Anhedonia refers to various deficits in the hedonic function, including reducing the motivation or ability to experience pleasure. While an earlier definition of anhedonia emphasizes the inability to experience pleasure, anhedonia is used by researchers to refer to reduced motivation, decrease anticipatory pleasure ( desire ), reduce pleasure of pleasure ( likes ) , and deficits in strengthening learning. In DSM-V, anhedonia is a component of depressive disorders, substance-related disorders, psychotic disorders, and personality disorders, where it is defined by a reduced ability to experience pleasure, or decreased interest in engaging in enjoyable activities. While ICD-10 does not explicitly mention anhedonia, the symptoms of analogous depression to anhedonia as described in DSM-V are loss of interest or pleasure.
Video Anhedonia
Definisi
While anhedonia was originally defined in 1896 by ThÃÆ' Â © odule-Armand Ribot as a diminished ability to experience pleasure, it has been used to refer to deficits in various aspects of rewards. The re-conceptualization of anhedonia highlights the independence of "want" and "liking". "Wanting" is a component of positive anticipatory influences, mediating both motivation (ie, the importance of incentives) to engage with rewards, as well as positive emotions associated with gift anticipation. "Liking", on the other hand, is associated with the pleasure gained from consuming gifts. Awareness of reward-related processes has also been used to categorize rewards in the context of anhedonia, since studies that compare implicit behavior versus self explicit reports indicate dissociation of both. Learning has also been proposed as an independent aspect of rewards that may be impaired in conditions associated with anhedonia, but empirical evidence that separates learning from "desire" or "desire" is lacking.
Anhedonia has also been used to refer to "affective dulling", "limited effect range", "emotional numbness", and "flat influence", especially in the context of post-traumatic stress disorder. In PTSD patients, the scale measuring these symptoms correlates strongly with a scale that measures aspects of the more traditional anhedonia, which support this association.
Maps Anhedonia
Cause
Studies in clinical populations, healthy populations, and animal models have involved a number of neurobiological substrates in anhedonia. Areas involved in anhedonia include the entire prefrontal cortex, particularly the orbitofrontal cortex (OFC), the striatum, the amygdala, the anterior cingulate cortex (ACC), the hypothalamus, and the ventral tegmental area (VTA). Neuroimaging studies in humans have reported that a deficit in the healing aspect of reward is associated with abnormalities in the ventral striatum and medial prefrontal cortex, while the anticipatory deficit of the rewards is associated with abnormalities in the hippocampal, dorsal ACC and prefrontal regions. This disorder is generally consistent with animal models, except for inconsistent findings related to OFC. This inconsistency may be associated with difficulty in OFC imaging due to its anatomical location, or a small amount of research done on anhedonia; a number of studies have reported reduced activity in OFC in schizophrenia and major depression, as well as a direct relationship between reduced activity and anhedonia. The researchers theorize that anhedonia may result from damage to the brain reward system, which involves dopamine neurotransmitters. Anhedonia can be characterized as "an impaired ability to pursue, experience and/or learn about pleasure, which is often, but not always accessible to consciousness".
The condition of akinetic mutism and negative symptoms are closely related. In akinetic mutism, stroke or other lesions of the anterior cingulate cortex cause decreased motion (akinetik) and speech (mutism).
Genesis
Major depressive disorder
Anhedonia occurs in about 70% of people with major depressive disorder. Anhedonia is the main symptom of major depressive disorder, therefore individuals who experience these symptoms can be diagnosed with depression, even in the absence of low mood/depression. The Diagnostic and Statistical Guidelines for Mental Disorder (DSM) describe "lack of interest or pleasure", but this is difficult to understand given that people tend to be less interested in things that do not give them pleasure. The DSM criteria of weight loss may be related, and many individuals with these symptoms describe the lack of food enjoyment. People suffering from anhedonia in relation to depression generally feel suicidal in the morning and better at night because sleep seems the only way out, resembling death. They can describe non-psychotic symptoms and signs of depression.
