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Journal of Clinical Psychology Jul 2024Anhedonia and irritability are two prevalent symptoms of major depressive disorder (MDD) that predict greater depression severity and poor outcomes, including...
BACKGROUND
Anhedonia and irritability are two prevalent symptoms of major depressive disorder (MDD) that predict greater depression severity and poor outcomes, including suicidality. Although both symptoms have been proposed to result from paradoxical reward processing dysfunctions, the interactions between these symptoms remain unclear. Anhedonia is a multifaceted symptom reflecting impairments in multiple dimensions of reward processing (e.g., pleasure, desire, motivation, and effort) across distinct reward types (e.g., food, sensory experiences, social activities, hobbies) that may differentially interact with irritability. This study investigated the complex associations between anhedonia and irritability using network analysis.
METHOD
Participants (N = 448, Mage = 33.29, SD = 14.58) reported their symptoms of irritability on the Brief Irritability Test (Holtzman et al., 2015) and anhedonia (i.e., pleasure, desire, motivation, and effort dimensions across four reward types) on the Dimensional Anhedonia Rating Scale (Rizvi et al., 2015). A regularized Gaussian Graphical Model was built to estimate the network structure between items.
RESULTS
Irritability was negatively related to willingness to expand effort to obtain food/drinks (estimate = -0.18), social activities (-0.13), and hobbies (-0.12) rewards. Irritability was positively associated with a desire for food/drinks (0.12).
LIMITATIONS
Only a small proportion (5.8%) of our sample was clinical and the study design was cross-sectional.
CONCLUSION
A specific link between irritability and the effort dimension of the hedonic response across three reward types was identified. Investigating effort expenditure deficits with experimental paradigms may help us understand the mechanisms underlying the comorbidity between irritability and anhedonia in the context of MDD.
Topics: Humans; Anhedonia; Irritable Mood; Adult; Female; Male; Middle Aged; Young Adult; Depressive Disorder, Major; Adolescent
PubMed: 38497904
DOI: 10.1002/jclp.23679 -
Neuroscience Dec 2023Depressive disorder is a psychiatric condition that is characterized by the core symptoms of anhedonia and learned helplessness. Myelination loss was recently found in...
Depressive disorder is a psychiatric condition that is characterized by the core symptoms of anhedonia and learned helplessness. Myelination loss was recently found in the prefrontal cortex (PFC) of patients with depression and animal models, but the mechanism of this loss is unclear. In our previous study, chronic restraint stress (CRS) mice showed depressive-like symptoms. In this study, we found that myelin was reduced in the PFC of CRS mice. We also observed increased mammalian target of rapamycin (mTOR) phosphorylation levels in the PFC. Chronic injections of rapamycin, a mTOR complex inhibitor, prevented depressive behavior as shown by the forced swimming test and sucrose preference test. Rapamycin also increased myelination in the PFC of CRS mice. In summary, we found that CRS enhanced mTOR signaling and reduced myelination in the PFC and that rapamycin could prevent it. Our study provides the etiology of reduced myelin in depressive symptoms and suggests that mTOR signaling could be a target for treating depression or improving myelination deficits in depressive disorders.
Topics: Humans; Mice; Animals; Sirolimus; Antidepressive Agents; TOR Serine-Threonine Kinases; Signal Transduction; Prefrontal Cortex; Depression; Stress, Psychological; Disease Models, Animal; Mammals
PubMed: 37926147
DOI: 10.1016/j.neuroscience.2023.10.025 -
Behaviour Research and Therapy Oct 2023This cluster randomised controlled trial examined the effectiveness of universal school-based mindfulness training (MT; vs. passive control) to lower anhedonia and... (Randomized Controlled Trial)
Randomized Controlled Trial
The effect of universal school-based mindfulness on anhedonia and emotional distress and its underlying mechanisms: A cluster randomised controlled trial via experience sampling in secondary schools.
