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This study aimed to examine the potential of experiencing aesthetic chills to enhance reward learning in individuals with elevated depressive symptoms, specifically anhedonia, by investigating the effect of chills on participants' ability to modulate behavior as a function of rewards. A total of 103 participants with elevated depressive symptoms took part in the experiment. Among them, 59 participants had depressive symptoms (BDI ≥ 20), with 26 classified as "High Anhedonic" (HA) and 33 as "Low Anhedonic" (LA). Additionally, 39 participants without elevated depressive symptoms (BDI < 20 and SHAPs <32) were included as the control group. We utilized ChillsDB, an open-source database of validated audiovisual stimuli known to elicit chills in the US population. Anhedonic participants who experienced chills demonstrated a significant increase in response bias (p =.004) towards rewards compared to those who did not experience chills. Highlighting specificity, no significant difference in reward bias was observed among LA participants. These findings suggest that the experience of chills has the potential to impact reward learning in anhedonic individuals, aligning with the known neurobiology of this phenomenon. These results highlight the potential of aesthetic chills as a novel approach to elicit and enhance positive affect in depressed populations. • The study investigates whether aesthetic chills can enhance reward learning in individuals with anhedonic depression. • 103 participants completed the probabilistic reward task (PRT) before and after viewing videos to elicit chills. • High anhedonic participants who experienced chills showed improved reward learning post-exposure. • Chills exposure correlated with elevated positive emotions (valence/arousal) in high anhedonic participants. • Findings suggest chills may temporarily boost reward processing and positive affect in anhedonic individuals. [ABSTRACT FROM AUTHOR]

Perinatal depression is a significant concern affecting both women and men during pregnancy and postpartum periods. While maternal postpartum depression has been extensively studied, paternal depression remains under-researched despite its prevalence and impact on family well-being. This study aimed to estimate the trajectories of perinatal and postpartum depression in Japanese parents over ten years and to determine the details of the symptoms of postpartum depression for each trajectory group, considering reciprocal effects between maternal and paternal depression. A total of 789 couples used the Edinburgh Postnatal Depression Scale to rate their depressive symptoms prenatally; at 5 weeks, 3 months, 6 months, and 1 year postpartum; and then yearly thereafter until the 10th year. Parallel-process latent class growth analysis was used to group participants according to their longitudinal patterns of depressive symptoms. For both mothers and fathers, four depressive symptom trajectories fit the data best and were most informative (escalating: 6.5 %; mothers low and fathers moderate: 17.2 %; mothers high and fathers low: 17.9 %; low: 58.4 %). A variance analysis showed significant class-parent interactions across anhedonia, anxiety, and depression subscales, indicating distinct patterns of depressive symptomatology. Tailored mental health programs and universal screening using the Edinburgh Postnatal Depression Scale are recommended to address the specific needs of each trajectory class. This study contributes to the understanding of long-term depressive symptom trajectories in parents and emphasizes the necessity of comprehensive support strategies to enhance family well-being and resilience. • Postnatal depression trajectories were characterized over 10-years. • We compared the EPDS subscales of anhedonia, anxiety, and depression. • Perinatal depression, whether mild or severe, often begins during pregnancy. • Men may be more vulnerable to stress after childbirth as they do not seek help. • Anxiety and depression in mothers remained at high levels for 10 years postpartum. [ABSTRACT FROM AUTHOR]

Background: Anhedonia and suicidal ideation are symptoms of major depressive disorder (MDD) that are not regularly captured in structured scales but may be captured in unstructured clinical notes. Natural language processing (NLP) techniques may be used to extract longitudinal data on suicidal behaviors and anhedonia within unstructured clinical notes. This study assessed the accuracy of using NLP techniques on electronic health records (EHRs) to identify these symptoms among patients with MDD. Methods: EHR-derived, de-identified data were used from the NeuroBlu Database (version 23R1), a longitudinal behavioral health real-world database. Mental health clinicians annotated instances of anhedonia and suicidal symptoms in clinical notes creating a ground truth. Interrater reliability (IRR) was calculated using Krippendorff's alpha. A novel transformer architecture-based NLP model was trained on clinical notes to recognize linguistic patterns and contextual cues. Each sentence was categorized into one of four labels: (1) anhedonia; (2) suicidal ideation without intent or plan; (3) suicidal ideation with intent or plan; (4) absence of suicidal ideation or anhedonia. The model was assessed using positive predictive values (PPV), negative predictive values, sensitivity, specificity, F1-score, and AUROC. Results: The model was trained, tested, and validated on 2,198, 1,247, and 1,016 distinct clinical notes, respectively. IRR was 0.80. For anhedonia, suicidal ideation with intent or plan, and suicidal ideation without intent or plan the model achieved a PPV of 0.98, 0.93, and 0.87, an F1-score of 0.98, 0.91, and 0.89 during training and a PPV of 0.99, 0.95, and 0.87 and F1-score of 0.99, 0.95, and 0.89 during validation. Conclusions: NLP techniques can leverage contextual information in EHRs to identify anhedonia and suicidal symptoms in patients with MDD. Integrating structured and unstructured data offers a comprehensive view of MDD's trajectory, helping healthcare providers deliver timely, effective interventions. Addressing current limitations will further enhance NLP models, enabling more accurate extraction of critical clinical features and supporting personalized, proactive mental health care. [ABSTRACT FROM AUTHOR]

