Chapman Physical Anhedonia Scale Research Articles

Impulsivity, Sensation Seeking and Anhedonia as Possible Explanations for Cannabis Abuse Comorbidity among First Psychotic Episode Inpatients

Objective: There have been relatively few reported carefully constructed studies to date concerning the link between psychoactive substance abuse among first-episode psychotic individuals and specific behavioral aspects that might clarify the comorbidity. Using standard toxicological testing, we compared consecutively admitted inpatients diagnosed with first psychotic episode with and without lifetime and/or active (last month) cannabis abuse or dependence and the levels of impulsivity, sensation seeking and anhedonia. Methods: Ninety-one consecutively admitted psychiatric patients diagnosed using the DSM-IV criteria with a first psychotic episode due to schizophrenia, schizophreniform disorder, bipolar disorder, brief psychotic episode, and psychosis NOS disorder were included in the study. Patients were aged 18 to 41 (mean 27.1+9.2); seventy-six of the patients (83.5%) were males. Standard urine tests for tetrahydrocannabinol (THC) were performed and self-report questionnaires were administered during the first 48 h after admission. The following rating scales were used: the PANSS (Positive and Negative Syndrome Scale), the Barratt Impulsivity Scale (a 34-item self-report), the Zuckerman Sensation-Seeking Scale (form V), and the Chapman Physical Anhedonia Scale (a 61-item self-report). Results: According to bivariate correlations, the PANSS Positive Scale was significantly correlated with the Barratt Rating Scale (0.260; p ≤ 0.05) and the PANSS Negative with Physical Anhedonia Scale (0.389, p ≤ 0.001). Rates for the Zuckerman Rating Scale (f=20.1, p ≤ 0.001) and the Barratt Rating Scale (f=5.15, p ≤ 0.05) were significantly higher in the group of cannabis abusers with no clear difference between abusers and nonusers in the PANSS and the Physical Anhedonia Scale. Conclusion: The results of the study showed high levels of impulsivity and sensation seeking in the group of inpatients suffering from first psychotic episode and cannabis abuse comorbidity compared to first-episode inpatients with no substance abuse.

Neurophysiological differences in reward processing in anhedonics

Anhedonia is characterized by a reduced capacity to experience pleasure in response to rewarding stimuli and has been considered a possible candidate endophenotype in depression and schizophrenia. However, it is still not well understood whether these reward deficits are confined to anticipatory and/or to consummatory experiences of pleasure. In the present study, we recorded electrophysiological responses (event-related brain potentials [ERPs] and oscillatory activity) to monetary gains and losses in extreme groups of anhedonic and nonanhedonic participants. The anhedonic participants showed reduced motivation to incur risky decisions, especially after monetary rewards. These sequential behavioral effects were correlated with an increased sensitivity to punishment, which psychometrically characterized the anhedonic group. In contrast, both electrophysiological measures associated with the impacts of monetary losses and gains--the feedback-related negativity (FRN) and the beta-gamma oscillatory component--clearly revealed preserved consummatory responses in anhedonic participants. However, anhedonics showed a drastic increase in frontal medial theta power after receiving the maximum monetary gain. This increase in theta oscillatory activity could be associated with an increase in conflict and cognitive control for unexpected large positive rewards, thus indexing the violation of default negative expectations built up across the task in anhedonic participants. Thus, the present results showed that participants with elevated scores on Chapman's Physical Anhedonia Scale were more sensitive to possible punishments, showed deficits in the correct integration of response outcomes in their actions, and evidenced deficits in sustaining positive expectations of future rewards. This overall pattern suggests an effect of anhedonia in the motivational aspects of approach behavior rather than in consummatory processes.

