Social anhedonia Anhedonia

1 social anhedonia

1.1 definition
1.2 signs , symptoms
1.3 background , clinical observation
1.4 comorbidity

1.4.1 depression
1.4.2 social anxiety


1.5 primary relevance in schizophrenia , schizophrenia spectrum disorders
1.6 treatment
1.7 gender differences
1.8 assessing social anhedonia
1.9 genetic components
1.10 neurobiological correlates

social anhedonia

definition

social anhedonia defined trait-like disinterest in social contact , characterized social withdrawal , decreased pleasure in social situations. characteristic typically manifests indifference other people. in contrast introversion, nonpathological dimension of human personality, social anhedonia represents deficit in ability experience pleasure. additionally, social anhedonia differs social anxiety in social anhedonia predominantly typified diminished positive affect, while social anxiety distinguished both decreased positive affect , exaggerated negative affect. trait seen central characteristic to, predictor of, schizophrenia spectrum disorders, seen potential evolution of personality disorders, if patient above age 24, when prodromal schizophrenia may excluded.

signs , symptoms

decreased ability experience interpersonal pleasure
social withdrawal/isolation
decreased need social contact
lack of close friends , intimate relationships, , decreased quality of relationships
poor social adjustment
decreased positive affect
flat affect
depressed mood
state-related anxiety

social anhedonia trait-related, meaning remains stable throughout life, independent of diagnosis, treatment, or symptom remission.

background , clinical observation

the term anhedonia derived greek an-, without , hēdonē, pleasure . interest in nature of pleasure , absence dates ancient greek philosophers such epicurus. symptoms of anhedonia introduced realm of psychopathology in 1809 john haslam, characterized patient suffering schizophrenia indifferent “those objects , pursuits formerly proved sources of delight , instruction.”. concept formally coined théodule-armand ribot , later used psychiatrists paul eugen bleuler , emil kraepelin describe core symptom of schizophrenia. theorists sándor radó , paul meehl posited anhedonia represents underlying genetic vulnerability schizophrenia-spectrum disorders. in particular, rado postulated schizotypes, or individuals schizophrenic phenotype, have 2 key genetic deficits, 1 related ability feel pleasure (anhedonia) , 1 related proprioception. in 1962 meehl furthered rado s theory through introduction of concept of schizotaxia, genetically-driven neural integrative defect thought give rise personality type of schizotypy. loren , jean chapman further distinguished between 2 types of anhedonia: physical anhedonia, or deficit in ability experience physical pleasure, , social, or deficit in ability experience interpersonal pleasure.

recent research suggests social anhedonia may represent prodrome of psychotic disorders. first-degree relatives of individuals schizophrenia show elevated levels of social anhedonia, higher baseline scores of social anhedonia associated later development of schizophrenia. these findings provide support conjecture represents genetic risk marker schizophrenia-spectrum disorders.

additionally, elevated levels of social anhedonia in patients schizophrenia have been linked poorer social functioning. socially anhedonic individuals perform worse on number of neuropsychological tests non-anhedonic participants, , show similar physiological abnormalities seen in patients schizophrenia.

comorbidity

anhedonia present in several forms of psychopathology. however, social anhedonia not necessary symptom criterion of disorder. social anhedonia manifests in variety of different mental illness, differing reasons. frequently, social anhedonia associated schizophrenia , schizophrenia spectrum disorders (including schizotypal personality disorder, paranoid personality disorder, , schizoid personality disorder). social anhedonia has been implicated in other psychological disorders:

depression

social anhedonia observed in both depression , schizophrenia. however, social anhedonia state related depressive episode , other trait related personality construct associated schizophrenia. these individuals both tend score highly on self-report measures of social anhedonia. blanchard, horan, , brown (2001) demonstrated that, although both depression , schizophrenia patient groups can similar in terms of social anhedonia cross sectionally, on time individuals depression experience symptom remission, show fewer signs of social anhedonia, while individuals schizophrenia not. blanchard , colleagues (2011) found individuals social anhedonia had elevated rates of lifetime mood disorders including depression , dysthymia compared controls.

social anxiety

as mentioned above, social anxiety , social anhedonia differ in important ways. however, social anhedonia , social anxiety comorbid each other. people social anhedonia may display increased social anxiety , @ increased risk social phobias , generalized anxiety disorder. has yet determined exact relationship between social anhedonia , social anxiety is, , if 1 potentiates other. individuals social anhedonia may display increased stress reactivity, meaning feel more overwhelmed or helpless in response stressful event compared control subjects experience same type of stressor. dysfunctional stress reactivity may correlate hedonic capacity, providing potential explanation increased anxiety symptoms experienced in people social anhedonia. in attempt separate out social anhedonia social anxiety, revised social anhedonia scale didn t include items potentially targeted social anxiety. however, more research must conducted on underlying mechanisms through social anhedonia overlaps , interacts social anxiety. efforts of “social processes” rdoc initiative crucial in differentiating between these components of social behavior may underlie mental illnesses such schizophrenia.

