Social Anhedonia in the Daily Lives of People with Schizophrenia: Examination of Anticipated and Consummatory Pleasure

Abstract

Social withdrawal is a disabling feature of schizophrenia. To understand its development, researchers have focused on social anhedonia— diminished pleasure from social interactions. Discrepancies in anticipated versus consummatory pleasure for non-social stimuli are well-documented in schizophrenia. Thus, a similar emotional paradox may underlie social anhedonia. If so, our understanding of social anhedonia—including how to treat it in schizophrenia—could be enhanced. This project used a 5-day experience sampling method (ESM) to measure discrepancies between anticipated and consummatory pleasure for real-world social activities in people with schizophrenia and healthy controls (n=30/group). Results suggest people with schizophrenia exhibited similar levels of anticipated and consummatory social pleasure as controls, and both groups were accurate in their short-term predictions of pleasure. Yet, healthy control participants were somewhat more precise in their short-term pleasure predictions, and clinical interviews revealed those with schizophrenia showed moderate deficits in long-term social pleasure prediction. Negative symptoms and cognitive impairment in schizophrenia were related to anticipated, but not consummatory, social pleasure, suggesting anhedonia is driven by deficits in thinking about pleasure, rather than inability to experience pleasure. Clinical implications include focusing on building upon short-term ability to predict pleasure in therapy in order to increase social motivation in schizophrenia. Moreover, exploratory analyses revealed differences in qualitative aspects of social activities such as level of engagement may lead to social anhedonia in schizophrenia and are a promising treatment target for addressing social dysfunction.