title: Reconceptualizing anhedonia: novel perspectives on balancing the pleasure networks in the human brain.
abstract: Anhedonia, the lack of pleasure, has been shown to be a critical feature of a range of psychiatric disorders. Yet, it is currently measured primarily through subjective self-reports and as such has been difficult to submit to rigorous scientific analysis. New insights from affective neuroscience hold considerable promise in improving our understanding of anhedonia and for providing useful objective behavioral measures to complement traditional self-report measures, potentially leading to better diagnoses and novel treatments. Here, we review the state-of-the-art of hedonia research and specifically the established mechanisms of wanting, liking, and learning. Based on this framework we propose to conceptualize anhedonia as impairments in some or all of these processes, thereby departing from the longstanding view of anhedonia as solely reduced subjective experience of pleasure. We discuss how deficits in each of the reward components can lead to different expressions, or subtypes, of anhedonia affording novel ways of measurement. Specifically, we review evidence suggesting that patients suffering from depression and schizophrenia show impairments in wanting and learning, while some aspects of conscious liking seem surprisingly intact. Furthermore, the evidence suggests that anhedonia is heterogeneous across psychiatric disorders, depending on which parts of the pleasure networks are most affected. This in turn has implications for diagnosis and treatment of anhedonia.
authors: Center of Functionally Integrative Neuroscience (CFIN), University of Aarhus Aarhus, Denmark ; Department of Psychiatry, Warneford Hospital, University of Oxford Oxford, UK ; Centre for Alcohol and Drug Research, School of Business and Social Sciences, University of Aarhus Aarhus, Denmark.
authors: Kristine
authors: K
authors: Rømer Thomsen
authors: Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, LA, USA.
authors: Peter C
authors: PC
authors: Whybrow
authors: Center of Functionally Integrative Neuroscience (CFIN), University of Aarhus Aarhus, Denmark ; Department of Psychiatry, Warneford Hospital, University of Oxford Oxford, UK.
authors: Morten L
authors: ML
authors: Kringelbach
keywords: depression; dopamine; learning; liking; opioids; orbitofrontal cortex; schizophrenia; wanting