Social feedback biases emerge during recall but not prediction and shift across the development of social anxiety.

Memory is a reconstructive process that can result in events being recalled as more positive or negative than they actually were. While positive recall biases may contribute to well-being, negative recall biases may promote internalizing symptoms, such as social anxiety. Adolescence is characterized by increased salience of peers and peak incidence of social anxiety. Symptoms often wax and wane before becoming more intractable during adulthood. Open questions remain regarding how and when biases for social feedback are expressed and how individual differences in biases may contribute to social anxiety across development. Two studies used a social feedback and cued response task to assess biases about being liked or disliked when retrieving memories vs. making predictions. Findings revealed a robust positivity bias about memories for social feedback, regardless of whether memories were true or false. Moreover, memory bias was associated with social anxiety in a developmentally sensitive way. Among adults (study 1), more severe symptoms of social anxiety were associated with a negativity bias. During the transition from adolescence to adulthood (study 2), age strengthened the positivity bias in those with less severe symptoms and strengthened the negativity bias in those with more severe symptoms. These patterns of bias were isolated to perceived memory retrieval and did not generalize to predictions about social feedback. These results provide initial support for a model by which schemas may infiltrate perceptions of memory for past, but not predictions of future, social events, shaping susceptibility for social anxiety, particularly during the transition into adulthood.

Neural response to monetary and social rewards in adolescent girls and their parents.

Functional magnetic resonance imaging (fMRI) studies have indicated that the mesocorticolimbic dopamine system is heavily involved in all stages of reward processing. However, the majority of research has been conducted using monetary rewards and it is unclear to what extent other types of rewards, such as social rewards, evoke similar or different neural activation. There have also been few investigations into potential differences or similarities between reward processing in parents and offspring. The present study examined fMRI neural activation in response to monetary and social reward in a sample of 14-22-year-old adolescent girls (N = 145) and a biological parent (N = 124) and compared activation across adolescent-parent dyads (N = 82). Across all participants, both monetary and social reward elicited bilateral striatal activation, which did not differ between reward types or between adolescents and their parents. Neural activation in response to the different reward types were positively correlated in the striatum among adolescents and in the mPFC and OFC among parents. Overall, the present study suggests that both monetary and social reward elicit striatal activation regardless of age and provides evidence that neural mechanisms underlying reward processing may converge differentially among youth and adults.

Neural response to monetary and social rewards and familial risk for psychopathology in adolescent females.

BACKGROUND: Adolescence is a key developmental period for the emergence of psychopathology. Reward-related brain activity increases across adolescence and has been identified as a potential neurobiological mechanism of risk for different forms of psychopathology. The reward positivity (RewP) is an event-related potential component that indexes reward system activation and has been associated with both concurrent and family history of psychopathology. However, it is unclear whether the RewP is also associated with higher-order psychopathology subfactors and whether this relationship is present across different types of reward. METHODS: In a sample of 193 adolescent females and a biological parent, the present study examined the association between adolescent and parental psychopathology subfactors and adolescent RewP to monetary and social reward. RESULTS: Results indicated that the adolescent and parental distress subfactors were negatively associated with the adolescent domain-general RewP. The adolescent and parental positive mood subfactors were negatively associated with the adolescent domain-general and domain-specific monetary RewP, respectively. Conversely, the adolescent and parental fear/obsessions subfactors were positively associated with the adolescent domain-general RewP. The associations between parental and adolescent psychopathology subfactors and the adolescent RewP were independent of each other. CONCLUSIONS: The RewP in adolescent females is associated with both concurrent and parental psychopathology symptoms, suggesting that it indexes both severity and risk for higher-order subfactors.

Don't worry, it won't be fine. Contributions of worry and anxious arousal to startle responses and event-related potentials in threat anticipation.

