Charlotte Vrijen

Study protocol for a randomized controlled trial to explore the effects of personalized lifestyle advices and tandem skydives on pleasure in anhedonic young adults

BackgroundAnhedonia is generally defined as the inability to feel pleasure in response to experiences that are usually enjoyable. Anhedonia is one of the two core symptoms of depression and is a major public health concern. Anhedonia has proven particularly difficult to counteract and predicts poor treatment response generally. It has often been hypothesized that anhedonia can be deterred by a healthy lifestyle. However, it is quite unlikely that a one-size-fits-all approach will be effective for everyone. In this study the effects of personalized lifestyle advice based on observed individual patterns of lifestyle behaviors and experienced pleasure will be examined. Further, we will explore whether a tandem skydive following the personalized lifestyle advice positively influences anhedonic young adults’ abilities to carry out the recommended lifestyle changes, and whether this ultimately improves their self-reported pleasure.MethodsOur study design is an exploratory intervention study, preceded by a cross-sectional survey as a screening instrument. For the survey, 2000 young adults (18–24 years old) will be selected from the general population. Based on survey outcomes, 72 individuals (36 males and 36 females) with persistent anhedonia (i.e., more than two months) and 60 individuals (30 males and 30 females) without anhedonia (non-anhedonic control group) will be selected for the intervention study. The non-anhedonic control group will fill out momentary assessments of pleasure and lifestyle behaviors three times a day, for one month. The anhedonic individuals will fill out momentary assessments for three consecutive months. After the first month, the anhedonic individuals will be randomly assigned to (1) no intervention, (2) lifestyle advice only, (3) lifestyle advice plus tandem skydive. The personalized lifestyle advice is based on patterns observed in the first month.DiscussionThe present study is the first to examine the effects of a personalized lifestyle advice and tandem skydive on pleasure in anhedonic young adults. Results of the present study may improve treatment for anhedonia, if the interventions are found to be effective.Trial registrationDutch Trial Register, NTR5498, registered September 22, 2015 (retrospectively registered).

Slow identification of facial happiness in early adolescence predicts onset of depression during 8 years of follow-up

Adolescent onset depression places a high burden on those who suffer from it, and is difficult to treat. An improved understanding of mechanisms underlying susceptibility to adolescent depression may be useful in early detection and as target in treatment. Facial emotion identification bias has been suggested as trait marker for depression, but results have been inconclusive. To explore whether facial emotion identification biases may be trait markers for depression, we tested whether the speed with which young adolescents identified happy, sad, angry and fearful facial emotions predicted the onset of depression during an eight-year follow-up period. We hypothesized that facial emotion identification speed predicts depression in a symptom-congruent way and differentially predicts symptoms of anhedonia and sadness. Data were collected as part of the TRacking Adolescents’ Individual Lives Survey (TRAILS), and involved 1840 adolescents who participated in a facial emotion identification test at age 11 and were subjected to the World Health Organization Composite International Diagnostic Interview (CIDI) at age 19. In a multi-emotion model, slow identification of happy facial emotions tentatively predicted onset of depressive disorder within the follow-up period. Slow identification of happy emotions and fast identification of sad emotions predicted symptoms of anhedonia, but not symptoms of sadness. Our results suggest that the relative speed of identification of happiness in relation to the identification of sadness is a better predictor of depression than the identification of either facial emotion alone. A possible mechanism underlying the predictive role of facial emotion identification may be a less reactive reward system.

An Exploratory Randomized Controlled Trial of Personalized Lifestyle Advice and Tandem Skydives as a Means to Reduce Anhedonia

