Department of Psychiatry, University of Western Ontario, London, Ontario, Canada.
Eur J Psychotraumatol. 2012;3. doi: 10.3402/ejpt.v3i0.8587. Epub 2012 Jan 11.
Symptoms of anhedonia, or deficits in the ability to experience positive affect, are increasingly recognized as an outcome of traumatic stress including in individuals with PTSD. However, little research has investigated negative affective responses to what would normally be considered pleasant events (e.g., receiving a compliment or gift, physical affection) in traumatized persons. We demonstrate not only self-reported decreased positive affect but also increased negative affect in response to positive events in 55 women with PTSD, in comparison with 35 women without PTSD, via their response to a Hedonic Deficit & Interference Scale (HDIS). The HDIS demonstrated strong internal validity, convergent and incremental validity relative to other measures of anhedonia, and discriminant validity in relation to depression versus anxiety symptoms in this sample. In addition, in response to imagery of social versus non-social positive events, HDIS scores predicted self-report positive and negative affective responses. In a sub-sample of participants completing the imagery task while undergoing fMRI (n=12), HDIS scores also predicted BOLD response within the left orbitofrontal cortex, ventromedial prefrontal cortex, amygdala, and cerebellum. Future research and clinical directions are discussed.
快感缺失的症状，或体验积极情绪的能力缺陷，越来越被认为是创伤后应激的结果，包括 PTSD 患者。然而，很少有研究调查创伤后个体对通常被认为是愉快事件（例如，收到赞美或礼物、身体接触）的负面情绪反应。我们通过他们对快乐缺陷和干扰量表（HDIS）的反应，不仅证明了 PTSD 女性（55 名）报告的积极情绪减少，而且对积极事件的负面情绪增加，与没有 PTSD 的女性（35 名）相比。HDIS 表现出很强的内部有效性、相对于其他快感缺失测量方法的收敛有效性和增量有效性，以及相对于该样本中抑郁与焦虑症状的区分有效性。此外，在对社会与非社会积极事件的意象进行反应时，HDIS 分数预测了自我报告的积极和消极情感反应。在完成 fMRI 任务的参与者子样本中（n=12），HDIS 分数也预测了左眶额皮质、腹内侧前额皮质、杏仁核和小脑的大脑 BOLD 反应。未来的研究和临床方向进行了讨论。
