Social and Non-social Reward Processing and Depressive Symptoms Among Sexual Minority Adolescents.

Kristen L Eckstrand,Kati L Healey,Erika E Forbes,Michael P Marshal,Nicholas B Allen,Jennifer S Silk,Marissa Cross,Luis E Flores Jr

doi:10.3389/fnbeh.2019.00209

Abstract

Sexual minority adolescents (SMA) are more likely to suffer from depression, putatively through experiences of social stress and victimization interfering with processing of social reward. Alterations in neural reward networks, which develop during adolescence, confer risk for the development of depression. Employing both social and monetary reward fMRI tasks, this is the first neuroimaging study to examine function in reward circuitry as a potential mechanism of mental health disparities between SMA and heterosexual adolescents. Eight SMA and 38 heterosexual typically developing adolescents completed self-report measures of depression and victimization, and underwent fMRI during monetary and peer social reward tasks in which they received positive monetary or social feedback, respectively. Compared with heterosexual adolescents, SMA had greater interpersonal depressive symptoms and exhibited blunted neural responses to social, but not monetary, reward in socioaffective processing regions that are associated with depressive symptoms. Specifically, compared with heterosexual adolescents, SMA exhibited decreased activation in the right medial prefrontal cortex, left anterior insula (AI), and right temporoparietal junction (TPJ) in response to being liked. Lower response in the right TPJ was associated with greater interpersonal depressive symptoms. These results suggest that interpersonal difficulties and the underlying substrates of response to social reward (perhaps more so than response to monetary reward) may confer risk for development of depressive symptoms in SMA.

Highlights

Sexual minority adolescents (SMA), including those who identify as lesbian, gay, or bisexual, are four times more likely to meet criteria for Major Depressive Disorder and are at three times greater risk for suicidal thoughts and behaviors compared with their heterosexual peers (Fergusson et al, 1999; Marshal et al, 2011; Burton et al, 2013)
The findings from this study suggest that SMA—who experienced greater interpersonal depressive symptoms compared with heterosexual adolescents—may exhibit altered function in salience and social processing networks in response to social reward compared with heterosexual adolescents
Blunted neural response in the right temporoparietal junction (TPJ)—a region implicated in perspective-taking and processing social information—was associated with higher interpersonal depressive symptom severity

Summary

Introduction

Sexual minority adolescents (SMA), including those who identify as lesbian, gay, or bisexual, are four times more likely to meet criteria for Major Depressive Disorder and are at three times greater risk for suicidal thoughts and behaviors compared with their heterosexual peers (Fergusson et al, 1999; Marshal et al, 2011; Burton et al, 2013). SMA who live in less socially supportive environments are more likely to attempt suicide than those living in supportive environments (Williams et al, 2005; Hatzenbuehler, 2011) Even after disclosing their sexual orientation to others (‘‘coming out’’), SMA who perceive that they are not accepted or are a ‘‘burden’’ to others experience greater depressive symptoms and suicidal ideation (Baams et al, 2015). These findings suggest that depression among LGB youth results from both the presence of interpersonal stress and disruption of reward, during social situations (e.g., receiving social approval)

Methods

Results

Conclusion