P300 amplitude during a monetary incentive delay task predicts future therapy completion in individuals with major depressive disorder

Evan J. White, Mariah Nacke, Elisabeth Akeman, Mallory J. Cannon, Ahmad Mayeli, James Touthang, Obada al Zoubi, Timothy J. McDermott, Namik Kirlic, Jessica Santiago, Rayus Kuplicki, Jerzy Bodurka, Martin P. Paulus, Michelle G. Craske, Kate Wolitzky-Taylor, James Abelson, Christopher Martell, Ashley Clausen, Jennifer L. Stewart, Robin L. Aupperle

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Introduction: Treatment effectiveness for major depressive disorder (MDD) is often affected by client non-adherence, dropout, and non-response. Identification of client characteristics predicting successful treatment completion and/or response (i.e., symptom reduction) may be an important tool to increase intervention effectiveness. It is unclear whether neural attenuations in reward processing associated with MDD predict behavioral treatment outcome. Methods: This study aimed to determine whether blunted neural responses to reward at baseline differentiate MDD (n = 60; 41 with comorbid anxiety) and healthy control (HC; n = 40) groups; and predict MDD completion of and response to 7–10 sessions of behavior therapy. Participants completed a monetary incentive delay (MID) task. The N200, P300, contingent negative variation (CNV) event related potentials (ERPs) and behavioral responses (reaction time [RT], correct hits) were quantified and extracted for cross-sectional group analyses. ERPs and behavioral responses demonstrating group differences were then used to predict therapy completion and response within MDD. Results: MDD exhibited faster RT and smaller P300 amplitudes than HC across conditions. Within the MDD group, treatment completers (n = 37) exhibited larger P300 amplitudes than non-completers (n = 21). Limitations: : This study comprises secondary analyses of EEG data; thus task parameters are not optimized to examine feedback ERPs from the paradigm. We did not examine heterogenous presentations of MDD; however, severity and comorbidity did not influence findings. Conclusions: Previous studies suggest that P300 is an index of motivational salience and stimulus resource allocation. In sum, individuals who deploy greater neural resources to task demands are more likely to persevere in behavioral therapy.

Original languageEnglish
Pages (from-to)873-882
Number of pages10
JournalJournal of Affective Disorders
StatePublished - 1 Dec 2021
Externally publishedYes


  • Behavioral therapy
  • Depression
  • Event-related potential
  • P300
  • Treatment outcome


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