Risk tolerance in youth with emerging mood disorders

Reward-seeking behavior drives adolescents toward risky decision-making. As compared to their older and younger peers, adolescents experience higher rates of anxiety and depressive disorders, leading to impaired decision-making with negative consequences. At two time points, separated by 6–8 weeks, we measured risky and ambiguous choices concurrently with levels of dysregulated emotion for youth aged 16–25 (N = 30, mean age 19.22 years, 19 males) attending a youth mental health clinic. The Kessler Psychological Distress Scale (10 items) (K10), the Quick Inventory of Depressive Symptomatology Adolescent (17 items) (QIDS-A17) specifically designed for youth, and the Somatic and Psychological Health Report (12 items) (SPHERE-12) questionnaires were used to evaluate participant’s self-reported anxiety and depression scores. Risk and ambiguity tolerance was calculated at the individual and group level. At baseline, 25 (83%) participants were rated as experiencing a mental health condition, and 15 (50%) rated high on all three psychological questionnaires combined, scoring “severely” depressed and “severely” anxious. At follow-up, 25 returning participants, 80% (N = 20) remained distressed, with 11 continuing to rate high on all psychological scores. In Session 1, participants had a mean of approximately 14 risky choices (SD = 4.6), and 11 ambiguous choices (SD = 7.6), whilst in Session 2, participants’ mean equated to approximately 13 ambiguous choices (SD = 8.5), but their risk increased to 15 choices (SD = 6.5). Applying a multiple regression analysis at the group level, the data suggests that participants were risk averse (α = 0.55, SE = 0.05), and preferred making ambiguous choices (β = 0.25, SE = 0.04). These results suggest that high trait-like anxiety in youth is associated with risk intolerance. These findings may have implications for screening young people with emerging mood disorders.