A widely shared framework suggests that anxiety maps onto two dimensions: anxious apprehension and anxious arousal. Previous research linked individual differences in these dimensions to differential neural response patterns in neuropsychological, imaging, and physiological studies. Differential effects of the anxiety dimensions might contribute to inconsistencies in prior studies that examined neural processes underlying anxiety, such as hypersensitivity to unpredictable threat. We investigated the association between trait worry (as a key component of anxious apprehension), anxious arousal, and the neural processing of anticipated threat. From a large online community sample (N = 1,603), we invited 136 participants with converging and diverging worry and anxious arousal profiles into the laboratory. Participants underwent the NPU-threat test with alternating phases of unpredictable threat, predictable threat, and safety, while physiological responses (startle reflex and startle probe locked event-related potential components N1 and P3) were recorded. Worry was associated with increased startle responses to unpredictable threat and increased attentional allocation (P3) to startle probes in predictable threat anticipation. Anxious arousal was associated with increased startle and N1 in unpredictable threat anticipation. These results suggest that trait variations in the anxiety dimensions shape the dynamics of neural processing of threat. Specifically, trait worry seems to simultaneously increase automatic defensive preparation during unpredictable threat and increase attentional responding to threat-irrelevant stimuli during predictable threat anticipation. The current study highlights the utility of anxiety dimensions to understand how physiological responses during threat anticipation are altered in anxiety and supports that worry is associated with hypersensitivity to unpredictable, aversive contexts.

Neurobiological sensitivity to unpredictable threat and familial risk for the internalizing and externalizing spectra in adolescents.

BACKGROUND: Adolescence is a key developmental period for the emergence of psychiatric disorders. However, there is still no consensus on the core mechanisms of dysfunction in youth. Neurobiological sensitivity to unpredictable threat has been associated with several psychiatric disorders in adults. The present study examined adolescent defensive motivation (startle reflex) and attention (event-related potentials) in anticipation of unpredictable threat in relation to both adolescent and maternal (i.e. familial risk) internalizing and externalizing spectra. METHODS: The sample included 395 15-year-old adolescents and their biological mothers. Adolescent startle potentiation and probe P300 suppression (indicating increased attention to threat) were measured in anticipation of predictable and unpredictable threat. Adolescent and maternal lifetime history of psychiatric disorders were assessed via semi-structured diagnostic interviews, and confirmatory factor analysis was used to model internalizing and externalizing spectra. RESULTS: The adolescent internalizing spectrum was positively associated with adolescent startle potentiation and probe P300 suppression to unpredictable threat. Conversely, the adolescent externalizing spectrum was negatively associated with adolescent P300 suppression to unpredictable threat. The maternal internalizing spectrum was positively associated with adolescent startle potentiation to unpredictable threat and P300 suppression to both predictable and unpredictable threat. The maternal externalizing spectrum was negatively associated with adolescent startle potentiation to unpredictable threat and P300 suppression to both predictable and unpredictable threat. Adolescent and maternal internalizing and externalizing spectra were independently related to adolescent startle potentiation and P300 suppression. CONCLUSIONS: Adolescent neurobiological sensitivity to unpredictable threat is associated with both personal history and familial risk for the internalizing and externalizing spectra.

Gender and Racial/Ethnic Disparities in Undergraduate and Graduate Students' Mental Health and Treatment Use Amid the COVID-19 Pandemic.

The COVID-19 pandemic has negatively impacted numerous people?s mental health and created new barriers to services. To address the unknown effects of the pandemic on accessibility and equality issues in mental health care, this study aimed to investigate gender and racial/ethnic disparities in mental health and treatment use in undergraduate and graduate students amid the COVID-19 pandemic. The study was conducted based on a largescale online survey (N = 1,415) administered during the weeks following a pandemic-related university-wide campus closure in March 2020. We focused on the gender and racial disparities in current internalizing symptomatology and treatment use. Our results showed that in the initial period of the pandemic, students identified as cis women (p < .001), non-binary/genderqueer (p < .001), or Hispanic/Latinx (p = .002) reported higher internalizing problem severity (aggregated from depression, generalized anxiety, intolerance of uncertainty, and COVID-19-related stress symptoms) compared to their privileged counterparts. Additionally, Asian (p < .001) and multiracial students (p = .002) reported less treatment use than White students while controlling for internalizing problem severity. Further, internalizing problem severity was associated with increased treatment use only in cisgender, non-Hispanic/Latinx White students (pcis man = 0.040, pcis woman < 0.001). However, this relationship was negative in cis-gender Asian students (pcis man = 0.025, pcis woman = 0.016) and nonsignificant in other marginalized demographic groups. The findings revealed unique mental health challenges faced by different demographic groups and served as a call that specific actions to enhance mental health equity, such as continued mental health support for students with marginalized gender identities, additional COVID-related mental and practical support for Hispanic/Latinx students and promotion of mental health awareness, access, and trust in non-White, especially Asian, students are desperately needed.

