Clinical Depression and Punishment Sensitivity on the BART.

David Hevey,Karen Looney,Kevin Thomas,Sofia Laureano-Schelten,Richard Booth

doi:10.3389/fpsyg.2017.00670

Abstract

Depression is associated with altered sensitivity to reward and punishment, which can influence complex decision-making. We examined punishment sensitivity in the performance of participants with major depressive disorder (MDD) with that of a comparison group on the automatic Balloon Analogue Risk Task (BART), which is a direct measure of risk taking. The present study examined the BART performance of 30 individuals with MDD and 30 matched comparison individuals. The comparison group (M = 63.25) entered a significantly (p < 0.001; d = 1.1) higher number of pumps on the BART than the MDD group (M = 50.83). Higher levels of depression symptoms were significantly correlated (r = -0.40, p < 0.05) with entering a lower number of pumps in the MDD group. MDD patients showed an increased sensitivity to punishment on the BART: after a loss, the MDD group decreased (M = 13.7) the number of subsequent pumps they entered by a significantly (p < 0.001, d = 0.81) greater amount than the comparison group (M = 4.35). This difference applied to losses only: no difference was found between the groups regarding the magnitude of change in pumps selected after a win. Findings suggest the presence of elevated punishment sensitivity among individuals with MDD, which may contribute to the maintenance of depressive symptoms.

Highlights

Psychological approaches to depression emphasize the importance of cognitive dysfunction in the disorder, and the Diagnostic and Statistical Manual of Mental Disorders-V (DSM-V; American Psychiatric Association, 2013) considers decision-making impairment a possible symptom for major depressive disorder (MDD)
There was no significant difference in the age of the MDD group (M = 39.47; SD = 12.20) and the comparison group (M = 38.13; SD = 11.35), t(58) = 0.66, p = 0.66, Cohen’s d = 0.11; 95% CI = −0.39 to 0.62; Bayes factor = 1.87
Examination of the scatter plot between the Balloon Analogue Risk Task (BART) and Beck Depression Inventory-II (BDI-II) scores among the MDD group showed that their relationship could be modeled as linear: a Pearson correlation test showed that the BART target score significantly correlated with the BDI-II [r (28 df ) = −0.40, p < 0.05]

Summary

Introduction

Psychological approaches to depression emphasize the importance of cognitive dysfunction in the disorder, and the Diagnostic and Statistical Manual of Mental Disorders-V (DSM-V; American Psychiatric Association, 2013) considers decision-making impairment a possible symptom for major depressive disorder (MDD). Increased pumping on the BART was significantly related to alcohol and drug use, cigarette smoking, gambling, theft, aggression, and unprotected sexual intercourse in both adolescent (Lejuez et al, 2003; Aklin et al, 2005) and adult samples (Lejuez et al, 2002, 2004) It was associated with psychopathy and impulsivity among young adults (Hunt et al, 2005). The BART is a reliable (White et al, 2008) simple laboratory task that captures the defining characteristic of risk taking in the real world—when participants pump the balloon, they pursue the reward of monetary gain while exposing themselves to potential punishment with the loss of money

Methods

Results

Discussion

Conclusion