Nakonezny Paul A, Morris David W, Greer Tracy L, Byerly Matthew J, Carmody Thomas J, Grannemann Bruce D, Bernstein Ira H, Trivedi Madhukar H
Department of Clinical Sciences, Division of Biostatistics, The University of Texas Southwestern Medical Center, Dallas, TX, USA.
Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX, USA.
J Psychiatr Res. 2015 Jun;65:124-30. doi: 10.1016/j.jpsychires.2015.03.010. Epub 2015 Mar 21.
Anhedonia or inability to experience pleasure not only is a core symptom of major depressive disorder (MDD), but also is identified as an important component of the positive valence system in the NIMH Research Domain Criteria. The Snaith-Hamilton Pleasure Scale (SHAPS) has been developed for the assessment of hedonic experience or positive valence, but has not been well-studied in depressed outpatient populations. The current study examined the reliability and validity of the SHAPS using a sample of adult outpatients with treatment resistant MDD. Data for the current study were obtained from 122 adult outpatients with a diagnosis of MDD and non-response to adequate treatment with an SSRI and who participated in Project TReatment with Exercise Augmentation for Depression (TREAD). A Principal Components Analysis was used to define the dimensionality of the SHAPS. Convergent and discriminant validity were evaluated via correlations of the SHAPS total score with "gold standard" measures of depression severity and quality of life. The SHAPS was found to have high internal consistency (Cronbach's coefficient α = .82). A Principal Components Analysis suggests that the SHAPS is mainly "unidimensional" and limited to hedonic experience among adult outpatients with MDD. Convergent and discriminant validity were assessed by examining the Spearman rank-order correlation coefficient between the SHAPS total score and the HRSD17 (rs = 0.22, p < .03), IDS-C30 (rs = 0.26, p < .01), IDS-SR30 (rs = 0.23, p < .02), QIDS-C16 (rs = 0.22, p < .03), QIDS-SR16 (rs = 0.17, p < .10), QLES-Q (rs = -0.32, p < .002), and the pleasure/enjoyment item (sub-item 21) of the IDS-C (rs = 0.44, p < .0001) and IDS-SR (rs = 0.38, p < .0002). The self-administered SHAPS showed modest sensitivity (76%) and specificity (54%) with the self-administered pleasure/enjoyment single item (sub-item 21) of IDS-SR30. The current study shows that the SHAPS is a reliable and valid instrument to assess hedonic experience or positive valence in adult outpatients with MDD and provides a broader assessment of this important domain.
快感缺失或无法体验愉悦感不仅是重度抑郁症（MDD）的核心症状，也是美国国立精神卫生研究所（NIMH）研究领域标准中积极效价系统的重要组成部分。斯奈斯 - 汉密尔顿愉悦量表（SHAPS）已被开发用于评估享乐体验或积极效价，但在抑郁症门诊患者中尚未得到充分研究。本研究使用对治疗有抵抗性的成年门诊MDD患者样本，检验了SHAPS的信效度。本研究的数据来自122名被诊断为MDD且对足量SSRI治疗无反应、并参与了抑郁症运动强化治疗项目（TREAD）的成年门诊患者。采用主成分分析来确定SHAPS的维度。通过SHAPS总分与抑郁症严重程度和生活质量的“金标准”测量指标的相关性，评估其收敛效度和区分效度。发现SHAPS具有较高的内部一致性（克朗巴哈系数α = 0.82）。主成分分析表明，SHAPS在成年门诊MDD患者中主要是“单维的”，且仅限于享乐体验。通过检验SHAPS总分与HRSD17（rs = 0.22，p < 0.03）、IDS - C30（rs = 0.26，p < 0.01）、IDS - SR30（rs = 0.23，p < 0.02）、QIDS - C16（rs = 0.22，p < 0.03）、QIDS - SR16（rs = 0.17，p < 0.10）、QLES - Q（rs = -0.32，p < 0.002）以及IDS - C（rs = 0.44，p < 0.0001）和IDS - SR（rs = 0.38，p < 0.0002）的愉悦/享受项目（子项目21）之间的斯皮尔曼等级相关系数，评估收敛效度和区分效度。自我施测的SHAPS与IDS - SR�⁰的自我施测愉悦/享受单项（子项目21）相比，显示出中等的敏感性（76%）和特异性（54%）。本研究表明，SHAPS是评估成年门诊MDD患者享乐体验或积极效价的可靠且有效的工具，并对这一重要领域提供了更广泛的评估。