Anhedonia, a core symptom of depression, has been defined as the loss of pleasure or lack of reactivity to pleasurable stimuli. Considering the relevance of alpha asymmetry to MDD and anhedonia, we explored the effect of dorsolateral prefrontal cortex (DLPFC) stimulation on frontal and posterior EEG alpha asymmetry (FAA and PAA, respectively), in this exploratory investigation. 61 participants randomly received sham (n = 11), bilateral (BS; n = 25), or unilateral stimulation (US; n = 25) of the DLPFC. The Snaith-Hamilton Pleasure Scale (SHAPS) was administered. FAA and PAA were calculated by subtracting the natural log-transformed alpha power of the right (F8 or T6) from that of the left (F7 or T5) EEG channel. Furthermore, alpha peak was defined as the frequency where alpha power was at its maximum. BS and US both reduced anhedonia symptoms in the active compared to the sham group. Even non-responders in the BS group showed a decreased anhedonia. Interestingly in the BS group, only the patients who showed a right-lateralized FAA or PAA at baseline showed a reduction in anhedonia. However, in the US group, only patients with left-lateralized FAA or right-lateralized PAA showed a decrease in anhedonia. PAA at baseline predicted symptoms post treatment. Furthermore, a significant positive correlation between baseline alpha peak values and SHAPS scores post treatment were found in the BS group. PAA was a better predictor of anhedonia and reduction of depressive symptoms in both groups. BS may produce larger effects with regard to anhedonia. [ABSTRACT FROM AUTHOR]

Anhedonia, characterized by diminished motivation and pleasure sensitivity, is increasingly recognized as prevalent among patients with chronic pain. Deep Endometriosis (DE), the most severe endophenotype of the disease, is commonly presented with chronic pelvic pain. This cross-sectional study reports, for the first time, the prevalence of anhedonia in a sample comprised by 212 premenopausal women with suspected DE referred to a tertiary hospital. Our findings show that 27,8% [95% CI 22.1, 26.5] of DE patients experience abnormal hedonic tone. Severity of DE pain-related symptoms significantly correlated with anhedonia, consistent with previous findings. Chronic pelvic pain emerged as a significant predictor of anhedonia (OR 1.5, 95% CI 1.0–1.22, p < 0.05) with the odds increasing to 2.28 [95% CI 1.12, 4.23] when pain was severe. The most affected areas in DE patients were interests, social interaction and food pleasure. The present results are representative of DE patients under multimodal treatment, limiting generalizability. Overall, our study highlights the impact of chronic pain on hedonic functioning in DE. Therapeutic approaches targeting hedonic capacity in DE patients are crucial for restoring health and well-being. [ABSTRACT FROM AUTHOR]

Purpose: Despite the advent of heated tobacco products (HTPs), their relationship to mental health remains unclear. This study aimed to determine associations between the use of combustible cigarettes (CCs) and HTPs with depressive symptoms. Methods: This descriptive-analytical cross-sectional study was conducted in March 2023. Using the 8th Korea National Health and Nutrition Examination Survey, 5,349 adults aged 19 years or older were classified into four groups: non-users, CC-only users, HTP-only users, and dual users. Relationships between exclusive or dual use of CCs and HTPs and depressive symptoms were analyzed using item scores and total scores of the Patient Health Questionnaire-9 (PHQ-9). To examine associations between exclusive or dual use of CCs and HTPs and depressive symptoms, a multinomial regression analysis was performed using the PHQ-9 total score. Results: HTP-only users had the highest proportion of those with anhedonia and depressed mood. CC-only users had the highest proportion of individuals with trouble sleeping, while dual users had a higher proportion of those with fatigue and appetite problems. After adjusting for general characteristics, compared to non-users, CC-only users were more likely to have mild and moderate to severe depressive symptoms. HTP-only users and dual users were also more likely to have moderate to severe depressive symptoms. Conclusions: All smokers have a higher risk of depression than non-smokers. Health care providers should closely monitor depressive symptoms, especially in HTP users and dual users of tobacco products. [ABSTRACT FROM AUTHOR]

The presentation of major depressive disorder (MDD) can vary widely due to its heterogeneity, including inter- and intraindividual symptom variability, making MDD difficult to diagnose with standard measures in clinical settings. Prior work has demonstrated that passively collected actigraphy can be used to detect MDD at a disorder level; however, given the heterogeneous nature of MDD, comprising multiple distinct symptoms, it is important to measure the degree to which various MDD symptoms may be captured by such passive data. The current study investigated whether individual depressive symptoms could be detected from passively collected actigraphy data in a (a) clinical subpopulation (i.e., moderate depressive symptoms or greater) and (b) general population. Using data from the National Health and Nutrition Examination Survey, a large nationally representative sample (N = 8,378), we employed a convolutional neural network to determine which depressive symptoms in each population could be detected by wrist-worn, minute-level actigraphy data. Findings indicated a small-moderate correspondence between the predictions and observed outcomes for mood, psychomotor, and suicide items (area under the receiver operating characteristic curve [AUCs] = 0.58–0.61); a moderate-large correspondence for anhedonia (AUC = 0.64); and a large correspondence for fatigue (AUC = 0.74) in the clinical subpopulation (n = 766); and a small-moderate correspondence for sleep, appetite, psychomotor, and suicide items (AUCs = 0.56–0.60) in the general population (n = 8,378). Thus, individual depressive symptoms can be detected in individuals who likely meet the criteria for MDD, suggesting that wrist-worn actigraphy may be suitable for passively assessing these symptoms, providing important clinical implications for the diagnosis and treatment of MDD. General Scientific Summary: The coupling of deep learning methods with passive monitoring of an individual's naturalistic movement provides a unique opportunity to detect depressive symptoms without the necessity for frequent clinical visits or self-report measures. The present work builds upon previous efforts to evaluate which depressive symptoms are best captured by passively collected physical activity data, and how this differs between individuals in the general population and individuals who meet criteria for depression. Our findings provide insight into which individual depressive symptoms may be best detected by passively collected physical activity data, providing important assessment and treatment implications for depression. [ABSTRACT FROM AUTHOR]

