Differentiating Generalized Anxiety Disorder from Major Depressive Disorder by Examining Reward Sensitivity in a Laboratory Setting
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Date
2016-05
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The Ohio State University
Abstract
Generalized anxiety disorder (GAD) and major depressive disorder (MDD) are frequently co-occurring disorders (e.g., Kessler et al., 2005). Based on the current diagnostic criteria (American Psychiatric Association, 2013), there is a large overlap in symptoms and thus the two disorders are closely associated. However, there is growing evidence that suggests the importance of separating GAD from MDD, given their different patterns of emotion regulation (e.g., Mennin & Fresco, 2014). This may be examined through differential responses to rewards and punishments; however, there has been no systematic examination of reactivity to reward and punishment in laboratory settings in relation to GAD and MDD. This study examines sensitivity to reward and sensitivity to punishment via self-report measures (subjective) and physiological reactivity. Participants were presented with a food stimulus (popcorn) and a series of four videos (two disgust, two craving) in a randomized order. They were instructed to either eat or save popcorn. The crave-eat (reward) block provided the highest reward, followed by crave-save (frustrative non-reward), disgust-save (relief), and finally, the disgust-eat block (punishment). Participants reported the extent to which they experienced anxiety, disgust and craving, and we recorded heart rate variability (HRV; which reflects physiological flexibility) and cardiac impedance (pre-ejection period, which reflects sensitivity to rewards) throughout each of the blocks. I found 1) high levels of GAD symptoms were associated with elevated anxiety in all contexts 2) high levels of MDD symptoms were associated with increased anxiety in all contexts. This study yielded no differences in craving or disgust based on GAD or MDD symptom levels and yielded no differences for HRV or PEP measures based on film clip or GAD or MDD symptom levels. Also, these findings did not lend support to context insensitivity theories for GAD or MDD. Future studies should examine these effects in a larger, clinical sample.
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Keywords
Anxiety, Depression, Emotion, Reward