Neural changes in reward processing following approach-avoidance training for depression

Abstract

Altered approach motivation is hypothesized to be critical for the maintenance of depression. Computer-administered approach-avoidance training programs to increase approach action tendencies toward positive stimuli produce beneficial outcomes. However, there have been few studies examining neural changes following approach-avoidance training. Participants with Major Depressive Disorder were randomized to an Approach Avoidance Training (AAT) manipulation intended to increase approach tendencies for positive social cues (n=13) or a control procedure (n=15). We examined changes in neural activation (primary outcome) and connectivity patterns using Group Iterative Multiple Model Estimation during a social reward anticipation task (exploratory). A laboratory-based social affiliation task was also administered following the manipulation to measure affect during anticipation of real-world social activity. Individuals in the AAT group demonstrated increased activation in reward processing regions during social reward anticipation relative to the control group from pre to post-training. Following training, connectivity patterns across reward regions were observed in the full sample and connectivity between the medial PFC and caudate was associated with anticipatory positive affect before the social interaction; preliminary evidence of differential connectivity patterns between the two groups also emerged. Results support models whereby modifying approach-oriented behavioral tendencies with computerized training leads to alterations in reward circuitry. (NCT02330744)

Approach avoidance training versus Sham in veterans with alcohol use disorder: protocol for a randomized controlled trial

“…This study protocol described a double-blind randomized controlled trial to assess the clinical utility of AAT as an adjunctive treatment to standard care in Veterans with AUD and comorbid psychiatric disorders. Prior research supports the use of AAT as an adjunctive treatment for substance use disorders [ 34 , 44 , 53 – 55 ] and emerging research suggests that variations of cognitive training for approach/avoidance biases may be beneficial for symptoms of other psychiatric disorders [ 29 , 56 , 57 ]. However, the impact of AAT treatment on alcohol consumption and functional recovery outcomes in Veterans with AUD and comorbid psychiatric disorders remains unaddressed.…”

AI-based dimensional neuroimaging system for characterizing heterogeneity in brain structure and function in major depressive disorder: COORDINATE-MDD consortium design and rationale

“…University of California at San Francisco (UCSF) cohort consists of first episode and recurrent MDD and healthy control participants [70,71]. Symptom severity has been measured using standardised clinician-rated symptom scales: 17-item Hamilton Rating Scale for Depression (HRSD) [72] (EMBARC, HMRRC, KCL, LIBR, Neuropharm1, Oxford, Stanford, SWU), 24-item HRSD (PReDICT), Montgomery-Åsberg Depression Rating Scale (MADRS) [73] (CAN-BIND, LIBR, Manchester; PRe-DICT), and Quick Inventory for Depressive Symptomatology (QIDS-SR) [74,75] (EMBARC, PReDICT, STRADL).…”