Increases in depression and anxiety symptoms in adolescents and young adults during the COVID-19 pandemic.

BACKGROUND: The coronavirus [coronavirus disease 2019 (COVID-19)] pandemic has introduced extraordinary life changes and stress, particularly in adolescents and young adults. Initial reports suggest that depression and anxiety are elevated during COVID-19, but no prior study has explored changes at the within-person level. The current study explored changes in depression and anxiety symptoms from before the pandemic to soon after it first peaked in Spring 2020 in a sample of adolescents and young adults (N = 451) living in Long Island, New York, an early epicenter of COVID-19 in the U.S. METHODS: Depression (Children's Depression Inventory) and anxiety symptoms (Screen for Child Anxiety Related Symptoms) were assessed between December 2014 and July 2019, and, along with COVID-19 experiences, symptoms were re-assessed between March 27th and May 15th, 2020. RESULTS: Across participants and independent of age, there were increased generalized anxiety and social anxiety symptoms. In females, there were also increased depression and panic/somatic symptoms. Multivariable linear regression indicated that greater COVID-19 school concerns were uniquely associated with increased depression symptoms. Greater COVID-19 home confinement concerns were uniquely associated with increased generalized anxiety symptoms, and decreased social anxiety symptoms, respectively. CONCLUSIONS: Adolescents and young adults at an early epicenter of the COVID-19 pandemic in the U.S. experienced increased depression and anxiety symptoms, particularly amongst females. School and home confinement concerns related to the pandemic were independently associated with changes in symptoms. Overall, this report suggests that the COVID-19 pandemic is having multifarious adverse effects on the mental health of youth.

The Hierarchical Taxonomy of Psychopathology (HiTOP) in psychiatric practice and research.

The Hierarchical Taxonomy of Psychopathology (HiTOP) has emerged out of the quantitative approach to psychiatric nosology. This approach identifies psychopathology constructs based on patterns of co-variation among signs and symptoms. The initial HiTOP model, which was published in 2017, is based on a large literature that spans decades of research. HiTOP is a living model that undergoes revision as new data become available. Here we discuss advantages and practical considerations of using this system in psychiatric practice and research. We especially highlight limitations of HiTOP and ongoing efforts to address them. We describe differences and similarities between HiTOP and existing diagnostic systems. Next, we review the types of evidence that informed development of HiTOP, including populations in which it has been studied and data on its validity. The paper also describes how HiTOP can facilitate research on genetic and environmental causes of psychopathology as well as the search for neurobiologic mechanisms and novel treatments. Furthermore, we consider implications for public health programs and prevention of mental disorders. We also review data on clinical utility and illustrate clinical application of HiTOP. Importantly, the model is based on measures and practices that are already used widely in clinical settings. HiTOP offers a way to organize and formalize these techniques. This model already can contribute to progress in psychiatry and complement traditional nosologies. Moreover, HiTOP seeks to facilitate research on linkages between phenotypes and biological processes, which may enable construction of a system that encompasses both biomarkers and precise clinical description.

Neural Response to Rewards, Stress and Sleep Interact to Prospectively Predict Depressive Symptoms in Adolescent Girls.

