I Knew You Weren’t Going to Like Me! Neural Response to Accurately Predicting Rejection is associated with Anxiety and Depression

Anxiety and depression often emerge in adolescence. A normative increase in the desire for peer acceptance may be one of many contributing factors. These shifts occur during a phase of development in which neural reward networks, including structures such as the ventral striatum, undergo critical changes. Despite the salience of peer feedback during adolescence, neural responses to reward have largely been examined in the monetary domain, leaving many open questions about responses to social rewards. Moreover, most paradigms do not tease apart different aspects of reward processing (e.g., receiving feedback, being correct). Anxiety and depression are also associated with alterations in reward networks; however, little is known about how anxiety and depression in adolescence relate to differences in social vs non-social reward processing. In this study, adolescents (N=28) underwent fMRI while completing novel monetary and social feedback tasks, which tease apart reward domain (social/monetary), valence (positive/negative), and outcome (correct/incorrect). Participants were shown a pair of stimuli (doors/age-matched peers) and asked to indicate which stimulus would provide positive (win money/social like), or negative (lose money/social dislike) feedback. Participants then received feedback about the purported accuracy of their response. Region of interest analyses showed that left ventral striatum response varied by domain (social/monetary), valence (positive/negative) and outcome (correct/incorrect) of reward. Additionally, unique associations between anxiety, depression, and brain function were observed for correct, but not for incorrect trials, in the social, but not monetary task. Specifically, adolescents with high anxiety symptoms, but low depression, displayed greater left ventral striatum activation when correctly identifying peers who gave dislike (vs. like) feedback. Thus, anxious youth exhibited enhanced activation in a brain region implicated in reward processing when they accurately predicted someone was going to dislike them. Higher levels of both depression and anxiety symptoms were associated with greater striatal activation to correctly identifying peers who gave like (vs. dislike) feedback. These results suggest a neural mechanism by which negative prediction biases may be reinforced in anxious youth.