The effect of vortioxetine on anhedonia in patients with schizophrenia

OBJECTIVE

Anhedonia is a common symptom of depression, but is also a negative symptom of schizophrenia. The purpose of this study was to examine the effects of vortioxetine on anhedonia in patients with schizophrenia.

METHODS

A total of 120 patients with schizophrenia in remission who met inclusion criteria were randomized 1:1 by the envelope method into intervention and control groups. All participants in both groups were divided into three subgroups based on the antipsychotic therapy they were receiving (olanzapine, risperidone, or aripiprazole). Vortioxetine was administered to those in the intervention group at a fixed dose of 10 mg per day. The Positive and Negative Syndrome Scale (PANSS), Calgary Depression Scale for Schizophrenia (CDSS), and Chapman Scale for Social and Physical Anhedonia (CSPA) were administered. The study lasted 12 weeks. Participants were assessed twice: At baseline and at the end of the study. Six participants dropped out, with 114 completing the trial.

FINDINGS

Vortioxetine treatment had a significant effect on level of physical anhedonia. The treatment interaction was also statistically significant, but with a relatively small effect (F = 3.17, P < .05; η2 = .061). Vortioxetine treatment had a particularly strong effect on the level of social anhedonia. The interaction between the treatment and the type of antipsychotics was also statistically significant with a small effect (F = 5.04, P < 0. 01; η2 = .091).

CONCLUSION

The combination of olanzapine and vortioxetine was found to be the best option to reduce symptoms of social and physical anhedonia in these patients with remitted schizophrenia.

Diminished hedonic capacity in social activities as a mediator of the link between dysfunctional behavioral activation system and depressive symptoms

Background

Adolescence is a crucial period for the development of depression, and previous studies have suggested that the Behavioral Activation System (BAS) plays a significant role. However, little is known about the underlying mechanisms. This study aimed to explore the mediating role of anhedonia in the relationship between BAS and depressive symptoms among Chinese adolescents.

Method

A total of 1,023 high-school students aged 15-18 years participated in the study, with 916 continuing their participation three months later. All participants completed the Behavioral Inhibition System/Activation System (BIS/BAS) scale, Dimensional Anhedonia Rating Scale (DARS), Children's Depression Inventory (CDI), and the State-Trait Anxiety Inventory (STAI-S/T). Pathway model analysis was performed to examine the concurrent and prospective mediating effects of anhedonia and the potential moderating effect of sex.

Result

Anhedonia in the domains of social activities, hobbies and sensory experiences significantly mediated the cross-sectional relationship between BAS and depressive level three months later. Furthermore, the beta-value of the mediating effect of social activities was significantly higher than that of the other domains of hedonic capacity cross-sectionally and longitudinally. However, sex showed no significant moderating effect.

Conclusion

Our findings underscore the importance of hedonic capacity, especially within the social domain, in the development of depressive symptoms. These findings contribute to the early diagnosis and prevention of depressive disorders.

Social anhedonia, communication, and marital satisfaction in newlywed couples

OBJECTIVE

Social anhedonia is associated with disinterest in social interactions and poor relationship functioning, yet little is known about the specific mechanisms underlying associations between social anhedonia and romantic relationship behaviors and satisfaction. We examined the links between social anhedonia, perceptions of conflict communication patterns, and marital satisfaction.

METHOD

The current research examined the role of social anhedonia on marital quality and functioning longitudinally across a year in a sample of 100 newlywed couples using an actor-partner interdependence framework.

RESULTS

Social anhedonia was negatively associated with own and partner's marital satisfaction. It was also negatively associated with constructive communication and positively associated with destructive communication. Furthermore, cross-sectional mediation analyses showed that communication patterns mediated the social anhedonia-satisfaction link.

CONCLUSIONS

Taken together, these findings suggest that social anhedonia is likely to lead to lower marital satisfaction, partly through its effect on communication between partners.

Approaches to Studying and Improving Social Motivation in Schizophrenia

Social motivation impairments, or "asociality," have long been considered a core clinical feature of schizophrenia. Although the prevalence and pervasive negative impact of poor social motivation is well-documented, our understanding is limited regarding causal mechanisms. Advances in definition, conceptualization, and characterization are needed to inform research aimed at understanding these mechanisms and developing effective interventions. This theme issue is intended to accelerate efforts to study and treat social motivation in schizophrenia by synthesizing the current knowledge and providing new frameworks to guide future research in this area.

Do People With Schizophrenia Enjoy Social Activities as Much as Everyone Else? A Meta-analysis of Consummatory Social Pleasure

BACKGROUND

The "emotion paradox" of schizophrenia suggests people with schizophrenia demonstrate deficits when reporting anticipated and retrospective pleasure; yet, in-the-moment, consummatory pleasure is largely intact. It is uncertain how these findings extend to social situations. This meta-analysis aimed to (1) determine the mean difference in consummatory social pleasure between people with schizophrenia and healthy controls, and (2) examine moderators of this effect, including study design and clinical characteristics of participants.

