Neural systems of positive affect: Relevance to understanding child and adolescent depression?

Abstract

From an affective neuroscience perspective, the goal of achieving a deeper, more mechanistic understanding of the development of depression will require rigorous models that address the core underlying affective changes. Such an understanding will necessitate developing and testing hypotheses focusing on specific components of the complex neural systems involved in the regulation of emotion and motivation. In this paper, we illustrate these principles by describing one example of this type of approach: examining the role of disruptions in neural systems of positive affect in major depressive disorder in school-age children and adolescents. We begin by defining positive affect, proposing that positive affect can be distinguished from negative affect by its neurobehavioral features. We provide an overview of neural systems related to reward and positive affect, with a discussion of their potential involvement in depression. We describe a developmental psychopathology framework, addressing developmental issues that could play a role in the etiology and maintenance of early-onset depression. We review the literature on altered positive affect in depression, suggesting directions for future research. Finally, we discuss the treatment implications of this framework. This research was supported by a Klingenstein Third Generation Foundation Postdoctoral Fellowship, NIMH Training Grant T32 MH018269, and NIMH Research Network R24 MH67346. We thank David J. Kupfer for his compelling suggestions about clinical course and development across the life span, and we thank Anna Lotze for help with references.