Merklein Sarah A, Peterburs Jutta, Mundorf Annakarina
Institute for Systems Medicine and Department of Human Medicine, MSH Medical School Hamburg, Hamburg, Germany.
Department of Psychology, MSH Medical School Hamburg, Hamburg, Germany.
PLoS One. 2025 Sep 11;20(9):e0331769. doi: 10.1371/journal.pone.0331769. eCollection 2025.
Anhedonia, the inability to experience pleasure or interest in activities, is a key symptom across various psychiatric disorders, including depression. It links to poor quality of life, higher suicide risk, and poorer prognosis. While anhedonia is often studied in clinical populations, its prevalence in healthy individuals and its dimensional nature remain underexplored. This study examined the prevalence of anhedonia in 128 German university students, comparing those with and without psychiatric symptoms and modeling psychiatric symptoms as predictor of anhedonia, measured with the Dimensional Anhedonia Rating Scale (DARS). Results showed that the clinical group demonstrated relatively low levels of anhedonia (total DARS-26: 85.03 ± 12.88) that did not differ from the healthy group (88.80 ± 7.88). Considerable variability suggests that a purely categorical approach to anhedonia may not capture its full complexity. Multiple regression analyses revealed that negative symptoms (e.g., affective flattening) were the strongest predictor of anhedonia, both in the full (b = -0.54, p < .001) and within the (sub-)clinical sample (b = -0.64, p < .001). Anxiety was also a significant predictor in the (sub-)clinical group (b = -1.06, p = .01), underscoring its impact on reward processing. Depression did not emerge as a strong predictor (b = -0.21, p = .49) when considered alongside other variables, indicating that its link to anhedonia may be mediated by other factors. Multigroup confirmatory factor analysis of the DARS showed that the 17-item version provided a better fit than the 26-item version, reinforcing the shorter version as a more efficient tool for assessing anhedonia. Taken together, the present findings support the use of a dimensional approach to anhedonia, which offers a more nuanced view of the underlying psychological and neurological mechanisms. Future research should explore anhedonia in larger, diverse samples for a comprehensive understanding of the link between anhedonia and mental illness. Registration: The study was pre-registered on OSF: https://doi.org/10.17605/OSF.IO/234A7.
快感缺失，即无法体验愉悦或对活动缺乏兴趣，是包括抑郁症在内的各种精神障碍的关键症状。它与生活质量差、自杀风险高以及预后不良有关。虽然快感缺失经常在临床人群中进行研究，但其在健康个体中的患病率及其维度性质仍未得到充分探索。本研究调查了128名德国大学生的快感缺失患病率，比较了有精神症状和无精神症状的学生，并将精神症状作为快感缺失的预测因素进行建模，快感缺失用维度快感缺失评定量表（DARS）进行测量。结果显示，临床组的快感缺失水平相对较低（DARS - 26总分：85.03±12.88），与健康组（88.80±7.88）无差异。相当大的变异性表明，对快感缺失采用纯粹的分类方法可能无法捕捉其全部复杂性。多元回归分析显示，阴性症状（如情感平淡）是快感缺失最强的预测因素，在整个样本（b = - 0.54，p <.001）和（亚）临床样本中（b = - 0.64，p <.001）均如此。焦虑在（亚）临床组中也是一个显著的预测因素（b = - 1.0[具体缺失内容]6，p = 0.01），强调了其对奖赏处理的影响。当与其他变量一起考虑时，抑郁并未成为一个强有力的预测因素（b = - 0.21，p = 0.49），这表明其与快感缺失的联系可能由其他因素介导。对DARS的多组验证性因素分析表明，17项版本比26项版本拟合度更好，这强化了较短版本作为评估快感缺失更有效工具的地位。综上所述，本研究结果支持对快感缺失采用维度方法，该方法能更细致地了解潜在的心理和神经机制。未来的研究应在更大、更多样化的样本中探索快感缺失，以全面理解快感缺失与精神疾病之间的联系。注册情况：该研究已在开放科学框架（OSF）上预先注册：https://doi.org/10.176（具体缺失内容）5/OSF.IO/234A7 。
