The reward positivity as a predictor of first lifetime onsets of depression, anxiety, and suicidal ideation in high-risk adolescents.

Background: Reduced reward Positivity (RewP), an electroencephalography (EEG) marker elicited by feedback indicating reward, has been associated with an increased risk for depression in adolescence. However, the predictive capability of RewP in predicting the first-lifetime onset of depressive disorders, as opposed to anxiety and suicidal ideation in high-risk populations, has not been thoroughly investigated. In this study, the authors examine if RewP predicts the first-lifetime onset of depression, anxiety, and suicidal ideation over 18 months in familial high-risk adolescents.

Methods: The sample included 145 adolescents (64.8% male), aged 11-17 years, who had at least one parent with a history of mood and anxiety disorders and completed baseline and at least one follow-up measurement. At baseline, RewP was measured using a simple gambling task, their current internalizing symptoms were assessed using self-report questionnaires, and the youth's psychiatric diagnoses were evaluated with diagnostic interviews. The same interview was administered to the adolescents again at 9 months and 18 months later.

Results: Logistic regression models showed that higher RewP scores significantly predicted a lower likelihood of developing a first onset of Major Depressive Disorder (MDD) over 18 months, even after controlling for sex, age, and baseline internalizing symptoms. In contrast, RewP did not significantly predict the first onset of anxiety disorders or suicidal ideation.

Conclusions: Reduced RewP precedes the first onset of depression in high-risk adolescents, highlighting RewP's predictive capability in predicting depression risk in predisposed populations. Blunted RewP could complement self-reported symptoms in screening and prevention.