Beyond the emotion paradox: Avenues to understanding anhedonia in schizophrenia

Le résumé fourni par la source

In people with schizophrenia, anhedonia is commonly conceptualized using the notion of an "emotion paradox." This "emotion paradox" refers to relatively preserved positive affect during immediate exposure to pleasant stimuli despite reduced pleasure on non-current self-reports and lower engagement in pleasurable activities. Across levels of analysis, case-control studies have converged in suggesting impairments in representational and evaluative processes involved in anticipating, maintaining, and translating reward into motivated behavior, rather than a uniform incapacity to experience pleasure in the moment. In this critical perspective, we argue that the "emotion paradox" framework remains valuable but requires refinement. We review evidence that normatively pleasant situations may elicit co-occurring negative affect, affective ambivalence, and reduced positivity offset, each of which may weaken the motivational impact of reward. We further argue that momentary positive affect is not uniform across schizophrenia samples but may vary with overall negative symptom severity. Moreover, we show how measures labeled as "momentary" differ in their reliance on bottom-up and top-down information sources when individuals report emotional experience. These methodological differences may create method-specific artifacts that mimic a dissociation between intact laboratory responding and impaired non-current affective self-reports. We conclude that case-control approaches may obscure meaningful heterogeneity and that understanding anhedonia in schizophrenia requires greater attention to negative affective dynamics, dimensional accounts of negative symptoms, and impaired representational processes.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.