Targeting Positive Valence Systems Function in Children of Mothers with Depressive Symptoms: A Pilot Randomized Trial of an RDoC-Informed Preventive Intervention

Reduced activation of the Research Domain Criteria (RDoC) positive valence systems (PVS) is observed in high-risk (HR) children of depressed mothers and predictive of future psychopathologies. We developed a dyadic, neuroscience-informed preventive intervention, Family Promoting Positive Emotions (FPPE), designed to prevent psychopathology in HR children by targeting PVS processes. We evaluated the initial efficacy of FPPE compared to written information (WI) psychoeducation in engaging PVS-related targets and reducing perceived stress and emotional distress symptoms in HR youth. Participants included 74 children ages 8-12 years and their biological mothers reporting elevated depressive symptoms. Following random assignment, 55 dyads completed FPPE (n = 29) or WI (n = 26) and pre-post assessments of child clinical symptoms. Youth completed a reinforcement learning task and 10 days of positive affect ratings to assess PVS-related targets. Results revealed a small within-subjects increase in child daily positive affect in FPPE, but not WI. Further, FPPE resulted in reductions in mother-reported child perceived stress and symptoms of anger, anxiety, and depression with medium-to-large within-subjects effects. Intervention effects on reinforcement learning and child-rated clinical symptoms were not observed. This study suggests FPPE shows promise in enhancing positive affect and reducing the emergence of clinical symptoms in HR children. CLINICALTRIALS.GOV IDENTIFIER: NCT05223842.