Blunted reward processing both characterizes major depressive disorder and predicts increases in depressive symptoms. However, little is known about the interaction between blunted reward processing and other risk factors in relation to increases in depressive symptoms. Stressful life events and sleep problems are prominent risk factors that contribute to the etiopathogenesis of depression and have been linked to reward dysfunction; these factors may interact with reward dysfunction to predict increased depressive symptoms. In a large sample of 8- to 14-year-old adolescent girls, the current study examined how blunted reward processing, stressful life events, and sleep problems at baseline interacted to predict increases in depressive symptoms 1 year later. Reward processing was indexed by the reward positivity (RewP), an event-related potential elicited during a simple monetary reward paradigm (i.e., Doors task). Two-way interactions confirmed that a blunted RewP predicted increased depressive symptoms at (a) high levels of stress but not average or low levels of stress, and (b) high and average levels of sleep problems but not low levels of sleep problems. Finally, a 3-way interaction confirmed that a blunted RewP predicted increased depressive symptoms at high levels of stress and sleep problems but not average or low levels of stress and sleep problems. Thus, adolescents characterized by low reward response (i.e., blunted RewP) were at an increased risk of developing depressive symptoms if they experienced increased stressful life events or sleep problems; moreover, risk was greatest among adolescents characterized by all 3.

Reliability of reward- and error-related brain activity in early childhood.

Event-related potential (ERP) measures of reward- and error-related brain activity have emerged as potential biomarkers of risk for the development of psychopathology. However, the psychometric properties of reward- and error-related brain activity have been primarily investigated in adolescents and adults. It is critical to also establish the reliability of ERPs in younger children, particularly if they are used as individual difference measures of risk during key developmental periods. The present study examined the reliability of the reward positivity (RewP) and error-related negativity (ERN) among 80 children (Mage  = 6.9 years old; 50% female). Participants completed the doors, flanker, and go/no-go tasks twice, separated by approximately 8 months, while electroencephalography (EEG) was recorded. Results indicated that the RewP demonstrated strong internal consistency and test-retest reliability. The ERN also demonstrated strong internal consistency, but test-retest reliability was only significant for the ERN measured during the flanker task and not the go/no-go task. These results are largely consistent with reported psychometric properties of reward- and error related ERPs in adolescents and adults, suggesting that the ERN and RewP may be appropriate biomarkers of individual differences in populations ranging from early childhood to adulthood.

Neuroticism and respiratory sinus arrhythmia predict increased internalizing symptoms during the COVID-19 pandemic.

The coronavirus (COVID-19) pandemic has impacted young adults across a number of different domains. It is critical to establish the degree to which the COVID-19 pandemic has affected mental health and identify predictors of poor outcomes. Neuroticism and (low) respiratory sinus arrhythmia (RSA) are risk factors of internalizing disorders that might predict increased psychopathology symptoms. The present study included 222 undergraduate students from [name removed] in Long Island, NY. Before the COVID-19 pandemic, participants completed self-report measures of neuroticism and internalizing symptoms and an electrocardiogram. Between April 15th to May 30th, 2020, participants again completed the measure of internalizing symptoms and a questionnaire about COVID-19 experiences. The COVID-19 pandemic was associated with increased distress, fear/obsessions, and (low) positive mood symptoms. There was a Neuroticism x RSA interaction in relation to distress symptoms, such that greater pre-COVID-19 neuroticism was associated with increased distress symptoms, but only in the context of low RSA. These findings suggest the COVID-19 pandemic has contributed to increased internalizing symptoms in young adults, and individuals with specific personality and autonomic risk factors may be at heightened risk for developing psychopathology.

Parenting style moderates the effects of exposure to natural disaster-related stress on the neural development of reactivity to threat and reward in children.

Little is known about the effect of natural disasters on children's neural development. Additionally, despite evidence that stress and parenting may both influence the development of neural systems underlying reward and threat processing, few studies have brought together these areas of research. The current investigation examined the effect of parenting styles and hurricane-related stress on the development of neural reactivity to reward and threat in children. Approximately 8 months before and 9 months after Hurricane Sandy, 74 children experiencing high and low levels of hurricane-related stress completed tasks that elicited the reward positivity and error-related negativity, event-related potentials indexing sensitivity to reward and threat, respectively. At the post-Hurricane assessment, children completed a self-report questionnaire to measure promotion- and prevention-focused parenting styles. Among children exposed to high levels of hurricane-related stress, lower levels of promotion-focused, but not prevention-focused, parenting were associated with a reduced post-Sandy reward positivity. In addition, in children with high stress exposure, greater prevention-focused, but not promotion-focused, parenting was associated with a larger error-related negativity after Hurricane Sandy. These findings highlight the need to consider contextual variables such as parenting when examining how exposure to stress alters the development of neural reactivity to reward and threat in children.

