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Anhedonia in Trauma Related Disorders: The Good, the Bad, and the Shut-Down

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Anhedonia: A Comprehensive Handbook Volume II

Abstract

The present chapter reviews the evidence for anhedonia in trauma-related disorders. Clinical observations and empirical evidence are presented as arguments for distinguishing between two clinical presentations of anhedonia in trauma-related disorders: (1) Hedonic Deficit, defined as an inability to experience positive affect, and (2) Negative Affective Interference, defined as the experience of negative emotions in situations that normally would be considered positive. We situate these two forms of anhedonia within existing models of affective experience, suggest ways in which this formulation may be tested empirically, and argue for the clinical relevance of increasing understanding of positive affect intolerance in trauma-related disorders.

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Abbreviations

BPD:

Borderline Personality Disorder

ERP-R:

Emotion Regulation Profile-Revised

FCPCS:

Fawcet Clark Pleasure Capacity Scale

HD:

Hedonic Deficit

HDIS:

Hedonic Deficit and Interference Scale

NAI:

Negative Affective Interference

PE:

Positive Emotionality

PTSD:

Posttraumatic Stress Disorder

SHAPS:

Snaith-Hamilton Pleasure Scale

References

  1. Frewen PA, Dean JA, Lanius RA. Assessment of anhedonia in psychological trauma: development of the Hedonic Deficit and Interference Scale. Eur J Psychotraumatol. 2012;3:8585.

    Google Scholar 

  2. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Washington, DC: Authors; 2013.

    Google Scholar 

  3. Kashdan TB, Elhai JD, Frueh BC. Anhedonia and emotional numbing in combat veterans with PTSD. Behav Res Ther. 2006;44:457–67.

    Article  PubMed  Google Scholar 

  4. Kashdan TB, Elhai JD, Frueh BC. Anhedonia, emotional numbing, and symptom overreporting in male veterans with PTSD. Pers Individ Differ. 2007;43:725–35.

    Article  Google Scholar 

  5. Feeny NC, Zoellner LA, Fitzgibbons LA, Foa EB. Exploring the roles of emotional numbing, depression, and dissociation in PTSD. J Trauma Stress. 2000;13:489–98.

    Article  CAS  PubMed  Google Scholar 

  6. Dowd EC, Barch DM. Anhedonia and emotional experience in schizophrenia: neural and behavioral indicators. Biol Psychiatry. 2010;67:902–11.

    Article  PubMed Central  PubMed  Google Scholar 

  7. Buck B, Lysaker PH. Anhedonia in schizophrenia: a brief history and overview of the construct. In: Ritsner MS, editor. Anhedonia: a comprehensive handbook, vol 2. Neuropsychiatric and physical disorders. Dordrecht: Springer; 2013.

    Google Scholar 

  8. Treadway MT, Zald DH. Reconsidering anhedonia in depression: lessons from translational neuroscience. Neurosci Biobehav Rev. 2011;35:537–55.

    Article  PubMed Central  PubMed  Google Scholar 

  9. McCabe C. Neural correlates of anhedonia as a trait marker for depression. In: Ritsner MS, editor. Anhedonia: a comprehensive handbook, vol 2. Neuropsychiatric and physical disorders. Dordrecht: Springer; 2013.

    Google Scholar 

  10. Spahic-Mihajlovic A, Crayton JW, Neafsey EJ. Selective numbing and hyperarousal in male and female Bosnian refugees with PTSD. J Anxiety Disord. 2005;19:383–402.

    Article  PubMed  Google Scholar 

  11. Elman I, Ariely D, Mazar N, et al. Probing reward function in post-traumatic stress disorder with beautiful facial images. Psychiatry Res. 2005;135:179–83.

    Article  PubMed  Google Scholar 

  12. Hopper JW, Pitman RK, Su Z, et al. Probing reward function in posttraumatic stress disorder: expectancy and satisfaction with monetary gains and losses. J Psychiatr Res. 2008;42:802–7.

    Article  PubMed Central  PubMed  Google Scholar 

  13. Elman I, Lowen S, Frederick BB, et al. Functional neuroimaging of reward circuitry responsivity to monetary gains and losses in posttraumatic stress disorder. Biol Psychiatry. 2009;66:1083–90.