Anhedonia, the loss of interest and pleasure, is a core symptom of depression that is resistant to treatment. Anhedonic young people describe a weakened sense of self and reduced meaning in life. Knowing if these experiences predict anhedonia could reveal novel targets for intervention development. We recruited young people (N = 429, mean age: 20 years) with a range of depression scores. Using path analysis, we examined anhedonia, sense of self, meaning in life, and prosocial behaviours cross-sectionally and longitudinally at ∼5-month follow-up (N = 160). Cross-sectionally, sense of self (β =. 81, p <.001) and prosocial behaviours (β = 0.37, p <.001) had direct effects on meaning in life, and meaning in life had a direct effect on anhedonia (β = −0.11, p <.001). Sense of self (β = −0.09, p <.001) and prosocial behaviours (β = −0.04, p <.001) had indirect effects on anhedonia, mediated by meaning in life. In the longitudinal analysis, sense of self at T1 had a direct effect on meaning in life at T2 (β = 0.36, p <.01) and an indirect effect on anhedonia at T2 (β = −0.05, p <.01), mediated by meaning in life. Approximately 70 % of the participants were female. Future studies should include equal numbers of males and females. We provide novel evidence that targeting meaning in life, sense of self, or prosocial behaviours in psychotherapeutic interventions could be effective in alleviating anhedonia. • We examined whether sense of self, prosocial behaviour and meaning in life predict anhedonia using path analysis in AMOS. • Higher sense of self, prosocial behaviour and meaning in life predict less anhedonia, even when controlling for depression. • Meaning in life mediates the effect of sense of self and prosocial behaviours on anhedonia when controlling for depression. • Longitudinal path analysis confirms that meaning in life mediates the effect of sense of self on anhedonia. [ABSTRACT FROM AUTHOR]

Introduction: Anhedonic symptoms in bipolar I (BP-I) depression are associated with decreased quality of life and impaired functioning. We evaluated the effects of cariprazine in patients with BP-I depression with lower or higher levels of anhedonia at baseline. Methods: Data were pooled from three clinical trials (NCT01396447, NCT02670538, NCT02670551) analyzing the effects of cariprazine 1.5 and 3 mg/day in adults with BP-I depression. During post hoc analysis, patients were stratified by baseline median Montgomery-Åsberg Depression Rating Scale (MADRS) anhedonia factor score into a lower (score < median) or higher (score ≥ median) anhedonia subgroup. Outcomes included change from baseline to week 6 in MADRS total and anhedonia factor score, with the latter also evaluated after adjusting for other depressive symptoms. Between-group differences in change from baseline to week 6 were compared using least-squares mean differences (LSMD) analyzed via a mixed-effect model for repeated measures. Results: Median baseline anhedonia factor score was 19, defining the lower (placebo = 211; cariprazine 1.5 mg/day = 200, 3 mg/day = 212) and higher (placebo = 249; cariprazine 1.5 mg/day = 261, 3 mg/day = 250) anhedonia subgroups. In the lower subgroup, cariprazine 1.5 mg/day but not 3 mg/day was superior to placebo in reducing MADRS total (LSMD [95% CI] 1.5 mg/day = − 2.61 [− 4.28, − 0.93], P =.0024) and anhedonia factor scores (− 1.70 [− 2.77, − 0.62], P =.0021) at week 6. In the higher subgroup, both cariprazine doses were associated with significantly greater reductions than placebo in MADRS total (1.5 mg/day = − 3.01 [− 4.84, − 1.19], P =.0012; 3 mg/day = − 3.26 [− 5.12, − 1.40], P =.0006) and anhedonia factor scores (1.5 mg/day = − 1.97 [− 3.13, − 0.81], P =.0009; 3 mg/day = − 2.07 [− 3.26, − 0.89], P =.0006). Anti-anhedonic effects were preserved after adjusting for other depressive symptoms, suggesting the effect was not pseudospecific. Patients in the higher subgroup had higher baseline depression and therefore the lower subgroup may have had a floor effect. Conclusion: Cariprazine demonstrated antidepressant and specific anti-anhedonic effects regardless of baseline anhedonia symptoms in patients with BP-I depression. Trial Registration: ClinicalTrials.gov identifiers, NCT02670538, NCT02670551, NCT01396447. Plain Language Summary: Anhedonia, or the lack of interest or pleasure, is common in patients with bipolar I depression. Cariprazine is a medication approved for the treatment of bipolar I depression. However, its effect on anhedonia is unclear. To understand the effect of cariprazine on anhedonia, we combined data from three bipolar I depression trials. We compared the effect of cariprazine treatment (1.5 mg or 3 mg per day) for 6 weeks against placebo in patients who had lower and higher levels of anhedonia before they started treatment. A total of 1383 patients were included in the study. There were 623 patients with lower anhedonia and 760 with higher anhedonia. Patients with higher anhedonia were more depressed overall than those with lower anhedonia. In patients with lower anhedonia, cariprazine 1.5 mg per day was better than placebo at reducing both anhedonia and depression. In patients with higher anhedonia, both cariprazine doses were better than placebo at reducing anhedonia and depression. Our results suggest that cariprazine reduces symptoms of both depression and anhedonia in patients with bipolar I depression. [ABSTRACT FROM AUTHOR]