Anhedonia is a major public health concern and has proven particularly difficult to counteract. It has been hypothesized that anhedonia can be deterred by engagement in rewarding social and physical events. The aims of the present study were to examine (1) the effects of personalized lifestyle advice based on observed individual patterns of lifestyle factors and experienced pleasure in anhedonic young adults; and (2) whether a tandem skydive can enhance the motivation to carry out the recommended lifestyle changes. Participants (N = 69; Mage = 21.5, SD = 2.0; 79.7% female) were selected through an online screening survey among young adults. Inclusion criteria were persistent anhedonia and willingness to perform a tandem skydive. Participants filled out questionnaires on their smartphones for 2 consecutive months (3 times per day). After the first month, they were randomly assigned to one of three groups: (1) no intervention, (2) lifestyle advice, and (3) lifestyle advice and tandem skydive. The momentary questionnaire data were analyzed using interrupted time series analyses (ITSA) in a multilevel model and monthly pleasure and depression questionnaires by repeated measures ANOVA. No group differences were found in monthly depression and pleasure scores, but the momentary data showed higher positive affect (PA) and pleasure ratings in the month following the intervention in the two intervention groups than in the control group. The tandem skydive did not have any effects above the effects of the lifestyle advice. Our results indicate that providing personalized lifestyle advice to anhedonic young adults can be an effective way to increase PA and pleasure.

Lower Sensitivity to Happy and Angry Facial Emotions in Young Adults with Psychiatric Problems

Many psychiatric problem domains have been associated with emotion-specific biases or general deficiencies in facial emotion identification. However, both within and between psychiatric problem domains, large variability exists in the types of emotion identification problems that were reported. Moreover, since the domain-specificity of the findings was often not addressed, it remains unclear whether patterns found for specific problem domains can be better explained by co-occurrence of other psychiatric problems or by more generic characteristics of psychopathology, for example, problem severity. In this study, we aimed to investigate associations between emotion identification biases and five psychiatric problem domains, and to determine the domain-specificity of these biases. Data were collected as part of the ‘No Fun No Glory’ study and involved 2,577 young adults. The study participants completed a dynamic facial emotion identification task involving happy, sad, angry, and fearful faces, and filled in the Adult Self-Report Questionnaire, of which we used the scales depressive problems, anxiety problems, avoidance problems, Attention-Deficit Hyperactivity Disorder (ADHD) problems and antisocial problems. Our results suggest that participants with antisocial problems were significantly less sensitive to happy facial emotions, participants with ADHD problems were less sensitive to angry emotions, and participants with avoidance problems were less sensitive to both angry and happy emotions. These effects could not be fully explained by co-occurring psychiatric problems. Whereas this seems to indicate domain-specificity, inspection of the overall pattern of effect sizes regardless of statistical significance reveals generic patterns as well, in that for all psychiatric problem domains the effect sizes for happy and angry emotions were larger than the effect sizes for sad and fearful emotions. As happy and angry emotions are strongly associated with approach and avoidance mechanisms in social interaction, these mechanisms may hold the key to understanding the associations between facial emotion identification and a wide range of psychiatric problems.

Ryle and Collingwood: Their Correspondence and its Philosophical Context *

Gilbert Ryle and R. G. Collingwood are not commonly associated with each other. From Ryle’s autobiographical essay (1971) we know that he saw Collingwood as an exact personification of pre-war Oxford: stuffy, hermetically closed off and philosophically dull; and, as did most of his analytically minded colleagues in philosophy, Ryle regarded Collingwood’s philosophy as a relic of past metaphysical theory. Collingwood, in turn, never paid any particular attention to Ryle’s philosophical writings, except on one occasion in 1935 when Ryle and Collingwood discussed their philosophical views with one another. At the time, Ryle was a lecturer at Christ Church College in Oxford and was already regarded as a promising philosopher, and Collingwood was Waynflete Professor of Metaphysical Philosophy. The tone in their brief correspondence was often biting and chilly, and the two philosophers seemed to disagree about almost everything. On the other hand, a few striking similarities between Ryle and Collingwood have been brought to our attention by Collingwood scholars such as Alan Donagan, David Boucher, W. J. van der Dussen and Giuseppina D’Oro. These philosophers pointed at similarities between Ryle and Collingwood with respect to their rejection of Cartesian dualism and their idea of intelligence as ‘knowing how’. Donagan claims:

Alpha-amylase reactivity and recovery patterns in anhedonic young adults performing a tandem skydive

