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Impaired probabilistic reversal learning in youths with mood and anxiety disorders

Published online by Cambridge University Press:  12 October 2009

D. P. Dickstein ,
E. C. Finger ,
M. A. Brotman ,
B. A. Rich ,
D. S. Pine ,
J. R. Blair  and
E. Leibenluft
D. P. Dickstein*
Affiliation:
National Institute of Mental Health (NIMH) Mood and Anxiety Disorders Program
E. C. Finger
Affiliation:
National Institute of Mental Health (NIMH) Mood and Anxiety Disorders Program
M. A. Brotman
Affiliation:
National Institute of Mental Health (NIMH) Mood and Anxiety Disorders Program
B. A. Rich
Affiliation:
National Institute of Mental Health (NIMH) Mood and Anxiety Disorders Program
D. S. Pine
Affiliation:
National Institute of Mental Health (NIMH) Mood and Anxiety Disorders Program
J. R. Blair
Affiliation:
National Institute of Mental Health (NIMH) Mood and Anxiety Disorders Program
E. Leibenluft
Affiliation:
National Institute of Mental Health (NIMH) Mood and Anxiety Disorders Program
*
*Address for correspondence: D. P. Dickstein, M.D., EP Bradley Hospital, Bradley/Hasbro Children's Research Center, 1 Hoppin Street, Coro West 2nd Floor, Providence, RI02903, USA. (Email: Daniel_Dickstein@Brown.edu)
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Abstract

Background

From an affective neuroscience perspective, our understanding of psychiatric illness may be advanced by neuropsychological test paradigms probing emotional processes. Reversal learning is one such process, whereby subjects must first acquire stimulus/reward and stimulus/punishment associations through trial and error and then reverse them. We sought to determine the specificity of previously demonstrated reversal learning impairments in youths with bipolar disorder (BD) by now comparing BD youths to those with severe mood dysregulation (SMD), major depressive disorder (MDD), anxiety (ANX), and healthy controls.

Method

We administered the probabilistic response reversal (PRR) task to 165 pediatric participants aged 7–17 years with BD (n=35), SMD (n=35), ANX (n=42), MDD (n=18) and normal controls (NC; n=35). Our primary analysis compared PRR performance across all five groups matched for age, sex and IQ.

Results

Compared to typically developing controls, probabilistic reversal learning was impaired in BD youths, with a trend in those with MDD (p=0.07).

Conclusions

Our results suggest that reversal learning deficits are present in youths with BD and possibly those with MDD. Further work is necessary to elucidate the specificity of neural mechanisms underlying such behavioral deficits.

Keywords

Adolescentanxiety disordersbipolar disorderchildpsychological tasksreversal learning
Type
Original Articles
Information
Psychological Medicine , Volume 40 , Issue 7 , July 2010 , pp. 1089 - 1100
Copyright
Copyright © Cambridge University Press 2009

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