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Associations between insomnia and reward learning in clinical depression

Published online by Cambridge University Press:  26 February 2021

Gabrielle I. Liverant Open the ORCID record for Gabrielle I. Liverant [Opens in a new window] ,
Kimberly A. Arditte Hall Open the ORCID record for Kimberly A. Arditte Hall [Opens in a new window] ,
Sarah T. Wieman Open the ORCID record for Sarah T. Wieman [Opens in a new window] ,
Suzanne L. Pineles Open the ORCID record for Suzanne L. Pineles [Opens in a new window]  and
Diego A. Pizzagalli Open the ORCID record for Diego A. Pizzagalli [Opens in a new window]
Gabrielle I. Liverant*
Affiliation:
Department of Psychology, Suffolk University, Boston, MA, USA
Kimberly A. Arditte Hall
Affiliation:
Department of Psychology and Philosophy, Framingham State University, Framingham, MA, USA
Sarah T. Wieman
Affiliation:
Department of Psychology, Suffolk University, Boston, MA, USA
Suzanne L. Pineles
Affiliation:
National Center for PTSD, Women's Health Sciences Division, Veterans Affairs Boston Healthcare System, Boston, MA, USA Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
Diego A. Pizzagalli
Affiliation:
Department of Psychiatry, Harvard Medical School, Boston, MA, USA Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA
*
Author for correspondence: Gabrielle I. Liverant, E-mail: gliverant@suffolk.edu
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Abstract

Background

Depression and insomnia commonly co-occur. Yet, little is known about the mechanisms through which insomnia influences depression. Recent research and theory highlight reward system dysfunction as a potential mediator of the relationship between insomnia and depression. This study is the first to examine the impact of insomnia on reward learning, a key component of reward system functioning, in clinical depression.

Methods

The sample consisted of 72 veterans with unipolar depression who endorsed sleep disturbance symptoms. Participants completed the Structured Clinical Interview for DSM-IV, self-report measures of insomnia, depression, and reward processing, and a previously validated signal detection task (Pizzagalli et al., 2005, Biological Psychiatry, 57(4), 319–327). Trial-by-trial response bias (RB) estimates calculated for each of the 200 task trials were examined using linear mixed-model analyses to investigate change in reward learning.

Results

Findings demonstrated diminished rate and magnitude of reward learning in the Insomnia group relative to the Hypersomnia/Mixed Symptom group across the task. Within the Insomnia group, participants with more severe insomnia evidenced the lowest rates of reward learning, with increased RB across the task with decreasing insomnia severity.

Conclusions

Among individuals with depression, insomnia is associated with decreased ability to learn associations between neutral stimuli and rewarding outcomes and/or modify behavior in response to differential receipt of reward. This attenuated reward learning may contribute to clinically meaningful decreases in motivation and increased withdrawal in this comorbid group. Results extend existing theory by highlighting impairments in reward learning specifically as a potential mediator of the association between insomnia and depression.

Keywords

depressioninsomniareward learning
Type
Original Article
Information
Psychological Medicine , Volume 52 , Issue 15 , November 2022 , pp. 3540 - 3549
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Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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