Department of Psychiatry, Faculty of Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada.
Curr Top Behav Neurosci. 2022;58:305-323. doi: 10.1007/7854_2022_317.
The following essay addresses the evolution of the term "anhedonia" as a key construct in biological psychiatry, especially as it pertains to positive emotional and motivational states central to mental health and well-being. In its strictest definition, anhedonia was intended to convey an inability to experience "pleasure" derived from ingestion of sweet tastes or the experience of pleasant odors and tactile sensations, among a host of positive sensations. However, this definition has proved to be too restrictive to capture the complexity of key psychological factors linked to major depression, schizophrenia, and substance use disorders it was originally intended to address. Despite the appeal of the elegant simplicity of the term anhedonia, its limitations soon became apparent when used to explain psychological constructs including aspects of learning, memory, and incentive motivation that are major determinants of success in securing the necessities of life. Accordingly, the definition of anhedonia has morphed into a much broader term that includes key roles in the disturbance of motivation in the form of anergia, impaired incentive motivation, along with deficits in associative learning and key aspects of memory, on which the ability to predict the consequences of one's actions are based. Here we argue that it is this latter capacity, namely predicting the likely consequences of motivated behavior, which can be termed "anticipation," that is especially important in the key deficits implied by the general term anhedonia in the context of neuropsychiatric conditions.
本文探讨了“快感缺失”一词在生物精神病学中的演变,作为一个关键结构,特别是它与心理健康和幸福感相关的积极情感和动机状态有关。在最严格的定义中,快感缺失旨在传达无法体验到“愉悦”,这种愉悦来自于摄入甜食的味道或愉快气味和触觉的体验,以及一系列积极的感觉。然而,这个定义被证明过于局限,无法捕捉到与重度抑郁症、精神分裂症和物质使用障碍等主要心理因素相关的复杂性,而这些正是它最初旨在解决的问题。尽管“快感缺失”一词的优雅简洁具有吸引力,但当它被用来解释包括学习、记忆和激励动机等方面的心理结构时,其局限性很快就显现出来,而这些方面是确保生活必需品成功获得的主要决定因素。因此,快感缺失的定义已经演变成一个更广泛的术语,它包括了动机障碍的关键作用,表现为乏力、激励动机受损,以及联想学习和记忆的关键方面的缺陷,而这些是基于预测个人行为后果的能力。在这里,我们认为,正是这种预测动机行为可能后果的能力,即“预期”,在神经精神疾病中,一般术语“快感缺失”所暗示的关键缺陷中尤为重要。