This cluster randomised controlled trial examined the effectiveness of universal school-based mindfulness training (MT; vs. passive control) to lower anhedonia and emotional distress among mid-adolescents (15-18 years). It further examined three potential mechanisms: dampening of positive emotions, non-acceptance/suppression of negative emotions, and perceived social pressure not to experience/express negative emotions. Adolescents (n = 136, n = 95) participated in three assessment points (before, after and two/three months after the in-class MT), consisting of Experience Sampling (ES) assessments and self-report questionnaires (SRQs) to corroborate the ES assessments. Analyses were based on general linear modelling and multilevel modelling. Overall, no evidence was found for a significant beneficial and long-lasting impact of the MT on adolescents' mental health. Importantly, some barriers inherently linked to universal MT approaches (low engagement in and mixed attitudes towards the MT) may have tempered the effectiveness of the MT in the current trial. Further research should prioritise overcoming these barriers to optimise programme implementation. Additionally, given the potential complex interplay of moderators at micro- (home practice), meso- (school climate), and macro-level (broader context), research should simultaneously focus on alternative ways of delivering MT at schools to strengthen adolescents' mental health.
Topics: Adolescent; Humans; Mindfulness; Anhedonia; Ecological Momentary Assessment; Emotions; Schools; Psychological Distress
PubMed: 37797436
DOI: 10.1016/j.brat.2023.104405 -
BJPsych Open Nov 2023There is a common perception that creativity is associated with psychopathology. Previous studies have shown that members of creative groups such as comedians, artists...
BACKGROUND
There is a common perception that creativity is associated with psychopathology. Previous studies have shown that members of creative groups such as comedians, artists and scientists scores higher than the norm on psychotic traits, and scientists in STEM (science, technology, engineering and mathematics) fields score highly on autistic traits.
AIMS
To test whether magicians, a creative group that has not been studied before, also score highly on psychopathological traits and autism, and to test the associations of creative self-efficacy and creative identity with schizotypal and autistic traits among magicians.
METHOD
A sample of 195 magicians and 233 people from the general population completed measures of schizotypal traits (Oxford-Liverpool Inventory of Feelings and Experiences) and autism (Abridged Version of the Autism-Spectrum Quotient), as well as the Short Scale of Creative Self. Magicians were also compared with other creative groups with respect to schizotypal traits, based on previously published data.
RESULTS
Magicians scored lower than the general population sample on three of the four schizophrenia measures (cognitive disorganisation, introvertive anhedonia and impulsive nonconformity) but did not differ with respect to unusual experiences or autism scores. Magicians scored higher on creative self-efficacy and creative personal identity than the general sample. Magicians' scores on schizotypal traits were largely lower than those of other creative groups. Originality of magic was positively correlated with unusual experiences ( = 0.208), creative self-efficacy ( = 0.251) and creative identity ( = 0.362).
CONCLUSIONS
This is the first study to show a creative group with lower scores than norms on psychotic traits. The results highlight the unique characteristics of magicians and the possible myriad associations between creativity and mental disorders among creative groups.
PubMed: 37964594
DOI: 10.1192/bjo.2023.609 -
MedRxiv : the Preprint Server For... Dec 2023Dysfunctional reward processing in major depressive disorder (MDD) involves functional circuitry of the habenula (Hb) and nucleus accumbens (NAc). Ketamine elicits rapid...
