Blunted neural response to gains versus losses associated with both risk-prone and risk-averse behavior in a clinically diverse sample.

Reduced responsiveness to reward has been associated with both risk-prone and risk-averse behavior, common features of externalizing and internalizing psychopathology, respectively. Thus, evidence has suggested a potential quadratic relationship (i.e., inverted U) between reward sensitivity and risk-taking propensity. Blunted response to reward compared to loss may therefore demonstrate transdiagnostic utility as it relates to different patterns of maladaptive risk behavior. The current study sought to disentangle the relationship between risk and reward in a clinically diverse sample. In a sample of 210 adults (aged 18-30), the RewP (an ERP indexing differentiation between rewards and losses) was measured during a monetary guessing game, and risk-taking propensity was measured with a behavioral task (i.e., BART) that simulates real-world risk taking. Participants also completed clinical assessments to assess for lifetime psychopathology. Results indicated that there was no linear association between the RewP and risk-taking propensity; however, there was a significant quadratic relationship. Thus, a reduced sensitivity to reward receipt was associated with both risk-prone and risk-averse behavior. There was also a significant quadratic relationship between the RewP and money won during the BART, indicating that being too risk prone or risk averse is disadvantageous and leads to missed reward. Overall, these findings suggested that blunted neural differentiation between gains and losses may contribute to deficits in effectively weighing reward and loss and result in maladaptive risk-taking behavior. These findings support continued examination of reward dysfunction dimensionally in order to better characterize behavioral profiles implicated in clinical phenotypes.