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Depression is associated with altered sensitivity to reward and punishment, which can influence complex decision-making. We examined punishment sensitivity in the performance of participants with major depressive disorder (MDD) with that of a comparison group on the automatic Balloon Analogue Risk Task (BART), which is a direct measure of risk taking. The present study examined the BART performance of 30 individuals with MDD and 30 matched comparison individuals. The comparison group ( M  = 63.25) entered a significantly ( p  < 0.001;  d  = 1.1) higher number of pumps on the BART than the MDD group ( M  = 50.83). Higher levels of depression symptoms were significantly correlated ( r  = -0.40,  p  < 0.05) with entering a lower number of pumps in the MDD group. MDD patients showed an increased sensitivity to punishment on the BART: after a loss, the MDD group decreased ( M  = 13.7) the number of subsequent pumps they entered by a significantly ( p  < 0.001,  d  = 0.81) greater amount than the comparison group ( M  = 4.35). This difference applied to losses only: no difference was found between the groups regarding the magnitude of change in pumps selected after a win. Findings suggest the presence of elevated punishment sensitivity among individuals with MDD, which may contribute to the maintenance of depressive symptoms.

Clinical Depression and Punishment Sensitivity on the BART