Disentangling Anhedonia and Self-Stigma in Schizophrenia Using Bayesian Network Analysis

The interrelationships among the negative symptoms of schizophrenia and factors affecting quality of life remain unclear. To address this gap, the present study explores the complex interrelationships among anhedonia, self-stigma, self-esteem, psychological resilience, and social support in individuals with schizophrenia.

A comprehensive battery of measures was used to assess 447 patients with schizophrenia. Undirected network analysis was employed to examine the centrality of various factors, and Bayesian network analysis was used to explore the indirect influence of upstream variables on anhedonia through psychological factors.

Self-stigma was identified as the most central factor. Among the subdimensions of anhedonia, abstract anticipatory pleasure and contextual consummatory pleasure demonstrated the highest centrality. Negative symptoms of schizophrenia and social support were found to indirectly influence different aspects of anhedonia through psychological factors such as self-esteem and resilience. In one of the identified pathways, social support influenced psychological resilience, which in turn affected abstract anticipatory pleasure, contextual consummatory pleasure, and contextual anticipatory pleasure.

Our findings suggest that social support is associated with pleasure experiences partly through psychological resilience and underscore the potential mediating role of psychological factors in linking clinical symptoms, social resources, and hedonic capacity in schizophrenia.