Schizophrenia
Anhedonia is usually listed as one component of negative symptoms in schizophrenia. Although five domains are usually used to classify negative symptoms, the questionnaire factor analysis yields two factors, with one including a deficit in pleasure and motivation. People with schizophrenia retrospectively report fewer positive emotions than healthy people. However, "liking" or perfect pleasure is intact in schizophrenics, as they report experiencing the same level of positive influence when presented with useful stimuli. Neuroimaging studies support this behavioral observation, as most studies report an intact response in the reward system (ie ventral striatum, VTA) for simple benefits. However, the study of prize money sometimes reports a reduction in response. More consistent reductions are observed in relation to the emotional response during the anticipation of reward, which is reflected in the reduced response of the cortical and subcortical components of the reward system. Schizophrenia is associated with a reduction in positive predictive error (a normal response pattern of unexpected rewards), which some studies have shown correlate with negative symptoms. Schizophrenia suggests a disruption in strengthening learning tasks only when the task requires explicit learning, or is quite complex. Implicit strengthening learning, on the other hand, is relatively intact. This deficit may be related to dysfunction in ACC, OFC and dlPFC leading to an abnormal representation of rewards and goals.
Anhedonia often occurs in people who depend on various drugs, including alcohol, opioids, and nicotine. Although anhedonia becomes less severe over time, it is a significant predictor of relapse.
Post a traumatic stress disorder
While PTSD is associated with reduced motivation, part of anticipative "desire", it is also associated with increased sensational search, and no deficit in physiological arousal, or self-reported pleasure against positive stimuli. PTSD is also associated with a dull effect, which may be due to high comorbidity with depression.
Parkinson's disease
Anhedonia is common in Parkinson's disease, with rates between 7% -45% reported. Whether anhedonia is associated with high rates of depression in Parkinson's disease is unknown.
Sexual anhedonia
Sexual anhedonia in men is also known as 'anhedonia ejaculation'. This condition means men will experience ejaculation without the pleasure that accompanies it.
This condition is most often found in men, but women can suffer from lack of pleasure when the body goes through the process of orgasm as well.
Sexual anhedonia can be caused by:
- Hyperprolactinemia
- Hypoactive sexual desire disorder (HSDD), also called stunted sexual desire
- Low testosterone levels
- spinal cord injury
- Multiple sclerosis
- Use of SSRI antidepressants
- Use (or prior use) neuroleptic antidopaminergic (anti-psychotic)
- Fatigue
- Physical Illness
It is not uncommon that neurologic examinations and blood tests can determine the cause of certain sexual anhedonia cases.
Patients may be prescribed continuous bupropion to assist in treatment, which has been shown to reduce sexual dysfunction even in patients without depression.
Anhedonia social
Definitions
social Anhedonia is defined as a similar disinterest in social contact and is characterized by social withdrawal and decreased pleasure in social situations. This characteristic usually manifests as indifference to others. Unlike the introversion, the nonpathological dimension of human personality, social anhedonia is a deficit in the ability to experience pleasure. In addition, social anhedonia differs from social anxiety in social anhedonia largely characterized by a decrease in positive influence, while social anxiety is distinguished by both a decrease in positive influence and excessive negative influences. This property is currently seen as a major characteristic, as well as a predictor of schizophrenic spectrum disorder, as seen as a potential evolution of most personality disorders, if patients are over 24 years of age, when prodromal schizophrenia can be excluded.
Signs and symptoms
- Decreased ability to experience interpersonal pleasure
- Withdrawal/social isolation
- Decreased needs for social contact
- Lack of close friends and intercourse, and decreased relationship quality
- Bad social customization
- Reduced positive influence
- Flat influence
- Depressed mood
- Country related anxiety
Social anhedonia is associated with the nature, which means it remains stable throughout life, free from diagnosis, treatment, or remission of symptoms.
