The Anhedonia Paradox in Schizophrenia

“The blunted motivation characteristic of schizophrenia appears to be due not to diminished hedonic responses, but rather to impairments in representing the hedonic value of stimuli and response options, and thus in translating such representations into goal-directed behavior”

Schizophrenia is characterized by significant reward processing dysfunctions. However, in-the-moment affective responses to evocative stimuli (consummatory pleasure or liking ) are surprisingly intact. In contrast, mounting evidence indicates that anhedonia in schizophrenia might stem from impairments in generating, accessing, and/or maintaining representations of hedonic values, resulting in deficits in anticipatory pleasure ( wanting ) and goal-directed behavior

(3,4). A better understanding of the precise psychological and neurobiological mechanisms underlying anhedonia will be a necessary step toward the development of better treatment interventions in schizophrenia. In this respect, findings emerging from studies rooted within an affective neuroscience approach – including the one featured in the current issue of Biological Psychiatry (5) – suggest that the future promises to yield rewarding outcomes.

Diego A. Pizzagalli, Ph.D.