Gard David E, Kring Ann M, Gard Marja Germans, Horan William P, Green Michael F
Department of Psychology, San Francisco State University, 1600 Holloway Avenue, San Francisco, CA, 94132-4168, United States.
Schizophr Res. 2007 Jul;93(1-3):253-60. doi: 10.1016/j.schres.2007.03.008. Epub 2007 May 9.
Research on anhedonia in schizophrenia has revealed mixed results, with patients reporting greater anhedonia than healthy controls on self-report measures and semi-structured interviews, but also reporting comparable experiences of positive emotions in response to pleasurable stimuli. Basic science points to the importance of distinguishing between anticipatory and consummatory (or in-the-moment) pleasure experiences, and this distinction may help to reconcile the mixed findings on anhedonia in schizophrenia. In two studies, we tested the hypothesis that anhedonia in schizophrenia reflects a deficit in anticipatory pleasure but not consummatory pleasure. In Study 1, we used experience sampling methodology to assess reported experiences of consummatory and anticipated pleasure among schizophrenia patients and controls. In Study 2, schizophrenia patients and controls completed a self-report trait measure of anticipatory and consummatory pleasure and interviews that assessed negative symptoms, including anhedonia, and community functioning. In both studies, we found evidence for an anticipatory but not a consummatory pleasure deficit in schizophrenia. In addition, anticipatory pleasure was related to clinical ratings of anhedonia and functional outcome. Clinical and research implications of these findings are discussed.
对精神分裂症中快感缺失的研究结果不一，患者在自我报告测量和半结构化访谈中报告的快感缺失程度高于健康对照组，但在对愉悦刺激的反应中报告的积极情绪体验却相当。基础科学指出区分预期性愉悦体验和满足性（或即时性）愉悦体验的重要性，这种区分可能有助于调和精神分裂症中快感缺失的混合研究结果。在两项研究中，我们检验了以下假设：精神分裂症中的快感缺失反映了预期性愉悦的缺陷，而非满足性愉悦的缺陷。在研究1中，我们使用经验抽样法评估精神分裂症患者和对照组报告的满足性和预期性愉悦体验。在研究2中，精神分裂症患者和对照组完成了一份关于预期性和满足性愉悦的自我报告特质测量，以及评估包括快感缺失在内的阴性症状和社区功能的访谈。在两项研究中，我们都发现了精神分裂症存在预期性而非满足性愉悦缺陷的证据。此外，预期性愉悦与快感缺失的临床评分和功能结果相关。我们讨论了这些发现的临床和研究意义。
