Anhedonia and Abstinence as Predictors of the Subjective Pleasantness of Positive, Negative, and Smoking-Related Pictures.

Abstract

Anhedonia-diminished interest or pleasure in response to rewards-is a dimension implicated in several psychiatric disorders linked to smoking. This laboratory study sought to identify motivational mechanisms linking anhedonia and tobacco addiction by testing the hypothesis that anhedonia, abstinence, and their interaction would predict excesses and deficits in the perceived pleasantness of smoking-related and positive pictures, respectively. We assessed the pleasantness of negative pictures as a secondary outcome. After a baseline session involving self-report measures of anhedonia and other factors, 125 regular smokers attended two counterbalanced experimental sessions (overnight abstinent and non-abstinent) at which they rated the pleasantness of positive, smoking-related, negative, and neutral (control) pictures presented via computer. The difference in pleasantness ratings of positive, smoking-related, and negative pictures relative to neutral pictures served as the index of participants' appraisal of the motivational salience of nondrug reward, drug reward, and aversive signals, respectively. With and without adjusting for sex and depressive symptoms, greater anhedonia significantly or marginally predicted greater pleasantness of smoking (vs. neutral), lower pleasantness of positive (vs. neutral), less unpleasantness of negative (vs. neutral) pictures (|βs| = 0.18 to 0.35, ps = .007 to .07). Anhedonia by abstinence interaction effects on pleasantness ratings of each stimulus category (vs. neutral) were not significant (|βs| ≤ 0.02, ps ≥ .36). Anhedonia and abstinence additively increase the salience of smoking-related cues in anhedonic smokers. Smoking cessation efforts that attenuate sensitization to smoking stimuli may benefit anhedonic smokers early in quit attempts. Taken together, these findings provide tentative evidence that anhedonia is associated with a relative imbalance in the motivational salience of drug relative to nondrug rewards and may be associated with a generalized hypo-reactivity to both positive and negative stimuli. Though some prior smoking research has evidenced this relative imbalance in anhedonia with self-report or a smoking-choice task, we additionally show that this pattern may extend to hyper-affective reactivity to smoking-related stimuli being coincident with hypo-affective reactivity to nondrug-related positive stimuli (ie, may extend to greater pleasantness ratings of smoking pictures being accompanied by lower pleasantness ratings of positive pictures).