Dysfunctional reward processing in major depressive disorder (MDD) involves functional circuitry of the habenula (Hb) and nucleus accumbens (NAc). Ketamine elicits rapid antidepressant and alleviates anhedonia in MDD. To clarify how ketamine perturbs reward circuitry in MDD, we examined how serial ketamine infusions (SKI) modulate static and dynamic functional connectivity (FC) in Hb and NAc networks. MDD participants (n=58, mean age=40.7 years, female=28) received four ketamine infusions (0.5mg/kg) 2-3 times weekly. Resting-state fMRI scans and clinical assessments were collected at baseline and 24 hours post-SKI completion. Static FC (sFC) and dynamic FC variability (dFCv) were calculated from left and right Hb and NAc seeds to all other brain regions. Paired t-tests examined changes in FC pre-to-post SKI, and correlations were used to determine relationships between FC changes with mood and anhedonia. Following SKI, significant increases in left Hb-bilateral visual cortex FC, decreases in left Hb-left inferior parietal cortex FC, and decreases in left NAc-right cerebellum FC occurred. Decreased dFCv between left Hb and right precuneus and visual cortex, and decreased dFCv between right NAc and right visual cortex both significantly correlated with improvements in Hamilton Depression Rating Scale. Decreased FC between left Hb and bilateral visual/parietal cortices as well as increased FC between left NAc and right visual/parietal cortices both significantly correlated with improvements in anhedonia. Subanesthetic ketamine modulates functional pathways linking the Hb and NAc with visual, parietal, and cerebellar regions. Overlapping effects between Hb and NAc functional systems were associated with ketamine's therapeutic response.
PubMed: 38106178
DOI: 10.1101/2023.12.01.23299282 -
Psychiatria Polska Apr 2024"Schizotypy" is a term describing personality traits reflected in emotional, perceptual and cognitive styles. Affective temperaments are trait-like features which were...
OBJECTIVES
"Schizotypy" is a term describing personality traits reflected in emotional, perceptual and cognitive styles. Affective temperaments are trait-like features which were observed to be stable in time and predispose to mood disorders. The purpose of this study was to examine relationship between schizotypal features, affective temperaments and anhedonia in patients with bipolar depression.
METHODS
54 patients with bipolar depression were included in the study. Participant were administered the following psychometric tools: Dimensional Anhedonia Rating Scale (DARS), Snaith-Hamilton Pleasure Scale (SHAPS), Oxford-Liverpool Inventory of Feelings and Experiences (O-LIFE), Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A), and Quick Inventory of Depressive Symptomatology - Self-Report (QIDS-SR). Correlations between the variables were calculated and linear regression models were built.
RESULTS
Only hyperthymia (affective temperament) and introvertive anhedonia (schizotypal domain) were statistically significantly correlated with anhedonia. In regression models, introvertive anhedonia predicted higher whereas hyperthymic features lower severity of anhedonia (measured by the SHAPS scale).
CONCLUSIONS
Hyperthymic features are protective and introvertive anhedonia is a risk factor for consummatory anhedonia.
PubMed: 38805600
DOI: 10.12740/PP/OnlineFirst/178345 -
JMIR Public Health and Surveillance Nov 2023Bullying victimization is highly prevalent among sexual minority youths, particularly in educational settings, negatively affecting their mental health. However,...
BACKGROUND
Bullying victimization is highly prevalent among sexual minority youths, particularly in educational settings, negatively affecting their mental health. However, previous studies have scarcely explored the symptomatic relationships among anxiety, depression, and posttraumatic stress disorder (PTSD) among sexual minority youths who experienced bullying on college campuses.
OBJECTIVE
The objectives of our study were to (1) characterize the anxiety-depression-PTSD network structures of gay or lesbian, bisexuals, and other sexual minority youths previously bullied on college campuses; and (2) compare symptomatic associations in the anxiety-depression-PTSD networks among bullied sexual minority youths and heterosexual youths' groups.
METHODS
This cross-sectional study recruited college participants from Jilin Province, China. Data were analyzed using a subset of the data extracted after screening for sexual orientation and history of bullying victimization. Sexual minority youths were then divided into 3 subgroups: gay or lesbian (homosexual), bisexual, and other. Mental health symptom severity was assessed using scales: the 7-item Generalized Anxiety Disorder Scale measuring anxiety, the 9-item Patient Health Questionnaire measuring depression, and the 10-item Trauma Screening Questionnaire measuring PTSD symptoms. Combining the undirected and Bayesian network analyses, the anxiety-depression-PTSD networks were compared among sexual minority youths subgroups, and the difference between heterosexual youths and sexual minority youths was investigated. Chi-square tests were used to compare the difference in categorical variables, while independent-sample t tests were run on continuous variables.
