Reward functioning in PTSD: A systematic review exploring the mechanisms underlying anhedonia

Nawijn, Laura; Zuiden, Mirjam van; Frijling, Jessie L.; Koch, Saskia B.J.; Veltman, Dick J.; Olff, Miranda

doi:10.1016/j.neubiorev.2015.01.019

Cited by 215 publications

(171 citation statements)

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“…Hence, one could expect that the nature of anhedonia and emotional numbing would be better captured by employment of social reward stimuli such as, for example, faces. Indeed, a recent review of reward functioning in PTSD (Nawijn et al, 2015) suggests that more consistent reward functioning deficiencies are seen in posttraumatic stress related pathology when related to social reward. This calls for further investigation of the distinctive features of anhedonia and emotional numbing in stress-related psychopathology.…”

Section: Discussionmentioning

confidence: 99%

“…As such, reward is pivotal for driving many human behaviours. Following this, different phases of reward functioning may be defined as distinct behaviours (Berridge & Kringelbach, 2008; Nawijn et al, 2015). Reward wanting is the anticipatory motivation towards obtaining the stimulus, whereas reward consumption is linked to the pleasure felt by obtaining the stimulus.…”

Section: Introductionmentioning

confidence: 99%

“…A recent review has described existing research efforts investigating reward functioning in PTSD (Nawijn et al, 2015). While results were mixed, the authors concluded that, in general, decreased reward anticipation and reward consumption responses were observed more often in PTSD-patients compared to controls.…”

Section: Introductionmentioning

confidence: 99%

“…While results were mixed, the authors concluded that, in general, decreased reward anticipation and reward consumption responses were observed more often in PTSD-patients compared to controls. The authors highlight the heterogeneity of PTSD (Galatzer-Levy & Bryant, 2013) as a potential explanation for the mixed findings, and suggest that future research should move away from the simple comparison of PTSD-patients versus healthy controls, and instead focus on specific symptoms and symptom clusters and their relation to reward functioning (Nawijn et al, 2015). …”

Section: Introductionmentioning

confidence: 99%

“…As noted by Nawijn and colleagues (2015), previous attempts at finding correlates between reward function and symptoms of PTS may have partly been occluded by case-control designs that do not reflect the symptom heterogeneity within the PTS spectrum. In the current study, we take a different approach to the investigation of reward functioning related to PTS.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Anhedonia and emotional numbing in treatment-seeking veterans: behavioural and electrophysiological responses to reward

Eskelund¹,

Karstoft

Andersen

2018

European Journal of Psychotraumatology

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Background: Anhedonia is a common symptom following exposure to traumatic stress and a feature of the PTSD diagnosis. In depression research, anhedonia has been linked to deficits in reward functioning, reflected in behavioural and neural responses. Such deficits following exposure to trauma, however, are not well understood.Objective: The current study aims to estimate the associations between anhedonia, PTSD symptom-clusters and behavioural and electrophysiological responses to reward.Methods: Participants (N = 61) were recruited among Danish treatment-seeking veterans at the Department of Military Psychology in the Danish Defence. Before entering treatment, participants were screened with symptom measurement instruments and participated in a joint behavioural-electrophysiological experiment. The experimental paradigm consisted of a signal-detection task aimed at assessing reward-driven learning. Simultaneous electrophysiological-recordings were analysed to evaluate neural responses upon receiving reward, as indicated by the Feedback-Related Negativity (FRN) component.Result: Anhedonia as conceptualized in depression correlated with behavioural learning (r = -0.28, p = .032). Neither anhedonia nor behavioural learning correlated with FRN. However, the anhedonia symptom cluster of PTSD did correlate with FRN (r = 0.29, p = .023). Extending upon this in an exploratory analysis, the specific PTSD-symptom emotional numbing was found to correlate moderately with FRN (r = 0.38, p = .003).Conclusion: The present data suggest that anhedonia in trauma-exposed individuals is related to the anticipatory aspect of reward, whereas the neural consummatory reward response seems unlinked. Interestingly, emotional numbing in the same population is related to the consummatory phase of reward, correlating with the FRN response. This suggests that anhedonia and emotional numbing in response to trauma might pertain to different phases of reward processing.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Anhedonia and emotional numbing in treatment-seeking veterans: behavioural and electrophysiological responses to reward

