Anhedonia and its sub-component processes predict clinically significant symptoms of Major Depressive Disorder (MDD) and loneliness in young people.

Abstract

Objectives: Anhedonia, a core symptom of Major Depressive Disorder (MDD), is a risk factor for future depressive episodes and is associated with social withdrawal, which may contribute to loneliness-another risk factor for depression. Understanding how anhedonia and its sub-component processes relate to depression and loneliness could reveal key targets for intervention development.

Methods: We recruited 275 young people (M_age: 20.50) with clinically significant symptoms of depression, indicated by scores ≥27 on the Mood and Feelings Questionnaire (MFQ). Participants completed the Anhedonia Scale for Adolescents (ASA) and its three subscales: ASA-S1 (Enjoyment, Excitement, and Emotional Flattening); ASA-S2 (Enthusiasm, Connection, and Purpose); ASA-S3 (Effort, Motivation, and Drive); and the UCLA Loneliness Scale (UCLA) at baseline and at four-month follow-up (N = 173). Multiple regression analyses examined the relationships between anhedonia, MDD, and loneliness, both cross-sectionally and longitudinally.

Results: Cross-sectionally, the ASA total scores (β = .655, p < .001), ASA-S1 (β = .586, p < .001), and ASA-S3 (β = .153, p = .034) were associated with MDD. ASA total scores (β = .651, p < .001), ASA-S1 (β = .397, p < .001), ASA-S2 (β = .196, p < .001), and ASA-S3 (β = .176, p = .018) were associated with loneliness. Longitudinally, ASA total scores (β = .485, p < .001) and ASA-S1 (β = .298, p = .008) predicted MDD, while ASA-S2 showed a trend toward predicting loneliness (β = .099, p = .058).

Conclusions: This study highlights how specific anhedonia sub-component processes predict increases in clinically significant symptoms of MDD and loneliness among young people, informing the development of more targeted treatments for anhedonia.