Erika Forbes, PhD

Neural Reward Systems as a Mechanism and Treatment Target in Adolescent Depression

After a long history of emphasis on disruptions to negative affect and threat systems in depression, clinical and affective neuroscience research on postulated alterations to positive affect and reward systems is finally catching up. A developmental perspective can provide critical insights on the mechanisms of depression, as the emergence of depression typically coincides with changes in reward-related neural systems and behavior during youth. Anhedonia, a symptom reflecting difficulty with motivation for or enjoyment of reward, could be an especially fruitful focus for translational applications of this approach because it is associated with pernicious clinical course. This presentation will describe findings on function in neural reward systems in adolescent depression and anhedonia, with extension to understanding clinical course, disparities in mental health, suicidality, and treatment.

Erika Forbes, PhD, is Professor of Psychiatry, Psychology, Pediatrics, and Clinical and Translational Science at the University of Pittsburgh. She received her AB in History and Literature from Harvard University and her PhD in Clinical and Developmental Psychology from the University of Pittsburgh. She completed a predoctoral clinical psychology internship and a postdoctoral fellowship in the Department of Psychiatry at the University of Pittsburgh and then joined the faculty in 2005. Her research uses longitudinal, developmental psychopathology designs and neuroimaging, ecological momentary assessment, behavioral, and neuromodulation techniques. The central theme of her work is the role of neural reward systems in the development, pathophysiology, and treatment of depression. She has published over 210 peer-reviewed publications, attained an h index of 71, and received honors such as the American College of Neuropsychopharmacology Eva King Killam Award.

Reading List

Eckstrand, Kristen L., et al. “Medial prefrontal cortex activity to reward outcome moderates the association between victimization due to sexual orientation and depression in youth.” Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, vol. 7, no. 12, Dec. 2022, pp. 1289–1297, https://doi.org/10.1016/j.bpsc.2022.08.009.

Forbes, Erika E., and Ronald E. Dahl. “Research review: Altered reward function in adolescent depression: What, when and how?” Journal of Child Psychology and Psychiatry, vol. 53, no. 1, 28 Nov. 2011, pp. 3–15, https://doi.org/10.1111/j.1469-7610.2011.02477.x.

Forbes, Erika E., et al. “Altered striatal activation predicting real-world positive affect in adolescent major depressive disorder.” American Journal of Psychiatry, vol. 166, no. 1, Jan. 2009, pp. 64–73, https://doi.org/10.1176/appi.ajp.2008.07081336.

Gupta, Tina, et al. “Continuous theta burst stimulation to dorsomedial prefrontal cortex in young adults with depression: Changes in resting frontostriatal functional connectivity relevant to positive mood.” Behaviour Research and Therapy, vol. 174, Mar. 2024, p. 104493, https://doi.org/10.1016/j.brat.2024.104493.

Sequeira, Stefanie L., et al. “Association of Neural Reward Circuitry function with response to psychotherapy in youths with Anxiety Disorders.” American Journal of Psychiatry, vol. 178, no. 4, 1 Apr. 2021, pp. 343–351, https://doi.org/10.1176/appi.ajp.2020.20010094.