Reward-related decision-making in pediatric major depressive disorder: an fMRI study

J Child Psychol Psychiatry. 2006 Oct;47(10):1031-40. doi: 10.1111/j.1469-7610.2006.01673.x.


Background: Although reward processing is considered an important part of affective functioning, few studies have investigated reward-related decisions or responses in young people with affective disorders. Depression is postulated to involve decreased activity in reward-related affective systems.

Methods: Using functional magnetic resonance imaging (fMRI), we examined behavioral and neural responses to reward in young people with depressive disorders using a reward decision-making task. The task involved choices about possible rewards involving varying magnitude and probability of reward. The study design allowed the separation of decision/anticipation and outcome phases of reward processing. Participants were 9-17 years old and had diagnoses of major depressive disorder (MDD), anxiety disorders, or no history of psychiatric disorder.

Results: Participants with MDD exhibited less neural response than control participants in reward-related brain areas during both phases of the task. Group differences did not appear to be a function of anxiety. Depressive and anxiety symptoms were associated with activation in reward-related brain areas.

Conclusions: Results suggest that depression involves altered reward processing and underscore the need for further investigation of relations among development, affective disorders, and reward processing.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Affect
  • Anxiety Disorders / diagnosis
  • Anxiety Disorders / epidemiology
  • Anxiety Disorders / physiopathology
  • Brain / physiopathology*
  • Child
  • Comorbidity
  • Decision Making*
  • Depressive Disorder, Major / diagnosis
  • Depressive Disorder, Major / epidemiology
  • Depressive Disorder, Major / physiopathology*
  • Dysthymic Disorder / diagnosis
  • Dysthymic Disorder / epidemiology
  • Dysthymic Disorder / physiopathology
  • Female
  • Gyrus Cinguli / physiopathology
  • Humans
  • Magnetic Resonance Imaging*
  • Male
  • Reward*
  • Severity of Illness Index