New study reveals connection with anhedonia

An experiment in France found that both healthy and depressive individuals tend to avoid sitting next to visibly angry people, preferring instead to sit beside those who appear happy. However, individuals with depression were less inclined than their healthy counterparts to choose seats next to cheerful people. This inclination was found to correlate with the intensity of their anhedonia symptoms. The study was published in Behavior Research and Therapy.

Depression, also known as major depressive disorder, is a prevalent and severe mental health condition. It manifests as enduring and overwhelming feelings of sadness, despair, and a diminished interest or pleasure in most activities. Those afflicted by this disorder often grapple with a spectrum of physical and emotional symptoms. These can include alterations in sleep patterns and appetite, fatigue, difficulties in concentration, and even thoughts of self-harm or suicide.

Anhedonia, the reduced ability to experience pleasure or interest in activities, is a hallmark symptom of depression. Individuals who exhibit pronounced anhedonia are more prone to suicidal ideation and often respond less positively to treatment. Additionally, they face significant challenges in their social interactions. Scientific research has associated anhedonia with intricate malfunctions in the brain circuits responsible for goal-driven behaviors—actions that prompt individuals to seek rewards and shun punishments.

Julie Grezes, the lead author of the study, and her team aimed to understand the extent to which individuals with depression value engaging with or avoiding others based on their emotional expressions. They also sought to determine the willingness of these individuals to modify their initial reactions when circumstances shift.

The researchers hypothesized that in social contexts, individuals with depression would be less inclined than healthy people to engage with cheerful individuals. Moreover, they posited that those with depression would be less apt to avoid individuals displaying anger. The team also anticipated that depressive individuals would be more resistant to altering their initial reactions.

The study encompassed three distinct participant groups: 24 depressive patients with a history of suicide attempts, 24 depressive patients without such a history, and 24 healthy individuals. The participants had an average age of approximately 36 years. Depressed patients were sourced from both inpatient and outpatient units of the Department of Emergency Psychiatry & Post-Acute Care at Montpellier Academic Hospital in France. The healthy group comprised volunteers who were matched with the depressive cohorts based on age and gender.

Participants completed assessments of depression symptom severity (the Beck Depression Inventory), anhedonia (the Snaith-Hamilton Pleasures Scale), anxiety (the State Trait Spielberger Anxiety Scale), impulsiveness (the BIS/BAS scale), empathy (the Interpersonal Reactivity Index, IRI), mentalizing capacity (the Reflective Functioning Questionnaire,) and childhood trauma (the Childhood Trauma Questionnaire).

Participants also completed a social free-choice task. This task involved viewing images of a waiting area with two seated individuals. Beside each individual was an unoccupied chair. In every image, one person displayed a neutral demeanor, while the other exhibited a neutral, angry, or happy expression. The entire activity comprised 120 distinct images, each showcasing different actor combinations, seating arrangements, and facial expressions. Each participant reviewed these images three times, with the third viewing reversing the response keys, totaling 360 trials.

During the task, participants had 1.5 seconds to view each image and decide which chair they would choose by pressing the corresponding left or right key. Upon key selection, an on-screen cursor moved in the chosen direction. Participants then released the key to finalize their choice.

To gauge the participants’ readiness to rectify undesirable outcomes, in a third of the trials, the researchers inverted the key configurations. This meant that pressing the left key moved the cursor right, and vice versa. The researchers closely observed whether participants would attempt to rectify their choices under these conditions.

The results showed that participants chose to avoid sitting next to persons with angry faces and preferred to sit next to persons with happy faces. The tendency to sit next to a happy looking person was significantly less pronounced in depressive individuals. The strength of this tendency was associated with anhedonia. The stronger anhedonia symptoms were in the individual with depression the less likely that person was to prefer sitting next to a happy-face person.

When analyzing responses during reversed key-binding trials, the data indicated that participants were less likely to change their decisions when their initial choice was desirable than when it was neutral. Healthy participants exhibited a higher propensity to rectify their choices to achieve a favorable outcome compared to those with depression. Moreover, those with intensified anhedonia symptoms showed a lower likelihood of making corrections.

“Our results showed that all participants, whether depressed or not, preferred to approach happy and to avoid angry individuals, but depressed participants approached happy individuals less than controls. Moreover, when after the first choice the response cursor was headed toward the undesirable outcome by approaching angry or avoiding happy individuals, depressed participants were less willing to produce an additional effort (change key press) to correct their initial response, as compared to controls,” the study authors explained.

“Finally, across participants, approach motivation to positive social signals and willingness to expend effort to obtain desirable socio-emotional outcomes were negatively correlated with the severity of anhedonia. Together, these findings convincingly highlight how altered valuation and diminished willingness to exert effort impact approach/avoidance decisions in socio-emotional contexts in depression.”

The study makes a valuable contribution to the scientific understanding of motivational changes in depression. However, it also has limitations that need to be taken into account. Notably, the study sample was very small. It also remains uncertain how much making a choice in a fictive situation presented in a picture corresponds to how a person behaves in real social interactions.

The study, “Depression and approach-avoidance decisions to emotional displays: The role of anhedonia”, was authored by Julie Grezes, Nathan Risch, Philippe Courtet, Emilie Olie, and Rocco Mennella.

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