Reward processing disruption in anxiety: fMRI evidence of vulnerability to frustration non-reward

Background Anxiety is a persistent trait that disrupts functioning and increases the risk of severe consequences, while reward processing has garnered attention in anxiety research. Here, we report a critical concern in reward processing among individuals with anxiety: although anxious individuals may show similar reward processing abilities as non-anxious individuals in typical environments, they are more vulnerable to disruptions in positive emotions caused by frustrative non-reward, leading to maladaptive reward processing patterns. Methods The functional magnetic resonance imaging (fMRI) was used in this study. A total of 66 participants were recruited for the experiment, with 33 in the high anxiety (HA) group and 33 in the low anxiety (LA) group. The simulation of frustrative non-reward was conducted during fMRI scanning. Results Under the low frustration condition, the HA group exhibited task accuracy comparable to the LA group and showed greater activation in visual processing regions (inferior occipital gyrus, superior occipital gyrus, angular gyrus) and cognitive control areas (precuneus, precentral gyrus) during attentional reorienting following frustration. However, in the high frustration condition, the HA group displayed significantly lower accuracy, with maladaptive information processing patterns observed in several brain regions associated with the cognitive-emotional control system (cuneus-precuneus, anterior cingulate cortex, precentral gyrus, inferior frontal gyrus, superior frontal gyrus, orbitofrontal cortex, and amygdala). Conclusions This demonstration of two contrasting processing patterns deepens the current understanding of reward processing in anxiety. It also holds significance for a broader understanding of the risk factors in cognitive processing among individuals with anxiety.