DESIGN

A literature search using PsycINFO, Web of Science, Pubmed, and EMBASE databases was conducted. Studies measuring consummatory social pleasure using experience sampling methods and laboratory social simulations were included. Random effects meta-analyses were conducted using Hedge's g.

RESULTS

Meta-analysis of 26 studies suggests people with schizophrenia exhibited a small, significant deficit in consummatory social pleasure (g = -0.38, 90% CI [-0.53, -0.22]). There was significant heterogeneity in effect sizes; magnitude was moderated by study design and type of measure used to assess social pleasure.

CONCLUSIONS

Overall, people with schizophrenia seem to exhibit less consummatory social pleasure than controls. However, this deficit is smaller than in studies of anticipated and retrospective pleasure. Thus, consummatory social pleasure may not be quite as impaired in people with schizophrenia as traditional anhedonia research suggests. Moreover, pleasure deficits observed in people with schizophrenia may result from differences in the quality of their daily social experiences rather than differences in their capacity for social pleasure. Results have important implications for clinical interventions that address barriers to social engagement, low-pleasure beliefs, and cognitive remediation to treat schizophrenia.

50-kHz ultrasonic vocalizations do not signal social anhedonia in transgenic DISC1 rats

Patients diagnosed with neuropsychiatric disorders, such as autism and schizophrenia, suffer from disorganized speech. The disrupted-in-schizophrenia 1 (DISC1) protein pathway is considered a risk factor for the development of several psychiatric disorders and plays an important role in the dysregulation of dopamine (DA), which in turn plays an important role in the regulation of ultrasonic vocalizations (USVs) in rats. Moreover, the DISC1 protein pathway has been identified as a cause of social anhedonia, that is, a decrease in the drive for social interactions. USVs transmit specific affective information to other rats, with 50-kHz calls indicating a positive affective state in rats. Dysregulation of the dopaminergic system impacts the qualitative and quantitative features of USVs, such as duration, peak frequency, and the call rate. In this study, we thus used a well-established transgenic DISC1 (tgDISC1) rat line to investigate whether the neural (decreased DA levels in the dorsal striatum, amygdala, and hippocampus (HPC)) and behavioral (social anhedonia) features of tgDISC1 rats could be manifested through the modulation of their 50-kHz USVs. Analyses of three features (call rate, duration, and peak frequency) of all 50-kHz revealed no significant differences between groups, suggesting decreased DA levels in the dorsal striatum and amygdala, and HPC may affect social interaction but leave 50-kHz USV production intact.

The Associations of Neutrophil-Lymphocyte, Platelet-Lymphocyte, Monocyte-Lymphocyte Ratios and Immune-Inflammation Index with Negative Symptoms in Patients with Schizophrenia

Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), monocyte-lymphocyte ratio (MLR) and systemic immune-inflammation index (SII index) are increasingly used as indicators of inflammation in different conditions, including schizophrenia. However, their relationship with negative symptoms, including anhedonia, is largely unknown. Included were 200 patients with schizophrenia and 134 healthy controls (HC), assessed for physical anhedonia (PA), using the Revised Physical Anhedonia Scale (RPAS), and social anhedonia (SA) by the Revised Social Anhedonia Scale (RSAS). Patients were rated by the Positive and Negative Syndrome Scale (PANSS), the Clinical Assessment Interview for Negative Symptoms (CAINS) and the Brief Negative Symptom Scale (BNSS). Most of the negative symptoms were in a weak to moderate positive correlations with blood cell inflammatory ratios, namely, between NLR and MLR with PANSS negative scale, CAINS, and BNSS, and in male patients, between PLR and PANSS negative scale and CAINS. Fewer correlations were detected in females, but also in a positive direction. An exception was SA, given the negative correlation between its severity and the SII index in females, and its presence and higher PLR in males. While different negative symptoms were associated with subclinical inflammation, the relationship between SA and lower inflammatory markers deserves further exploration.

The anticipatory and consummatory interpersonal pleasure scale: Applicability to Chinese OCD patients

As a transdiagnostic symptom, social anhedonia has gained increasing attention. Evidence suggests that obsessive-compulsive disorder (OCD) patients demonstrate social anhedonia. This study examined the psychometric properties of the Anticipatory and Consummatory Interpersonal Pleasure Scale (ACIPS) in an undergraduate sample and Chinese OCD patients. Furthermore, we explored the relationship between clinical symptoms and ACIPS scores. This study involved 3,306 undergraduate students and 293 patients with OCD. Internal consistency and convergent validity of ACIPS were examined. Confirmatory factor analysis (CFA) was applied to determine the best-fitting of potential factor models, and multi-group CFA was used to examine measurement invariance across genders and samples. Additionally, hierarchical linear regression was conducted in order to investigate the relationship between clinical symptoms and ACIPS scores in patients suffering from OCD. ACIPS showed acceptable internal consistency in undergraduate and OCD samples (Cronbach's α = 0.93 and 0.89, respectively). In both samples, the four-factor structure had the best fit index. Scalar invariance was established across undergraduate and OCD samples, while residual invariance was established across genders. In both samples, the ACIPS was significantly correlated with the Revised Social Anhedonia Scale and Beck Depression Inventory. Depression and the severity of obsessive thoughts significantly and negatively correlated with the ACIPS score in OCD patients (p < 0.05). In conclusion, ACIPS is a reliable, effective, simple, and convenient tool for the assessment of social anhedonia. Depression and obsessive thoughts contribute to social anhedonia in OCD patients.

Altered empathy correlates with reduced social and non-social reward anticipation in individuals with high social anhedonia

This study examined the correlations of affective and cognitive components of empathy with reward anticipation toward monetary and social incentives in individuals with social anhedonia (SocAnh). According to the scores on the Revised Social Anhedonia Scale, 109 participants were divided into high (n = 57) and low (n = 52) SocAnh groups. Empathy was assessed with the Questionnaire of Cognitive and Affective Empathy (QCAE) and the Interpersonal Reactivity Index (IRI) Scale. Social and non-social reward anticipations were assessed by the Social and Monetary Incentive Delay Tasks, respectively. We performed independent-sample t tests and repeated-measures ANOVAs to examine the group differences on empathy and reward anticipation. Correlation analyses between empathy and reward anticipation were conducted. Results showed that the high SocAnh group reported reduced scores on empathy and reward anticipation for monetary and social incentives compared to their low SocAnh counterparts. Correlation analysis further indicated that monetary reward anticipation correlated with cognitive empathy, while social reward anticipation correlated with affective empathy. Our findings suggested that participants with high SocAnh exhibited poorer empathy and reduced reward anticipation than those with low SocAnh level. More importantly, social and non-social reward anticipation may distinctly contribute to affective and cognitive components of empathy.

Neural Correlates of Variation in Personal Space and Social Functioning in Schizophrenia and Healthy Individuals

BACKGROUND

Changes in the regulation of interpersonal distance, or "personal space" (PS), have been repeatedly observed in schizophrenia and, in some studies, linked to negative symptoms. However, the neurobiological basis of these impairments is poorly understood.

METHODS

Personal space measurements, functional connectivity of a brain network sensitive to intrusions into PS, and symptoms of social withdrawal and anhedonia were assessed, and associations among these outcomes measured, in 33 individuals with a psychotic disorder (primarily schizophrenia [SCZ]) and 36 control subjects (CON).

RESULTS

Personal space size was significantly higher (P = .002) and PS permeability (reflecting the capacity to tolerate intrusions into PS) was significantly lower (P = .021) in the SCZ relative to the CON group, and both measures were significantly correlated with social anhedonia and withdrawal in the full sample (all P < .007). Moreover, functional connectivity between the PS and default mode (DM) networks was significantly correlated with the permeability, but not the size, of PS in the full sample and in the SCZ and CON groups separately, and with social withdrawal in the SCZ group. Lastly, the association between PS-DM network connectivity and social withdrawal in the SCZ group was fully mediated by PS permeability.

DISCUSSION

Neural and behavioral aspects of PS regulation are linked to social motivation in both healthy individuals and those with psychotic disorders, suggesting that measurements of PS could serve as transdiagnostic markers of social functioning.

MDMA-Assisted Therapy as a Means to Alter Affective, Cognitive, Behavioral, and Neurological Systems Underlying Social Dysfunction in Social Anxiety Disorder

Social anxiety disorder (SAD) is a prevalent and often debilitating psychiatric disorder that can assume a chronic course even when treated. Despite the identification of evidence-based pharmacological and behavioral treatments for SAD, much room for improved outcomes exists and 3,4-methylenedioxymethamphetamine (MDMA) has been proposed as a promising adjunctive treatment to psychological interventions for disorders characterized by social dysfunction. A small randomized, placebo-controlled trial of MDMA-assisted therapy (MDMA-AT) for social anxiety in autistic adults offered encouraging results, but more research is sorely needed to explore the potential for MDMA-AT in treating SAD. This review aims to stimulate future study by summarizing research on disruptions in neurological, perceptual, receptive, and expressive systems regulating social behavior in SAD and proposing how MDMA-AT may alter these systems across four domains. First, we review research highlighting the roles of social anhedonia and reduced social reward sensitivity in maintaining SAD, with specific attention to the reduction in positive affect in social situations, infrequent social approach behaviors, and related social skills deficits. We posit that MDMA-AT may enhance motivation to connect with others and alter perceptions of social reward for an extended period following administration, thereby potentiating extinction processes, and increasing the reinforcement value of social interactions. Second, we review evidence for the central role of heightened social evaluative threat perception in the development and maintenance of SAD and consider how MDMA-AT may enhance experiences of affiliation and safety when interacting with others. Third, we consider the influence of shame and the rigid application of shame regulation strategies as important intrapersonal processes maintaining SAD and propose the generation of self-transcendent emotions during MDMA sessions as a mechanism of shame reduction that may result in corrective emotional experiences and boost memory reconsolidation. Finally, we review research on the role of dysfunctional interpersonal behaviors in SAD that interfere with social functioning and, in particular, the development and maintenance of close and secure relationships. We discuss the hypothesized role of MDMA-AT in improving social skills to elicit positive interpersonal responses from others, creating a greater sense of belonging, acceptance, and social efficacy.

Altered activation and functional connectivity in individuals with social anhedonia when envisioning positive future episodes

BACKGROUND

Anticipatory pleasure deficits are closely correlated with negative symptoms in schizophrenia, and may be found in both clinical and subclinical populations along the psychosis continuum. Prospection, which is an important component of anticipatory pleasure, is impaired in individuals with social anhedonia (SocAnh). In this study, we examined the neural correlates of envisioning positive future events in individuals with SocAnh.

METHODS

Forty-nine individuals with SocAnh and 33 matched controls were recruited to undergo functional MRI scanning, during which they were instructed to simulate positive or neutral future episodes according to cue words. Two stages of prospection were distinguished: construction and elaboration.

RESULTS

Reduced activation at the caudate and the precuneus when prospecting positive (v. neutral) future events was observed in individuals with SocAnh. Furthermore, compared with controls, increased functional connectivity between the caudate and the inferior occipital gyrus during positive (v. neutral) prospection was found in individuals with SocAnh. Both groups exhibited a similar pattern of brain activation for the construction v. elaboration contrast, regardless of the emotional context.

CONCLUSIONS

Our results provide further evidence on the neural mechanism of anticipatory pleasure deficits in subclinical individuals with SocAnh and suggest that altered cortico-striatal circuit may play a role in anticipatory pleasure deficits in these individuals.

Network analysis of executive function, emotion, and social anhedonia

This study constructed the network structure of social anhedonia, emotion processing, and executive function in college students using network analysis. We calculated the strength of each node in the network. The results suggest that social anhedonia had negative effects on executive function, emotion experience, and emotion expression.

Social and physical anhedonia in relation to grandiose and vulnerable narcissism

BACKGROUND

Narcissism has two different dimensions which differ in terms of social functioning. Grandiose narcissism is associated with higher extraversion, while vulnerable narcissism is associated with greater introversion. Both forms of narcissism present numerous forms of social maladjustment. Anhedonia (social and physical) is associated with measures of social maladjustment and is one of the core symptoms of serious mental conditions. The aim of the current study was to investigate the relationship between social and physical anhedonia and the two forms of narcissism, grandiose and vulnerable.

PARTICIPANTS AND PROCEDURE

A sample of 339 young adults completed the Polish version of the Hypersensitive Narcissism Scale, the Narcissistic Personality Inventory, and two subscales of the Wisconsin Schizotypy Scales - Short Form: the Revised Social Anhedonia Scale and the Physical Anhedonia Scale.

RESULTS

We found a positive correlation between social anhedonia and vulnerable narcissism, and a negative correlation between social anhedonia and grandiose narcissism. Physical anhedonia was not related to any form of narcissism. Older people and men scored higher on the social anhedonia scale.

CONCLUSIONS

Vulnerable narcissistic personality is associated with social deficits, namely social anhedonia. Future research could investigate the relationship between vulnerable narcissism and schizotypy to establish whether vulnerable personality is a risk factor for developing serious mental illnesses.

Neural dynamics of monetary and social reward processing in social anhedonia

Being characterized by reduced pleasure from social interaction, social anhedonia constitutes a transdiagnostic marker for various psychiatric disorders. However, the neural portrait of social anhedonia remains elusive because of heterogeneities of reward type and reward dynamics in previous studies. The present event-related potential study investigated neural dynamics in response to monetary and social rewards in social anhedonia. Event-related potential responses were examined when a high social anhedonia (HSA, N = 23) group and a low social anhedonia (LSA, N = 26) group were anticipating and consuming social and monetary rewards. LSA but not HSA participants showed an increased stimulus-preceding negativity (anticipatory phase) and and increased reward positivity (consummatory phase) for monetary as compared with social rewards. This group difference could spring from an increased relevance of social rewards or a general decline in affective responding due to a potential association between social anhedonia and depression. Our findings provide preliminary evidence for neural aberrations of the reward system in social anhedonia, which is contingent upon reward type and reward dynamics.

Impaired perceptual processing of facial expression categorization in social anhedonia

The current event-related potential study investigated the perceptual processing of the categorization advantage of happy over sad faces in social anhedonia with a nonclinical sample. A high social anhedonia (HSA, N = 25) group and a low social anhedonia (LSA, N = 27) group performed a facial expression categorization task during which they classified facial expressions (happy, neutral, sad), irrespective of face orientation (upright, upside-down). Behaviorally, happy faces were identified more quickly than sad ones in the upright but not inverted orientation. Electrophysiologically, the LSA group showed earlier N170 latencies for happy than for sad faces in the upright but not upside-down orientation, whereas the HSA group did not show any expression effect on N170 latencies. Moreover, N170 and P2 amplitude results revealed that HSA relative to LSA individuals showed delayed neural discrimination between happy and sad faces. These results suggest that social anhedonia is associated with a deficit of perceptual processing during facial expression categorization.

Developmental antecedents of social anhedonia: The roles of early temperament and sex

Social anhedonia is well established as a transdiagnostic factor, but little is known about its development. This study examined whether temperament and parenting in early childhood predict social anhedonia in early adolescence. We also explored whether the relationships between early predictors and social anhedonia are moderated by a child's sex. A community sample of children participated in laboratory observations of temperament and parenting practices at age 3 (n = 275). The participants returned at age 12 and completed the Anticipatory and Consummatory Interpersonal Pleasure Scale-Child Version (ACIPS-C). Our results indicated that, at age 3, lower observed sociability predicted higher levels of social anhedonia at age 12. These associations were moderated by child sex, such that males with diminished sociability reported greater social anhedonia. These findings indicate that predictors of early adolescent social anhedonia are evident as early as 3 years of age. However, these effects were evident only for males, suggesting that the pathways to social anhedonia in early adolescence differ as a function of sex.

Effects of working memory training on emotion regulation: Transdiagnostic review

Working memory training is widely used transdiagnostically to improve cognition. However, more recently, studies using working memory training packages have targeted emotion-regulation outcomes to determine whether far transfer effects can be achieved. A narrative review is conducted of studies that have used standardized computerized working memory training packages across healthy volunteers, affect, anxiety, post-traumatic stress disorder (PTSD), and eating disordered populations with emotion-regulation outcomes. Working memory training has been used in children, adolescents, and adults to improve emotion regulation. Many studies have reported gains in mood as well as emotion-regulation strategies following working memory training, regardless of clinical indication and whether near transfer gains were achieved in cognitive domains. Significant emotion-regulation outcomes include: state and trait anxiety, rumination, brooding, positive appraisal, decreasing maladaptive emotion-regulation strategies, and decreasing intrusive thoughts. It is speculated that these far transfer outcomes from working memory training are possible due to the cognitive and neural overlap between cognitive and affective working memory, and emotion regulation. Working memory training could improve cognitive efficiency, which, in turn, increases the availability of cognitive resources during times when emotion regulation is taxed. Future studies need to consider the role of participant expectancy in predicting outcome measure performance, and including subjective and objective outcomes is paramount to study design. Furthermore, sample sizes require additional attention, given that the current review highlights that individual differences in non-clinical and clinical populations influence the outcomes from working memory training. Working memory training offers a possibility for improving emotion regulation transdiagnostically.

Classification of social anhedonia using temporal and spatial network features from a social cognition fMRI task

Previous studies have suggested that the degree of social anhedonia reflects the vulnerability for developing schizophrenia. However, only few studies have investigated how functional network changes are related to social anhedonia. The aim of this fMRI study was to classify subjects according to their degree of social anhedonia using supervised machine learning. More specifically, we extracted both spatial and temporal network features during a social cognition task from 70 subjects, and used support vector machines for classification. Since impairment in social cognition is well established in schizophrenia-spectrum disorders, the subjects performed a comic strip task designed to specifically probe theory of mind (ToM) and empathy processing. Features representing both temporal (time series) and network dynamics were extracted using task activation maps, seed region analysis, independent component analysis (ICA), and a newly developed multi-subject archetypal analysis (MSAA), which here aimed to further bridge aspects of both seed region analysis and decomposition by incorporating a spotlight approach.We found significant classification of subjects with elevated levels of social anhedonia when using the times series extracted using MSAA, indicating that temporal dynamics carry important information for classification of social anhedonia. Interestingly, we found that the same time series yielded the highest classification performance in a task classification of the ToM condition. Finally, the spatial network corresponding to that time series included both prefrontal and temporal-parietal regions as well as insula activity, which previously have been related schizotypy and the development of schizophrenia.

Explicit and Implicit Affect and Judgment in Schizotypy

Although emotion deficits in schizotypy have been reported, the exact nature of these deficits is now well understood. Specifically, for social anhedonia (SocAnh), there are questions about whether any decrease in positive affect only reflects an explicit bias not observed in other measures (e.g., implicit affect measure). At the same time, for individuals with elevated levels of perceptual aberrations or magical ideation (PerMag), there is some evidence of an increased influence of affect on judgment. It is also possible that the influence of implicit affect on judgment might be especially pronounced in PerMag; however, this has not been previously examined. The current study involved people with elevated levels of SocAnh (n = 95), elevated levels of PerMag (n = 62), and people with average or lower levels of both (n = 246). We found that SocAnh was associated with decreases in both explicit and implicit positive affect. We also found that PerMag was related to stronger relationships between implicit affect, both positive and negative, and a judgment task. These results suggest that decreased positive affect is a core feature of SocAnh and that a heightened influence of affect could be related to the development of peculiar beliefs/experiences associated with PerMag.

Social anhedonia and gamma band abnormalities as a composite/multivariate endophenotype for schizophrenia: a dense array EEG study

AIM

Social anhedonia and gamma band oscillations are proposed as a promising endophenotype for schizophrenia (SZ). The aim was to assess whether social anhedonia and spontaneous gamma band oscillations could be used as multivariate/composite endophenotypic measures for SZ.

METHODS

Sixty consented subjects, of which 20 remitted SZ patients, 20 unaffected siblings of patients with schizophrenia (US) and 20 healthy controls (HC) were recruited for the study. The Revised Social Anhedonia Scale, Temporal Experience of Pleasure Scale and the Schizotypal Personality Questionnaire assessed social anhedonia, temporal experience of pleasure and schizotypal features. All participants underwent awake, resting state 192-channel dense array electroencephalographic recording. Gamma spectral power and coherence were calculated. We performed chi-square test, one-way analysis of variance, Pearsons correlation coefficient and step-by-step linear discriminant functional analysis.

RESULTS

Social anhedonia was significantly higher and anticipatory aspects of pleasure were significantly lower in both SZ and US compared with HC. US scored significantly higher than HC in the Schizotypal Personality Questionnaire. Spectral power of high gamma band (>70 Hz) was significantly lower over the right temporo-parietal and midline regions in both SZ and US than HC. We accurately classified (85%) three groups when social anhedonia, high gamma band spectral power of midline, right frontal and right fronto-temporal interhemispheric gamma coherence were considered as composite measures rather than each variable representing independently.

CONCLUSION

We propose region-specific high gamma spectral 'power and coherence' and social anhedonia as composite/multivariate measures could be a useful measure in distinguishing schizophrenia patients and unaffected siblings from healthy controls.

Effectiveness of emotional skills training for patients with anorexia nervosa with autistic symptoms in group and individual format

OBJECTIVE

The aim of this study was to examine the effectiveness of CREST interventions in individual and group formats for adult anorexia nervosa. Furthermore, this study also aims to analyse whether patients with high levels of autistic symptoms respond differently.

METHODS

Participants' self-report measures were taken before and after individual and group interventions (N = 66 and N = 62, respectively). Mixed effects analysis was used to analyse overall response to both formats and assess interaction with autism symptoms.

RESULTS

Significant improvements were observed for patients' alexithymia in individual format, and motivation increased for participants in both interventions. Significant interactions were observed between alexithymia, social anhedonia, and autism symptoms in individual format and alexithymia in group format. No interactions between autism and time were observed for either format.

CONCLUSIONS

CREST in both formats offers participants improvements in social-emotional and motivational domains. Patients with high levels of autism symptoms also score high on both social anhedonia and alexithymia measures, but this does not affect their response to treatment.

Confirmatory Factor Analysis of the French Version of the Anticipatory and Consummatory Interpersonal Pleasure Scale

The Anticipatory and Consummatory Interpersonal Pleasure Scale (ACIPS), a measure specifically designed to assess hedonic capacity for social and interpersonal pleasure, was used to evaluate the presence of social anhedonia in patients as well as the general population. The first goal of this study was to validate the structure of the French version of the ACIPS. The second objective was to verify whether a one, two or three factor solution is most appropriate for the ACIPS scale. The French version of the ACIPS was tested on 263 French-speaking pre-graduate students or professional volunteers. For the confirmatory factor analysis, data were treated as categorical ordinal and all the models were estimated using a robust weighted least squares estimator with adjustments for the mean and variance. Three models were estimated. A one-factor model representing a general undifferentiated "pleasure" latent construct was first tested on the 17 ACIPS items. A two-factor model distinguishing anticipatory-pleasure and consummatory-pleasure was tested next. Finally, a three-factor model including subdomains of intimate social interactions, group social interactions, and social bonding was tested. The one and two-factor models showed a somewhat poor fit to the data. However, the goodness of fit of the three factor model was adequate. These results suggest that individuals who enjoyed interaction in one of these three subdomains were more likely to enjoy doing so in the two other domains. However, on the basis of the comparison between the one and three factor models, these three types of interactions may not be considered as indistinguishable. Rather, they represent distinct and theoretically meaningful dimensions. These results show the French version of the ACIPS is a useful and valid scale to measure the capacity of savoring different kinds of social relationships.

The Predictive Value of the NEO-FFI Items: Parsing the Nature of Social Anhedonia Using the Revised Social Anhedonia Scale and the ACIPS

The goal was to examine the nature of social anhedonia using two validated measures and study their relationship to scores on the NEO-Five Factor Inventory (NEO-FFI). Nearly 1,900 college-aged participants completed the Chapman Revised Social Anhedonia Scale (RSAS), Anticipatory and Consummatory Interpersonal Pleasure Scale (ACIPS), and the NEO-FFI. Although both the RSAS and ACIPS were associated with the NEO-FFI domains of Extraversion, Agreeableness, and Neuroticism, linear regression analyses revealed that the RSAS and ACIPS were differentially predicted by NEO-FFI item clusters. The RSAS scores were predicted by Sociability, Nonantagonistic Orientation, Positive Affect, and Activity item clusters. The ACIPS scores were predicted by Sociability, Prosocial Orientation, Activity, and Positive Affect item clusters in addition to gender. In summary, it appears that social anhedonia is multidimensional, associated with various personality domains encompassing social approach and withdrawal.

