Maternal Depression Moderates Neural Mechanisms of Irritability During Reward Processing in Early Childhood

Abstract

Youth irritability and maternal depression are two of the most robust markers of risk in early childhood; both predict impairment and multiple psychiatric outcomes and are associated with altered neural reward processing. They are also related to one another; thus, examining their combined effects on reward processing in early childhood may help distinguish shared versus specific pathways to psychopathology and guide early detection and intervention efforts. The current cross-sectional study examined the moderating effect of maternal depression on irritability-related differences in neural reward processing during reward anticipation and performance feedback via conservative whole-brain activation and seed-based connectivity analyses. Children (N = 182, mean age = 6.15 years, SD = .50) completed a child-friendly version of the monetary incentive delay task during functional MRI acquisition. Parents completed rating scales and questionnaires about their child, including the Multidimensional Assessment Profiles Temper Loss scale for irritability, as well as questionnaires and a semi-structured interview about their own psychiatric history. Children with higher irritability and a history of maternal depression demonstrated attenuated striatum and amygdala connectivity with prefrontal and occipital areas during reward anticipation and exaggerated activation and connectivity differences involving frontal, temporal, and parietal networks during performance feedback. Overall, there were opposite neural patterns for youth with high irritability and a history of maternal depression compared to youth with high irritability but no history of maternal depression, and all findings held after controlling for several demographic and psychopathology variables. These results highlight the important role of familial vulnerability in the neural mechanisms underlying early childhood irritability and point to potential targets for mechanism-driven interventions.