Reward Processing in Adolescents with Depression

The role of aberrant neural processing of rewards in the development of depression has long been proposed. This commentary reviews the reward literature in adolescent depression across imaging modalities such as functional magnetic resonance imaging and electroencephalography methodologies. When integrating findings across studies, consistent neural abnormalities emerge, expressed as reduced striatal blood oxygen level-dependent responses to anticipation and feedback outcome phases of reward tasks, altered frontostriatal connectivity, and blunted feedback-related negativity potentials. These are observed in current depression but, more importantly, have been found to be predictive of the onset of depression in longitudinal studies with community-based adolescent samples. The evidence for the specificity of these findings to depression is discussed, in addition to a review of intervention work probing this mechanism as it relates to decreases in depressive symptomatology. The chapter makes recommendations for future work that may continue to elucidate this relationship, a greater understanding of which may lead to more targeted and efficacious treatments for depression in adolescence.