Hurricane Sandy Exposure Alters the Development of Neural Reactivity to Negative Stimuli in Children.

This study examined whether exposure to Hurricane Sandy-related stressors altered children's brain response to emotional information. An average of 8 months (Mage  = 9.19) before and 9 months after (Mage  = 10.95) Hurricane Sandy, 77 children experiencing high (n = 37) and low (n = 40) levels of hurricane-related stress exposure completed a task in which the late positive potential, a neural index of emotional reactivity, was measured in response to pleasant and unpleasant, compared to neutral, images. From pre- to post-Hurricane Sandy, children with high stress exposure failed to show the same decrease in emotional reactivity to unpleasant versus neutral stimuli as those with low stress exposure. Results provide compelling evidence that exposure to natural disaster-related stressors alters neural emotional reactivity to negatively valenced information.

Unpredictability increases the error-related negativity in children and adolescents.

The error-related negativity (ERN) is a response-locked component in the event-related potential observed asa negative deflection 50-100ms following the commission of an error. An unpredictable context has been shown to potentiate amygdala activity, attentional bias toward threat, and the ERN in adults. However, it is unclear whether the impact of unpredictability on the ERN is also observed in children and adolescents. In a sample of 32 9-17year-old participants, we examined the influence of a task-irrelevant unpredictable context on neural response to errors. Participants completed a flanker task designed to elicit the ERN, while simultaneously being exposed to task-irrelevant tone sequences with either predictable or unpredictable timing. Unpredictable tones were rated as more anxiety provoking compared to the predictable tones. Fewer errors were made during unpredictable relative to predictable tones. Moreover, the ERN-but not the correct response negativity (CRN) or stimulus-locked N200-was potentiated during the unpredictable relative to predictable tones. The current study replicates and extends previous findings by demonstrating that an unpredictable context can increase task performance and selectively potentiate the ERN in children and adolescents. ERN magnitude can be modulated by environmental factors suggesting enhanced error processing in unpredictable contexts.

Pubertal development and anxiety risk independently relate to startle habituation during fear conditioning in 8-14 year-old females.

Reduced habituation to aversive stimuli has been observed during adolescence and may reflect an underlying mechanism of vulnerability for anxiety disorders. This study examined the startle reflex during a fear-learning task in 54 8-14-year-old girls. We examined the relationship between mean startle, startle habituation, pubertal development, and two measures linked to risk for anxiety: behavioral inhibition system (BIS) and the error-related negativity (ERN). Puberty, BIS, and the ERN were unrelated to mean startle; however, each measure modulated startle habituation. Greater pubertal development was associated with reduced startle habituation across the CS+ and CS-. Higher BIS related to a larger ERN, and both were associated with reduced startle habituation specifically to the CS+. All effects were independent of each other. Findings suggest that puberty alters habituation of defense system activation to both threat and safety cues, and this is independent of risk for anxiety, which uniquely impacts habituation to threat cues.

The impact of an unpredictable context and intolerance of uncertainty on the electrocortical response to monetary gains and losses.

