Anhedonia is a major public health concern and has proven particularly difficult to counteract. It has been hypothesized that anhedonia can be deterred by engagement in rewarding social and physical events. The aims of the present study were to examine (1) the effects of personalized lifestyle advice based on observed individual patterns of lifestyle factors and experienced pleasure in anhedonic young adults; and (2) whether a tandem skydive can enhance the motivation to carry out the recommended lifestyle changes. Participants (N = 69; M = 21.5, SD = 2.0; 79.7% female) were selected through an online screening survey among young adults. Inclusion criteria were persistent anhedonia and willingness to perform a tandem skydive. Participants filled out questionnaires on their smartphones for 2 consecutive months (3 times per day). After the first month, they were randomly assigned to one of three groups: (1) no intervention, (2) lifestyle advice, and (3) lifestyle advice and tandem skydive. The momentary questionnaire data were analyzed using interrupted time series analyses (ITSA) in a multilevel model and monthly pleasure and depression questionnaires by repeated measures ANOVA. No group differences were found in monthly depression and pleasure scores, but the momentary data showed higher positive affect (PA) and pleasure ratings in the month following the intervention in the two intervention groups than in the control group. The tandem skydive did not have any effects above the effects of the lifestyle advice. Our results indicate that providing personalized lifestyle advice to anhedonic young adults can be an effective way to increase PA and pleasure.

Adolescent onset depression places a high burden on those who suffer from it, and is difficult to treat. An improved understanding of mechanisms underlying susceptibility to adolescent depression may be useful in early detection and as target in treatment. Facial emotion identification bias has been suggested as trait marker for depression, but results have been inconclusive. To explore whether facial emotion identification biases may be trait markers for depression, we tested whether the speed with which young adolescents identified happy, sad, angry and fearful facial emotions predicted the onset of depression during an eight-year follow-up period. We hypothesized that facial emotion identification speed predicts depression in a symptom-congruent way and differentially predicts symptoms of anhedonia and sadness. Data were collected as part of the TRacking Adolescents’ Individual Lives Survey (TRAILS), and involved 1840 adolescents who participated in a facial emotion identification test at age 11 and were subjected to the World Health Organization Composite International Diagnostic Interview (CIDI) at age 19. In a multi-emotion model, slow identification of happy facial emotions tentatively predicted onset of depressive disorder within the follow-up period. Slow identification of happy emotions and fast identification of sad emotions predicted symptoms of anhedonia, but not symptoms of sadness. Our results suggest that the relative speed of identification of happiness in relation to the identification of sadness is a better predictor of depression than the identification of either facial emotion alone. A possible mechanism underlying the predictive role of facial emotion identification may be a less reactive reward system.Electronic supplementary materialThe online version of this article (doi:10.1007/s00787-016-0846-1) contains supplementary material, which is available to authorized users.

BackgroundAnhedonia is generally defined as the inability to feel pleasure in response to experiences that are usually enjoyable. Anhedonia is one of the two core symptoms of depression and is a major public health concern. Anhedonia has proven particularly difficult to counteract and predicts poor treatment response generally. It has often been hypothesized that anhedonia can be deterred by a healthy lifestyle. However, it is quite unlikely that a one-size-fits-all approach will be effective for everyone. In this study the effects of personalized lifestyle advice based on observed individual patterns of lifestyle behaviors and experienced pleasure will be examined. Further, we will explore whether a tandem skydive following the personalized lifestyle advice positively influences anhedonic young adults’ abilities to carry out the recommended lifestyle changes, and whether this ultimately improves their self-reported pleasure.MethodsOur study design is an exploratory intervention study, preceded by a cross-sectional survey as a screening instrument. For the survey, 2000 young adults (18–24 years old) will be selected from the general population. Based on survey outcomes, 72 individuals (36 males and 36 females) with persistent anhedonia (i.e., more than two months) and 60 individuals (30 males and 30 females) without anhedonia (non-anhedonic control group) will be selected for the intervention study. The non-anhedonic control group will fill out momentary assessments of pleasure and lifestyle behaviors three times a day, for one month. The anhedonic individuals will fill out momentary assessments for three consecutive months. After the first month, the anhedonic individuals will be randomly assigned to (1) no intervention, (2) lifestyle advice only, (3) lifestyle advice plus tandem skydive. The personalized lifestyle advice is based on patterns observed in the first month.DiscussionThe present study is the first to examine the effects of a personalized lifestyle advice and tandem skydive on pleasure in anhedonic young adults. Results of the present study may improve treatment for anhedonia, if the interventions are found to be effective.Trial registrationDutch Trial Register, NTR5498, registered September 22, 2015 (retrospectively registered).Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-016-0880-z) contains supplementary material, which is available to authorized users.