Gender and comorbidity moderate the relationship between mood disorder symptoms and effortful avoidance performance

Abstract

We must often decide how much effort to exert or withhold to avoid undesirable outcomes or obtain rewards. In depression and anxiety, levels of avoidance can be excessive and reward-seeking may be reduced. Yet outstanding questions remain about the links between motivated action/inhibition and anxiety and depression levels, and whether they differ between men and women. Here we examined the relationship between anxiety and depression scores, and performance on effortful active and inhibitory avoidance (Study 1) and reward seeking (Study 2) in humans. Undergraduates and paid online workers (NAvoid = 545, NReward = 310; NFemale = 368, NMale = 450, MAge = 22.58, RangeAge = 17-62) were assessed on the Beck Depression Inventory II (BDI) and the Beck Anxiety Inventory (BAI) and performed an instructed online avoidance or reward-seeking task. Participants had to make multiple presses on active trials and withhold presses on inhibitory trials to avoid an unpleasant sound (Study 1) or obtain points towards a monetary reward (Study 2). Overall, men deployed more effort than women in both avoidance and reward-seeking, and anxiety scores were negatively associated with active reward-seeking performance based on sensitivity scores. Gender interacted with anxiety scores and inhibitory avoidance performance, such that women with higher anxiety showed worse avoidance performance. Our results illuminate effects of gender in the relationship between anxiety and depression levels and the motivation to actively and effortfully respond to obtain positive and avoid negative outcomes. Significance statementWe must often take or withhold effortful action to avoid unpleasant outcomes or obtain rewards. Depression and anxiety can impact these behaviours effectiveness, but the roles of avoidance in depression and reward-seeking in anxiety are not fully understood. Gender differences in avoidance and reward-seeking have also not been examined. We present a task in which community participants with a range of anxiety and depression levels made or withheld button presses to avoid hearing an unpleasant sound or obtain a reward. Men deployed more effort than women in avoidance, and women with higher anxiety scores had lower avoidance performance than men. We illuminate gender differences in how depressive and anxiety scores impact our ability to avoid threats and obtain rewards.