<br>了解快感缺失：一项探索青少年抑郁症中兴趣和快乐丧失的定性研究。,European Child & Adolescent Psychiatry

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了解快感缺失：一项探索青少年抑郁症中兴趣和快乐丧失的定性研究。
European Child & Adolescent Psychiatry ( IF 6.0 ) Pub Date : 2019-07-03 , DOI: 10.1007/s00787-019-01364-y
Rebecca Watson ₁ , Kate Harvey ₁ , Ciara McCabe ₁ , Shirley Reynolds ₁

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快感缺乏（或失去兴趣和快乐）是抑郁症的核心症状，可能预示着治疗结果不佳。然而，人们对快感缺失的主观体验知之甚少，也很少将其作为抑郁症心理治疗的目标。本研究的目的是探讨年轻人在抑郁症背景下如何体验快感缺失。对 34 名初步诊断为抑郁症 (N = 12) 或抑郁症状加重 (N = 22) 的青少年进行了半结构化访谈。主题分析用于确定青少年经历的重要方面。确定了四个主题：（1）经历快乐的丧失和情绪的平淡； (2) 缺乏动力和积极参与；（3）失去联系感和归属感； (4)质疑自我意识、目标和大局观。研究结果挑战了快感缺失只是失去兴趣和快乐的框架。青少年报告了一系列与精神分裂症相关的阴性症状密切相关的经历，并且与帕金森病的“冷漠”特征感相似。这凸显了采用跨诊断方法来理解和治疗与心理健康问题相关的奖励缺陷的潜在好处。

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Understanding anhedonia: a qualitative study exploring loss of interest and pleasure in adolescent depression.

Anhedonia (or loss of interest and pleasure) is a core symptom of depression and may predict poor treatment outcome. However, little is known about the subjective experience of anhedonia, and it is rarely targeted in psychological treatment for depression. The aim of this study is to examine how young people experience anhedonia in the context of depression. Semi-structured interviews were conducted with 34 adolescents with a primary diagnosis of depression (N = 12) or elevated depressive symptoms (N = 22). Thematic analysis was used to identify important aspects of adolescents' experiences. Four main themes were identified: (1) experiencing a loss of joy and a flattening of emotion; (2) struggling with motivation and active engagement; (3) losing a sense of connection and belonging; and (4) questioning sense of self, purpose, and the bigger picture. The results challenge the framing of anhedonia as simply the loss of interest and pleasure. Adolescents reported a range of experiences that mapped closely onto the cluster of negative symptoms associated with schizophrenia and were similar to the sense of 'apathy' characteristic in Parkinson's disease. This highlights the potential benefit of taking a trans-diagnostic approach to understanding and treating reward deficits associated with mental health problems.

更新日期：2020-04-21

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