Behavioral alterations in reward system function: The role of childhood maltreatment and psychopathology

Objective: To examine in children the influence of maltreatment and associated psychiatric sequelae on behavioral responses to reward stimuli. Method: A computerized two-choice decision-making task involving probabilistic monetary gains was used to probe elemental processes of goal-directed actions. Using different risk contingencies, the authors examined decision-making, expectations of outcomes, and affective responses to rewards in 38 maltreated children and 21 demographically matched controls (8-14 years old). Results: Maltreated children selected risk options faster than controls; however, whereas controls responded more quickly as the chance of winning increased, maltreated children did not vary in response speed as a function of the likelihood of winning. When choosing between high- and low-risk options, maltreated children with depressive disorders more frequently selected safe over risky choices than did controls. No group differences emerged in self-report ratings of positive or negative reactions to winning or not winning, respectively. Conclusions: This initial experimental study of responses to reward lays the groundwork for subsequent research on neurodevelopmental aspects of reward processes in relationship to maltreatment and psychopathology. Clinical applications of these data may be relevant for developing treatment plans for maltreated children, particularly those with depression.