Eskelund¹,

Karstoft

Andersen

2018

European Journal of Psychotraumatology

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Neighborhood Disadvantage and Neural Correlates of Threat and Reward Processing in Survivors of Recent Trauma

Webb,

Ely,

Rowland

et al. 2023

JAMA Netw Open

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ImportanceDifferences in neighborhood socioeconomic characteristics are important considerations in understanding differences in risk vs resilience in mental health. Neighborhood disadvantage is associated with alterations in the function and structure of threat neurocircuitry.ObjectiveTo investigate associations of neighborhood disadvantage with white and gray matter and neural reactivity to positive and negative stimuli in the context of trauma exposure.Design, Setting, and ParticipantsIn this cross-sectional study, survivors of trauma who completed sociodemographic and posttraumatic symptom assessments and neuroimaging were recruited as part of the Advancing Understanding of Recovery After Trauma (AURORA) study between September 2017 and June 2021. Data analysis was performed from October 25, 2022, to February 15, 2023.ExposureNeighborhood disadvantage was measured with the Area Deprivation Index (ADI) for each participant home address.Main Outcomes and MeasuresParticipants completed separate threat and reward tasks during functional magnetic resonance imaging. Diffusion-weighted and high-resolution structural images were also collected. Linear models assessed the association of ADI with reactivity, microstructure, and macrostructure of a priori regions of interest after adjusting for income, lifetime trauma, sex at birth, and age. A moderated-mediation model tested whether ADI was associated with neural activity via microstructural changes and if this was modulated by PTSD symptoms.ResultsA total of 280 participants (183 females [65.4%]; mean [SD] age, 35.39 [13.29] years) completed the threat task and 244 participants (156 females [63.9%]; mean [SD] age, 35.10 [13.26] years) completed the reward task. Higher ADI (per 1-unit increase) was associated with greater insula (t274 = 3.20; β = 0.20; corrected P = .008) and anterior cingulate cortex (ACC; t274 = 2.56; β = 0.16; corrected P = .04) threat-related activity after considering covariates, but ADI was not associated with reward reactivity. Greater disadvantage was also associated with altered microstructure of the cingulum bundle (t274 = 3.48; β = 0.21; corrected P = .001) and gray matter morphology of the ACC (cortical thickness: t273 = −2.29; β = −0.13; corrected P = .02; surface area: t273 = 2.53; β = 0.13; corrected P = .02). The moderated-mediation model revealed that ADI was associated with ACC threat reactivity via cingulum microstructural changes (index of moderated mediation = −0.02). However, this mediation was only present in individuals with greater PTSD symptom severity (at the mean: β = −0.17; standard error = 0.06, t= −2.28; P = .007; at 1 SD above the mean: β = −0.28; standard error = 0.08; t = −3.35; P &lt; .001).Conclusions and RelevanceIn this study, neighborhood disadvantage was associated with neurobiology that supports threat processing, revealing associations of neighborhood disadvantage with neural susceptibility for PTSD and suggesting how altered structure-function associations may complicate symptoms. Future work should investigate specific components of neighborhood disadvantage that may be associated with these outcomes.

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Upregulating the positive affect system in anxiety and depression: Outcomes of a positive activity intervention

2017

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Reward functioning in PTSD: A systematic review exploring the mechanisms underlying anhedonia

Cited by 215 publications

References 91 publications

Anhedonia and emotional numbing in treatment-seeking veterans: behavioural and electrophysiological responses to reward

Anhedonia and emotional numbing in treatment-seeking veterans: behavioural and electrophysiological responses to reward

Neighborhood Disadvantage and Neural Correlates of Threat and Reward Processing in Survivors of Recent Trauma

Upregulating the positive affect system in anxiety and depression: Outcomes of a positive activity intervention

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