Hedonic Capacity Research Articles

Psychosocial factors associated with treatment outcomes in women with obesity and major depressive disorder who received behavioral activation for depression.

Behavioral activation is an empirically supported treatment for depression, but much is unknown about factors associated with treatment response. The present study aimed to determine whether baseline levels and subsequent changes in psychosocial factors were associated with improvement in depression in women with comorbid obesity who received behavioral activation treatment for depression and a lifestyle intervention. Multilevel modeling was used to estimate the associations between psychosocial factors and change in depression scores during the first 10weeks of treatment and associations between changes in psychosocial factors from baseline to 6-month follow-up and change in depression over the same time period. No baseline psychosocial factors were associated with depression improvement during treatment (p = 0.110-0.613). However, greater improvement in hedonic capacity (p = 0.001), environmental reward (p = 0.004), and social impairment (p = 0.012) were associated with greater reductions in depression over 6months. Findings highlight the differential relationship specific psychosocial factors have with depression treatment outcomes.

The characterization of social anhedonia and its correlates in schizophrenia and schizoaffective patients

Although social hedonic capacity is often assessed in clinical settings, its operational definitions have not been evaluated for concurrent validity. One hundred and twenty-five patients with schizophrenia and schizoaffective disorder were classified according to their self-reported social hedonic functioning into three groups on the basis of their total scores on the Anticipatory and Consummatory Interpersonal Pleasure Scale (ACIPS). Participants were assessed before discharge using questionnaires and psychiatric rating scales. Using an empirically based cutoff score, we identified three groups: an intact social hedonic group (WNL), a socially anhedonic group (SA), and a socially hypohedonic group (i.e., those with scores intermediate between normal functioning and aberrantly low functioning, H). The SA patients were significantly different from the two other groups (WNL and H) by their higher severity of psychopathology, lower levels of self-efficacy, and less self-esteem. The SA patients also reported less perceived social support, poorer quality of life, and less subjective recovery. Our findings indicate that social anhedonia is a meaningful target for intervention. Further implications of our findings are discussed.

Oxytocin and its association with reward-based personality traits: A multilocus genetic profile (MLGP) approach

Oxytocin is an evolutionarily ancient neuropeptide that aids in the regulation of many survival behaviors including affiliation, creativity, and reproduction. The oxytocin system also converges with mesolimbic dopamine pathways and thereby plays a role in reward motivation and hedonic capacity. The present study investigated genetic markers of two oxytocin genes in relation to reward-based personality traits. Since individual polymorphic loci typically contribute only a small proportion of phenotypic variance, we used a MLGP quantitative approach whereby genetic variants are aggregated into composites that reflect a polygenic liability. Eleven single nucleotide polymorphisms (SNPs) on the oxytocin receptor gene (OXTR), and two SNPs on the cluster-of-differentiation 38 gene (CD38) were selected for genotyping. Community-recruited healthy adults (N = 426) participated in the study. Results identified 4 OXTR and 2 CD38 SNPs with a significant genotypic association to the reward-based traits. The MLGP accounted for greater phenotypic variance than any of the SNPs individually. Findings confirm links between the oxytocin system and reward responsiveness —an important relationship in the preservation of evolutionarily significant survival behaviors. Future research would benefit from targeting additional SNPs that influence oxytocin levels in the brain, in order to enhance the predictive utility of the current MLGP.

Circuit Mechanisms of Reward, Anhedonia, and Depression.

Pleasure and motivation are important factors for goal-directed behavior and well-being in both animals and humans. Intact hedonic capacity requires an undisturbed interplay between a number of different brain regions and transmitter systems. Concordantly, dysfunction of networks encoding for reward have been shown in depression and other psychiatric disorders. The development of technological possibilities to investigate connectivity on a functional level in humans and to directly influence networks in animals using optogenetics among other techniques has provided new important insights in this field of research.In this review, we aim to provide an overview on the neurobiological substrates of anhedonia on a network level. For this purpose, definition of anhedonia and the involved reward components are described first, then current data on reward networks in healthy individuals and in depressed patients are summarized, and the roles of different neurotransmitter systems involved in reward processing are specified. Based on this information, the impact of different therapeutic approaches on reward processing is described with a particular focus on deep brain stimulation (DBS) as a possibility for a direct modulation of human brain structures in vivo.Overall, results of current studies emphasize the importance of anhedonia in psychiatric disorders and the relevance of targeting this phenotype for a successful psychiatric treatment. However, more data incorporating these results for the refinement of methodological approaches are needed to be able to develop individually tailored therapeutic concepts based on both clinical and neurobiological profiles of patients.

