The Critical Value of High-Risk Designs and Developmental Psychopathology Frameworks for Understanding Affective Psychopathology: Insights from Research on Anhedonia.

Abstract

Developmental psychopathology frameworks view development as a dynamic process that integrates multiple systems, clarifying how psychopathology develops and who develops it. High-risk study designs, such as those investigating progressive changes in youth with familial psychopathological histories, are one developmental research strategy. While much research focuses on clinical symptoms after they emerge, this approach hinders our understanding of when and how clinical symptoms and psychopathology develop and identification of risk factors, neural mechanisms, and clinical correlates. We review the critical value and advantages of using high-risk designs and developmental psychopathology frameworks to understand the emergence of affective psychopathology. We focus on anhedonia, a transdiagnostic affective symptom-defined as diminished experiences of pleasure-which emerges during adolescence, and occurs prior to onset of disorders like depression. We review the phenomenology, behavior, and neural mechanisms of anhedonia. Then we discuss the symptom from a developmental psychopathology perspective, outlining the advantages and disadvantages of using high-risk designs. From there, we synthesize the literature and conclude with clinical implications and considerations for future directions. These approaches are critical for understanding mental health, particularly affective psychopathology, and deserve more attention in the field.