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A new perspective on anhedonia in schizophrenia
Gregory P Strauss1, James M Gold
1Department of Psychiatry and the Mary land Psychiatric Research Center, Unive rsity of Mary land School of Medicine, Baltimore, USA. gstrauss@mprc.umaryland.edu
The American Journal of Psychiatry
|March 13, 2012
Summary
Anhedonia in schizophrenia is not a lack of pleasure but rather beliefs about low pleasure, particularly when recalling past feelings. This impacts understanding and treatment of schizophrenia.
Area of Science:
- Psychiatry
- Affective Science
- Cognitive Neuroscience
Background:
- Schizophrenia patients report current positive emotions similarly to healthy individuals, but lower noncurrent positive emotions, creating an "emotion paradox."
- This paradox complicates the understanding of anhedonia in schizophrenia, which is often viewed as a deficit in experiencing pleasure.
Purpose of the Study:
- To resolve the "emotion paradox" in schizophrenia by re-conceptualizing anhedonia.
- To propose a new psychological understanding of anhedonia in schizophrenia based on emotional self-report.
Main Methods:
- A review of empirical literature on anhedonia and emotional experience in schizophrenia.
- Application of the accessibility model of emotional self-report to analyze discrepancies in patient reporting.
Main Results:
- Cognitive impairments in schizophrenia may influence the reporting of noncurrent feelings.
- Anhedonia in schizophrenia is linked to beliefs about low pleasure, not an experiential deficit.
Conclusions:
- Anhedonia in schizophrenia is redefined as beliefs about low pleasure, surfacing during noncurrent emotional recall.
- Encoding and retrieval processes may perpetuate these beliefs, irrespective of actual experiences.
- This reconceptualization has implications for assessing and treating anhedonia in schizophrenia.
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