Differential effects of clomipramine on depression-like behaviors induced by the chronic social defeat paradigm in tree shrews.

Anhedonia is a hallmark symptom in major depression that reflects deficits in hedonic capacity and it is also linked to motivation for reward. However, studies of the features of motivation in depressed tree shrews are rather sparse. The study aimed to investigate the core feature of depression including lack of interest, motivation reduction, and social avoidance in tree shrews. Furthermore, the effects of the treatment using clomipramine on these depression-like behaviors were assessed. The paradigm of chronic social defeat in tree shrews was used to evaluate the core feature of depression through examining their sucrose preference, break-point for reward, and social interaction. The results showed that social defeat lowered the curves of the sucrose preference and the break-point, as well as decreased social interaction. The results suggested that the subordinate animals exhibited interest loss, motivational reduction, and social avoidance. After oral treatment with clomipramine (50 mg/kg/day) for four weeks, most of the depression-like behaviors were reversed, whereas the motivational reduction was not clearly affected. Notably, the motivational reduction appeared obviously during the first week after the social defeat, and the conventional tricyclic antidepressant clomipramine did not reverse the reduced motivation. These findings imply that motivational variation might be applied as a more sensitive behavioral index in subordinate animals and could furthermore be used to evaluate potential agents as antidepressants.

Development of Jam Product from Peel and Flesh of Dragon Fruit as High Antioxidant Snack

<em>This study aims to determine the effect of different proportion of peel and flesh red dragon fruit of the jam to organoleptic test, to obtain the results of analysis of chemical properties and physical properties of jam, and also the selected formula. This research used experimental method by using Randomized Design. The organoleptic test was then analyzed using Kruskal Wallis and Mann-Whitney method. The result showed that proportion of peel and flesh of red dragon fruit has significant test (p<0,005) on hedonic quality test of color, texture, taste, aftertaste and hedonic test of flavor and taste. Based on the hedonic test, water content, carbohydrate content, antioxidant capacity, total flavonoid, and viscosity of the selected formula were F3 (peel (70 g) and flesh (30g)), with water content (30,95%), ash content (0,27%), protein content (0,65%), fat content (0,20%), carbohydrate content (67,93%), antioxidant capacity (164,79 mg AEAC), total flavonoid (0,430 mg/g), viscosity (1333,67 cP) and polish (15,5 cm).</em>

Assessment of health needs, satisfaction with care, and quality of life in compulsorily admitted patients with severe mental disorders

This cross-sectional study compared the levels of needs, care satisfaction, quality of life, and social support of compulsory admitted patients with severe mental disorders to a comparable group of voluntary admitted patients. One hundred and twenty-five patients with schizophrenia and schizoaffective disorder were admitted to a hospital by district psychiatrist order (DPO), court observation order (COO), or voluntary (VA). Participants were assessed before discharge using questionnaires, and psychiatric rating scales. A linear discriminant analysis revealed eight variables that best differentiated the three groups. COO patients were significantly discriminated from the two other groups (DPO and VA) by severe negative symptoms, better satisfaction with both nursing staff and family support. COO subjects had more non-illness unmet needs, while reported better hedonic capacity for social and interpersonal pleasure – compared to VA patients. DPO patients were significantly indicated by poorer awareness to illness, but better satisfaction with subjective feelings. VA subjects were significantly discriminated from compulsory admitted patients by higher illness severity scores. Assessment of unmet needs, satisfaction with care, quality of life, hedonic capacity, and social support constitute the factors that differentiate compulsory admitted patients and could be targets for interventions aimed to reduce the negative effects of compulsory admissions.