Anhedonia and Reward System: Psychobiology, Evaluation, and Clinical Features

Anhedonia can be defined as a condition in which the hedonic capacity is totally or partially lost. From a psychobiological perspective, several researchers proposed that anhedonia has a putative neural substrate, the dopaminergic mesolimbic and mesocortical reward circuit, which involves the ventral tegmental area, the ventral striatum and part of the prefrontal cortex. Anhedonia is, besides depressed mood, one of the two core symptoms of depression; furthermore it is one of the most important negative symptom in schizophrenia. Anhedonia is also present in substance use disorders as part of the abstinence symptomatology, and interrelations between hedonic capability, craving and protracted withdrawal have been found, particularly in opiate-dependent subjects. Although anhedonia is regarded as an important symptom in psychopathology, so far it has received relatively little attention. In general, two main approaches have been utilized to investigate and assess anhedonia or hedonic capacity: laboratory-based measures and questionnaires. Among measurement scales, the most commonly used are the Snaith-Hamilton Pleasure Scale (SHAPS), the Fawcett-Clark Pleasure Scale (FCPS), and the Revised Chapman Physical Anhedonia Scale (CPAS). Nevertheless, other measurement scales, particularly used within broader psychopathological dimensions, are the Anhedonia-Asociality subscale (SANSanh) of the Scale for the Assessment of Negative Symptoms (SANS) and the Bech-Rafaelsen Melancholia Scale (BRMS). In this paper we analyze these different scales, individuating their strengths and limits and their current clinical applications.

Functional neural substrates of self-reported physical anhedonia in non-clinical individuals and in patients with schizophrenia

Background Anhedonia is a negative symptom of schizophrenia that has a detrimental impact on functioning and quality of life. Anhedonia also represents a vulnerability marker for schizophrenia when measured in non-clinical individuals. The investigation of the neural correlates of anhedonia in schizophrenia and non-clinical individuals could provide key insights on the pathophysiology of negative symptoms, as well as on the characterization of neural markers of vulnerability. Methods Thirty patients with schizophrenia and twenty-six non-clinical individuals were recruited. We used an event-related functional Magnetic Resonance Imaging paradigm involving an emotional picture viewing task. For each group, separately, we correlated the regional BOLD signal changes during hedonic processing with the Chapman Physical Anhedonia Scale scores. An interaction analysis identified the neural correlates of anhedonia specific to schizophrenia. Results We found that anhedonia severity in both groups was inversely correlated with the activity of a limited number of emotion-related regions, including the medial prefrontal cortex. The orbitofrontal cortex and putamen/ventral striatum activity was negatively correlated with anhedonia severity in people with schizophrenia only. Conclusions The data first suggest that anhedonia severity is linked to a poor modulation of emotional/attentional brain regions during the processing of hedonic information. The link between anhedonia and the activity of the ventral striatum and orbitofrontal cortex found in schizophrenia could reflect the specific impairment of indirect factors, such as reward anticipation deficits, that influence the measurement of anhedonia severity through self-report questionnaires.

Anhedonia as predictor of clinical events after acute coronary syndromes: a 3-year prospective study

Background Depression after acute coronary syndromes (ACS) is an important risk factor for further coronary events; but the influence of anhedonia, the decreased capacity to experience pleasure, has received little attention. The aim of the study was to investigate the effects of anhedonia on prognosis at 3-year follow-up in patients hospitalized for ACS. Method Consecutively admitted ACS patients (n = 291) completed the Chapman Physical Anhedonia Scale (PAS) and the Hospital Anxiety and Depression Scale depression subscale (HAD-D) at baseline (1-4 days after their admission). Two definitions of anhedonia were taken into account: dimensional definition using PAS score as well as categorical definition using several cutoff scores (hedonics: PAS less than 23 or 29; anhedonics: PAS equal to or greater than 23 or 29). Patients were followed during 3 years for adverse clinical events divided into severe cardiac events (mortality or myocardial infarction [MI]) and clinical events (mortality, MI, recurrence of ACS, hospital readmission, and onset or deterioration of heart failure). Results At follow-up, there were 176 clinical events (36 deaths, 8 MIs, 58 ACS, 55 hospital readmissions, 19 heart failures). Dimensional anhedonia and depression were associated with poor prognosis, but anhedonia was the only predictor of severe cardiac events and clinical events after adjusting for demographic and clinical variables. Contrary to depression, categorical anhedonia (PAS >23) was an independent and significant predictor of severe cardiac events after adjusting for clinical variables. The incidence of death/MI in hedonics vs anhedonics was 11.1% vs 22.1% (hazard ratio = 2.18; 95% confidence interval, 1.11-4.26). Conclusions Dimensional and categorical anhedonias predicted independently severe cardiac events and clinical events after ACS.

