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Mapping the relationship between anxiety, anhedonia, and depression
Open accessAbstract
Introduction Anxiety and depression are often comorbid conditions, but there is uncertainty as to how this comorbidity develops. Thus, in three studies, we attempted to discern whether anhedonia may be a key linking factor between anxiety and depression.Methods Three studies asked participants about their symptoms of anxiety and depression: in Study 1, 109 participants completed measures of anxiety, depression, activity avoidance, and perceived enjoyability and importance of avoided activities; in Study 2, 747 participants completed measures of anhedonia, anxiety, depression, and defensiveness; in Study 3, 216 participants completed measures assessing the same constructs as in Study 2 at four time-points (ranging 11 months in span).Results In Study 1, symptoms of anxiety and depression were positively related only in individuals who relinquished potential enjoyment due to their anxiety-related avoidance; in Study 2, the indirect effect of anhedonia helped explained how anxiety symptoms imparted risk onto depressive symptoms; and in Study 3, anxiety led to anhedonia and then depression over time and anhedonia led to anxiety and then depression at both 5 and 11 months.Limitations The manuscript is limited by the use of a student sample in study 2, cross-sectional methods in studies 1 and 2, and reliance on self-ratings.Conclusions Anxiety may devolve into depression through anhedonia, such that anxious individuals begin to lose pleasure in anxiety-provoking activities, which results in the development of other depressive symptoms.
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“anxiety can give rise to depression specifically when anxious avoidance leads individuals to abandon positive experiences and develop social anhedonia—a common correlate of diminished connectedness (Winer et al., 2017).”
From Enhancing social connectedness in anxiety and depression through amplification of positivity: Preliminary treatment outcomes and process of change (2020) · cites this paper as Winer et al., 2017
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Metadata
- Authors
- Winer, E. S., Bryant, J., Bartoszek, G., Rojas, E., Nadorff, M. R., & Kilgore, J.
- Affiliations
- Mississippi State University (US)
- University of Illinois Chicago (US)
- Baylor College of Medicine (US)
- Corresponding author
- Winer, E. Samuel
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2017-10
- Volume
- 221
- Pages
- 289-296
- ISSN
- 0165-0327 (ISSN-L)
- PMC
- PMC6080718
- OpenAlex
- W2626719695
- Cited by
- 124
- References
- 49
- Citations by year
- 2026: 14 · 2025: 27 · 2024: 12 · 2023: 18 · 2022: 16 · 2021: 15 · 2020: 10 · 2019: 9 · 2018: 3
- FWCI
- 7.78
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R15MH101573)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- anxiety, anhedonia, depression, comorbid depression and anxiety, activity avoidance, defensiveness, temporal dynamics of symptoms, loss of pleasure
- MeSH terms
- Adult, Anxiety Disorders, Cross-Sectional Studies, Depressive Disorder, Female, Humans, Male, Middle Aged, Surveys and Questionnaires, Students, Comorbidity, Uncertainty, Young Adult, Anhedonia
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