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Cited by 250Posttraumatic Stress Disorder ResearchNeurotransmitter Receptor Influence on BehaviorAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Reward functioning in PTSD: a systematic review exploring the mechanisms underlying anhedonia

Nawijn, Laura, van Zuiden, Mirjam, Frijling, Jessie L., Koch, Saskia B.J., Veltman, Dick J., Olff, Miranda·2015·Neuroscience & Biobehavioral Reviews
DOI 10.1016/j.neubiorev.2015.01.019
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Abstract

Post-traumatic stress disorder (PTSD) is a debilitating psychiatric disorder. An important diagnostic feature of PTSD is anhedonia, which may result from deficits in reward functioning. This has however never been studied systematically in PTSD. To determine if PTSD is associated with reward impairments, we conducted a systematic review of studies in which reward functioning was compared between PTSD patients and healthy control participants, or investigated in relation to PTSD symptom severity. A total of 29 studies were included, covering reward anticipation and approach ('wanting'), and hedonic responses to reward ('liking'). Overall, results were mixed, although decreased reward anticipation and approach and reduced hedonic responses were repeatedly observed in PTSD patients compared to healthy controls. Decreased reward functioning was seen more often in female than in male PTSD samples and most often in response to social positive stimuli. Though more research is needed, these findings are a first step in understanding the possible mechanisms underlying anhedonia in PTSD.

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  • Deficits in reward functioning may be a mechanism underlying anhedonia associated with PTSD.

    “Deficits in reward functioning may be a mechanism underlying anhedonia (lack of pleasure) associated with PTSD (68).”

    From A Biopsychosocial Overview of the Opioid Crisis: Considering Nutrition and Gastrointestinal Health (2019) · cites this paper as [68]

  • A growing recognition of alterations in reward processing led to a reconceptualization of PTSD as an imbalance between approach (reward-related) and avoidance (fear-related) systems.

    “While early research focused on fear-related processes, a growing recognition of alterations in reward processing (115, 116) led to a reconceptualization of PTSD as an imbalance between approach (reward-related) and avoidance (fear-related) systems (117–119).”

    From A transdiagnostic perspective on social anhedonia (2019) · cites this paper as [118]

  • Overall, a tendency to both reduced consummatory and motivational reward was noted in PTSD, especially in females with PTSD and in response to positive social stimuli compared to nonsocial stimuli, suggestive of social anhedonia.

    “Overall, however, a tendency to both reduced consummatory and motivational reward was noted, especially in females with PTSD and in response to positive social stimuli compared to nonsocial stimuli, suggestive of social anhedonia (118).”

    From A transdiagnostic perspective on social anhedonia (2019) · cites this paper as [118]

  • Reduced motivation to approach socially rewarding stimuli may be particularly evident in those with PTSD when greater effort is needed to gain reward, suggesting reduced sensitivity in the cognitive underpinning for 'wanting' social connections.

    “Reduced motivation to approach socially rewarding stimuli may be particularly evident in those with PTSD when greater effort is needed to gain reward (118), suggesting reduced sensitivity in the cognitive underpinning for “wanting” social connections.”

    From A transdiagnostic perspective on social anhedonia (2019) · cites this paper as [118]

  • Decreased sensitivity to social rewards is documented in schizophrenia, eating disorders, PTSD, and autism spectrum disorders.

    “Specifically, decreased sensitivity to social rewards is documented in schizophrenia (61), eating disorders (93), PTSD (118), and autism spectrum disorders (146).”

    From A transdiagnostic perspective on social anhedonia (2019) · cites this paper as [118]

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Authors
Nawijn, L., van Zuiden, M., Frijling, J. L., Koch, S. B. J., Veltman, D. J., & Olff, M.
Affiliations
  • Amsterdam UMC Location University of Amsterdam (NL)
  • Amsterdam UMC Location Vrije Universiteit Amsterdam (NL)
Corresponding author
Nawijn, Laura
ORCID
Venue
Neuroscience & Biobehavioral Reviews
Publisher
Elsevier BV
Published
2015-04
Volume
51
Pages
189-204
ISSN
0149-7634 (ISSN-L)
DOI
10.1016/j.neubiorev.2015.01.019
OpenAlex
W2016541117
Semantic Scholar
64b3d956bb37a28b619fb4c589c5d80de9f5effb
Cited by
250
References
101
Citations by year
2026: 12 · 2025: 20 · 2024: 25 · 2023: 23 · 2022: 23 · 2021: 34 · 2020: 35 · 2019: 21 · 2018: 23 · 2017: 16 · 2016: 13 · 2015: 5
FWCI
2.70
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Neuroscience & Biobehavioral Reviews (publishedVersion)
  • PubMed (publishedVersion)
  • Pure Amsterdam UMC (publishedVersion)
  • Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
Funders
  • ZonMw (91210041)
  • Academic Medical Center Research Council (110614)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
  • Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
post-traumatic stress disorder, anhedonia, reward processing, reward anticipation, approach behavior, hedonic response, sex differences, social reward, symptom severity
MeSH terms
Brain, Humans, Reward, Stress Disorders, Post-Traumatic, Anhedonia

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