Stability and relationships between trait or state anhedonia and schizophrenic symptoms in schizophrenia: A 13-year follow-up study

The aim of the present study was to explore the stability of anhedonia and its relationships with schizophrenic symptoms across a 13-year study period. We tested the hypothesis that trait anhedonia, rated by the Physical Anhedonia Scale (PAS), was stable and independent of schizophrenic symptoms across this period, while measures of state anhedonia were not. Sixty schizophrenic subjects were evaluated at two time points, at hospital admission or during an ambulatory psychiatric consultation and 13 years later. Trait anhedonia was assessed using the Chapman Physical Anhedonia Scale, while state anhedonia was assessed with a subscale extracted from the Beck Depression Inventory. The Positive and Negative Syndrome Scale (PANSS) was used to rate schizophrenic symptomatology. Unlike trait anhedonia, state anhedonia decreased significantly over time. Based on results from multiple regressions, negative and depressive dimensions were significant predictors of state anhedonia. Trait anhedonia was not associated with negative symptoms, but was associated with severity of disorganization symptoms at baseline and with our state measure of anhedonia at follow-up. In the current study, state and trait anhedonia were correlated, but depressive symptoms in general were not associated with physical anhedonia. The results indicated that trait anhedonia, in contrast to state anhedonia, had absolute stability, was independent of the negative dimension, as measured by the PANSS, of schizophrenic symptomatology and correlated with specific aspects of depressive anhedonia.

Magical ideation and hyperacusis

The subjective experience conferred by auditory perception has rarely been addressed outside of the studies of auditory hallucinations. The aim of this study is to describe the phenomenology of auditory experiences in individuals who endorse magical beliefs, but do not report hallucinations. We examined the relationship between subjective auditory sensitivity and a ‘psychotic-like’ thinking style. Hyperacusis questionnaire scores were compared between 25 high scoring participants on Chapman's magical ideation (MI) scale, 25 high scoring participants on Chapman's physical anhedonia scale and 25 control participants, pre-selected from a large student pool ( n = 1289). The participants who obtained high scores on the MI scale rated their auditory sensitivity higher than the two other groups. Our results indicate that, in healthy subjects, subjective auditory sensitivity is associated with MI without the mediation by anxiety commonly observed in pathological cases. We propose that hyperacusis associated to high scores of MI may be a predispositional factor to deviant auditory experiences. The relative uncoupling of perception from auditory sensory input may result in a central hypersensitivity, which could play a role in triggering off the experience of auditory hallucinations.

No evidence for physical anhedonia as a candidate symptom or an endophenotype in bipolar affective disorder

Bipolar affective disorder (BPAD) is clinically and genetically heterogeneous and the affected phenotype is poorly defined, hampering studies of its genetic basis. Studies of specific, familial, clinical indicators of BPAD may be useful for identifying heritable forms. Homogeneous forms of the disease may be identified in patients (candidate symptom approach) and some vulnerability markers may be sought in unaffected relatives of patients (intermediate traits or endophenotypes). Physical anhedonia (PA) is considered a possible candidate symptom and endophenotype in schizophrenia, but has never been specifically investigated in BPAD. Physical anhedonia scores (measured using Chapman's Physical Anhedonia Scale) were compared in 351 euthymic bipolar patients, 130 of their first-degree relatives and 170 healthy controls with no personal or familial history of schizophrenia, mood disorders or suicidal behavior. We investigated intrafamilial resemblance of PA and compared the progressive and clinical characteristics of hedonic and anhedonic bipolar probands. Physical anhedonia was a stable trait in normothymic bipolar patients and significant intrafamilial correlation of PA scores was observed in bipolar families. However, PA scores were similar in unaffected relatives and controls and the clinical characteristics of anhedonic and hedonic patients did not differ significantly. Physical anhedonia was not associated with an increased familial risk for bipolar disorder. Physical anhedonia is a stable, familial dimension in BPAD families. It cannot be considered an endophenotype because unaffected relatives of bipolar patients and healthy controls have similar PA scores. It also cannot be considered a candidate symptom because it does not identify a homogeneous clinical and familial sub-group of bipolar patients. Given the results of previous studies, PA might be a specific candidate symptom (and endophenotype) to schizophrenia. However, the validation of this hypothesis requires replication studies in bipolar disorder and schizophrenia and further investigations in other psychiatric diseases (in particular across the mood disorder spectrum).

