Anhedonia

Anhedonia is a key symptom (and often risk factor) for various neuropsychiatric disorders, including depression, schizophrenia, substance use disorders, post-traumatic stress disorders, and Parkinson’s Disease, among others. Across disorders, anhedonia has been associated with worse disease course, including poor response to pharmacological, psychological and neurostimulation treatments as well as completed suicide. Mounting evidence emerging from preclinical and translational sciences has clarified that “anhedonia” can be parsed into partially independent subcomponents, including incentive motivation, consummatory pleasure, reward learning, and effort-based decision making, pointing to distinct neurobiological substrates that could underlie anhedonic phenotypes. Taking an integrative approach that emphasizes cross-species integration and dimensional conceptualization of mental illnesses (e.g., Research Domain Criteria (RDoC)), this book represents the most comprehensive evaluation,synthesis and integration of theories and empirical findings focused on anhedonia.

Organized across five parts, the handbook starts with chapters on the history, etiology, and assessments of anhedonia (Part I), followed by a section on the role of anhedonia in psychiatric and neurological disorders (Part II). Using the RDoC Matrix as a guide, Part III presents chapters synthetizing preclinical and clinical findings on different reward processing subdomains (e.g., reward responsiveness, reward valuation, reward learning). Part IV is focused on selected special topics, including historical and current perspectives on the transdiagnostic nature and importance of social anhedonia, the role of inflammation in the pathophysiology of anhedonia, the use of computational modeling to “dissect” anhedonia and improve its understanding, and links between anhedonia and suicide. Finally, Part V includes chapters on pharmacological, psychological and neurostimulation treatments for anhedonia.

Table of Contents

Part I: Anhedonia – History, Etiology, and Assessments

• Clinical and Preclinical Assessments of Anhedonia in Psychiatric Disorders
• Developmental Trajectories of Anhedonia in Preclinical Models
• Origins of Anhedonia in Childhood and Adolescence
• Understanding Anhedonia from a Genomic Perspective
• Environmental Contributions to Anhedonia

Part II: Anhedonia in Psychiatric and Neurological Disorders

• Anhedonia in Depression and Bipolar Disorder
• Anhedonia in Schizophrenia
• Anhedonia, Hyperkatifeia, and Negative Reinforcement in Substance Use Disorders
• Anhedonia in Nicotine Dependence
• Anhedonia in Posttraumatic Stress Disorder: Prevalence, Phenotypes, and Neural Circuitry
• Anhedonia in Anxiety Disorders
• Anhedonia in Eating Disorders
• Anhedonia and Hyperhedonia in Autism and Related Neurodevelopmental Disorders
• Anhedonia in Neurodegenerative Diseases

Part Ill: Reward Processing Systems in Anhedonia

• Pleasure, Reward Value, Prediction Error and Anhedonia
• Anticipation: An Essential Feature of Anhedonia
• Vigor, Effort-Related Aspects of Motivation and Anhedonia
• Probabilistic Reinforcement Learning and Anhedonia

Part IV: Special Topics

• The Transdiagnostic Nature of Social Anhedonia: Historical and Current Perspectives
• Inflammation as a Pathophysiologic Pathway to Anhedonia: Mechanisms and Therapeutic Implications
• A Computational View on the Nature of Reward and Value in Anhedonia
• Anhedonia and Suicide

Part V: Treatments

• Pharmacological Treatments for Anhedonia
• Psychological Treatments for Anhedonia
• Circuit-Targeted Neuromodulation for Anhedonia

About the Author

Diego A. Pizzagalli, PhD, is founding director of the Center for Depression, Anxiety and Stress Research, director of the McLean Imaging Center, director of the Laboratory for Translational and Affective Neuroscience, and director of research for the Division of Depression and Anxiety Disorders at McLean Hospital, and is a professor of psychiatry at Harvard Medical School. He is an internationally known expert on the neurobiology of depression, and has made major contributions toward the identification of biomarkers of depression and treatment response.