primary relevance in schizophrenia , schizophrenia spectrum disorders

social anhedonia core characteristic of schizotypy, defined continuum of personality traits can range normal disordered , contributes risk psychosis , schizophrenia. social anhedonia dimension of both negative , positive schizotypy. involves social , interpersonal deficits, associated cognitive slippage , disorganized speech, both of fall category of positive schizotypy. not people schizophrenia display social anhedonia , likewise, people have social anhedonia may never diagnosed schizophrenia-spectrum disorder if not have positive , cognitive symptoms associated schizophrenia-spectrum disorders.

social anhedonia may valid predictor of future schizophrenia-spectrum disorders; young adults social anhedonia perform in similar direction schizophrenia patients in tests of cognition , social behavior, showing potential predictive validity. social anhedonia manifests in adolescence, possibly because of combination of occurrence of critical neuronal development , synaptic pruning of brain regions important social behavior , environmental changes, when adolescents in process of becoming individuals , gaining more independence.

treatment

there no validated treatment social anhedonia. future research should focus on genetic , environmental risk factors home in on specific brain regions , neurotransmitters may implicated in social anhedonia s cause , targeted medication or behavioral treatments. social support may play valuable role in treatment of social anhedonia. blanchard et al. (2011) found greater number of social supports greater perceived social support network related fewer schizophrenia-spectrum symptoms , better general functioning within social anhedonia group. far, no medicine has been developed target anhedonia.

gender differences

in general population, males score higher females on measures of social anhedonia. sex difference stable throughout time (from adolescence adulthood) , seen in people schizophrenia-spectrum disorders. these results may reflect more broad pattern of interpersonal , social deficits seen in schizophrenia-spectrum disorders. on average, males schizophrenia diagnosed @ younger age, have more severe symptoms, worse treatment prognosis, , decrease in overall quality of life compared females disorder. these results, coupled sex difference seen in social anhedonia, outline necessity research on genetic , hormonal characteristics differ between males , females, , may increase risk or resilience mental illnesses such schizophrenia.

assessing social anhedonia

there several self-report psychometric measures of schizotypy each contain subscales related social anhedonia:

revised social anhedonia scale—chapman psychosis proneness scales
no close friends subscale—schizotypyal personality questionnaire
introverted anhedonia subscale—oxford liverpool inventory of feelings & experiences

genetic components

l.j. , j.p. chapman first discuss possibility social anhedonia may stem genetic vulnerability. disrupted in schizophrenia 1 (disc1) gene has been consistently associated risk for, , cause of, schizophrenia-spectrum disorders , other mental illnesses. more recently, disc1 has been associated social anhedonia within general population. tomppo (2009) identified specific disc1 allele associated increase in characteristics of social anhedonia. identified disc1 allele associated decreased characteristics of social anhedonia, found preferentially expressed in women. more research needs conducted, social anhedonia may important intermediate phenotype (endophenotype) between genes associated risk schizophrenia , phenotype of disorder. continued study of social anhedonia , genetic components researchers , clinicians learn more cause of schizophrenia-spectrum disorders.

neurobiological correlates

researchers studying neurobiology of social anhedonia posit trait may linked dysfunction of reward-related systems in brain. circuitry critical sensation of pleasure, computation of reward benefits , costs, determination of effort required obtain pleasant stimulus, deciding obtain stimulus, , increasing motivation obtain stimulus. in particular, ventral striatum , areas of prefrontal cortex (pfc), including orbitofrontal cortex (ofc) , dorsolateral (dl) pfc, critically involved in experience of pleasure , hedonic perception of rewards. regards neurotransmitter systems, opioid, gamma-aminobutyric acid , endocannabinoid systems in nucleus accumbens, ventral pallidum, , ofc mediate hedonic perception of rewards. activity in pfc , ventral striatum have been found decreased in anhedonic individuals major depressive disorder (mdd) , schizophrenia. however, schizophrenia may less associated decreased hedonic capacity , more deficient reward appraisal. abnormal functioning of anterior insula , parietal cortex implicated in anhedonia. dowd & barch conducted fmri study in schizophrenia-spectrum disorder patients , control participants made valence , arousal ratings of own responses emotional stimuli. found higher levels of anhedonia associated diminished arousal, not valence, ratings. furthermore, found that, in controls, greater levels of social anhedonia related decreased bilateral caudate activation in response positive relative negative stimuli. authors posit striatum in anhedonic individuals might dysfunctional such fails tag saliency of positive events. consequently, these individuals may experience blunted emotion.

research further implicates abnormalities in circuitry underlying social cognition critically involved in generation of anhedonic symptoms. individuals high in social anhedonia show less activation in anterior portion of rostral medial prefrontal cortex (armfc), right superior temporal gyrus, , left somatosensory cortex during emotion discrimination task; these regions responsible processing facial emotions. moreover, armfc highly relevant social cognition, , mpfc , somatosensory cortex involved in theory of mind , mentalizing. thus, social anhedonia appears related dysfunction of neural systems involved in self/other representation , social perception.