Reward and Punishment Learning Among People with a Lifetime History of Anxiety, Depression, and Substance Use Disorder

Reward and punishment learning are critical across multiple clinical populations. The Iowa Gambling Task (IGT) is frequently used to assess these constructs and multiple forms of psychopathology are associated with IGT performance. However, it is not clear whether alterations in IGT performance are general to psychopathology, or specific to different forms of psychopathology. Thus, we examined whether IGT performance was uniquely predicted by anxiety, depression, and substance use disorder. We tested a sample of adults (N=293) on the play-or-pass version of the IGT. We characterized behavior using a hierarchical Bayesian computational model, formalizing parameters underlying task behavior. With the model, we examined unique associations between IGT performance and lifetime diagnostic history of anxiety, depression, and substance use disorder. Anxiety, but not depression or substance use, was associated with higher punishment learning rates, posterior mean β = 0.15, 95% CI [0.01,0.28]. In addition, women showed lower punishment learning rates, posterior mean β = -0.17, 95% CI [-0.30,-0.03], and lower response bias, posterior mean β = -0.30, 95% CI [-0.56,-0.05]. The relation between punishment learning rates and history of anxiety was small; however, our findings were consistent with established findings in anxiety derived from self-report. In addition, only main effects of diagnostic status were examined; thus, future research should examine comorbidity between diagnoses on IGT performance. Overall, our findings are consistent with research showing that anxiety is associated with punishment avoidance. In addition, our behavioral findings with respect to gender are also consistent with previous research employing the IGT.