Acute and Lifetime Stress and Psychotic Illness: The Roles of Reward and Salience Networks.

Affective reactions to acute stressors often evoke exacerbations of psychotic symptoms and sometimes de novo psychotic symptoms and initial psychotic episodes. Across the lifespan, affective reactions to acute stressors are enhanced by successive adverse childhood experiences (ACEs), in a process called "behavioral sensitization". The net effects of behavioral sensitization of acute stress responses are to alter responsivity to positive and negative feedback and to unexpected events, regardless of valence, leading to the maladaptive assignment of salience to stimuli and events. The assignment of "aberrant" salience to stimuli and events has profound consequences for learning and decision-making, which can influence both the positive and negative symptoms of psychosis. In this review, we discuss some of the psychological and neural mechanisms by which affective reactivity to acute stress, and its sensitization through the experience of stress and trauma across the lifespan, impact both the positive and negative symptoms of psychosis. We recount how the reward and salience networks of the brain, together with inputs from the dopamine and serotonin neurotransmitter systems, are implicated in both affective reactivity to stress and the symptoms of psychosis, likely mediate the effects of stress and trauma on the symptoms of psychosis and could serve as targets for interventions.

Anterior Cingulate Cortex Signals Attention in a Social Paradigm that Manipulates Reward and Shock.

The ability to recognize emotions in others and adapt one's behavior accordingly is critical for functioning in any social context. This ability is impaired in several psychiatric disorders, such as autism and psychopathy. Recent work has identified the anterior cingulate cortex (ACC) among other brain regions involved in this process. Neural recording studies have shown that neurons in ACC are modulated by reward or shock when delivered to a conspecific and when experienced first-hand. Because previous studies do not vary reward and shock within the same experiment, it has been unclear whether the observed activity reflects how much attention is being paid to outcomes delivered to a conspecific or the valence associated with those stimuli. To address this issue, we recorded from ACC as rats performed a Pavlovian task that predicted whether reward, shock, or nothing would be delivered to the rat being recorded from or a conspecific located in the opposite chamber. Consistent with previous reports, we found that the firing of ACC neurons was modulated by aversive stimuli delivered to the recording rat and their conspecific. Activity of some of these neurons genuinely reflected outcome identity (i.e., reward or shock); however, the population of neurons as a whole responded similarly for both reward and shock, as well as for cues that predicted their occurrence (i.e., reward > neutral and shock > neutral; attention). These results suggest that ACC can process information about outcomes (i.e., identity and recipient) in the service of promoting attention in some social contexts.