Substance misuse prevention: Addressing anhedonia

Abstract

Anhedonia refers to the inability of experiencing pleasure in positive life events. It has been conceptualized as a stable yet malleable characteristic and is associated with hypoactivity in the mesolimbic and mesocortical dopaminergic systems. Very recently, it has been posited as an etiologic factor associated with drug addiction onset, escalation, and relapse. Prevention programming could be developed to counteract the harmful impact of anhedonia, so as to minimize its impact on drug misuse. Remedial efforts are those that either (1) permit the individual to tolerate low levels of pleasure without resorting to drug misuse or other maladaptive behaviors that may unhealthily besot pleasure (for example, through normalization, structuring time, or meditation) or (2) counteract anhedonia by enhancing ones capability to experience pleasure (for example, behavioral activation, positive psychology, pharmacotherapy, or pursuit of positive addictions). School‐based activities could be developed that can be completed by individuals, small workgroups, or the whole classroom. The concept of anhedonia is described in this chapter, and possible prevention strategies that might be utilized in schools as well as other contexts are discussed.

Children’s brain activation during risky decision-making: A contributor to substance problems?

“…In our participants the severity of externalizing scores was associated with the severity of hypoactivity in the reward-mediating midbrain (including the regions of substantia nigra and ventral tegmental area) and basal ganglia (including nucleus accumbens and other regions of caudate and putamen). Under-activity there supports arguments ( e.g., Sussman and Leventhal, 2014) that reward-system deficiencies may contribute later to excessive reward-seeking with drugs and risky behaviors.…”

The Developmental Origins of Opioid Use Disorder and Its Comorbidities

“…Many of these are common across several mental illnesses and may share common biological substrates. Anhedonia defined broadly as an inability to experience pleasure is a feature of substance use disorder in some individuals (Ahmed and Koob, 1998 ; Koob and Moal, 2001 ; Janiri et al, 2005 ; Hatzigiakoumis et al, 2011 ; Sussman and Leventhal, 2014 ; Kiluk et al, 2019 ; Brenner et al, 2020 ) and of other psychiatric diagnoses that are comorbid with addiction (Gorwood, 2008 ), such as depression (Loas, 1996 ; Blanchard et al, 2001 ; Pizzagalli et al, 2008 ; Martinotti et al, 2012 ), schizophrenia and psychosis (Andreasen and Olsen, 1982 ; Blanchard et al, 2001 ; Martinotti et al, 2012 ), PTSD (Risbrough et al, 2018 ), eating disorders (Davis and Woodside, 2002 ; Halmi, 2009 ), and other “high-risk” behaviors (Franken et al, 2006 ).…”

21st century neurobehavioral theories of decision making in addiction: Review and evaluation

“…Individuals in the most advanced and severe stages of addiction may demonstrate concurrent patterns of overvaluation of addictive commodities, and undervaluation of alternative reinforcers, such as social and family engagement (Currie, 1994). Indeed, anhedonia, or the lack of ability to experience pleasure from commonly-enjoyable activities, may be widespread in individuals with addiction (Lubman et al, 2009; Sussman & Leventhal, 2014) and critical to the understanding of addictive behavior and motivation (Wise, 2008). Specifically, the relative insensitivity to otherwise rewarding events may have physiological underpinnings among individuals who are addicted (Koob & Volkow, 2010), and may be paired with relatively heightened sensitivity to the rewards of drugs and other addictive commodities (Leventhal et al, 2014).…”