Measuring hedonic capacity in depression: A psychometric analysis of three anhedonia scales

The present study evaluated and compared the psychometric properties of three self-report scales: the Snaith-Hamilton Pleasure Scale (SHAPS; R. P. Snaith, M. Hamilton, S. Morley, & A. Humayan, 1995), Fawcett-Clark Pleasure Capacity Scale (FCPS; J. Fawcett, D. C. Clark, W. A. Scheftner, & R. D. Gibbons, 1983), and the Revised Chapman Physical Anhedonia Scale (CPAS; L. J. Chapman, J. P. Chapman, & M. L. Raulin, 1976). These scales, designed to assess hedonic responsiveness, were administered to 157 college students. Confirmatory factor analysis revealed a Hedonic Capacity factor that was largely defined by the SHAPS but also had a substantial loading from the FCPS. Hedonic Capacity was minimally correlated with constructs of Depression and Anxiety, which were assessed by the Beck Depression Inventory-II and the Beck Anxiety Inventory. The CPAS (anhedonia) was not significantly related to Hedonic Capacity or Anxiety, but it did have a small positive loading on Depression. These findings suggest that further research is needed to clarify the meaning of and relationships among scales that are putative indicators of hedonic capacity and anhedonia.

Nicotine use in schizophrenia and disinhibition

The role of personality in nicotine use has been little studied in patients with schizophrenia. The objectives of the present study were to compare impulsivity, sensation seeking and anhedonia in a group of schizophrenic patients with and without current cigarette smoking. One hundred patients with schizophrenia or schizoaffective disorder (DSM-III-R criteria) were assessed with the Positive and Negative Syndrome Scale, the Fagerström Scale, the Barratt Impulsivity Scale, the Zuckerman Seeking Sensation Scale, and the Chapman Physical Anhedonia Scale. Among these patients, 67% were current smokers. The mean scores for sensation seeking were higher in the group of smokers than in the group of nonsmokers. The differences were found exclusively with the “disinhibition” subscale. No significant difference was found for impulsivity and physical anhedonia mean scores. The scores on the Sensation Seeking Scale were especially low in nonsmokers. Cigarette smoking could influence disinhibition and possibly help to normalize inhibition in schizophrenic patients.

Time-on-task effect in trait anhedonia

The capacity to sustain attention was explored in a sample of anhedonic subjects according to the Chapman physical anhedonia scale. Sustained attention was determined by studying task-induced changes over the duration of the Eriksen response competition task [Percept. Psychophys. 16 (1974) 143]. Anhedonic subjects had longer reaction times (RTs), but missed no more targets than control subjects. Anhedonic subject RTs got longer with time-on-task (TOT) and displayed greater intra-subject variability. These results confirm those of a previous study indicating that anhedonic subjects may have developed a more conservative response strategy [Psychophysiology 37 (2000) 711] and suggest that this strategy may result in a more rapid decrease in energetical resources. Moreover, the greater intra-subject variability demonstrates the importance of assessing performance over time and its relationship to the variability of responses in the cognitive performance of anhedonic subjects.

Substance abuse and suicidality in schizophrenia: a common risk factor linked to impulsivity

Lifetime substance abuse comorbidity is frequent in schizophrenic patients, but the clinical correlates remain unclear. We have explored the chronological relations between substance abuse and course of schizophrenia, and compared several clinical characteristics and personality dimensions in 50 schizophrenic patients with or without lifetime substance abuse or dependence. Abuse occurred mainly after the first prodromal symptoms and just before the first psychotic episode. Substance-abusing patients were not different from non-substance-abusing patients on the Chapman Physical Anhedonia Scale, PANSS total score, negative subscore or depression item, CGI, treatment response and demographic variables. In contrast, substance-abusing patients had higher scores on the Barratt Impulsivity Scale (total, cognitive and non-planning scores) and had attempted suicide more often. In patients with schizophrenia, as in the general population, substance abuse or dependence appears associated with higher impulsivity and suicidality. High impulsivity could facilitate substance abuse as a maladaptative behavior in response to prodromal symptoms, precipitating the onset of a characterized psychosis.

Reaction Time Crossover in Schizotypal Subjects

The present study investigated the relationship between reaction time crossover and schizotypy as measured by Chapman's Physical Anhedonia Scale (PAS). Twenty PAS-identified schizotypal college students and 20 nonschizotypal students were administered a computerized version of Rodnick and Shakow's crossover reaction time task. The hypothesized interaction (crossover) between preparatory interval duration and preparatory interval presentation pattern was observed for PAS-identified schizotypics. Results indicated that subjects identified on the basis of the PAS evidenced reaction time crossover patterns similar to those observed in schizophrenic and at-risk populations.