T210. PSYCHOSOCIAL CORRELATES OF INTERPERSONAL PLEASURE IN SCHIZOPHRENIA-SPECTRUM PATIENTS

BackgroundAlthough many people with schizophrenia-spectrum disorders report high levels of social anhedonia, it is not clear what differentiates those patients who self-report social anhedonia from those who do not. Moreover, the extent to which the hedonic functioning of severely disordered patients is associated with their clinical symptoms or with personality-related factors remains unresolved.MethodsWe administered the Anticipatory and Consummatory Interpersonal Pleasure Scale (ACIPS; Gooding & Pflum, 2014), a self-report measure designed to assess hedonic capacity for social and interpersonal pleasure, to 125 consecutively admitted inpatients with schizophrenia-spectrum disorder. The (81 schizophrenia, 44 schizoaffective disordered) patients were assessed in terms of their illness and symptom severity. They were also administered measures of self-efficacy (GSES; Jerusalem & Schwarzer, 1992), quality of life (Q-LES-Q-18; Ritsner et al., 2005), and recovery level (RAS-20; Salzer, 2010). Based on total ACIPS scores, two cut-off points were defined in order to classify participants as ‘normally hedonic’, ‘hypohedonic’ or ‘anhedonic’.ResultsThe ACIPS negatively correlated with 8 PANSS items: conceptual disorganization (P2, r=-0.24, p<0.01), hallucinatory behavior (P3, r=-0.28, p<0.01), suspiciousness (P6, r=-0.31, p<0.001), emotional withdrawal (N2, r=-0.24, p<0.01), stereotyped thinking (N7, r=-0.19, p<0.05), tension (G4, r=-0.23, p<0.01), G5 mannerism and posturing (G5, r=-0.22, p<0.05), and disturbance of volition (G13, r=-0.26, p<0.01).In addition, the ACIPS positively correlated with self-efficacy, self-esteem, perceived social support, subjective quality of life, and recovery scale scores.DiscussionThe ACIPS is a reliable and valid means to measure social anhedonia in a clinical sample. The findings revealed that the self-reported hedonic functioning of schizophrenia-spectrum patients is associated with both clinical symptomatology as well as some personality-related variables. Suggestions for further clinical and research applications using the ACIPS will be provided.

Anhedonia reflects impairment in making relative value judgments between positive and neutral stimuli in schizophrenia

Anhedonia (i.e., diminished capacity to experience pleasure) has traditionally been viewed as a core symptom of schizophrenia (SZ). However, modern laboratory-based studies suggest that this definition may be incorrect, as hedonic capacity may be intact. Alternative conceptualizations have proposed that anhedonia may reflect an impairment in generating mental representations of affective value that are needed to guide decision-making and initiate motivated behavior. The current study evaluated this hypothesis in 42 outpatients with SZ and 19 healthy controls (CN) who completed two tasks: (a) an emotional experience task that required them to indicate how positive, negative, and calm/excited they felt in response to a single emotional or neutral photograph; (b) a relative value judgment task where they selected which of 2 photographs they preferred. Results indicated that SZ and CN reported similar levels of positive emotion and arousal in response to emotional and neutral stimuli; however, SZ reported higher negative affect for neutral and pleasant stimuli than CN. In the relative value judgment task, CN displayed clear preference for stimuli differing in valence; however, SZ showed less distinct preferences for positive over neutral stimuli. Findings suggest that although in-the-moment experiences of positive emotion to singular stimuli may be intact in SZ, the ability to make relative value judgments that are needed to guide decision-making is impaired. Original conceptualizations of anhedonia as a diminished capacity for pleasure in SZ may be inaccurate; anhedonia may more accurately reflect a deficit in relative value judgment that results from impaired value representation.

Olfactory identification deficit and its relationship with hedonic traits in patients with first-episode schizophrenia and individuals with schizotypy

ObjectiveOlfactory identification impairments have been consistently found in schizophrenia patients. However, few previous studies have investigated this in first-episode patients. There are also inconsistent findings regarding olfactory identification ability in psychometrically-defined schizotypy individuals. In this study, we directly compared the olfactory identification ability of first-episode schizophrenia patients with schizotypy individuals. The relationship between olfactory identification impairments and hedonic traits was also examined. MethodsThirty-five first-episode schizophrenia patients, 40 schizotypy individuals as defined by the Chapman's Anhedonia Scales and 40 demographically matched controls were recruited. The University of Pennsylvania Smell Identification Test was administered. Hedonic capacity was assessed using the Temporal Experience of Pleasure Scale (TEPS). ResultsThe results showed that both the schizophrenia and schizotypy groups showed poorer olfactory identification ability than controls, and the impairment was significantly correlated with reduced pleasure experiences. ConclusionOur findings support olfactory identification impairment as a trait marker for schizophrenia.