Background Anhedonia (loss of pleasure) is characterized by low responsiveness to rewards and, by virtue of being one of the two core symptoms of depression, by altered responses to stress. We investigated the effect of an acute stress experience (i.e., a tandem skydive) that was expected to elicit both intense fear and intense euphoria in a sample of anhedonic young adults. Objective (1) To examine individual differences in alpha-amylase reactivity to and recovery from a tandem skydive in anhedonic young adults; (2) to investigate whether trait depressive and anxiety problems, trait positive affect (PA), i.e., level of pleasure and reward responsiveness, and state anxiety, PA and self-esteem prior to the skydive were associated with alpha-amylase reactivity and recovery patterns; (3) to investigate whether alpha-amylase reactivity and recovery patterns were associated with pre- to post-jump changes in state anxiety, PA, and self-esteem. Method Participants were 61 individuals with persistent anhedonia (Mage = 21.38, 78.7% female), who filled out a baseline questionnaire at the start of the study, and momentary questionnaires (3 times per day) before and after the tandem skydive. Alpha-amylase was measured at four time points by means of salivettes (2 before and 2 after the skydive). Results Alpha-amylase reactivity and recovery patterns were highly similar across individuals, although mean levels varied greatly. No associations were found between any of the trait and state measures and reactivity and recovery. Only state self-esteem was affected by the reactivity and recovery patterns, in that individuals who showed high reactivity and low recovery experienced decreases in self-esteem after the skydive. Conclusions Alpha-amylase patterns following a tandem skydive in anhedonic individuals are highly similar to patterns previously found in healthy individuals. Although replication is warranted, our findings tentatively suggest that a strong stress response that cannot be downregulated well predicts a decrease in self-esteem.

Reciprocal associations between positive emotions and motivation in daily life: Network analyses in anhedonic individuals and healthy controls

Anhedonia reflects a dysfunction in the reward system, which can be manifested in an inability to enjoy pleasurable situations (i.e., lack of positive emotions), but also by a lack of motivation to engage in pleasurable activities (i.e., lack of motivation). Little is known about the interrelations between positive emotions and motivation in daily life, and whether these associations are altered in anhedonic individuals. In the present study, we used a network approach to explore the reciprocal, lagged associations between positive emotions and motivation in anhedonic individuals (N = 66) and controls (N = 68). Participants (aged between 18 and 24 years) filled out momentary assessments of affect 3 times per day for 30 consecutive days. Our results showed that (a) anhedonic individuals and controls had similar moment-to-moment transfer of positive emotions; (b) in the anhedonic network feeling cheerful was the node with the highest outstrength, both within this group and compared with the control group; (c) feeling relaxed had the highest outstrength in the control network, and (d) anhedonic individuals had stronger pathways from positive emotions to motivation than controls. Taken together, our findings suggest that low levels of positive emotions lead to decreased motivation in the anhedonic group, which could instigate a negative spiral of low pleasure and low motivation. On a more positive note, we showed that cheerfulness had the highest outstrength in the network of anhedonic participants. Hence, interventions may focus on increasing cheerfulness in anhedonic individuals, as this will likely have the greatest impact on other positive emotions and motivations.

First thoughts: An unpublished letter from Gilbert Ryle to H. J. Paton

Much of H. J. Paton’s correspondence is preserved in Queen’s College Library, Oxford, and among it is a stray letter, not in any collection or series, from Gilbert Ryle, who was his pupil between 1920 and 1924. Later the two were to be colleagues in the university, as professors of Moral and Metaphysical Philosophy respectively, but here Ryle is essaying before his first mentor the first steps of his own that he was minded to take in philosophy. The circumstances were these: Paton had obtained a Laura Spelman Rockefeller Fellowship for a sabbatical year (1925–26) and was in California writing his first large book The Good Will. Ryle had gone to Christ Church to teach philosophy in 1924 and was appointed to a Studentship in 1925. During the latter year he taught some of Paton’s pupils (most of whose supervision was arranged by E. F. Carritt of University College) and there are some brief comments on these. We have omitted them with one apparent exception, which will justify itself. Other purely personal matter is also omitted. Thus truncated (by one page out of ten), the letter runs as follows: