The Temporal Experience of Pleasure Scale (TEPS): Measurement Invariance Across Gender in Chinese University Students

Effects of anhedonia on health-related quality of life and functional outcomes in major depressive disorder: A systematic review and meta-analysis

BACKGROUND

Major depressive disorder (MDD) is a heterogeneous group of mood disorders. A prominent symptom domain is anhedonia narrowly defined as a loss of interest and ability to experience pleasure. Anhedonia is associated with depressive symptom severity, MDD prognosis, and suicidality. We perform a systematic review and meta-analysis of extant literature investigating the effects of anhedonia on health-related quality of life (HRQoL) and functional outcomes in persons with MDD.

METHODS

A literature search was conducted on PubMed, OVID databases, and SCOPUS for published articles from inception to November 2023, reporting on anhedonia and patient-reported outcomes in persons with MDD. The reported correlation coefficients between anhedonia and self-reported measures of both HRQoL and functional outcomes were pooled using a random effects model.

RESULTS

We identified 20 studies that investigated anhedonia with HRQoL and/or functional outcomes in MDD. Anhedonia as measured by the Snaith-Hamilton Pleasure Scale (SHAPS) scores had a statistically significant correlation with patient-reported HRQoL (r = -0.41 [95 % CI = -0.60, -0.18]) and functional impairment (r = 0.39 [95 % CI = 0.22, 0.54]).

LIMITATIONS

These preliminary results primarily investigate correlations with consummatory anhedonia and do not distinguish differences in anticipatory anhedonia, reward valuation or reward learning; therefore, these results require replication.

CONCLUSIONS

Persons with MDD experiencing symptoms of anhedonia are more likely to have worse prognosis including physical, psychological, and social functioning deficits. Anhedonia serves as an important predictor and target for future therapeutic and preventative tools in persons with MDD.

Anhedonia in Acne Vulgaris: A Cross-Sectional Study of 104 Consecutive Acne Patients

Background

Anhedonia is defined as a reduced ability to experience or even a total loss of pleasure.

Purpose

This study was undertaken to evaluate anhedonia in 104 consecutive acne patients.

Material and Methods

Acne severity was assessed with Investigator Global Assessment (IGA), anhedonia was studied with the Snaith-Hamilton Pleasure Scale (SHAPS), Anticipatory and Consummatory Interpersonal Pleasure Scale (ACIPS) and Temporal Experience of Pleasure Scale (TEPS). Moreover, the quality of life (QoL) and stigmatization, as well as depression and anxiety (Hospital Anxiety and Depression Scale - HADS), were additionally evaluated.

Results

Anhedonia was found in 20.19% of acne patients and was more common (p=0.007) in males (34.29%) than in females (13.04%). Based on SHAPS, males with acne showed significantly (p=0.049) higher levels of anhedonia (2.39 ± 3.18 points) than acne females (1.26 ± 2.36 points). Anhedonia significantly correlated with the clinical acne severity (SHAPS: r=0.205, p=0.038 and ACIPS: r=-0.222, p=0.026). Although the intensity of anhedonia did not show any relationship with QoL and stigmatization assessments, there was a significant correlation between anhedonia and depressive symptoms (SHAPS: r=0.310, p<0.001; ACIPS: r=-0.364, p<0.001). Such dependency was not documented for anxiety.

Conclusion

Anhedonia seems to be a common phenomenon in acne and should be considered in the holistic approach to acne patients.

Neural Correlates of Anhedonia in Major Depressive Disorder: Insights from Concurrent Analysis of Feedback-Related Negativity and Stimulus-Preceding Negativity

Purpose

Anhedonia, a core symptom of major depressive disorder (MDD), is explored in this study, focusing on the neural underpinnings through the examination of two event-related potential (ERP) components: feedback-related negativity (FRN) and stimulus-preceding negativity (SPN).

Patients and Methods

This cross-sectional study was conducted in China from March 2022 to March 2023. It involved 35 MDD patients and 31 healthy controls (HC) participating in a modified 2-door task with simultaneous EEG recordings. Depression severity and anhedonia were assessed using the Hamilton Depression Scale (HAMD) and the Temporal Experience of Pleasure Scale (TEPS-CV), respectively. FRN and SPN metrics, along with correlations with each other and clinical assessments, were examined.

Results

In comparison to the HC group, the MDD group exhibited significantly lower scores in TEPS-CV (t = 2.854, p = 0.006) and its subscales (t = -3.596, p = 0.001 and t = 2.434, p = 0.018, respectively), along with consistently reduced amplitudes of FRN (F 1.64= 4.726, p = 0.033) and SPN (F 1.64= 4.195, p = 0.045) across all conditions. Limited correlations were observed between ERP metrics and clinical indicators, except for positive correlations between FRN amplitudes (loss minus win) and HAMD scores (r = 0.392, p = 0.020), and SPN amplitudes after losing (SPN-L) and TEPS-CV consumption subscale scores (r = 0.357, p = 0.035). Notably, while the HC group displayed no significant FRN-SPN correlations, the MDD group exhibited positive FRN-SPN correlations under distinct conditions (r = 0.376, p = 0.026 and r = 0.355, p = 0.037, respectively).

Conclusion

Our data reveal subjective and objective anhedonia in both consumption and anticipation, suggesting a shared impairment in reward feedback processing and anticipatory neural mechanisms in individuals with MDD. These findings deepen our understanding of anhedonia's neural foundations and may guide targeted interventions for this core symptom.

Psychosocial predictors of persistent suicidal ideation among Chinese adolescents: A longitudinal study

BACKGROUND

Suicide is the fourth leading cause of death among adolescents. Studies have shown that persistent suicidal ideation has a more important effect on suicidal behavior. The objective of this study was to identify predictors of persistent suicidal ideation.

METHODS

Data were collected from 4225 Chinese middle and high school students. These adolescents were assessed for suicidal ideation at baseline and the second year. We used multinomial logistic regression (n = 4171) for the predictive effect of these factors on persistent suicidal ideation. We controlled for gender, residence, clinical diagnosis, clinical diagnosis family, suicide planning, and suicide attempts.

RESULTS

Depressive symptoms are essential in predicting persistent suicidal ideation (OR = 14.0; p < 0.001). Persistent suicidal ideation was predicted by sleep disorders, such as poor sleep quality (OR = 2.3; p = 0.008), difficulty falling asleep (OR = 2.4; p = 0.005), frequently midnight awakening (OR = 1.9; p = 0.044), and frequent nightmares (OR = 2.1; p = 0.040). There was a significant association between concern with persistent ideation and parental-peer alienation (OR for father, 1.9[p = 0.024]; OR for mother, 3.1[p < 0.001]; OR for peer, 2.3[p = 0.003]).

LIMITATIONS

All measures are based on self-report rather than objective assessment or clinical diagnostic assessment.

CONCLUSIONS

Persistent suicidal ideation had a more important role in influencing suicide planning and attempt. Interventions targeting sleep disorders and attention to attachments in the home and school are particularly important in preventing persistent suicidal ideation in adolescents.

Abnormal functional connectivity of the nucleus accumbens subregions mediates the association between anhedonia and major depressive disorder

BACKGROUND

The nucleus accumbens (Nac) is a crucial brain region in the pathophysiology of major depressive disorder (MDD) patients with anhedonia. However, the relationship between the functional imaging characteristics of Nac subregions and anhedonia remains unclear. Thus, this study aimed to investigate the role of resting-state functional connectivity (rsFC) of the Nac subregions between MDD and anhedonia.

METHODS

We performed resting-state functional magnetic resonance imaging (fMRI) to measure the rsFC of Nac subregions in 55 MDD patients and 30 healthy controls (HCs). A two-sample t test was performed to determine the brain regions with varying rsFC among Nac subregions between groups. Then, correlation analyses were carried out to investigate the relationships between the aberrant rsFC of Nac subregions and the severity of anhedonia. Furthermore, we constructed a mediation model to explain the role of the aberrant rsFC of Nac subregions between MDD and the severity of anhedonia.

RESULTS

Compared with the HC group, decreased rsFC of Nac subregions with regions of the prefrontal cortex, insula, lingual gyrus, and visual association cortex was observed in MDD patients. In the MDD group, the rsFC of the right Nac shell-like subregions with the middle frontal gyrus (MFG)/superior frontal gyrus (SFG) was correlated with consummatory anhedonia, and the rsFC of the Nac core-like subdivisions with the inferior frontal gyrus (IFG)/insula and lingual gyrus/visual association cortex was correlated with anticipatory anhedonia. More importantly, the functional alterations in the Nac subregions mediated the association between anhedonia and depression.

CONCLUSIONS

The present findings suggest that the functional alteration of the Nac subregions mediates the association between MDD and anhedonia, which provides evidence for the hypothesis that MDD patients have neurobiological underpinnings of reward systems that differ from those of HCs.

The mobile phone addiction index: Cross gender measurement invariance in adolescents

The Mobile Phone Addiction Index (MPAI) is a short instrument to assess mobile phone addiction. The Chinese version of this scale has been widely used in Chinese students and shows promising psychometric characteristics. The present study tested the construct validity and measurement invariance of the MPAI by gender in middle school adolescents. The data were collected from 1,395 high school students (females, n = 646; M age = 15.3 years). Confirmatory factor analysis (CFA) and multiple-group CFA (MG-CFA) for invariance tests were conducted on the MPAI model which consisted of 17 observed items and 4 latent factors. Findings showed that the data fit the four-factor structure model well for both males and females. Furthermore, configural, metric, scalar, and residual invariance were established by gender. The results indicated that the MPAI has acceptable psychometric properties when used in adolescents. In addition, with the strict invariance requirements being satisfied, the underlying factor scores for MPAI can be meaningfully compared across genders. To our knowledge, this study is the first attempt to test the measurement invariance of the MPAI across male and female adolescents. Our results will support future research on mobile phone addiction in adolescents.

Gender differences in pleasure: the mediating roles of cognitive flexibility and emotional expressivity

BACKGROUND

Gender differences have been found to be associated with individuals' pleasure. Cognitive flexibility and emotional expressivity might play an important role between gender differences and pleasure. This current study is to explore the mediating role of cognitive flexibility and emotional expressivity in the relationship between gender differences and pleasure.

METHOD

In this cross-sectional study, a sample of 1107 full-time university students from five colleges in Tianjin, Chinese mainland was investigated by questionnaire. All participants completed the Temporal Experience of Pleasure Scale (TEPs), the Cognitive Flexibility Inventory (CFI), and the Berkeley Expressivity Questionnaire (BEQ).

RESULTS

The results of independent T-test suggested that females reported better emotional expressivity, anticipatory pleasure and consummatory pleasure than males, whereas males had better cognitive flexibility than females. Using bootstrapping approach revealed that the partially mediation effects of cognitive flexibility on gender differences in anticipatory and consummatory pleasure, and that of emotional expressivity on gender differences in anticipatory and consummatory pleasure. Results of this present study stated that cognitive flexibility and emotional expressivity play a partial mediating role in explaining gender differences in anticipatory and consummatory pleasure.

CONCLUSION

Females had higher anticipatory and consummatory pleasure because they tend to use emotional regulation strategy to express their emotion.

Self-Efficacy Beliefs of University Students: Examining Factor Validity and Measurement Invariance of the New Academic Self-Efficacy Scale

Academic self-efficacy beliefs influence students' academic and career choices, as well as motivational factors and learning strategies promoting effective academic success. Nevertheless, few studies have focused on the academic self-efficacy of university students in comparison to students at other levels. Furthermore, extant measures present several limitations. The first aim of this study was to develop a reliable and valid scale assessing university students' self-efficacy beliefs in managing academic tasks. The second aim was to investigate differences in academic self-efficacy due to gender, years of enrollment, and student status. The study involved 831 students (age M = 21.09 years; SD = 1.34 years; 66.3% women) enrolled in undergraduate programs. Indicators of academic experiences and performance (i.e., number of exams passed and average exam rating) were collected. A new scale measuring students' academic self-efficacy beliefs was administered. Results from a preliminary Exploratory Factor Analysis were consistently supported by findings from a Confirmatory Factor Analysis. Multigroup CFA supported the presence of measurement invariance. Analyses revealed that the new scale has eight factors: "Planning Academic Activities," "Learning Strategies," "Information Retrieval," "Working in Groups," "Management of Relationships with Teachers," "Managing Lessons," "Stress Management," and "Thesis Work." Self-efficacy dimensions showed significant relations with academic experiences and students' performance indicators, as well as differences due to gender, years of enrollment, and student status. Findings are discussed in terms of practical implications for the implementation of intervention programs aimed at fostering self-efficacy beliefs and academic success.

The Behavioral Inhibition System/Behavioral Activation System Scales: Measurement Invariance Across Gender in Chinese University Students

Objectives: To identify the optimal factor structure of the behavioral inhibition system/behavioral activation system (BIS/BAS) scales and to examine measurement invariance (MI) of the scales across gender among a sample of Chinese undergraduate students. Methods: Convenience sampling was employed to recruit 1,085 subjects. Participants completed the Chinese version of the BIS/BAS scales. A confirmatory factor analysis (CFA) of competing models was conducted to determine the optimal factor model, followed by a test of MI across gender based on the optimal model. Results: A single-group CFA indicated that the modified four-factor structure fits best in the total sample. Multiple-group CFAs demonstrated that configural invariance, weak invariance, strong invariance, and strict invariance models of the four-factor structure of the BIS/BAS scales were all acceptable. Conclusion: The four-factor structure of the Chinese version of the BIS/BAS scales possesses MI across gender.

Factor structure and sex invariance of the temporal experience of pleasure scale (TEPS) in Chinese university students and clinical population

BACKGROUND

A motivation dimension of the core psychiatric symptom anhedonia additional has been suggested. The Temporal Experience of Pleasure Scale (TEPS) has been reported to assess anticipatory and consummatory pleasure separately in multiple factor-structure models. This study explored the factor structure of a Chinese version of the 18-item TEPS and further explored the measurement invariance of the TEPS across sex and clinical status (non-clinical, psychiatric).

METHODS

Best-fit factor structure of the TEPS was examined in a non-clinical cohort of 7410 undergraduates, randomized into sample 1 (N = 3755) for exploratory factor analysis (EFA) and sample 2 (N = 3663) for confirmatory factor analysis (CFA). Additionally, serial CFA was conducted to evaluate measurement invariance across sex and between clinical (N = 313) and non-clinical (N = 341) samples.

RESULTS

EFA supported a new four-factor structure with a motivation component, based on the original two-factor model (consummatory pleasure with/without motivation drive, anticipatory pleasure with/without motivation drive). CFA confirmed the four-factor model as the best-fit structure and revealed a second-order hierarchy in non-clinical and clinical samples. Full scalar invariance was observed across clinical and non-clinical samples and across sex in the clinical sample; only partial scalar invariance was observed across sex in the non-clinical sample.

CONCLUSIONS

A four-factor structured TEPS can assess motivation-driving dimensions of anticipatory and consummatory pleasure, consistent with the recently advanced multidimensional structure of anhedonia. CFA and measurement invariance results support application of the TEPS for assessing motivation aspects of anhedonia.

Multimodal Investigations of Reward Circuitry and Anhedonia in Adolescent Depression

Depression is a highly prevalent condition with devastating personal and public health consequences that often first manifests during adolescence. Though extensively studied, the pathogenesis of depression remains poorly understood, and efforts to stratify risks and identify optimal interventions have proceeded slowly. A major impediment has been the reliance on an all-or-nothing categorical diagnostic scheme based solely on whether a patient endorses an arbitrary number of common symptoms for a sufficiently long period. This approach masks the well-documented heterogeneity of depression, a disorder that is highly variable in presentation, severity, and course between individuals and is frequently comorbid with other psychiatric conditions. In this targeted review, we outline the limitations of traditional diagnosis-based research and instead advocate an alternative approach centered around symptoms as unique dimensions of clinical dysfunction that span across disorders and more closely reflect underlying neurobiological abnormalities. In particular, we highlight anhedonia-the reduced ability to anticipate and experience pleasure-as a specific, quantifiable index of reward dysfunction and an ideal candidate for dimensional investigation. Anhedonia is a core symptom of depression but also a salient feature of numerous other conditions, and its severity varies widely within clinical and even healthy populations. Similarly, reward dysfunction is a hallmark of depression but is evident across many psychiatric conditions. Reward function is especially relevant in adolescence, a period characterized by exaggerated reward-seeking behaviors and rapid maturation of neural reward circuitry. We detail extensive work by our research group and others to investigate the neural and systemic factors contributing to reward dysfunction in youth, including our cumulative findings using multiple neuroimaging and immunological measures to study depressed adolescents but also trans-diagnostic cohorts with diverse psychiatric symptoms. We describe convergent evidence that reward dysfunction: (a) predicts worse clinical outcomes, (b) is associated with functional and chemical abnormalities within and beyond the neural reward circuitry, (c) is linked to elevated peripheral levels of inflammatory biomarkers, and (d) manifests early in the course of illness. Emphasis is placed on high-resolution neuroimaging techniques, comprehensive immunological assays, and data-driven analyses to fully capture and characterize the complex, interconnected nature of these systems and their contributions to adolescent reward dysfunction.