    Article  PubMed  Google Scholar 

  14. Jatzko A, Schmitt A, Demirakca T, et al. Disturbance in the neural circuitry underlying positive emotional processing in post–traumatic stress disorder (PTSD). Eur Arch Psychiatry Clin Neurosci. 2006;256:112–4.

    Article  PubMed  Google Scholar 

  15. Meehl PE. Hedonic capacity: some conjectures. Bull Menninger Clin. 1975;39:295–307.

    CAS  PubMed  Google Scholar 

  16. Nelis D, Quoidbach J, Hansenne M. Measuring individual differences in emotion regulation: the emotion regulation profile-revised (ERP-R). Psychol Belg. 2011;51:49–91.

    Article  Google Scholar 

  17. Quoidbach J, Berry EV, Hansenne M, Mikolajczak M. Positive emotion regulation and well- being: comparing the impact of eight savoring and dampening strategies. Pers Individ Differ. 2010;49:368–73.

    Article  Google Scholar 

  18. Orsillo SM, Batten SV, Plumb JC, et al. An experimental study of emotional responding in women with posttraumatic stress disorder related to interpersonal violence. J Trauma Stress. 2004;17:241–8.

    Article  PubMed  Google Scholar 

  19. Frewen PA, Dozois DJA, Neufeld RWJ, et al. Social emotions and emotional valence during imagery in women with PTSD: affective and neural correlates. Psychol Trauma Theory Res Pract Policy. 2010;2:145–57.

    Article  Google Scholar 

  20. Armony JL, Corbo V, Clément M-H, Brunet A. Amygdala response in patients with acute PTSD to masked and unmasked emotional facial expressions. Am J Psychiatry. 2005;162:1961–3.

    Article  PubMed  Google Scholar 

  21. Frewen PA, Dozois DJA, Lanius RA. Assessment of anhedonia in psychological trauma: psychometric and neuroimaging perspectives. Eur J Psychotraumatol. 2012;3:8587.

    Google Scholar 

  22. Fawcett J, Clark DC, Scheftner WA, Gibbons RD. Assessing anhedonia in psychiatric patients: the pleasure scale. Arch Gen Psychiatry. 1983;40:79–84.

    Article  CAS  PubMed  Google Scholar 

  23. Schacter DL, Addis DR. On the nature of medial temporal lobe contributions to the constructive simulation of future events. Philos Trans R Soc B Biol Sci. 2009;364:1245–53.

    Article  Google Scholar 

  24. Strick PL, Dum RP, Fiez JA. Cerebellum and nonmotor function. Annu Rev Neurosci. 2009;32:413–34.

    Article  CAS  PubMed  Google Scholar 

  25. Scholz J, Triantafyllou C, Whitfield-Gabrieli S, et al. Distinct regions of right temporo-parietal junction are selective for theory of mind and exogenous attention. PLoS One. 2009;4:e4869.

    Article  PubMed Central  PubMed  Google Scholar 

  26. Snaith RP, Hamilton M, Morley S, et al. A scale for the assessment of hedonic tone: the Snaith-Hamilton Pleasure Scale. Br J Psychiatry. 1995;167:99–103.

    Article  CAS  PubMed  Google Scholar 

  27. Frewen PA, Lanius RA. Healing the traumatized self: consciousness, neuroscience, treatment. New York: Norton Publishing Company; 2013.

    Google Scholar 

  28. Russell JA. A circumplex model of affect. J Pers Soc Psychol. 1980;39:1161–78.

    Article  Google Scholar 

  29. Yik M, Russell JA, Steiger JH. A 12-point circumplex structure of core affect. Emotion. 2011;11:705–31.

    Article  PubMed  Google Scholar 

  30. Weems CF, Saltzman KM, Reiss AL, Carrlon VG. A prospective test of the association between hyperarousal and emotional numbing in youth with a history of traumatic stress. J Clin Child Adolesc Psychol. 2003;32:166–71.

    Article  PubMed  Google Scholar 

  31. van der Kolk BA. The compulsion to repeat the trauma: re-enactment, revictimization, and masochism. Psychiatr Clin N Am. 1989;12:389–411.

