Do Individual Differences in Reward and Threat Sensitivity Predict Family History of Psychopathology?

The classification and diagnosis of depression and anxiety disorders has evolved greatly since the introduction of DSM-I. Under the current system (DSM-IV), depression and anxiety disorders are viewed as separate categorical entities that are diagnosed via patient self-report using a syndromal approach. However, despite being a largely reliable diagnostic system, there are still many problems with the current approach (e.g., heterogeneity, comorbidity, reliance on overt clinical presentation) that raise questions as to whether the DSM categories constitute a valid way of classifying depression and anxiety disorders. An alternative approach is to identify underlying mechanisms of dysfunction that move beyond categorical syndromes. The present study examined whether heightened sensitivity to threat and reduced sensitivity to reward predicted a well-established indicator of risk – family history. Specifically, 173 individuals diagnosed with panic disorder (PD), major depressive disorder (MDD), both (comorbids), or healthy controls completed two experimental paradigms designed to assess sensitivity to threat (measured via startle response) and sensitivity to reward (measured via frontal EEG asymmetry). Family history of psychopathology was assessed using the Family History Screen. Results indicated that across all participants: 1) startle potentiation to unpredictable threat was associated with family history of PD (but not depression) and 2) frontal EEG asymmetry while anticipating reward was associated with family history of depression (but not PD). In addition, both measures continued to be associated with family history of psychopathology after controlling for current DSM diagnosis. Results from the present study suggest that including an indicator of sensitivity to unpredictable threat and reward may add to the predictive validity of the current anxiety and depression syndromal constructs, respectively