IS - 11
ER -