B - 16 Neurocognitive Training to Boost Reward Sensitivity Modulates Positive Affect in Individuals with Generalized Anxiety Disorder: a Proof-of-Concept Study

Abstract Objective Anhedonia (i.e., reduced positive affect and decreased sensitivity to rewards) is observed in many psychiatric conditions, including generalized anxiety disorder (GAD). We tested the usefulness of a cognitive training program aimed at boosting reward responsiveness (a multi-arm bandit task; MAB) to decrease anhedonia in individuals with anxiety and depressive symptoms. Methods Individuals (N = 50; 54% Female; 18–65 yo) with high levels of anhedonia as measured by the Positive and Negative Affect Scale (PANAS; score < 25) and diagnostic levels of depression and/or anxiety (Patient Health Questionnaire-8/PHQ-8 or General Anxiety Disorder-7/GAD-7 score ≥ 10) were randomly assigned to a high-reward MAB training with either high variance (HV) or low variance (LV) in reward rates. The HV condition was expected to boost reward maximization and decrease anhedonic symptoms. State anhedonia levels as measured by the PANAS were collected before and after completing MAB training. Results Individuals with both higher baseline anhedonia (PANAS positive affect score < 18) and a GAD diagnosis who underwent the HV vs the LV training MAB exhibited a decrease in anhedonia when compared to pre-training levels (odds ratio/OR: 1.65, 95% CI = [1.16,2.35], t = 2.8, p = 0.027). This effect was not seen in individuals with GAD and lower levels of anhedonia (PANAS positive affect score > 18) or in those who did not meet diagnostic criteria for GAD (ps > 0.05). Conclusions These results suggest a role for HV MAB training in decreasing anhedonia in individuals with GAD. Targeting anhedonia for these individuals during treatment may help improve clinical outcomes.