Background: Major depressive disorder (MDD) is a highly prevalent mental disorder with devastating consequences that often first manifest during adolescence. Anhedonia has emerged as one of the most promising symptoms of adolescent MDD, which means a longer time to remission， fewer depression-free days, and also increased risk of suicide ideas or actions. Research has shown that at least two-thirds of depressed adolescents have significant sleep-onset or sleep-maintenance problems. However, the association between sleep disorder and anhedonia, and the potential mediators are less understood. Methods: This is a cross-sectional study that includes 200 adolescents suffered from MDD between the ages of 12–17. We use Spearman's test to explore the relationship among main variables. To evaluate the mediating effects of stress, we applied regression models and used bootstrap method to validate the significance of effects. Results: Significant correlation exists among sleep disorder, stress, and anhedonia (P<0.05).The direct effect of sleep disorder on anhedonia was 0.214 (95% CI: 1.5235, 6.2073), while the total effect was 0.295 (95% CI: 2.9683, 7.6924). The indirect effect of sleep disorder on anhedonia mediated by stress was 0.081 (95% CI: 0.5842, 2.5268). Robustness of the regression analysis results has been verified by bootstrap test. Conclusions: Our finding suggested a positive correlation between sleep disturbance and anhedonia in adMDD. Stress partially mediated the relationship between sleep disorder and anhedonia. Due to the deleterious effects of anhedonia on depressed adolescents, these findings provide impetus to investigate further the causal relationship between sleep problems and anhedonia. Trial registration: ChiCTR2200060176(Registration Date: 21/05/2022). [ABSTRACT FROM AUTHOR]

Background: Anhedonia—a core symptom of major depressive disorder (MDD)—is closely related to diminished reward sensitivity. Nonetheless, the psychopathological and computational mechanism underlying anhedonia in young patients with MDD remains unclear. Therefore, this study aims to investigate reward sensitivity in adolescents and young adults with MDD using computational modelling. Methods: Overall, 70 patients with MDD and 54 age- and sex-matched healthy controls (HC) completed a probabilistic reward task (PRT) to assess their general behavioral inclination towards more frequently reinforced stimuli (i.e., "response bias"). Bayesian hierarchical drift diffusion modeling (HDDM) was employed to determine changes in reward sensitivity and computational process during decision-making. Results: Adolescents with depression showed a trend toward reduced response bias compared to those in HC. HDDM analysis revealed wider decision thresholds in both adolescents and young adults with MDD group. Adolescents with MDD exhibited significantly lower drift rates and reduced starting point bias compared to those in HC. Higher anhedonia levels were linked to lower drift rates and wider decision thresholds. Additionally, increased discriminability correlated with higher drift rates, while higher response bias was linked to larger starting points. Conclusions: Our findings suggest that reduced reward sensitivity and slower evidence accumulation during reward learning may serve as potential indicators of anhedonia in adolescents with MDD. These findings provided crucial insights into the dysregulated positive affect model, underscoring a dysfunctional reward system as a key factor in anhedonia developmental psychopathology in depression. [ABSTRACT FROM AUTHOR]

Deficits in cognition and motivation predict functioning in depressive and psychotic disorders. However, experimental tasks of cognitive motivation are inconsistently correlated with functioning, time-intensive, and not intuitive in clinical practice. We aimed to develop and validate a self-report instrument to assess motivation processes pertinent to engagement with cognitive activities in daily life. Following item generation, scale dimensionality, reliability, and validity were evaluated iteratively over Studies 1–3 with online general adult participants (n 1 = 205; n 2 = 235; n 3 = 181). The 20-item Cognitive Motivation scale was also validated in a Study 3 sub-sample reporting high levels of depressive symptoms (n = 74) and Study 4 early psychosis outpatients (n = 25). Two-factor model of cognitive approach and cognitive withdrawal, each with good internal consistency, convergent validity, discriminant validity was supported. Cognitive withdrawal showed stronger associations with cognitive difficulties, depressive symptoms, and functional impairments than traditional motivation scale. Participants reporting high depression levels showed more severe difficulties with cognitive motivation than participants reporting low depression levels. In early psychosis outpatients, correlations with functioning and cognitive effort expenditure provided support for scale validity. Cross-sectional data collection restricted evaluation of repeated administration psychometric properties. Scale validation was mostly established in online community samples and a small patient sample during the COVID-19 pandemic, thereby limiting generalizability of clinical applications. Cognitive Motivation scale is a promising tool for future intervention trials seeking to target motivational processes associated with functioning in the general population and potentially across patient groups with amotivation symptoms. • Novel scale validly measures cognitive motivation in general and psychiatric adults • Two factors of cognitive motivation confirmed: cognitive approach and withdrawal • New scale demonstrated superior clinical utility over traditional scale • Scale sensitive to impaired cognitive motivation in depressed and psychotic samples • Robust subscale relationships with depression, negative symptoms, and functioning [ABSTRACT FROM AUTHOR]

