Anhedonia in Schizophrenia: A Review of Assessment Strategies

Abstract

Anhedonia, the diminished capacity to experience pleasant emotions, is a common, treatment-resistant feature of schizophrenia that is often included among the negative symptoms of this disorder. This selective review describes the 3 most commonly used approaches to assess anhedonia in schizophrenia: interview-based measures, self-report trait questionnaires, and laboratory-based assessments of emotional experience. For each assessment approach, psychometric properties, relationships to other symptoms and features of schizophrenia, and relationships with the other assessment approaches are evaluated. It is concluded that anhedonia can be reliably assessed and constitutes a distinctive, clinically important aspect of schizophrenia that should be included in a comprehensive evaluation of negative symptoms. Current efforts to define more precisely the nature of the hedonic deficit in schizophrenia are discussed, and recommendations for optimal assessment of anhedonia in clinical trials of novel treatments for negative symptoms are provided.

The validity of Psychosis Proneness Scales as vulnerability indicators in recent-onset schizophrenia patients

“…Anhedonia and reward processing are complex, multifaceted constructs and further specification of the precise nature of the hedonic deficit in schizophrenia is needed. For example, it is not yet clear whether anhedonia in schizophrenia involves the appetitive or consummatory components of hedonic experience (Horan et al 2006c). In addition, not all schizophrenia patients experience substantial anhedonia.…”

“…In biological relatives, elevations have most commonly been reported for PhysAnh and SocAnh (Edell 1995;Horan et al 2006a). PerAb and MagId have typically not shown elevations in biological relatives ( (Edell 1995) but see (Lenzenweger and Loranger 1989)).…”

“…Studies of these scales in schizophrenia patients have been almost exclusively cross-sectional and therefore address only the first criterion. Patients have repeatedly shown elevated PhysAnh and SocAnh (Horan et al 2006c) and less frequently, but consistently, elevated PerAb (Edell 1995). The remaining scales have been examined much less frequently, though elevated MagId (George and Neufeld 1987) and ImpNon (Chapman et al 1984) have been reported in inpatient samples.…”

Individual differences in trait anhedonia: a structural and functional magnetic resonance imaging study in non-clinical subjects

“…In both patient and non-clinical samples, PAS reliability is consistently very good, with a coefficients typically exceeding 0.80. 29 Scores range from 0 to 61 (the lower the score, the less severe is anhedonia). We chose the PAS for our study because Chapman's anhedonia questionnaires are by far the most common scales used to study the trait-like dimension of anhedonia.…”

Explanatory pluralism: An unrewarding prediction error for free energy theorists

“…Impairments in mesocortical DA circuits in patients with these disorders are specifically associated with the motivational deficits in anhedonia (Treadway & Zald 2011;Howes & Kapur 2009;Horan et al 2006). In patients with major depressive disorder, quantitative measures of anhedonia severity are negatively correlated with the response magnitude in the ventral striatum to pleasant stimuli, and positively correlated with the magnitude of activity in the ventromedial PFc (Keedwell et al 2005;Gaillard et al 2013).…”