RESULTS
In this large-scale sample of 89,342 participants, 12,249 identified as sexual minority youths, of which 1603 (13.1%, 95% CI 12.5%-13.7%) reported being bullied on college campuses in the past year. According to the expected influence (EI) and bridge expected influence (bEI) index, in the global network structure of anxiety, depression, and PTSD, sad mood (EI=1.078, bEI=0.635) and irritability (EI=1.077, bEI=0.954) were identified as central and bridge symptoms; emotional cue reactivity (EI=1.015) was a central symptom of PTSD in this global network. In the anxiety-depression-PTSD Bayesian network, anhedonia had the highest prediction priority for activating other symptoms; and feeling afraid linked symptoms from anxiety to the PTSD community. Compared to their heterosexual counterparts, sexual minority youths exhibited a stronger association between difficulty concentrating and appetite. The "sad mood-appetite" edge was strongest in the gay or lesbian network; the "irritability-exaggerated startle response" edge was strongest in the bisexual network.
CONCLUSIONS
For the first time, this study identified the most central and bridge symptoms (sad mood and irritability) within the depression-anxiety-PTSD network of sexual minority youths with past bullying-victim experiences on college campuses. Emotional cue reactivity, anhedonia, and feeling afraid were other vital symptoms in the comorbid network. Symptomatic relationships existed showing heterogeneity in bullied heterosexual youths and sexual minority youth networks, which also was present within the sexual minority youth subgroups. Consequently, refined targeted interventions are required to relieve anxiety, depression, and PTSD symptoms.
Topics: Adolescent; Female; Humans; Male; Stress Disorders, Post-Traumatic; Anhedonia; Bayes Theorem; Cross-Sectional Studies; Depression; Anxiety; Sexual and Gender Minorities; Bullying
PubMed: 37910159
DOI: 10.2196/47233 -
Journal of Affective Disorders May 2024Anhedonia is a transdiagnostic symptom often resistant to treatment. The identification of biomarkers sensitive to anhedonia treatment will aid in the evaluation of...
BACKGROUND
Anhedonia is a transdiagnostic symptom often resistant to treatment. The identification of biomarkers sensitive to anhedonia treatment will aid in the evaluation of novel anhedonia interventions.
METHODS
This is an exploratory analysis of changes in subcortical brain volumes accompanying psychotherapy in a transdiagnostic anhedonic sample using ultra-high field (7-Tesla) MRI. Outpatients with clinically impairing anhedonia (n = 116) received Behavioral Activation Treatment for Anhedonia, a novel psychotherapy, or Mindfulness-Based Cognitive Therapy (ClinicalTrials.gov Identifiers NCT02874534 and NCT04036136). Subcortical brain volumes were estimated via the MultisegPipeline, and regions of interest were the amygdala, caudate nucleus, hippocampus, pallidum, putamen, and thalamus. Bivariate mixed effects models estimated pre-treatment relations between anhedonia severity and subcortical brain volumes, change over time in subcortical brain volumes, and associations between changes in subcortical brain volumes and changes in anhedonia symptoms.
RESULTS
As reported previously (Cernasov et al., 2023), both forms of psychotherapy resulted in equivalent and significant reductions in anhedonia symptoms. Pre-treatment anhedonia severity and subcortical brain volumes were not related. No changes in subcortical brain volumes were observed over the course of treatment. Additionally, no relations were observed between changes in subcortical brain volumes and changes in anhedonia severity over the course of treatment.
LIMITATIONS
This trial included a modest sample size and did not have a waitlist-control condition or a non-anhedonic comparison group.
CONCLUSIONS
In this exploratory analysis, psychotherapy for anhedonia was not accompanied by changes in subcortical brain volumes, suggesting that subcortical brain volumes may not be a candidate biomarker sensitive to response to psychotherapy.
