Evaluation of anhedonia with the Snaith–Hamilton Pleasure Scale (SHAPS) in adult outpatients with major depressive disorder

Abstract

Anhedonia or inability to experience pleasure not only is a core symptom of major depressive disorder (MDD), but also is identified as an important component of the positive valence system in the NIMH Research Domain Criteria. The Snaith-Hamilton Pleasure Scale (SHAPS) has been developed for the assessment of hedonic experience or positive valence, but has not been well-studied in depressed outpatient populations. The current study examined the reliability and validity of the SHAPS using a sample of adult outpatients with treatment resistant MDD. Data for the current study were obtained from 122 adult outpatients with a diagnosis of MDD and non-response to adequate treatment with an SSRI and who participated in Project TReatment with Exercise Augmentation for Depression (TREAD). A Principal Components Analysis was used to define the dimensionality of the SHAPS. Convergent and discriminant validity were evaluated via correlations of the SHAPS total score with "gold standard" measures of depression severity and quality of life. The SHAPS was found to have high internal consistency (Cronbach's coefficient α = .82). A Principal Components Analysis suggests that the SHAPS is mainly "unidimensional" and limited to hedonic experience among adult outpatients with MDD. Convergent and discriminant validity were assessed by examining the Spearman rank-order correlation coefficient between the SHAPS total score and the HRSD17 (rs = 0.22, p < .03), IDS-C30 (rs = 0.26, p < .01), IDS-SR30 (rs = 0.23, p < .02), QIDS-C16 (rs = 0.22, p < .03), QIDS-SR16 (rs = 0.17, p < .10), QLES-Q (rs = -0.32, p < .002), and the pleasure/enjoyment item (sub-item 21) of the IDS-C (rs = 0.44, p < .0001) and IDS-SR (rs = 0.38, p < .0002). The self-administered SHAPS showed modest sensitivity (76%) and specificity (54%) with the self-administered pleasure/enjoyment single item (sub-item 21) of IDS-SR30. The current study shows that the SHAPS is a reliable and valid instrument to assess hedonic experience or positive valence in adult outpatients with MDD and provides a broader assessment of this important domain.

Anhedonia is associated with blunted reward sensitivity in first-degree relatives of patients with major depression

“…Importantly, even after controlling for general depressive symptoms, anhedonia measured by the SHAPS still predicted reward bias, both in the whole sample and in the high BDI relatives group. The SHAPS evaluates hedonic experience or positive valence, which is a related, but conceptually distinct construct to depression (Franken et al, 2007; Franz et al, 1998; Leventhal et al, 2006; Liu et al, 2012; Nakonezny et al, 2015). This result suggests that altered behavioural responsiveness to reward may be specifically relevant to the positive valence system in relatives with high BDI scores, who are at high risk of developing depression.…”

Exercise is an effective treatment for positive valence symptoms in major depression

“…Receiver Operating Characteristic (ROC) analysis suggested that a score of greater than 2 on the SHAPS indicates clinically abnormal results (Snaith et al, 1995). It is well validated and has been analyzed for psychometric properties, including using the TREAD sample data (Nakonezny et al, 2010, 2015). By asking directly about the experience of pleasure, the SHAPS items are associated closely with the DSM conceptualization of anhedonia as well as RDoC approach motivation and reward responsiveness.…”

Personality traits, gender differences and symptoms of anhedonia: What does the Hospital Anxiety and Depression Scale (HADS) measure in nonclinical settings?

“…This study replicated the findings of men having a higher score than women on HADS‐D. The anhedonic content in the HADS depression scale probably explains this result, as gender differences in negative affect are consistent, while gender differences in anhedonia, positive affect, and extroversion are considerably smaller and sometimes reversed (Costa et al ., ; Fujita et al ., ; Snaith et al ., ; Nakonezny et al ., ). Positive affect seems important in explaining gender differences in HADS, and the results suggest that the HADS‐D dimension is better referred to as a measure of anhedonic depression than a general measure of depression.…”

“…Anhedonia (reduced positive affect, loss of interest and pleasure, and lack of reactivity to usually pleasurable stimuli) is a key feature in many psychiatric disorders (Liu, Wang, Zhu, Li & Chan, 2012;Rømer-Thomsen, Whybrow & Kringelbach, 2015). Although viewed as a core symptom in the psychopathology of major depressive disorder and included as such in diagnostic manuals, its measurement in depression has received limited attention (Nakonezny, Carmody, Morris, Kurian, & Trivedi, 2010). It is suggested that anhedonia is represented by pleasure networks in the brain (Rømer-Thomsen et al, 2015).…”