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<p>Objective:&#xa0;The Fear of Positive Evaluation (FPE) has become relevant in Major Depressive Disorder (MDD), as research indicates that depression can hinder how individuals process positive self-information. Anhedonia’s role in FPE is gaining attention, suggesting a need for further exploration. Understanding the components of anhedonia may clarify its connection to FPE and MDD. Reward Learning, especially the subcomponent of Probabilistic and Reinforcement Learning (PRL), affects how individuals respond to evaluations and integrate social information. This study examined FPE in MDD patients with varying levels of anhedonia compared to Healthy Controls (HC), while also assessing the relationship between FPE and PRL.&#xa0;Method:&#xa0;This analytic and descriptive study examined inpatients with MDD, aged 18 to 65, divided into high anhedonia (<i>n</i> = 33) and low anhedonia (<i>n</i> = 35) groups, compared to HC (<i>n</i> = 35). Levels of FPE were assessed using a computer-based reward test and the FPE scale, and the relationship between PRL and FPE was also analyzed.&#xa0;Results:&#xa0;MDD patients with high anhedonia reported higher levels of FPE than those with low anhedonia and HC. FPE was correlated with PRL in three groups of high and low in anhedonia and HC (<i>r</i> = − .44, − 0.53, − 0.35, respectively), which aligns with the existing theories. Regression analyses revealed that after controlling for group and social anxiety, PRL significantly predicted FPE.&#xa0;Conclusion:&#xa0;Our finding is significant for clinical practice; positive feedback for individuals with MDD and high anhedonia can be distressing and may predict poor treatment outcomes. Longitudinal studies or interventions targeting PRL and FPE in MDD patients are suggested for future research.</p>

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Fear of positive evaluation in anhedonic patients suffering from major depressive disorder: the role of probabilistic and reinforcement learning

  • 期刊论文

  • 发表日期：

    2025年4月22日

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  • Somayeh Daneshvar,
  • Zahra Zeraatpisheh,
  • Laura Jobson

摘要

Objective: The Fear of Positive Evaluation (FPE) has become relevant in Major Depressive Disorder (MDD), as research indicates that depression can hinder how individuals process positive self-information. Anhedonia’s role in FPE is gaining attention, suggesting a need for further exploration. Understanding the components of anhedonia may clarify its connection to FPE and MDD. Reward Learning, especially the subcomponent of Probabilistic and Reinforcement Learning (PRL), affects how individuals respond to evaluations and integrate social information. This study examined FPE in MDD patients with varying levels of anhedonia compared to Healthy Controls (HC), while also assessing the relationship between FPE and PRL. Method: This analytic and descriptive study examined inpatients with MDD, aged 18 to 65, divided into high anhedonia (n = 33) and low anhedonia (n = 35) groups, compared to HC (n = 35). Levels of FPE were assessed using a computer-based reward test and the FPE scale, and the relationship between PRL and FPE was also analyzed. Results: MDD patients with high anhedonia reported higher levels of FPE than those with low anhedonia and HC. FPE was correlated with PRL in three groups of high and low in anhedonia and HC (r = − .44, − 0.53, − 0.35, respectively), which aligns with the existing theories. Regression analyses revealed that after controlling for group and social anxiety, PRL significantly predicted FPE. Conclusion: Our finding is significant for clinical practice; positive feedback for individuals with MDD and high anhedonia can be distressing and may predict poor treatment outcomes. Longitudinal studies or interventions targeting PRL and FPE in MDD patients are suggested for future research.