title: Approach and avoidance learning in patients with major depression and healthy controls: relation to anhedonia.
abstract: BACKGROUND
  Central to understanding of the behavioural consequences of depression has been the theory that the disorder is accompanied by an increased sensitivity to negative compared with positive reinforcement (negative bias), whereas other theorists have emphasized a global reduction in sensitivity to reinforcement in depression (blunting).
  
  
  METHODS
  In this study, we used a probabilistic selection task that was designed to examine independently rates of learning to predict both positive and negative reinforcement. Twenty-three depressed out-patients and 23 healthy controls from the local population participated in the study.
  
  
  RESULTS
  No evidence for a negative bias was observed on the task, either during acquisition of the task or during generalization of the learned information. Depressed patients responded slower on the task than controls but showed a similar modulation of reaction times (RTs) as controls following reinforcement. Evidence for blunting was observed on the training phase, as reflected in reduced trial-by-trial adjustment during this phase. However, this effect was related specifically to the severity of anhedonia, as measured by the Snaith-Hamilton Pleasure Scale (SHAPS), and was independent of overall depression severity.
  
  
  CONCLUSIONS
  We argue that the observation of a negative bias or blunting in a group of depressed patients may be dependent on the neuropsychological task and the symptoms of the patients tested. Our results provide insight into how these theories might be further tested.
authors.affiliation: Behavioural and Clinical Neuroscience Institute, University of Cambridge, UK. henry.chase@nottingham.ac.uk
authors.forename: H W
authors.initials: HW
authors.lastname: Chase
authors.forename: M J
authors.initials: MJ
authors.lastname: Frank
authors.forename: A
authors.initials: A
authors.lastname: Michael
authors.forename: E T
authors.initials: ET
authors.lastname: Bullmore
authors.forename: B J
authors.initials: BJ
authors.lastname: Sahakian
authors.forename: T W
authors.initials: TW
authors.lastname: Robbins
mesh_terms: D000342:Affective Symptoms / Q000150:complications* / Q000175:diagnosis / Q000523:psychology*; D000704:Analysis of Variance; D001362:Avoidance Learning; D003865:Major Depressive Disorder / Q000150:complications* / Q000523:psychology*; D005260:Female; D005793:Generalization, Psychological; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011930:Reaction Time; D012054:Reinforcement, Psychology; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires