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J Psychiatr Res. 2019 Feb;109:202-213. doi: 10.1016/j.jpsychires.2018.11.029. Epub 2018 Dec 1.

Contrasting contributions of anhedonia to obsessive-compulsive, hoarding, and post-traumatic stress disorders.

Author information

1
Section of Comparative Medicine, Yale School of Medicine, New Haven, CT, 06510, USA; Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA. Electronic address: helen.pushkarskaya@yale.edu.
2
Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA.
3
Section of Comparative Medicine, Yale School of Medicine, New Haven, CT, 06510, USA.
4
Department of Psychology, Yale University, New Haven, CT, 06510, USA; Anxiety Disorders Center, Institute of Living, Hartford Hospital, Hartford, CT, 06114, USA.
5
Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA; National Institute on Alcohol Abuse and Alcoholism (NIAAA) Center for the Translational Neuroscience of Alcoholism (CTNA), Yale University, New Haven, CT, 06519, USA; Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, Department of Psychiatry, Yale University, New Haven, CT, 06519, USA.
6
Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA; Olin Neuropsychiatry Research Center, Institute of Living, Hartford Hospital, Hartford, CT, 06114, USA.
7
Section of Comparative Medicine, Yale School of Medicine, New Haven, CT, 06510, USA; Department of Neurobiology, Yale School of Medicine, New Haven, CT, 06510, USA.
8
Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA; National Center for PTSD, VA Connecticut Healthcare System and Yale Department of Psychiatry, USA.
9
Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA; Department of Psychology, Yale University, New Haven, CT, 06510, USA; Child Study Center, Yale School of Medicine, New Haven, CT, 06510, USA.

Abstract

Anhedonia is a transdiagnostic construct that can occur independent of other symptoms of depression; its role in neuropsychiatric disorders that are not primarily affective, such as obsessive compulsive disorder (OCD), hoarding disorder (HD), and post-traumatic stress disorder (PTSD) has received limited attention. This paper addresses this gap. First, the data revealed a positive contribution of anhedonia, beyond the effects of general depression, to symptom severity in OCD but not in HD or PTSD. Second, anhedonia was operationalized as a reduced sensitivity to rewards, which allowed employing the value based decision making framework to investigate effects of anhedonia on reward-related behavioral outcomes, such as increased risk aversion and increased difficulty of making value-based choices. Both self-report and behavior-based measures were used to characterize individual risk aversion: risk perception and risk-taking propensities (measured using the Domain Specific Risk Taking scale) and risk attitudes evaluated using a gambling task. Data revealed the positive theoretically predicted correlation between anhedonia and risk perception in OCD; effects on self-reported risk taking and behavior-based risk aversion were non-significant. The same relations were weaker in HD and absent in PTSD. Response time during a gambling task, an index of difficulty of making value-based choices, significantly correlated with anhedonia in individuals with OCD and individuals with HD, even after controlling for general depression, but not in individuals with PTSD. The results suggest a unique contribution of one aspect of anhedonia in obsessive-compulsive disorder and confirm the importance of investigating the role of anhedonia transdiagnostically beyond affective and psychotic disorders.

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