Abstract
Background
Individuals with schizophrenia (SCZ) may have deficits in anticipatory but not consummatory components of pleasure, which are associated with negative symptoms including social anhedonia and reduced social motivation. In contrast, more general hedonic deficits in SCZ may be associated with depression. Much of the research on these distinct components of pleasure has focused on non-social stimuli, with less work on social pleasure. Although lab-based studies on social pleasure suggest that SCZ show deficits in both anticipatory and consummatory components of socialization, SCZ report a normative need for social affiliation as well as greater positive and less negative affect when with others than alone. We examined anticipatory and consummatory pleasure in SCZ in a social context using ecological momentary assessment (EMA), testing the hypotheses that: 1) clinician rated social anhedonia and amotivation are associated with decreases in anticipatory but not consummatory pleasure in daily life; 2) depression is associated with deficits in both anticipatory and consummatory pleasure in daily life; 3) current socialization is associated with both increased current pleasure and increased anticipation of future events.
Methods
Participants SCZ (N=63) were recruited as part of two separate EMA studies. The EMA questionnaire included questions assessing participants’ current socialization (with known others or alone/with strangers), happiness (as a measure of in-the-moment mood), current enjoyment of activities, and anticipated enjoyment, among other questions related to their responses to daily activities. Participants were prompted to complete the EMA survey four times per day for seven days. Clinical assessments of social motivation and social anhedonia using the Clinical Assessment Interview for Negative Symptoms and Beck’s Depression Inventory scores were also obtained in the lab.
Results
Hierarchical linear modeling showed that social anhedonia and social amotivation predicted decreased anticipated enjoyment (social motivation β= -0.228 p =0.016; social anhedonia β= -0.203, p= 0.0287) when accounting for current socialization, but not decreased consummatory enjoyment or happiness. Depression predicted current happiness (β=-0.024, p= 0.0125), current enjoyment (β=-0.020, p= 0.004) and future enjoyment (β= -0.030, p <0.001). However, depression no longer predicted future enjoyment when accounting for current happiness. Both current happiness and current socialization predicted current enjoyment (happiness β= 0.37, p < 0.001; socialization β= 0.098, p= 0.0148). Current happiness also predicted anticipated enjoyment (β= 0.190, p< 0.001), while current socialization did not.
Discussion
Consistent with our hypotheses, the current findings indicated differential relationships of depression and social anhedonia/motivation in SCZ to social consummatory versus anticipatory pleasure. Social amotivation and social anhedonia predicted decreased anticipated but not consummatory (i.e., current) pleasure when accounting for socialization. In contrast, current social experience predicted consummatory but not anticipatory pleasure, contrary to our hypothesis. Further, depression predicted current mood (happiness) and both consummatory and anticipatory pleasure, but the association with anticipatory pleasure was mediated by depression’s relationship to current happiness. These findings extend the work on non-social components of pleasure in SCZ to a social context and provide evidence that broader hedonic deficits are associated with mood, while negative symptoms are more specifically associated deficits in anticipatory pleasure.
Self-Report Measures of Anhedonia and Approach Motivation Weakly Correspond to Anhedonia and Depression Assessed via Clinical Interviews
