Preschool-Onset Major Depressive Disorder is Characterized by Electrocortical Deficits in Processing Pleasant Emotional Pictures

  • Diana J. WhalenEmail author
  • Kirsten E. Gilbert
  • Danielle Kelly
  • Greg Hajcak
  • Emily S. Kappenman
  • Joan L. Luby
  • Deanna M. Barch


Reductions in positive affect are a salient feature of preschool-onset major depressive disorder. Yet, little is known about the psychophysiological correlates of this blunted positive affect and whether reduced physiological responding to pleasant stimuli may differentiate depressed and healthy young children. 120 four-to-seven year old children with current depression and 63 psychiatrically healthy 4-to-7 year old children completed a simple picture-viewing task of pleasant and neutral pictures while event-related potentials (ERPs) were recorded. The early-childhood version of the Kiddie Schedule for Affective Disorders and Depression was used to establish psychiatric diagnoses. A one-way ANCOVA was used to test for group differences in response to pleasant and neutral pictures. Young children with depression showed a reduced response to pleasant vs. neutral pictures (LPP), after controlling for children’s age (F(1,180) = 4.15, p = 0.04, η2 = 0.02). The LPP for the children with preschool-onset depression (M = 0.99, SE = 0.65) was significantly smaller than the LPP in the healthy group of young children (M = 3.27, SE = 0.90). This difference did not vary as a function of depression or anhedonia severity within the group with depression or the healthy children. Similar to older children and adolescents with depression, young children with depression display reductions in responsivity to pleasant stimuli as indexed by the LPP. These findings extend prior findings indicating a blunted response to pleasant stimuli in preschool- onset depression. Given the greater neuroplasticity of emotional response and regulation, these findings suggest clinical attention to emotional response to pleasure is an important target in preschool-onset depression. Clinical trial registration information: A Randomized Control Trial of PCIT-ED for Preschool Depression;;NCT02076425.


Late positive potential (LPP) Early childhood Depression ERP 



The authors wish to thank the many parents and children who participated in the Parent-Child Interaction Treatment Emotion Development (PCIT-ED) study.

Compliance with Ethical Standards  

Conflict of Interest

Dr. Barch consults for Pfizer. Dr. Luby receives royalties from Guildford Press. All other authors report no biomedical financial interests or potential conflicts of interest.

Ethics and Consent Statement

This study was carried out in accordance with the recommendations of Washington University School of Medicine Institutional Review Board with written informed consent from all caregivers and verbal assent from all preschoolers. All caregivers gave written informed consent in accordance with the Declaration of Helsinki. The protocol was approved by the Washington University School of Medicine Institutional Review Board

Supplementary material

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of PsychiatryWashington University School of Medicine in St. LouisSt. LouisUSA
  2. 2.Department of PsychologyFlorida State UniversityTallahasseeUSA
  3. 3.Department of PsychologySan Diego State UniversitySan DiegoUSA
  4. 4.The Program in NeuroscienceWashington University in St. LouisSt. LouisUSA
  5. 5.Department of PsychologyWashington University in St. LouisSt. LouisUSA
  6. 6.Department of RadiologyWashington University in St. LouisSt. LouisUSA

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