Reward Motives are Differentially Related to Depression, Anxiety, and ADHD Symptoms in Middle Childhood.

Deviations in reward anticipation and response are associated with internalizing and externalizing disorders. However, relationships between different types of reward motivations and psychopathology have been less explored. We examine how preferences for absolute (gaining points) and relative (gaining more points than others) rewards relate to psychopathological symptoms in middle childhood. A community sample (N=133 6-9-year-olds) was assessed for child characteristics (gender, age, resource deprivation) and psychiatric symptoms (Child Behavior Checklist dimensional subscales: depression, anxiety, Attention-Deficit/Hyperactivity Disorder (ADHD), Oppositional Defiant Disorder (ODD), and Conduct Disorder (CD)). Children completed a behavioral economic game, selecting equal or unequal point splits for themselves and another player. Each round offered one of four unequal point splits: absolute rewards (more overall points), relative rewards (more points than another player), both, or neither. Multilevel binary logistic regressions found that depression was associated with an increased preference for gaining more points than the other player (t=1.986, p=.047), anxiety was associated with a reduced preference for maximizing points (t=-3.259, p=.001) and gaining more points than the other player (t=-3.148, p=.002), and ADHD was associated with an increased preference for maximizing points regardless of what the other player received (t=2.392, p=.017). Our results suggest depression, anxiety, and ADHD may differentially influence the types of rewards children find motivating and choose to pursue. Future work should explore the impact of integrating these preferences into treatment to reduce pediatric psychopathology.