Motivation deficits in individuals with social anhedonia

Patients with schizophrenia have been reported to exhibit anhedonia, a reduced hedonic capacity and deficits in motivation for reward pursuit. However, it is unclear whether these deficits also exist in at-risk individuals prone to psychosis or not. The present study compared 26 individuals with social anhedonia and 28 healthy controls using a grip Effort-based Pleasure Experience Task (E-PET). The findings showed that individuals with social anhedonia did not increase their hard task choices with the elevation of reward magnitude and probability while healthy controls did. Higher reward probability and magnitude did not lead to more anticipatory pleasure in individuals with social anhedonia. The mean anticipatory pleasure experience ratings in individuals with social anhedonia were significantly lower than controls. Our results suggest that individuals with social anhedonia already exhibit motivational deficits during reward pursuit.

P 10 Automatic processing of masked facial emotions in social anhedonia

Background Anhedonia, the reduced ability to experience pleasure, is a prominent feature of major depression and schizophrenia-spectrum disorders. Anhedonia is not only a state accompanying psychiatric disorders but is also considered as a personality trait, which might increase the susceptibility to psychiatric disorders. Only few neuroimaging studies investigated neural alterations in high anhedonia, isolated from other psychopathological variables, by including only participants without clinical diagnoses. Although findings from previous studies in healthy populations are rather heterogeneous, prior research suggests neurobiological alterations in the perception of emotional and rewarding stimuli as underlying mechanisms in the manifestation of anhedonia. Methods The present study examined healthy individuals scoring high vs. low in social anhedonia, thoroughly selected from a sample of N = 282 participants. As a subtype of reduced hedonic capacity in general, social anhedonia refers to a diminished hedonic experience in interpersonal contacts. In order to reveal differences in automatic brain responses to social-affective stimuli between high compared to low social anhedonia participants, we used functional magnetic resonance imaging. To assess early, automatic stages of emotion processing, we administered a paradigm presenting brief (33 ms) and backward-masked happy, sad, and neutral facial expressions. Results Individuals high in social anhedonia demonstrated increased activation in the bilateral thalamus and left red nucleus in response to masked sad faces relative to individuals low in social anhedonia. Regardless of stimulus valence, no significant group differences in brain activation emerged in other regions known to be involved in emotion and reward processing, including amygdala and nucleus accumbens. Discussion Our results suggest that high social anhedonia in otherwise healthy individuals is associated with exaggerated automatic reactivity in the thalamus, a brain structure that has been implicated in the pathophysiology of major depression. Heightened processing of depression-related stimuli in the thalamus might be a mechanism through which social anhedonia increases the vulnerability to major depression.

Confirmatory Factor Analysis of the French Version of the Anticipatory and Consummatory Interpersonal Pleasure Scale

The Anticipatory and Consummatory Interpersonal Pleasure Scale (ACIPS), a measure specifically designed to assess hedonic capacity for social and interpersonal pleasure, was used to evaluate the presence of social anhedonia in patients as well as the general population. The first goal of this study was to validate the structure of the French version of the ACIPS. The second objective was to verify whether a one, two or three factor solution is most appropriate for the ACIPS scale. The French version of the ACIPS was tested on 263 French-speaking pre-graduate students or professional volunteers. For the confirmatory factor analysis, data were treated as categorical ordinal and all the models were estimated using a robust weighted least squares estimator with adjustments for the mean and variance. Three models were estimated. A one-factor model representing a general undifferentiated “pleasure” latent construct was first tested on the 17 ACIPS items. A two-factor model distinguishing anticipatory-pleasure and consummatory-pleasure was tested next. Finally, a three-factor model including subdomains of intimate social interactions, group social interactions, and social bonding was tested. The one and two-factor models showed a somewhat poor fit to the data. However, the goodness of fit of the three factor model was adequate. These results suggest that individuals who enjoyed interaction in one of these three subdomains were more likely to enjoy doing so in the two other domains. However, on the basis of the comparison between the one and three factor models, these three types of interactions may not be considered as indistinguishable. Rather, they represent distinct and theoretically meaningful dimensions. These results show the French version of the ACIPS is a useful and valid scale to measure the capacity of savoring different kinds of social relationships.

Reward Capacity Predicts Leptin Dynamics During Laboratory-Controlled Eating in Women as a Function of Body Mass Index.