Adults with high social anhedonia have altered neural connectivity with ventral lateral prefrontal cortex when processing positive social signals

Social anhedonia (SA) is a debilitating characteristic of schizophrenia, a common feature in individuals at psychosis-risk, and a vulnerability for developing schizophrenia-spectrum disorders. Prior work (Hooker et al., 2014) revealed neural deficits in the ventral lateral prefrontal cortex (VLPFC) when processing positive social cues in a community sample of people with high SA. Lower VLPFC neural activity was related to more severe self-reported schizophrenia-spectrum symptoms as well as the exacerbation of symptoms after social stress. In the current study, psycho-physiological interaction (PPI) analysis was applied to further investigate the neural mechanisms mediated by the VLPFC during emotion processing. PPI analysis revealed that, compared to low SA controls, participants with high SA exhibited reduced connectivity between the VLPFC and the motor cortex, the inferior parietal and the posterior temporal regions when viewing socially positive (relative to neutral) emotions. Across all participants, VLPFC connectivity correlated with behavioral and self-reported measures of attentional control, emotion management, and reward processing. Our results suggest that impairments to the VLPFC mediated neural circuitry underlie the cognitive and emotional deficits associated with social anhedonia, and may serve as neural targets for prevention and treatment of schizophrenia-spectrum disorders.

Attentional control mediates the relationship between social anhedonia and social impairment

Social anhedonia (SA), a trait-like disinterest in social contact and diminished capacity to experience pleasure from social interactions, is consistently associated with social impairments in both healthy and clinical populations. However, the mechanisms underlying the relationship between SA and social impairment are poorly understood. Attentional control, selecting and focusing on relevant information and inhibiting irrelevant, may be one such mechanism. We examined individual differences in SA, attentional control, and social impairment in 108 healthy adults. High SA related to low attentional control and high social impairment. Moreover, attentional control mediated the relationship between SA and social impairment, establishing attentional control as one mechanism underlying aberrations in the fundamental human need for social contact. Although both attentional deficits and social impairment have been separately noted in SA, the relationship between SA, attentional control and social impairment in this non-clinical sample reflects a novel contribution.

Schizotypal personality disorder: a current review

The study of schizotypal personality disorder (SPD) is important clinically, as it is understudied, challenging to treat, often under-recognized or misdiagnosed, and associated with significant functional impairment. SPD also represents an intermediate schizophrenia-spectrum phenotype, and therefore, can provide a better understanding of the genetics, pathogenesis, and treatment of related psychotic illnesses. In this review we discuss recent findings of SPD related to epidemiology and functional impairment, heritability and genetics, working memory and cognitive impairments, social-affective disturbances, and neurobiology. Additionally, we examine the challenges associated with treating patients with SPD, as well as clinical recommendations. Finally, we address future directions and areas in need of further exploration.

Disrupted-in-schizophrenia-1 Gln31Leu polymorphism results in social anhedonia associated with monoaminergic imbalance and reduction of CREB and β-arrestin-1,2 in the nucleus accumbens in a mouse model of depression

Disrupted-in-schizophrenia-1 (DISC1) is associated with mental disorders, including major depression. We previously showed that DISC1-Q31L mutant mice have depression-like behaviors and can therefore be used to study neurobiological mechanisms of depression and antidepressant (AD) medication action. First, we found reduced levels of dopamine, serotonin and norepinephrine in the nucleus accumbens (NAC) of DISC1-Q31L mutants. Next, we assessed social-conditioned place preference as a reward-dependent task and the capacity of distinct ADs to correct impaired social behavior in DISC1-Q31L mice. Bupropion, but not fluoxetine or desipramine, was able to correct deficient social facilitation, social reward, and social novelty in DISC1-Q31L mutants, whereas all three ADs were able to improve social motivation and behavioral despair in DISC1-Q31L mutants. Furthermore, we sought to correlate social anhedonia with molecular and cellular features including dendritic spine density, β-arrestin-1,2, and cAMP-response-element-binding protein (CREB) in the NAC as biomarkers related to depression and the DISC1 pathway. DISC1-Q31L mutants showed reduced levels of β-arrestin-1,2, CREB, and spine density in the NAC, further supporting the construct validity of the genetic model. Bupropion induced the greatest effect on CREB in DISC1-Q31L mutants, whereas all studied ADs corrected the reduced levels of β-arrestin-1,2 and modestly ameliorated deficient spine density in this brain region. Overall, we find neurobiological changes accompanying social anhedonia in the NAC of DISC1-Q31L mutant mice, consistent with a role for DISC1 in regulating social reward as an endophenotype of depression.

Social networking profile correlates of schizotypy

Social networking sites, such as Facebook, are extremely popular and have become a primary method for socialization and communication. Despite a report of increased use among those on the schizophrenia-spectrum, few details are known about their actual practices. In the current research, undergraduate participants completed measures of schizotypy and personality, and provided access to their Facebook profiles. Information from the profiles were then systematically coded and compared to the questionnaire data. As predicted, social anhedonia (SocAnh) was associated with a decrease in social participation variables, including a decrease in number of friends and number of photos, and an increase in length of time since communication with a friend, but SocAnh was also associated with an increase in profile length. Also, SocAnh was highly correlated with extraversion. Relatedly, extraversion uniquely predicted the number of friends and photos and length of time since communication with a friend. In addition, perceptual aberration/magical ideation (PerMag) was associated with an increased number of "black outs" on Facebook profile print-outs, a measure of paranoia. Overall, results from this naturalistic-like study show that SocAnh and extraversion are associated with decreased social participation and PerMag with increased paranoia related to information on social networking sites.