Anxiety and depression are often comorbid and chronic disorders. Previous research indicates that positivity relinquishment is a moderator of anxiety and depression, such that only anxious individuals who endorsed relinquishing positivity were also depressed. We sought to extend those findings by conducting three network analyses with self-report measures of anxiety, depression, activity avoidance, and perceived positivity of avoided activities (N = 104). We pre-registered our hypothesis for the first two networks that relinquishment of positivity would emerge as a central bridge symptom between anxiety and depressive symptoms. After combining redundant nodes, we estimated three networks and investigated the bridge symptoms in each network. Relinquishment of positivity bridged the symptom clusters in the first network, and avoidance of positivity was found to bridge the two symptom clusters of anxiety and depression in networks two and three. Additionally, an anhedonia circuit was uncovered in all three networks in which loss of interest/worthlessness, loss of energy, and loss of pleasure/pessimism connected to anxiety through relinquishment or avoidance. Our findings suggest that both relinquishment of positivity as well as avoidance of positivity could be potential pathways explaining the development and maintenance of anxiety and depression and should be properly targeted in treatment. • Relinquishment of positivity was found to bridge symptoms of depression and anxiety. • Positivity avoidance was found to bridge symptoms of depression and anxiety. • Anhedonia items were influential in a network of anxiety and depression symptoms. [ABSTRACT FROM AUTHOR]

Purpose: Reduced motivation to expend cognitive effort is a clinically relevant but understudied feature of depression. Preliminary research indicates that depressed and dysphoric individuals may be less willing to expend cognitive effort for reward than non-depressed individuals. However, the extent to which this is due to reduced expectations of reward, and whether willingness to expend effort can be increased by altering affective expectations of reward, are unknown. The purpose of this study was to examine the effects of dysphoria, anhedonia, and affective expectations on cognitive effort expenditure for reward. Methods: Dysphoric (n = 85) and non-dysphoric participants (n = 79) were randomly assigned to either a high expectancy condition designed to increase individuals' expectations of a reward that could be earned during a cognitive effort progressive ratio task or a neutral expectancy condition that did not attempt to alter expectations. Expected pleasure ratings were collected, and then participants completed the cognitive effort progressive ratio task. Results and Conclusions: The expectancy manipulation was unsuccessful, but we found that dysphoria group interacted with participants' self-reported expectations of pleasure to predict their cognitive effort expenditure. Within the dysphoric group, higher expectations of pleasure were significantly associated with greater effort. In contrast, within the non-dysphoric group, effort was relatively high regardless of expectations. Anhedonia further moderated this relationship; in the dysphoric group, the relationship between expected pleasure and effort expenditure weakened as anhedonia increased. Implications for the treatment of depression are discussed. [ABSTRACT FROM AUTHOR]

Stressors and blunted reward processing are implicated in depression. The current study simultaneously examined the impact of an acute stressor on cortisol and reward processing, measured using the reward positivity (RewP) in 66 participants. Participants completed a reward task during a stressor and a control condition, counterbalanced, and separated by 1 week, while saliva samples were collected before, immediately following, and 25 min after the reward task. Participants reported that the stressor condition was more stressful than the control condition. Cortisol levels did not differ before the reward task; however, cortisol levels were higher both immediately and 25 min after the task. The RewP was blunted during the stressor compared to the control condition, and participants with a larger stress‐induced increase in cortisol had greater reductions in their RewP. The current study provides evidence that stress‐induced changes in HPA‐axis functioning relate to reductions in neural correlates of reward processing. Major depressive disorder is a leading cause of disability in the world. Exposure to stressors and blunted reward processing are implicated in its etiology and pathology. The results of the study indicated that acute stress‐induced reductions in reward‐related neural activity are associated with stress‐induced elevations in cortisol. These novel results link changes in cortisol with changes in reward‐related neural activity, suggesting a possible account of how stressors could lead to reduced reward processing and possibly anhedonia. [ABSTRACT FROM AUTHOR]

This study investigated how individual differences in schizotypy differentially predicted types of loneliness – direct, social, emotional, and existential loneliness (in relationships and meaninglessness in life). We presented participants with the brief version of the Oxford-Liverpool Inventory of Feelings and Experiences and the de Jong Giervald loneliness scale and used dominance analysis to evaluate the dominant predictors of schizotypy on loneliness. We also evaluated the impact of depression on each model. In our preregistered analysis we found evidence to suggest that cognitive disorganization and introvertive anhedonia are consistently the most dominant of the schizotypy predictors. Introvertive anhedonia was the most dominant predictor for social loneliness and existential loneliness in relationships, and cognitive disorganization was the most dominant predictor of direct, emotional and existential meaninglessness in life loneliness. Depression became the most dominant predictor of all types of loneliness when added to the models. This research is limited by the cross-sectional nature of the data which is unable to account for changes in loneliness over time, and we acknowledge that the relationship between predictors and outcome is likely bi-directional. Our findings highlight the diverse relationship between schizotypy and loneliness type and suggest that schizotypy domains linked to social anxiety and withdrawal are key predictors of loneliness. These findings are important for the development of focused interventions and the prevention of clinical disorder development. [ABSTRACT FROM AUTHOR]