ObjectiveThe role of leptin in mesolimbic signaling non-food-related reward has been well established at the pre-clinical level, yet studies in humans are lacking. The present investigation explored the association between hedonic capacity and leptin dynamics, and whether this association differed by BMI class.MethodsIn this cross-sectional study of 75 women (42 with lean BMIs, 33 with obese BMIs), we measured serum leptin before/after meal consumption. Reward capacity was assessed using the Snaith-Hamilton Pleasure Scale (SHAPS). Multiple regression tested whether reward capacity was associated with leptin AUC, with an interaction term to test differences between lean (LN) and obese (OB) groups.ResultsThe interaction of SHAPS by BMI group was robust (β=−.40, p=.005); among women with obesity, greater SHAPS score was associated with lower leptin AUC (β=−.35, p=.002, adjusted R-squared=.66). Among the lean group, the association was not statistically significant (β=−.16, p=.252, adjusted R-squared=.22). Findings were above and beyond BMI and age.ConclusionsIn this sample a robust, negative association between reward capacity and circulating leptin was stronger in women with obesity compared to lean counterparts. These findings suggest that despite likely leptin resistance, inhibitory leptin functioning related to non-food reward may be spared in women with obesity.

Individual Differences in Subjective Utility and Risk Preferences: The Influence of Hedonic Capacity and Trait Anxiety.

Individual differences in decision-making are important in both normal populations and psychiatric conditions. Variability in decision-making could be mediated by different subjective utilities or by other processes. For example, while traditional economic accounts attribute risk aversion to a concave subjective utility curve, in practice other factors could affect risk behavior. This distinction may have important implications for understanding the biological basis of variability in decision-making and for developing interventions to improve decision-making. Another aspect of decision-making that may vary between individuals is the sensitivity of subjective utility to counterfactual outcomes (outcomes that could have occurred, but did not). We investigated decision-making in relation to hedonic capacity and trait anxiety, two traits that relate to psychiatric conditions but also vary in the general population. Subjects performed a decision-making task, in which they chose between low- and high-risk gambles to win 0, 20, or 40 points on each trial. Subjects then rated satisfaction after each outcome on a visual analog scale, indicating subjective utility. Hedonic capacity was positively associated with the subjective utility of winning 20 points but was not associated with the concavity of the subjective utility curve (constructed using the mean subjective utility of winning 0, 20, or 40 points). Consistent with economic theory, concavity of the subjective utility curve was associated with risk aversion. Hedonic capacity was independently associated with risk seeking (i.e., not mediated by the shape of the subjective utility curve), while trait anxiety was unrelated to risk preferences. Contrary to our expectations, counterfactual sensitivity was unrelated to hedonic capacity and trait anxiety. Nevertheless, trait anxiety was associated with a self-report measure of regret-proneness, suggesting that counterfactual influences may occur via a pathway that is separate from immediate counterfactual processing biases. Taken together, our results show that hedonic capacity but not trait anxiety affects risk-taking through a mechanism that appears independent of the shape of the subjective utility curve, while hedonic capacity and trait anxiety do not affect the influence of counterfactual outcomes on subjective utility. The results have implications for understanding the underlying mechanisms of variable decision-making and for developing interventions to improve decision-making.

Sex differences in the effect of chronic mild stress on mouse prefrontal cortical BDNF levels: A role of major ovarian hormones

Depression induced by stress is affected by sex, age and hormonal status of the animal and also by duration and type of the stressors. Moreover, higher prevalence of depression and comorbidities in women than men implies the need to include the sex variable in studies on animal models of depression. The present study was therefore initiated to evaluate the effect of sex and ovarian hormones on depression-like phenotypes in mice exposed to a 21-day Chronic Variable Mild Stress (CVMS) paradigm. Adult male, intact female and, ovariectomized (OVX) female mice exposed to CVMS displayed despair behavior, a depression-like phenotype, in all the groups. However, intact females alone, but not males and OVX females, showed anhedonia, another depression-like phenotype. At the molecular level, the expression of Brain-Derived Neurotrophic Factor (BDNF), a neuropeptide associated with depression, and few other stress-specific genes CRH, NR3C1, CART, and NPY were measured in the Prefrontal Cortex (PFC) region of the reward circuitry. There was a significant decrease in the BDNF protein expression along with an increase in the mRNA expression of CRH, NR3C1, CART, and NPY in intact females, but not in the other two groups of mice. OVX females resembled males in behavioral and molecular responses to CVMS. 17β-Estradiol (E2) administration, not Progesterone (P4), to OVX female stress mice, mitigated despair and enhanced hedonic capacity with an increased expression of BDNF in PFC. This study strengthens the evidence for the beneficial effects of E2 administration in stress condition.