Background and preliminary clinical observation
The term anhedonia is derived from the Greek an - , "without" and h? Don? , "fun". His interest in the nature of pleasure and his absence originated from ancient Greek philosophers such as Epicurus. The symptoms of anhedonia were introduced to the world of psychopathology in 1809 by John Haslam, which marked patients suffering from schizophrenia as unconcerned about "objects and pursuits that were previously a source of pleasure and instruction." This concept was formally created by ThÃÆ' Â © odule-Armand Ribot and later used by psychiatrist Paul Eugen Bleuler and Emil Kraepelin to illustrate the core symptoms of schizophrenia. Specifically, Rado postulates that a schizophrenic, or an individual with a schizophrenic phenotype, has two key genetic deficits, associated with the ability to feel pleasure (anhedonia) and associated with proprioception. In 1962, Meehl continued Rado's theory through the introduction of the concept of schizotaxia, a genetically driven neural integrative deformity that is thought to give rise to a schizotypy personality type. Loren and Jean Chapman further distinguish between two types of anhedonia: physical anhedonia, or deficits in the ability to experience physical pleasure, and social, or deficit in the ability to experience interpersonal pleasure.
Recent research has shown that social anhedonia may represent a prodrome of psychotic disorders. Individual first-degree relatives with schizophrenia exhibit increased levels of social anhedonia, higher baseline scores of social anhedonia are associated with later schizophrenic developments. These findings provide support for the allegation that it is a marker of genetic risk for schizophrenic-spectrum disorders.
In addition, elevated levels of social anhedonia in patients with schizophrenia have been associated with worse social function. Socially anhedonic individuals had poorer performance on a number of neuropsychological tests than non-anhedonic participants, and showed similar physiologic abnormalities seen in patients with schizophrenia.
Comorbidity
Anhedonia is present in some form of psychopathology. However, social anhedonia is not a necessary symptom of symptoms for any disorder. Social anhedonia manifests equally in a variety of different mental illnesses, but for different reasons. Most often, social anhedonia is associated with schizophrenia disorder and schizophrenia spectrum (including schizotypal personality disorder, paranoid personality disorder, and schizoid personality disorder). Social anhedonia has also been implicated in other psychological disorders:
Depression
Social anhedonia is observed both in depression and schizophrenia. However, social anhedonia is a state associated with episodes of depression and the other is the nature associated with personality constructs associated with schizophrenia. These individuals tend to score high on the steps of self-reporting of social anhedonia. Blanchard, Horan, and Brown (2001) suggest that, although both depression and the group of schizophrenic patients may look very similar in terms of cross-sectional social anhedonia, over time as individuals with depression experience remission of symptoms, they show fewer social signs. anhedonia, while individuals with schizophrenia do not. Blanchard and colleagues (2011) found individuals with social anhedonia also had elevated levels of lifetime mood disorders including depression and dysthymia compared with controls.
Social anxiety
As mentioned above, social anxiety and social anhedonia differ in important matters. However, social anhedonia and social anxiety are also often comorbid to each other. People with social anhedonia may show increased social anxiety and are at increased risk for social phobia and generalized anxiety disorders. It has not been determined what is the exact relationship between social anhedonia and social anxiety, and if one potentiates the other. Individuals with social anhedonia may exhibit increased stress reactivity, which means that they feel more overwhelmed or helpless in response to a stressful event compared to control subjects experiencing the same type of stress. This dysfunctional stress reactivity may be correlated with hedonic capacity, providing a potential explanation for the improvement of anxiety symptoms experienced in people with social anhedonia. In an attempt to separate social anhedonia from social anxiety, the Social Revision Anhedonia Scale excludes items potentially targeting social anxiety. However, further research should be conducted on the underlying mechanisms in which social anhedonia overlaps and interacts with social anxiety. The RDoC "social process" initiative effort will be important in distinguishing between the social behavioral components that underlie mental illness such as schizophrenia.
The major relevance to schizophrenia and spectrum schizophrenia disorder
Social anhedonia is a major characteristic of schizotypy, defined as a continuum of personality traits that can range from normal to disorder and contribute to the risk of psychosis and schizophrenia. Social anhedonia is a negative and positive schizotypy dimension. It involves social and interpersonal deficits, but is also associated with cognitive slippage and disorganized speech, both of which fall into the positive schizotypy category. Not everyone with schizophrenia displays social anhedonia and also, people who have social anhedonia can never be diagnosed with schizophrenia-spectrum disorder if they do not have the positive and cognitive symptoms most often associated with most schizophrenic-spectrum disorders.