An 8‐week study involving patients with treatment‐resistant depression has found that repetitive transcranial magnetic stimulation (rTMS) was significantly more effective than a change in antidepressant regimen in reducing depressive symptoms. The researchers found rTMS was also more effective in reducing symptoms of anxiety and anhedonia. Study results were published online Aug. 7, 2024, in the American Journal of Psychiatry. [ABSTRACT FROM AUTHOR]

Anhedonia is an enduring symptom of subthreshold depression (StD) and predict later onset of major depressive disorder (MDD). Brain structural covariance describes the inter-regional distribution of morphological changes compared to healthy controls (HC) and reflects brain maturation and disease progression. We investigated neural correlates of anhedonia from the structural covariance. T1-weighted brain magnetic resonance images were acquired from 79 young adults (26 StD, 30 MDD, and 23 HC). Intra-individual structural covariance networks of 68 cortical surface area (CSAs), 68 cortical thicknesses (CTs), and 14 subcortical volumes were constructed. Group-level hubs and principal edges were defined using the global and regional graph metrics, compared between groups, and examined for the association with anhedonia severity. Global network metrics were comparable among the StD, MDD, and HC. StD exhibited lower centralities of left pallidal volume than HC. StD showed higher centralities than HC in the CSAs of right rostral anterior cingulate cortex (ACC) and pars triangularis, and in the CT of left pars orbitalis. Less anhedonia was associated with higher centralities of left pallidum and right amygdala, higher edge betweenness centralities in the structural covariance (EBSC) of left postcentral gyrus-parahippocampal gyrus and LIPL-right amygdala. More anhedonia was associated with higher centralities of left inferior parietal lobule (LIPL), left postcentral gyrus, left caudal ACC, and higher EBSC of LIPL-left postcentral gyrus, LIPL-right lateral occipital gyrus, and left caudal ACC-parahippocampal gyrus. This study has a cross-sectional design. Structural covariance of brain morphologies within the salience and limbic networks, and among the salience-limbic-default mode-somatomotor-visual networks, are possible neural correlates of anhedonia in depression. [Display omitted] • The first brain structural covariance(SC) study of anhedonia in subthreshold depression(StD) • Lowered global segregation and integration of SC in StD than healthy control (HC) • Less anhedonia associated with higher centrality of amygdala and pallidum in the SC • More anhedonia with lower centrality of inferior parietal lobule, anterior cingulate, postcentral gyrus • Inter-network SC among the default mode-limbic-somatomotor-visual networks underlie anhedonia [ABSTRACT FROM AUTHOR]

Anhedonia stands as a life-threatening transdiagnostic feature of many mental illnesses, most notably major depression and involves neural circuits for processing reward information. The paraventricular nucleus of the thalamus (PVT) is associated with reward-seeking behavior, however, links between the PVT circuit and anhedonia have not been investigated in humans. In a sample of adults with and without psychiatric symptoms (n = 75, 18–41 years, 55 female), we generated an anhedonia factor score for each participant using a latent factor analysis, utilizing data from depression and anxiety assessments. Functional connectivity between the PVT and the nucleus accumbens (NAc) was calculated from high-resolution (1.5 mm) resting state fMRI. Anhedonia factor scores showed a positive relationship with functional connectivity between the PVT and the NAc, principally in males and in those with psychiatric symptoms. In males, connectivity between other midline thalamic nuclei and the NAc did not show these relationships, suggesting that this link may be specific to PVT. This cohort was originally recruited to study depression and not anhedonia per se. The distribution of male and female participants in our cohort was not equal. Partial acquisition in high-resolution fMRI scans restricted regions of interest outside of the thalamus and reward networks. We report evidence that anhedonia is associated with enhanced functional connectivity between the PVT and the NAc, regions that are relevant to reward processing. These results offer clues as to the potential prevention and prevention and treatment of anhedonia. • Anhedonia has been associated with alterations in reward processing neural circuits. • The paraventricular nucleus of the thalamus (PVT) projects to reward and threat regions. • Altering PVT is associated with anhedonia in animal models. • In humans, anhedonia symptoms are associated with increased functional connectivity between PVT and nucleus accumbens, particularly in males. • This provides evidence that the human PVT circuit is involved in anhedonia. [ABSTRACT FROM AUTHOR]

Background Anhedonic features within major depressive disorder (MDD) have been associated with worse course and outcome and may predict nonresponse to treatment. However, a detailed clinical profile of anhedonia in MDD is still lacking. Materials and Methods One thousand two hundred ninety-four patients with MDD were selected from the cross-sectional European multicenter Group for the Study of Resistant Depression study. Anhedonia was assessed through the Montgomery–Åsberg Depression Rating Scale anhedonia item "inability to feel." Clinical and demographic features were then analyzed. Results The presence of anhedonia related to a distinct demographical (living alone) and clinical profile (thyroid diseases, diabetes, suicide risk, high number of previous depressive episodes, more severe MDD, and more frequent inpatient status). Furthermore, anhedonia was associated with nonresponse to treatment and treatment resistance, even after adjusting for confounding variables. Conclusions Our findings support the role of anhedonia as a modulating feature of MDD, being associated with a more severe depression profile. Moreover, anhedonic features are independent predictors of poor treatment response. [ABSTRACT FROM AUTHOR]