314. Hedonic Capacity as a Predictor of ADHD and Treatment Response in Depressed Patients

314. Hedonic Capacity as a Predictor of ADHD and Treatment Response in Depressed Patients

Individual differences in hedonic capacity, depressed mood, and affective states predict emotional reactivity.

Identifying factors that contribute to inter-individual differences in emotional reactivity is central to understanding the basic mechanisms that give rise to adaptive emotion reactivity and to disruptions that may occur in psychopathology. The current study related emotional reactivity in an unselected young adult sample (N = 101) to individual difference factors relevant to emotional functioning and mood pathology, specifically anhedonia, depressed mood, and current affective state. To assess emotional reactivity, participants rated their emotional responses to 100 pictures from the International Affective Picture System. Increased self-reported anhedonia (i.e. reduced hedonic capacity) predicted blunted emotional reactivity to both positive and negative images, relative to neutral images, while elevated depressed mood predicted potentiated emotional reactivity to negative vs. neutral images. Anhedonia also accounted for far greater variance in emotional reactivity than depressed mood. Further, more positive affective state predicted potentiated reactivity to positive versus neutral images while more negative affective state predicted potentiated reactivity to negative versus neutral images beyond effects of anhedonia and depressed mood. The current study identified separable effects of anhedonia, depressed mood, and current affect on emotional reactivity.

Behavioral characterization of blocking the ErbB signaling during adolescent and adulthood in reward-liking (preference) and reward-related learning

Adolescence is a critical period in brain development. During this critical period the seeking for hedonic activities is increased, and their activity signals are stronger than the regulatory signals of judgment and reasoning. We recently reported that alteration of ErbB signaling during this period led to elevated striatal dopamine levels and reduced preference for sweetness without affecting locomotor activity and exploratory behavior. In the current study, we extend our findings and explore whether inhibition of the ErbB pathway during adolescence or adulthood also affects alcohol preference (hedonic “liking”), avoidance learning, and motivational reward “wanting”. We demonstrated that chronic administration of the pan-ErbB kinase inhibitor JNJ28871063 (JNJ) to adolescent mice, but not to adult mice, reduced alcohol preference compared with the saline-injected group, without affecting avoidance learning as measured by increasing concentrations of quinine in the bitter avoidance test. Adolescent JNJ-treated mice continue to demonstrate less alcohol preference in adulthood compared with their saline-injected controls. In addition, adolescent JNJ-treated mice and their saline-injected controls did not differ in the time they spent in the food-condition chamber, and in their preference for social odor. In contrast to adolescent JNJ- treated mice, blocking the pathway during adulthood alter the preference to natural reward. These data support our initial findings that interruption of the ErbB pathway during adolescence emerges in a reduced hedonic capacity that persists into adulthood, without disturbing avoidance and reward learning. In addition, this paper provides a further behavioral role of the ErbB signaling pathway in the reward system, and suggests a different time period for the involvement of the pathway in the “liking” and the “wanting” components of the system.

Health-relevant personality is associated with sensitivity to sound (hyperacusis).

Hyperacusis, over-sensitivity to sounds, causes distress and disability and the etiology is not fully understood. The study aims to explore possible associations between health-relevant personality traits and hyperacusis. Hyperacusis was assessed using the Hyperacusis Questionnaire (HQ), and clinical uncomfortable loudness levels (ULL). Personality was measured with the Health-relevant Personality (HP5i) Inventory. The study sample was 348 (140 men and 208 women; age 23-71years). Moderate correlations were found between the personality trait negative affectivity (NA; a facet of neuroticism) and dimensions of the HQ and weak correlations were found with the ULLs. Hedonic capacity (a facet of extraversion) was significantly correlated with the HQ but not with the ULLs. Impulsivity (a facet of conscientiousness) was correlated with the HQ and the ULLs. A significant difference in mean values was found in all hyperacusis measures and different levels of NA - those with higher levels displayed more severe signs of hyperacusis. A multiple logistic regression analysis showed that higher levels of NA increases the odds of having hyperacusis on average 4.6 times for men and 2.4 times for women. These findings imply that health-relevant personality traits should be considered in the diagnosis and treatment of hyperacusis.