title: Anhedonia in the psychosis risk syndrome: associations with social impairment and basal orbitofrontal cortical activity.
abstract: OBJECTIVE
  Anhedonia is associated with poor social function in schizophrenia. Here, we examined this association in individuals at clinical high risk (CHR) for schizophrenia and related psychotic disorders, taking into account social anxiety. We then explored correlations between anhedonia and basal metabolic activity in selected forebrain regions implicated in reward processing.
  
  
  METHODS
  In 62 CHR individuals and 37 healthy controls, we measured social adjustment (Social Adjustment Self-Report Scale), social and physical anhedonia (Chapman Revised Anhedonia Scales), and social anxiety (Social Anxiety Scale for Adolescents) in cross-section. In a subgroup of 25 CHR individuals for whom high-spatial-resolution basal-state functional magnetic resonance imaging data were available, we also assessed correlations of these socio-affective constructs with basal cerebral blood volume in orbitofrontal cortex and related regions involved in reward processing.
  
  
  RESULTS
  Relative to controls, CHR individuals reported social impairment, greater social and physical anhedonia, and more social anxiety, exhibiting impairments comparable to schizophrenia. Regression analyses showed that anhedonia predicted social impairment and correlated negatively with basal cerebral blood volume within the orbitofrontal cortex (all P's<0.05).
  
  
  CONCLUSIONS
  Anhedonia and social anxiety are prominent in CHR individuals. Trait-like anhedonia may be a core phenotype related to orbitofrontal cortical function that, independent of symptoms, predicts social impairment. These data provide a rationale for interventions that target anhedonia and related activity in orbitofrontal cortical circuits in CHR individuals.
authors.affiliation: Department of Psychiatry, Columbia University College of Physicians and Surgeons , New York, NY, USA.
authors.forename: Victoria L
authors.initials: VL
authors.lastname: Cressman
authors.affiliation: Department of Psychiatry, Columbia University College of Physicians and Surgeons , New York, NY, USA.
authors.forename: Scott A
authors.initials: SA
authors.lastname: Schobel
authors.affiliation: The New York State Psychiatric Institute , New York, NY, USA.
authors.forename: Sara
authors.initials: S
authors.lastname: Steinfeld
authors.affiliation: The New York State Psychiatric Institute , New York, NY, USA.
authors.forename: Shelly
authors.initials: S
authors.lastname: Ben-David
authors.affiliation: Department of Psychiatry, Columbia University College of Physicians and Surgeons , New York, NY, USA.
authors.forename: Judy L
authors.initials: JL
authors.lastname: Thompson
authors.affiliation: Department of Neurology, Columbia University College of Physicians and Surgeons , New York, NY, USA.
authors.forename: Scott A
authors.initials: SA
authors.lastname: Small
authors.affiliation: Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA; The New York State Psychiatric Institute, New York, NY, USA.
authors.forename: Holly
authors.initials: H
authors.lastname: Moore
authors.affiliation: Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA; The New York State Psychiatric Institute, New York, NY, USA.
authors.forename: Cheryl M
authors.initials: CM
authors.lastname: Corcoran