    Google Scholar 

  32. Young JE, Klosko JS, Weishaar ME. Schema therapy: a practitioner’s guide. New York: Guilford Press; 2003.

    Google Scholar 

  33. Kellogg SH, Young JE. Schema therapy for borderline personality disorder. J Clin Psychol. 2006;62:445–58.

    Article  PubMed  Google Scholar 

  34. Cooper AB, Guynn RW. Transcription of fragments of lectures in 1948 by Harry Stack Sullivan. Psychiatry Interpers Biol Process. 2006;69:101–6.

    Article  Google Scholar 

  35. Hoffmann SG, Grossman P, Hinton DE. Loving-kindness and compassion meditation: potential for psychological interventions. Clin Psychol Rev. 2011;31:1126–32.

    Article  Google Scholar 

  36. Frewen PA, Allen SA, Lanius RA, Neufeld RWJ. Measuring perceived symptom causal relations: examination with posttraumatic stress, depression, and anxiety symptomatology. Assessment. 2012;19:480–93.

    Article  PubMed  Google Scholar 

  37. Frewen PA, Schmittman VD, Bringann LF, Borsboom D. Perceived causal relations between anxiety, posttraumatic stress and depression: extension to moderation, mediation, and network analysis. Eur J Psychotraumatol. 2013;4:20656.

    Google Scholar 

  38. Lanius RA, Vermetten E, Loewenstein RJ, Brand B, Schmahl C, Bremner JD, Spiegel D. Emotion modulation in PTSD: clinical and neurobiological evidence for a dissociative subtype. Am J Psychiatry. 2010;167:640–7.

    Article  PubMed Central  PubMed  Google Scholar 

  39. Lanius RA, Brand B, Vermetten E, Frewen PA, Spiegel D. The dissociative subtype of posttraumatic stress disorder: rationale, clinical and neurobiological evidence, and implications. Depress Anxiety. 2012;29:701–8.

    Article  PubMed  Google Scholar 

  40. Marissen MA, Arnold N, Franken IH. Anhedonia in borderline personality disorder and its relation to symptoms of impulsivity. Psychopathology. 2012;45:179–84.

    Article  PubMed  Google Scholar 

  41. Nock M, Prinstein MJ. Contextual features and behavioral functions of self-mutilation among adolescents. J Abnorm Psychol. 2005;114:140–6.

    Article  PubMed  Google Scholar 

  42. Nock M, Mendes WB. Physiological arousal, distress tolerance, and social problem solving deficits among adolescent self-injurers. J Consult Clin Psychol. 2008;76:28–38.

    Article  PubMed  Google Scholar 

  43. Pole N. The psychophysiology of posttraumatic stress disorder: a meta-analysis. Psychol Bull. 2007;133:725–46.

    Article  PubMed  Google Scholar 

  44. Miller MW, Litz BT. Emotional-processing in posttraumatic stress disorder II: startle reflex modulation during picture processing. J Abnorm Psychol. 2004;113:451–63.

    Article  PubMed  Google Scholar 

  45. Bradley MM, Codispoti M, Cuthbert BN, Lang PJ. Emotion and motivation I: defensive and appetitive reactions in picture processing. Emotion. 2001;3:276–98.

    Article  Google Scholar 

  46. Limberg A, Barnow S, Freyberger HJ, Hamm AO. Emotional vulnerability in borderline personality disorder is cue specific and modulated by traumatization. Biol Psychiatry. 2011;69:574–82.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Psychology (Clinical), The New School for Social Research, 80 Fifth Ave (7th Floor), 10011, NY, New York, USA

    Jonathan M. DePierro & Wendy D’Andrea

  2. Department of Psychiatry, The University of Western Ontario, University Hospital (Rm A10-222), London, ON, Canada

    Paul Frewen Ph.D., C.Psych.

  3. Department of Psychology, The University of Western Ontario, London, ON, Canada

    Paul Frewen Ph.D., C.Psych.

Authors
  1. Jonathan M. DePierro
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  2. Wendy D’Andrea
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  3. Paul Frewen Ph.D., C.Psych.
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Corresponding author

Correspondence to Paul Frewen Ph.D., C.Psych. .