Wanting and Liking: Testing the Factor Structure of The Temporal Experience of Pleasure Scale in Major Depression and Community Samples

The Temporal Experience of Pleasure Scale (TEPS) is a multidimensional self-report measure that has been used to improve understanding of anticipation ("wanting") and consummation ("liking") of reward. The TEPS has been used to assess anhedonia in clinical depression, but its factor structure has not yet been confirmed in this population. This seems important given mixed findings on the model fit and factor structure of the TEPS in other clinical and community samples. To remedy this, the current study used confirmatory factor analysis to test models of the TEPS items across three studies: (a) in adults with major depression (n = 334), (b) in youth with major depression (n = 305), and (c) in a community sample (n = 320). In summary, the model fit of the two-factor TEPS scales was adequate in depressed and community Australian samples. Nevertheless, some items may require removal or revision based on cultural preferences for pleasurable experiences.

Anhedonia correlates with functional connectivity of the nucleus accumbens subregions in patients with major depressive disorder

BACKGROUND

The nucleus accumbens (NAc) is an important region in reward circuit that has been linked with anhedonia, which is a characteristic symptom of major depressive disorder (MDD). However, the relationship between the functional connectivity of the NAc subregions and anhedonia in MDD patients remains unclear.

METHODS

We acquired resting-state functional magnetic resonance imaging (fMRI) scans from fifty-one subjects (23 MDD patients and 28 healthy controls). We assessed subjects' trait anhedonia with the Temporal Experience of Pleasure Scale (TEPS). Seed-based resting-state functional connectivity (rsFC) was conducted for each of the NAc subregions (bilateral core-like and shell-like subdivisions) separately to identify regions whose rsFCs with the NAc subregions were altered in the MDD patients and regions whose rsFCs with the NAc subregions showed different correlates with anhedonia between the MDD patients and the healthy controls.

RESULTS

Compared with the health controls, the MDD patients showed decreased rsFCs of the right NAc core-like subdivision with the left mid-anterior orbital prefrontal cortex and the right inferior parietal lobe as well as decreased rsFC of the left NAc core-like subdivision with the right middle frontal gyrus. Moreover, the severity of anhedonia by the group interaction was significant for the rsFC of the right NAc shell-like subdivision with the subgenual/pregenual anterior cingulate cortex and the rsFC of the right NAc core-like subdivision with the precuneus.

CONCLUSIONS

We found that the neural correlates of anhedonia indicated by the rsFCs of the NAc subregions were modulated by depression. The modulation effect was regionally-dependent. These findings enrich our understanding of the neural basis of anhedonia in MDD.

Factor Structure and Gender Invariance of Chinese Version State-Trait Anxiety Inventory (Form Y) in University Students

Background

Anxiety can be classified as state anxiety and trait anxiety which present the current level of anxiety and the generalized anxiety tendencies of individuals, respectively. The State-Trait Anxiety Inventory form Y (STAI-Y) is a reliable instrument used to test both the levels of state and trait anxiety across various countries. However, the optimal factor structure of STAI-Y in different populations is not consistent and is not clear in Chinese university students. In addition, the gender invariance is the premise for comparing the scores of STAI-Y between men and women which also need to be verified. Therefore, this study explored the optimal factor structure of STAI-Y and examined whether the optimal factor structure satisfied measurement invariance across gender in Chinese university students.

Method

A sample of 2117 Chinese university students participated in this study including 748 men and 1369 women. The optimal factor structure was decided by singer group confirmatory factor analysis (CFA) and exploratory structural equation modeling (ESEM). Furthermore, the configural invariance, metric invariance, scalar invariance, and strict invariance models were administrated in multigroup CFA to detect the measurement equivalence of STAI-Y across gender in Chinese university students. The reliability of STAI-Y was tested by Cronbach’s alpha coefficient and McDonald’s omega coefficients.

Results

The optimal factor structure of STAI-Y was four-factor model and reached strict gender invariance in Chinese university students. Moreover, the STAI-Y also had adequate reliability in Chinese university students.

Conclusion

This study explored the factor structure and gender invariance of STAI-Y in Chinese university students. In sum, the four-factor structure of STAI-Y obtained the best goodness-of-fit and satisfied gender invariance which deepened the understanding of STAI-Y in Chinese university students.