Predicting mood disorders in adolescence is a challenge that motivates research to identify neurocognitive predictors of symptom expression and clinical profiles. This study used machine learning to test whether neurocognitive variables predicted future manic or anhedonic symptoms in two adolescent samples risk-enriched for lifetime mood disorders (Sample 1, n = 73, ages = 13-25, M [SD] = 19.22 [2.49] years, 68% lifetime mood disorder) or familial mood disorders (Sample 2, n = 154, ages = 13-21, M [SD] = 16.46 [1.95] years, 62% first-degree family history of mood disorder). Participants completed cognitive testing and functional magnetic resonance imaging at baseline, for behavioral and neural measures of reward processing and executive functioning. Next, participants completed a daily diary procedure for 8-16 weeks. Penalized mixed-effects models identified neurocognitive predictors of future mood symptoms and stress-reactive changes in mood symptoms. Results included the following. In both samples, adolescents showing ventral corticostriatal reward hyposensitivity and lower reward performance reported more severe stress-reactive anhedonia. Poorer executive functioning behavior was associated with heightened anhedonia overall in Sample 1, but lower stress-reactive anhedonia in both samples. In Sample 1, adolescents showing ventral corticostriatal reward hypersensitivity and poorer executive functioning reported more severe stress-reactive manic symptoms. Clustering analyses identified, and replicated, five neurocognitive subgroups. Adolescents characterized by neural or behavioral reward hyposensitivities together with average-to-poor executive functioning reported unipolar symptom profiles. Adolescents showing neural reward hypersensitivity together with poor behavioral executive functioning reported a bipolar symptom profile (Sample 1 only). Together, neurocognitive phenotypes may hold value for predicting symptom expression and profiles of mood pathology. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Keira Herr,1 Michael Berk,2 Wei-Lieh Huang,3 Tadafumi Kato,4 Jung Goo Lee,5,6 Chong Guan Ng,7 Zhen Wang,8 Thomas David Webb,1 Mami Kasahara-Kiritani,9 Lawrence Phillip Vandervoort10 1Janssen Asia Pacific, Singapore; 2School of Medicine, Deakin University, Geelong, Victoria, Australia; 3Department of Psychiatry, National Taiwan University Hospital Yunlin Branch, Yunlin County, Taiwan; 4Department of Psychiatry and Behavioral Science, Juntendo University Graduate School of Medicine, Tokyo, Japan; 5Department of Psychiatry, College of Medicine, Haeundae Paik Hospital, Inje University, Busan, Republic of Korea; 6Paik Institute for Clinical Research, Inje University, Busan, Republic of Korea; 7Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; 8Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China; 9Janssen Pharmaceutical K.K., Tokyo, Japan; 10Oracle Life Sciences, SingaporeCorrespondence: Keira Herr, Janssen Asia Pacific, 2 Science Park Drive, Singapore Science Park 1, Ascent, &num;07-13, 118222, Singapore, Email keiraherr@gmail.comPurpose: To explore the prevalence of anhedonia (ANH) in major depressive disorder (MDD) and treatment expectation and satisfaction among patients with MDD and physicians in the Asia-Pacific region.Methods: This cross-sectional web-based survey was conducted in April-May 2023 among physicians and individuals aged ≥ 18 years with self-reported physician diagnosis of MDD (9-item Patient Health Questionnaire [PHQ-9] score ≥ 10) further stratified by anhedonia as measured by the Snaith-Hamilton Pleasure Scale (SHAPS): MDD-ANH (SHAPS score > 2) and MDD non-ANH (SHAPS score ≤ 2). The study assessed the prevalence of anhedonia in MDD as well as the perspectives on the treatment of anhedonia in MDD in terms of expectations and satisfaction among patients and physicians.Results: The regional estimated prevalence of MDD was 16.1% where 52.5% of MDD respondents had ANH (SHAPS score ≥ 2). Depressed mood, mental changes, and changes in sleeping patterns prompted MDD-ANH (n = 1448) or MDD non-ANH (n = 836) respondents to seek medical consultation. Respondents with MDD-ANH (vs MDD non-ANH) reported significantly higher levels of depression and anhedonia, longer treatment duration, and preferred switching their existing medications over adding additional medications (all, p < 0.001). Over half of physicians (55.0%) were not treating anhedonia separately. Anhedonia-specific treatment goals seemed important to all respondents, while avoiding suicidal ideation was significantly important to physicians. MDD-ANH respondents reported in general the lowest level of satisfaction with treatment goals than MDD non-ANH and physician, with “improvements in sexual satisfaction” being the treatment goal with the lowest level of satisfaction.Conclusion: This first large-scale study conducted across the Asia-Pacific region provides a recent update on the prevalence of MDD and anhedonia in MDD and highlights unmet needs in the current therapeutic landscape for anhedonia in MDD, emphasizing the need for novel treatment.Keywords: anhedonia, apathy, depression, emotional blunting, epidemiology, prevalence, treatment goals