PubMed: 38815760
DOI: 10.1016/j.jad.2024.05.140 -
Journal of Psychiatric Research Sep 2023To explore the factors influencing anhedonia at baseline and use them as confounding factors. To further investigate the correlation between overt aggression and...
OBJECTIVE
To explore the factors influencing anhedonia at baseline and use them as confounding factors. To further investigate the correlation between overt aggression and anhedonia during the acute phase of major depressive disorder.
METHODS
In this eight-week prospective study, 384 major depressive disorder patients were recruited from the outpatient section of Shanghai Mental Health Center from May 1, 2017, to October 30, 2018. Standard treatments were performed with escitalopram or venlafaxine for participants. Depressive symptoms, overt aggression, and anhedonia were assessed using the 17-item Hamilton Rating Scale for Depression, Modified Overt Aggression Scale, and Snaith-Hamilton Pleasure Scale at baseline, and in the 4th and 8th weeks.
RESULTS
Obsessive-compulsive symptoms and the duration of untreated psychosis were positively associated with aggression (P < 0.05). Patients with aggressive behaviour had worse cognitive impairment and severe anhedonia of pleasurable sensory experiences (P < 0.05). For anhedonia, being female (tau_b = -0.23, P = 0.012) was a protective factor, while number of recurrent, melancholic features, current obsessions, previous combination drug therapies, depressive symptoms, and aggressive behaviour were risk factors (P < 0.05). Social anhedonia related to interests/pastimes, and pleasurable sensory experiences were more severe in major depressive disorder patients with aggressive behaviour in the acute phase (P < 0.05).
CONCLUSIONS
Anhedonia persisted in major depressive disorder patients with aggressive behaviour after standardized treatment during the acute phase. Being female protected the pleasures from social interaction and sensory experience. However, the number of depressive episodes, melancholic features, current obsessive symptoms, previous combination drug therapies, depressive symptoms, and aggressive behaviour was positively associated with anhedonia.
Topics: Humans; Female; Male; Depressive Disorder, Major; Anhedonia; Prospective Studies; China; Aggression
PubMed: 37459777
DOI: 10.1016/j.jpsychires.2023.07.013 -
BMC Psychiatry Feb 2024Mood disorders are strongly associated with melatonin disturbances. However, it is unclear whether there is a difference in melatonin concentrations and melatonin...
BACKGROUND
Mood disorders are strongly associated with melatonin disturbances. However, it is unclear whether there is a difference in melatonin concentrations and melatonin circadian rhythm profiles between depression and bipolar disorder. In addition, the relationship between anhedonia, a common symptom of affective disorders, and its melatonin circadian rhythm remains under-investigated.
METHODS
Thirty-four patients with depression disorder, 20 patients diagnosed with bipolar disorder and 21 healthy controls participated in this study. The Revised Physical Anhedonia Scale (RPAS) was performed to assess anhedonia. Saliva samples were collected from all subjects at fixed time points (a total of 14 points) in two consecutive days for measuring the melatonin concentrations to fit circadian rhythms of subjects. Melatonin circadian rhythms were compared between the three groups using ANOVA. Partial correlation analysis and linear regression analysis were used to explore the correlation between melatonin rhythm variables and anhedonia.
RESULTS
We found that the peak phase of melatonin in the depression group was significantly advanced compared to the control group (P < 0.001) and the bipolar disorder group (P = 0.004). The peak phase of melatonin and RPAS showed a negative correlation (P = 0.003) in depression patients, which was also demonstrated in the multiple linear regression model (B=-2.47, P = 0.006).
CONCLUSIONS
These results suggest that circadian rhythms of melatonin are differentiated in depression and bipolar disorder and correlate with anhedonia in depression. Future research needs to explore the neurobiological mechanisms linking anhedonia and melatonin circadian rhythms in depressed patients.
Topics: Humans; Mood Disorders; Anhedonia; Melatonin; Cross-Sectional Studies; Circadian Rhythm
PubMed: 38413912
DOI: 10.1186/s12888-024-05606-5