Anhedonia On the Web
Anhedonia forms one of major criteria in the diagnosis of depression, but, it also seen in negative symptom of schizophrenia, psychosis. Anhedonia is studies in neuropsychiatrie disorders, substance use disorder, parkinson's disease, overeating, and various risky behaviors.
- Major Depressive Disorder
- Bipolar Depression
- Schizoaffective disorder
- Antidopaminergic neuroleptics like antipsychotic medication.
Sexual anhedonia is caused by:
- Hypoactive sexual desire disorder (HSDD), also called inhibited sexual desire
- Spinal cord injury
- Multiple sclerosis
- Use (or previous use) of SSRI antidepressants
- Use (or previous use) of antidopaminergic neuroleptics (anti-psychotics)
- Physical illness
Anhedonia is present in several forms of psychopathology. However, social anhedonia is not a necessary symptom criterion of any disorder. Social anhedonia manifests similarly in a variety of different mental illness, but for differing reasons. Most frequently, social anhedonia is associated with schizophrenia and schizophrenia spectrum disorders (including schizotypal personality disorder, paranoid personality disorder, and antisocial personality disorder). Social anhedonia has also been implicated in other psychological disorders:
Social anhedonia is observed in both depression and schizophrenia. However, social anhedonia is state related to the depressive episode and the other is trait related to the personality construct associated with schizophrenia. These individuals both tend to score highly on self-report measures of social anhedonia. Blanchard, Horan, and Brown (2001) demonstrated that, although both the depression and the schizophrenia patient groups can look very similar in terms of social anhedonia cross sectionally, over time as individuals with depression experience symptom remission, they show fewer signs of social anhedonia, while individuals with schizophrenia do not. Blanchard and colleagues (2011) found individuals with social anhedonia also had elevated rates of lifetime mood disorders including depression and dysthymia compared to controls.
As mentioned above, social anxiety and social anhedonia differ in important ways. However, social anhedonia and social anxiety are also often comorbid with each other. People with social anhedonia may display increased social anxiety and be at increased risk for social phobias and generalized anxiety disorder. It has yet to be determined what the exact relationship between social anhedonia and social anxiety is, and if one potentiates the other. Individuals with social anhedonia may display increased stress reactivity, meaning that they feel more overwhelmed or helpless in response to a stressful event compared to control subjects who experience the same type of stressor. This dysfunctional stress reactivity may correlate with hedonic capacity, providing a potential explanation for the increased anxiety symptoms experienced in people with social anhedonia. In an attempt to separate out social anhedonia from social anxiety, the Revised Social Anhedonia Scale  didn’t include items that potentially targeted social anxiety. However, more research must be conducted on the underlying mechanisms through which social anhedonia overlaps and interacts with social anxiety. The efforts of the “social processes” RDoC initiative will be crucial in differentiating between these components of social behavior that may underlie mental illnesses such as schizophrenia.
Primary relevance in schizophrenia & schizophrenia spectrum disorders
Social anhedonia is a core characteristic of schizotypy, which is defined as a continuum of personality traits that can range from normal to disordered and contributes to risk for psychosis and schizophrenia. Social anhedonia is a dimension of both negative and positive schizotypy. It involves social and interpersonal deficits, but is also associated with cognitive slippage and disorganized speech, both of which fall into the category of positive schizotypy. Not all people with schizophrenia display social anhedonia  and likewise, people who have social anhedonia may never be diagnosed with a schizophrenia-spectrum disorder if they do not have the positive and cognitive symptoms that are most frequently associated with most schizophrenia-spectrum disorders.
Social anhedonia may be a valid predictor of future schizophrenia-spectrum disorders; young adults with social anhedonia perform in a similar direction to schizophrenia patients in tests of cognition and social behavior tests, showing potential predictive validity. Social anhedonia usually manifests in adolescence, possibly because of a combination of the occurrence of critical neuronal development and synaptic pruning of brain regions important for social behavior and environmental changes, when adolescents are in the process of becoming individuals and gaining more independence.
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