Editor information

Editors and Affiliations

  1. Haifa & Sha'ar Menashe Mental Health Center, Israel Institute of Technology, Hadera, Israel

    Michael S. Ritsner

Appendix: Hedonic Deficit & Interference Scale (HDIS)

Appendix: Hedonic Deficit & Interference Scale (HDIS)

Please answer each question in terms of how true or frequent it has been of your experience over the past month. When answering each question, please give a number from 0 (zero) to 10 (ten), where “0” indicates the statement has been “Not At All or Never True”, “5” indicates the statement has been “Moderately True or Moderately Frequent”, and “10” indicates the statement has been “Completely True or Very Frequent” (Always or Almost Always the Case) of your experience over the past month. There are no right or wrong answers.

The first set of questions ask about how often you have experienced different positive emotions and positive feelings over the past month. Over the past month , would you say that you have experienced…

  1. 1.

    … feelings of true happiness, cheerfulness, and joy? _____

  2. 2.

    … feelings of physical or sensory enjoyment, like pleasure, euphoria, and ‘bliss’? _____

  3. 3.

    … feelings of interest, enthusiasm, and excitement? _____

  4. 4.

    … pleasant and serene feelings like relaxation and peacefulness? _____

  5. 5.

    … feelings of inner contentment, self-esteem, and pride? _____

The next set of questions ask to what extent you think you CAN’T, that is, you are NOT able to experience positive feelings in general.

Would you say that you can’t (you are not able to ) experience… even when you try, and even when good things in your life happen? (Remember: 0 indicates this is NOT TRUE, that you CAN experience positive feelings, and 10 indicates this IS TRUE, you CAN'T experience positive feelings)

  1. 6.

    feelings of true happiness, cheerfulness, and joy, …? _____

  2. 7.

    feelings of physical or sensory enjoyment, like pleasure, euphoria, and ‘bliss’, …? _____

  3. 8.

    feelings of interest, enthusiasm, and excitement, …? _____

  4. 9.

    pleasant and serene feelings like relaxation and peacefulness, …? _____

  5. 10.

    feelings of inner contentment, self-esteem and pride, …? _____

For some people, negative feelings tend to get in the way of their experiencing positive feelings. For these people, when something positive happens in their life, they tend to experience negative feelings. The next set of questions ask about the extent to which you experience various negative feelings when positive events happen in your life. When positive events happen in your life: (examples of positive events include social praise, getting a reward or gift, or physical/sensory pleasures like taking a bath, walking on the beach)…

  1. 11.

    do you feel ‘numb’, like you can’t feel emotions and feelings? _____

  2. 12.

    do you feel ‘out-of-touch’ with your emotional response, as if you are detached, separated, or disconnected from your feelings? _____

  3. 13.

    do you experience anxiety (nervousness, agitation)? _____

  4. 14.

    do you experience fear or panic? _____

  5. 15.

    do you experience guilt (for example, wondering if you are worthy or deserving of)? _____

  6. 16.

    do you experience self-criticalness? (for example, clearly feeling unworthy, undeserving of)? _____

  7. 17.

    do you experience shame and humiliation? _____

  8. 18.

    do you experience disgust (strong aversion, ‘grossness’, like feeling ‘sick to your stomach’)? _____

  9. 19.

    do you feel emotional emptiness, or feel empty inside? _____

  10. 20.

    do you feel lifeless inside, as if there’s nothing positive there to feel? _____

  11. 21.

    do you purposely attempt to suppress positive emotions and feelings? (trying to ‘stop’, ‘push away’, ‘turn off’, ‘not feel’, ‘distance yourself from’ positive feelings, e.g., by distracting yourself, denying what is happening, or controlling your feelings)? _____

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DePierro, J.M., D’Andrea, W., Frewen, P. (2014). Anhedonia in Trauma Related Disorders: The Good, the Bad, and the Shut-Down. In: Ritsner, M. (eds) Anhedonia: A Comprehensive Handbook Volume II. Springer, Dordrecht. https://doi.org/10.1007/978-94-017-8610-2_7

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  • DOI: https://doi.org/10.1007/978-94-017-8610-2_7

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  • Publisher Name: Springer, Dordrecht

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  • Online ISBN: 978-94-017-8610-2

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