Neuropsychological functioning and social anhedonia: three-year follow-up data from a longitudinal community high risk study

Social anhedonia is a promising vulnerability marker for schizophrenia-spectrum pathology. Prior research has demonstrated that individuals with psychometrically-defined social anhedonia show a range of "schizophrenia-like" neurocognitive abnormalities. However, this research is limited in that it is based largely on the study of college students. The present article reports findings from a longitudinal study of social anhedonia recruited from a community sample. As part of this study, a neurocognitive battery was administered at baseline and at three-year follow-up sessions to participants with (n = 78) versus without (n = 77) social anhedonia. Additional measures of global functioning and schizotypal, schizoid and paranoid schizophrenia-spectrum symptoms were also administered. Across groups, subjects showed significant improvement in neurocognitive functioning over time. Compared to controls, at follow-up, individuals with social anhedonia showed significantly poorer attentional vigilance and simple processing speed, but failed to evidence impairments in immediate or delayed verbal memory, immediate or delayed visual memory, visual or verbal working memory, olfaction or executive abilities. At follow-up, within the social anhedonia group, schizoid (and to a lesser extent, schizotypal) symptom severity was associated with a range of neurocognitive impairments. Neurocognitive impairments were generally not associated with paranoid symptoms or global functioning. Baseline neurocognitive performance was not significantly predictive of follow-up symptom severity or functioning. Collectively, these findings suggest that neurocognitive dysfunctions only characterize a subset of individuals with social anhedonia.

The challenges of fitting an item response theory model to the Social Anhedonia Scale

This study explored the application of latent variable measurement models to the Social Anhedonia Scale (SAS; Eckblad, Chapman, Chapman, & Mishlove, 1982), a widely used and influential measure in schizophrenia-related research. Specifically, we applied unidimensional and bifactor item response theory (IRT) models to data from a community sample of young adults (n = 2,227). Ordinal factor analyses revealed that identifying a coherent latent structure in the 40-item SAS data was challenging due to (a) the presence of multiple small content clusters (e.g., doublets); (b) modest relations between those clusters, which, in turn, implies a general factor of only modest strength; (c) items that shared little variance with the majority of items; and (d) cross-loadings in bifactor solutions. Consequently, we conclude that SAS responses cannot be modeled accurately by either unidimensional or bifactor IRT models. Although the application of a bifactor model to a reduced 17-item set met with better success, significant psychometric and substantive problems remained. Results highlight the challenges of applying latent variable models to scales that were not originally designed to fit these models.

Is social anhedonia related to emotional responsivity and expressivity? A laboratory study in women

Social anhedonia is an important feature of schizophrenia and it is a promising indicator of schizotypy. Although social anhedonia is defined as an affective construct (less pleasure derived from social encounters), little is known about the emotional responsivity and expressivity of individuals with high levels of social anhedonia. After screening a large sample of female undergraduate students (N = 1 085), a cohort of psychometrically identified individuals with high levels of social anhedonia (n = 34) and normally hedonic controls (n = 45) participated in laboratory assessments involving trait affectivity, self-reported dispositional emotional expressiveness, and the expression and experience of emotion in response to neutral, non-affiliative (i.e., comedy) and affiliative film clips. Results revealed that individuals with high levels of social anhedonia are characterized by lower positive affect, both as a trait and in response to emotionally evocative stimuli, and are less facially expressive, both by their own self-report and in response to film clips. Attenuated positive affect was observed across film stimuli, indicating a general reduction in affective response rather than a specific decrease in responsivity for affiliative stimuli. Future work should continue to investigate whether there is a unique role for social stimuli in the emotional lives of individuals with high levels of social anhedonia or whether these individuals tend to experience anhedonia more broadly regardless of social context.

Developmental instability in social anhedonia: an examination of minor physical anomalies and clinical characteristics

Developmental instability (DI) refers to the inability of the developing brain to buffer the effects of genetic and environmental insults. This concept has been invoked to better understand how fetal brain development goes awry in schizophrenia and related spectrum disorders. This study examined one marker of DI, minor physical anomalies (MPAs), and its association with a putative indicator of schizotypy, the trait of social anhedonia. MPAs and clinical symptoms were assessed within a community sample of psychometrically identified individuals high in social anhedonia and a matched group of healthy controls. Results indicated that, compared to the controls, MPAs were elevated in the social anhedonia group. Additionally, within the social anhedonia group, MPAs were significantly correlated with clinical ratings of schizoid personality disorder characteristics and also showed strong associations with schizotypal personality disorder ratings. These findings indicate a relationship between developmental anomalies and negative schizotypy and suggest that, when combined with psychometrically identified risk, the presence of MPAs may further elevate the probability of clinical manifestations of schizophrenia-spectrum characteristics.