4.7 Article

Anticipatory pleasure in current psychosis: Cognitive and emotional correlates

Journal

PSYCHIATRY RESEARCH
Volume 297, Issue -, Pages -

Publisher

ELSEVIER IRELAND LTD
DOI: 10.1016/j.psychres.2020.113697

Keywords

Anhedonia; Self-concept; Avoidance; Paranoia; Cognition; Activity; Anticipatory pleasure

Categories

Funding

  1. NIHR Research Professorship [NIHRRP201405003]
  2. NIHR Oxford Health Biomedical Research Centre [BRC121520005]
  3. National Institute for Health Research (NIHR)

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Patients with psychosis experience lower levels of anticipatory pleasure, with factors such as depression, negative self-beliefs, and suicidal ideation contributing to this decrease. Emotional factors may play a more significant role than cognitive difficulties in the experience of anhedonia in psychosis. Working memory, physical activity, or meaningful activity did not show significant associations with anticipatory pleasure.
Anticipation of pleasure ? a key aspect of hedonic experience - is a motivating factor for engaging in activities. Low levels of anticipatory pleasure and activity are found in individuals with psychosis. Cognitive factors (e.g., working memory and IQ) have been a focus of explanation for anticipation of pleasure in psychosis. However, cognitive factors do not fully account for such difficulties. It is plausible that emotional factors (e.g., depression, self-beliefs) also contribute. We examined anticipatory pleasure in relation to cognitive and emotional processes in patients with current psychosis. 128 patients with persecutory delusions in the context of non-affective psychosis completed assessments of anticipatory pleasure, cognitive functioning, emotional processes, and activity. Lower anticipatory pleasure was significantly associated with depression, insomnia, negative-self beliefs, suicidal ideation, poorer psychological wellbeing, and paranoia-related avoidance. There were no significant associations with working memory, physical activity, or meaningful activity. Emotional factors may play a more significant role than cognitive difficulties in the experience of anhedonia in psychosis. However, the cross-sectional design precludes causal inferences. Future research should examine whether, for example, improving self-concept or reducing paranoia-related avoidance leads to improvement in anticipatory pleasure in patients with psychosis.

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