There is growing evidence that unpredictability and uncertainty can alter reward system functioning. The present study examined the impact of (1) a task-irrelevant unpredictable relative to predictable context and (2) individual differences in intolerance of uncertainty (IU) on the reward-related positivity (RewP), an event-related potential (ERP) response to monetary gains relative to losses. Specifically, 64 participants listened to predictable and unpredictable tone sequences while electroencephalography was recorded during a monetary gambling task. Participants also completed the Intolerance of Uncertainty Scale, which measures both cognitive distress (prospective IU) and behavioral inhibition (inhibitory IU) elicited by uncertainty, in addition to the Depression Anxiety Stress Scale-21 and Penn State Worry Questionnaire. Results indicated that the RewP was reduced during the unpredictable relative to the predictable context. Greater self-reported anxiety elicited by the unpredictable context was associated with a decreased RewP, and a decreased RewP was associated with poorer lose-shift behavioral adjustment. Furthermore, the RewP mediated the relationship between self-reported anxiety elicited by the unpredictable context and lose-shift behavioral adjustment. The IU subscales demonstrated the opposite relationship with the RewP across both contexts-inhibitory IU was associated with an attenuated RewP and prospective IU was associated with an enhanced RewP. In contrast, anxiety, depression, stress, and worry symptomatology were not associated with the RewP. This is the first study to demonstrate that an unpredictable context and individual differences in the degree to which people cannot tolerate uncertainty impact an ERP measure of reward system functioning.

Intolerance of uncertainty and insula activation during uncertain reward.

Individuals with high intolerance of uncertainty (IU) have been shown to exhibit abnormal threat responding, which may be mediated by hyperactive anterior insula (aINS) response to uncertainty. Research has indicated that individuals with high IU also exhibit abnormal positive valence responding, suggesting that IU may impact responding to uncertainty regardless of the valence of the potential outcome. To date, no study has investigated the neural processes associated with IU and response to uncertain positive stimuli, such as rewards. Therefore, this study was designed to examine the association between individual differences in IU and neural activation during uncertain reward using functional magnetic resonance imaging (fMRI). Thirty-seven adults completed a self-report measure of IU and a reward task during fMRI. Consistent with the threat literature, greater IU was associated with increased aINS activation during uncertain reward. This association was more robust for the prospective IU subscale, a dimension characterized by worry about future events. Together with prior studies, these findings provide evidence that IU is related to abnormal threat and reward responding, and that these deficits may be similarly linked to hyperactive aINS response to uncertainty.

Visuospatial and mathematical dysfunction in major depressive disorder and/or panic disorder: A study of parietal functioning.

The parietal cortex is critical for several different cognitive functions, including visuospatial processing and mathematical abilities. There is strong evidence indicating parietal dysfunction in depression. However, it is less clear whether anxiety is associated with parietal dysfunction and whether comorbid depression and anxiety are associated with greater impairment. The present study compared participants with major depression (MDD), panic disorder (PD), comorbid MDD/PD and controls on neuropsychological measures of visuospatial processing, Judgement of Line Orientation (JLO), and mathematical abilities, Wide Range Achievement Test (WRAT) Arithmetic. Only comorbid MDD/PD was associated with decreased performance on JLO, whereas all psychopathological groups exhibited comparably decreased performance on WRAT Arithmetic. Furthermore, the results were not accounted for by other comorbid disorders, medication use or psychopathology severity. The present study suggests comorbid depression and anxious arousal are associated with impairment in visuospatial processing and provides novel evidence indicating mathematical deficits across depression and/or anxiety. Implications for understanding parietal dysfunction in internalising psychopathology are discussed.

Single-session attention bias modification and error-related brain activity.

An attentional bias to threat has been implicated in the etiology and maintenance of anxiety disorders. Recently, attention bias modification (ABM) has been shown to reduce threat biases and decrease anxiety. However, it is unclear whether ABM modifies neural activity linked to anxiety and risk. The current study examined the relationship between ABM and the error-related negativity (ERN), a putative biomarker of risk for anxiety disorders, and the relationship between the ERN and ABM-based changes in attention to threat. Fifty-nine participants completed a single-session of ABM and a flanker task to elicit the ERN--in counterbalanced order (i.e., ABM-before vs. ABM-after the ERN was measured). Results indicated that the ERN was smaller (i.e., less negative) among individuals who completed ABM-before relative to those who completed ABM-after. Furthermore, greater attentional disengagement from negative stimuli during ABM was associated with a smaller ERN among ABM-before and ABM-after participants. The present study suggests a direct relationship between the malleability of negative attention bias and the ERN. Explanations are provided for how ABM may contribute to reductions in the ERN. Overall, the present study indicates that a single-session of ABM may be related to a decrease in neural activity linked to anxiety and risk.