Jinqi Ding,1,&ast; Yue Wu,1,&ast; Hanxiaoran Li,1 Shengsheng Wang,1 Jia Cai,2 Hong Cheng,3 Sugai Liang1 1Affiliated Mental Health Center & Hangzhou Seventh People’s Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People’s Republic of China; 2Mental Health Center & Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China; 3Hangzhou City University, Hangzhou, Zhejiang, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Sugai Liang, Email liangsugai@zju.edu.cnPurpose: Network modeling has been suggested as an effective method to explore intricate relationships among antecedents, mediators, and symptoms. In this study, we aimed to investigate whether the severity of depressive symptoms in college students affects the multivariate relationships among anhedonia, smartphone addiction, and mediating factors.Methods: A survey was conducted among 1347 Chinese college students (587 female) to assess depressive symptoms, anhedonia, addictive behaviors, anxiety, and insomnia. The participants were categorized the non-depressive symptom (NDS) and depressive symptom (DS) groups based on a cut-off score of 5 on the 9-item Patient Health Questionnaire-9. Network analysis was performed to investigate the symptom-to-symptom influences of symptoms in these two groups.Results: The network of the DS group was more densely connected than that of the NDS group. Social anticipatory anhedonia was a central factor for DS, while withdraw/escape (one factor of smartphone addiction) was a central factor for NDS. The DS group exhibited greater strength between the PHQ9 score and social anticipatory anhedonia, as well as between the PHQ9 score and alcohol misuse score, compared to the NDS group. On the other hand, the NDS group had higher strength between anxiety and feeling lost, as well as between anxiety and withdraw/escape, compared to the DS group.Conclusion: The findings suggest that there is a close relationship between social anhedonia, smartphone addiction, and alcohol consumption in the DS group. Addressing on ameliorating social anhedonia and smartphone addiction may be effective in preventing and managing depression in college students.Keywords: depressive symptoms, anhedonia, smartphone addiction, network analysis, college students

Anhedonia is defined as the reduction of pleasure and reward-seeking behavior， and it is prevalent in approximately two-thirds of individuals diagnosed with post-traumatic stress disorder （PTSD）. Numerous empirical studies have consistently demonstrated that anhedonia represents an independent symptom dimension of PTSD. Furthermore， additional investigations have revealed that anhedonia plays a crucial role in the psychopathology of PTSD， contributing to the maintenance of post-traumatic stress responses， as well as more severe functional impairment and reduced therapeutic responsiveness. This paper aims to discuss the definition， psychopathology， genetic mechanisms and neurobiological underpinnings of anhedonia in PTSD， thus providing insights for future research on anhedonic symptoms. ［Funded by National Natural Science Foundation of China Joint Fund Key Project （number， U21A20364）； National Natural Science Foundation of China Youth Fund （number， 32300918）］

Introduction: Peripheral neurofilament light chain (NfL) reflect neuronal and axonal damage. Most studies have been focused on NfL cerebrospinal fluid measures since peripheral levels were difficult to detect. However, with recent advent of single molecule array (SIMOA) technology, NfL is now detectable peripherally at small concentrations (pg/ml). In neurodegenerative disorders, NfL peripheral levels have been found significantly elevated compared against psychiatric disorders. However, there is still controversy of whether NfL peripheral levels might be altered in psychiatric disorders like major depressive disorder (MDD) when compared against a normal population. Methods: We have measured NfL plasma levels by using single molecule array (SIMOA) technology in a Spanish small cohort of MDD patients (n = 15) and a HC group (n = 15). We have used subjective scales to estimate depression severity (HDRS), anhedonia (SAAS), the general cognitive state (MMSE) and episodic memory (FCSRT) in MDD patients. Results: We have not detected a significant alteration in NfL plasma levels in MDD patients when compared against the HC subjects (U = 97, p-value = 0.532). Moreover, we have not detected any significant correlation between NfL plasma levels with any subjective scales. The only parameter that significantly and positively correlated with NfL plasma levels was age in both MDD and HC. Discussion: Significant alteration in NfL plasma levels in MDD patients might reflect neurobiological changes behind the predisposition to develop future neurodegenerative disorders such as Alzheimer's or Parkinson's diseases for which depression represents a risk factor. However, whether there is an increase in NfL due to MDD regardless of the ageing process is still a matter of debate. [ABSTRACT FROM AUTHOR]

Anhedonia, the loss of interest in and pleasure from previously enjoyable activities is a core symptom of depression and presents a major challenge to treatments. Interventions involving positive mental imagery generation have been suggested to reduce anhedonia. However, it is not clear whether the imagery component of such interventions is crucial for these effects. The current study aimed to test this by contrasting repeated generation of positive mental imagery versus positive verbal thoughts. Over a one‐week period, 53 mildly anhedonic adults completed five sessions of a computerized training program involving the generation of either positive images or positive sentences. Compared to participants who generated sentences, participants who generated imagery showed greater improvements from pre‐ to post‐training on an individualized multi‐facetted measure of anhedonia (the Dimensional Anhedonia Rating Scale), but not on standardized measures of anticipated pleasure (the Snaith‐Hamilton Pleasure Scale), depression symptoms, or positive affect. The present study supports the proposal that positive imagery could provide a route to improve anhedonia, with generation of imagery in particular (as opposed to positive thoughts in general) as an important driving mechanism for these effects. This has theoretical and clinical implications for understanding the role of imagery in anhedonia and its treatment. [ABSTRACT FROM AUTHOR]