Differential neural activation during reward processing in preadolescent suicidal ideation

Youth suicide is a critical public health issue and has been associated with aberrant neural patterns during reward processing. However, the specific direction of neural effects has been mixed across studies, and few studies have examined associations between suicidality and reward processing in early adolescents. Associations between reward processing and youth- and parent-reported suicidal ideation were examined in the ABCD baseline sample (N = 5702). Whole brain analyses examined neural activation during the Monetary Incentive Delay (MID) task, a reward processing task that elicits the anticipation and receipt of rewards and losses. Preadolescents with youth- and parent-reported suicidal ideation demonstrated blunted activation during reward and loss anticipation compared to all other groups in broad frontal regions. Moreover, preadolescents with parent, but not youth-reported suicidal ideation exhibited heightened activation compared to preadolescents with neither youth- nor parent-reported suicidal ideation during reward and loss anticipation. Overall, this study supports the presence of aberrant reward processing in preadolescents with suicidal ideation, with variations based on whether the ideation is reported by the youth and/or their parents. Thus, future research should consider both youth and parent reports of suicidal ideation when designing interventions to improve their outcomes.