Rizvi Sakina J, Pizzagalli Diego A, Sproule Beth A, Kennedy Sidney H
ASR Chair in Suicide and Depression Studies Program, Department of Psychiatry, St. Michael's Hospital, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
Department of Psychiatry, Harvard Medical School and McLean Hospital, Belmont, MA, USA.
Neurosci Biobehav Rev. 2016 Jun;65:21-35. doi: 10.1016/j.neubiorev.2016.03.004. Epub 2016 Mar 6.
The resurgence of interest in anhedonia within major depression has been fuelled by clinical trials demonstrating its utility in predicting antidepressant response as well as recent conceptualizations focused on the role and manifestation of anhedonia in depression. Historically, anhedonia has been understood as a "loss of pleasure", yet neuropsychological and neurobiological studies reveal a multifaceted reconceptualization that emphasizes different facets of hedonic function, including desire, effort/motivation, anticipation and consummatory pleasure. To ensure generalizability across studies, evaluation of the available subjective and objective methods to assess anhedonia is necessary. The majority of research regarding anhedonia and its neurobiological underpinnings comes from preclinical research, which uses primary reward (e.g. food) to probe hedonic responding. In contrast, behavioural studies in humans primarily use secondary reward (e.g. money) to measure many aspects of reward responding, including delay discounting, response bias, prediction error, probabilistic reversal learning, effort, anticipation and consummatory pleasure. The development of subjective scales to measure anhedonia has also increased in the last decade. This review will assess the current methodology to measure anhedonia, with a focus on scales and behavioural tasks in humans. Limitations of current work and recommendations for future studies are discussed.
对重度抑郁症中快感缺失兴趣的再度兴起,是由临床试验推动的,这些试验证明了其在预测抗抑郁反应方面的效用,以及近期专注于快感缺失在抑郁症中的作用和表现的概念化研究。从历史上看,快感缺失一直被理解为“愉悦感丧失”,然而神经心理学和神经生物学研究揭示了一种多方面的重新概念化,强调享乐功能的不同方面,包括欲望、努力/动机、预期和满足性愉悦。为确保研究结果的普遍性,有必要评估现有的评估快感缺失的主观和客观方法。关于快感缺失及其神经生物学基础的大多数研究来自临床前研究,该研究使用初级奖励(如食物)来探究享乐反应。相比之下,人类行为研究主要使用次级奖励(如金钱)来衡量奖励反应的许多方面,包括延迟折扣、反应偏差、预测误差、概率性逆向学习、努力、预期和满足性愉悦。在过去十年中,用于测量快感缺失的主观量表的开发也有所增加。本综述将评估当前测量快感缺失的方法,重点关注人类的量表和行为任务。讨论了当前工作的局限性以及对未来研究的建议。