TY - JOUR T1 - Striatal reactivity during emotion and reward relates to approach–avoidance conflict behaviour and is altered in adults with anxiety or depression JF - Journal of Psychiatry and Neuroscience JO - JPN SP - E311 LP - E322 DO - 10.1503/jpn.220083 VL - 47 IS - 5 AU - Timothy J. McDermott AU - Hannah Berg AU - James Touthang AU - Elisabeth Akeman AU - Mallory J. Cannon AU - Jessica Santiago AU - Kelly T. Cosgrove AU - Ashley N. Clausen AU - Namik Kirlic AU - Ryan Smith AU - Michelle G. Craske AU - James L. Abelson AU - Martin P. Paulus AU - Robin L. Aupperle Y1 - 2022/09/01 UR - http://jpn.ca/content/47/5/E311.abstract N2 - Background: We have previously reported activation in reward, salience and executive control regions during functional MRI (fMRI) using an approach–avoidance conflict (AAC) decision-making task with healthy adults. Further investigations into how anxiety and depressive disorders relate to differences in neural responses during AAC can inform their understanding and treatment. We tested the hypothesis that people with anxiety or depression have altered neural activation during AAC.Methods: We compared 118 treatment-seeking adults with anxiety or depression and 58 healthy adults using linear mixed-effects models to examine group-level differences in neural activation (fMRI) during AAC decision-making. Correlational analyses examined relationships between behavioural and neural measures.Results: Adults with anxiety or depression had greater striatal engagement when reacting to affective stimuli (p = 0.008, d = 0.31) regardless of valence, and weaker striatal engagement during reward feedback (p = 0.046, d = −0.27) regardless of the presence of monetary reward. They also had blunted amygdala activity during decision-making (p = 0.023, d = −0.32) regardless of the presence of conflict. Across groups, approach behaviour during conflict decision-making was inversely correlated with striatal activation during affective stimuli (p < 0.001, r = −0.28) and positively related to striatal activation during reward feedback (p < 0.001, r = 0.27).Limitations: Our transdiagnostic approach did not allow for comparisons between specific anxiety disorders, and our cross-sectional approach did not allow for causal inference.Conclusion: Anxiety and depression were associated with altered neural responses to AAC. Findings were consistent with the role of the striatum in action selection and reward responsivity, and they point toward striatal reactivity as a future treatment target. Blunting of amygdala activity in anxiety or depression may indicate a compensatory response to inhibit affective salience and maintain approach. ER -