Social anhedonia may be a valid predictor for future schizophrenic-spectrum disorders; Young adults with social anhedonia perform in the same direction as schizophrenic patients in tests of cognition and social behavior, indicating potential predictive validity. Social anhedonia usually manifests in adolescence, perhaps due to a combination of critical neuronal development and synaptic pruning of the brain region that is essential for social behavior and environmental change, as adolescents are in the process of becoming individuals and gaining more freedom.
Treatment
No treatment is validated for social anhedonia. Future research should focus on genetic and environmental risk factors for homes in certain brain regions and neurotransmitters that may be involved in the cause of social anhedonia and can be targeted with treatment or behavioral care. Social support can also play a valuable role in the treatment of social anhedonia. Blanchard et al. (2011) found that the greater amount of social support, as well as the perceived social support network, was associated with fewer schizophrenia-spectrum symptoms and better general function in the social anhedonia group. So far, no drug has been developed specifically to target anhedonia.
Gender differences
In the general population, males score higher than women on the size of social anhedonia. This gender difference is stable over time (from adolescence to adulthood) and is also seen in people with schizophrenic-spectrum disorders. These results may reflect a wider pattern of interpersonal and social deficits seen in schizophrenic-spectrum disorders. On average, men with schizophrenia are diagnosed at a younger age, have more severe symptoms, a poorer prognosis of care, and a decline in overall quality of life compared to women with the disorder. These results, coupled with sex differences seen in social anhedonia, outline the need for research on different genetic and hormonal characteristics between men and women, and that may increase the risk or resilience for mental illness such as schizophrenia.
There are several psychometric measurements of self-report schizotypy each containing subscripts related to social anhedonia:
- Revision of Social Anhedonia Scale - Chapman Psychosis Loyalty Level
- No Friends Near Subscale - Schizotypyal Personality Questionnaire
- Introvert Anhedonia Subscale - Oxford Liverpool Inventory of Feelings & amp; Experience
Genetic component
L.J. and J.P. Chapman is the first to discuss the possibility that social anhedonia may stem from genetic susceptibility. Disturbed genes in Schizophrenia 1 (DISC1) are consistently associated with risk, and causes, schizophrenia-spectrum disorders and other mental illnesses. More recently, DISC1 has been associated with social anhedonia in the general population. Tomppo (2009) identifies a particular DISC1 allele associated with an elevated characteristic of social anhedonia. They also identified the DISC1 allele associated with decreased characteristics of social anhedonia, which were found to be exclusively expressed in women. More research needs to be done, but social anhedonia may be an important intermediate phenotype (endophenotype) between genes associated with schizophrenia risk and phenotype abnormalities. Further studies of social anhedonia and its genetic component will help researchers and doctors to learn more about the causes of schizophrenic-spectrum disorders.
Neurobiological correlation
Researchers who study neurobiology of social anhedonia argue that this trait may be related to gift-related system dysfunction in the brain. This circuit is very important for the sensation of pleasure, the calculation of benefits and prize costs, determining the effort needed to get a stimulus that is fun, deciding to get the stimulus, and increase motivation to get the stimulus. In particular, ventral striatum and the prefrontal cortex area (PFC), including orbitofrontal cortex (OFC) and dorsolateral (dl) PFC, are critically involved in the pleasure experience and hedonistic perception of rewards. With regard to the neurotransmitter system, opioids, gamma-aminobutyric acid and endocannabinoid systems in the nucleus accumbens, ventral pallidum, and OFC mediate the hedonic perception of appreciation. Activities in PFC and ventral striatum have been found to decrease in anhedonic individuals with Major Depressive Disorder (MDD) and schizophrenia. However, schizophrenia may be less associated with decreased hedonic capacity and more with less appraisal rewards.
Anhagon special musical
Recent studies have found people who have no problem processing tones or music beats, but not receiving the pleasure of listening to music. Anhedonia special music is different from melophobia, fears of music.
See also
- Avolition
- Clinical depression
- Dysthymia
- Schizophrenia
References
External links
directory
- Anhedonia - Gipsy Disorder Bipolar
- Tidak Pleasure, No Reward
Source of the article : Wikipedia
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