Hypohedonia: Description, Causes and Risk Factors:Hypohedonia is an impaired disposition to experience pleasure, accompanied behaviorally by weakened effect of objective positive reinforcement in conditioning and maintaining operants and respondents. The term is preferable to "anhedonia," which suggests zero pleasure; but the latter term is harmless when denoting the "hypohedonic extreme." Primary hypohedonia is the heritable component of pleasure impairment, a basic reduced capacity, polygenically determined but possibly involving a major locus in addition. The conjectured basic source is a deviation in the microanatomy or neurochemistry of the limbic system. Theorists argued that perhaps hypohedonia develops in reaction to schizophrenic illness. It may represent a defense against the highly unpredictable internal states to which schizophrenics are subjects. They suggest that schizophrenics are prone to state of cognitive & emotional overload from their social environments and may adopt a perceptual style which reduces the intensity of stimuli. A state of hypohedonia may severe to reduce excessive level of arousal. Another study emphasized the view of hypohedonia as a result of inadequate social learning. With the beginning of schizophrenia the individuals normal development disrupted. They young person may be deprived or participation in new experiences and activities. Without these the individual cannot develop his capacity for pleasure. If the individual continues in the sick role, he/she may spend years of unstimulating and undemanding institutional and community settings. These environments may maintain the individuals' isolation from pleasurable activities and experiences. This phenomenon has been referred to as "social breakdown or social poverty syndrome."
Symptoms:The depressed patients will often complain of vegetative symptoms including disturbance in sleep, sexual functioning, and appetite. Overcrowded, restrictive, and dingy or unstimulating living condition can also adversely affect the patients' ability to experience pleasure. He/she may also complain of more chronic and insidious nature that those of typical of depression. The hypohedonic patient will reveal a longstanding lack of interest and initiatives. He/she may remember a time, prior to the onset of the illness, when life provided more variety of enjoyment, but can identify few resources that could assist him/her in present or future.
Diagnosis:Despite the fact that hypohedonia has been recognized as a feature of schizophrenia which may have a pervasive effect on functional performance, there is a little in the literature to do with its assessment and treatment. Inactivity and affective dullness provide the first indication of a hypohedonia but the therapist must differentiate this phenomenon from other condition. While there are no established criteria to do this, guidelines are provided to facilitate assessment. If the therapist is able to define those activities that provide pleasure but participation is thwarted by fears of failure, rejection, or exacerbation of acute symptoms, then anxiety may be the primary factor. The depressed patients may be able to identify interest and activities that he/she participated in premorbidly. He/she may be able to describe the events that have contributed to his/her present depressed state, and may express a sense of sadness because of the loss of his/her formal Lifestyle. The occupational therapist should gather information about the pre-morbid and current patterns of enjoyment from the affected individual, significant others in his life and/or from other professionals working with the patient.
Treatment:There is no definite agreement about the fundamental cause of hypohedonia. At the present time it would be difficult, if not impossible, to differentiate the specific etiological factors that are instrumental in producing hypohedonia. It is possible that any case of hypohedonia is a result of many factors. Treatment that encourages structured, goal-directed plans for pleasurable events and stimulation that provide adaptive hedonic effects. In addition, given the proposed shared mechanism of dopamine depletion within the ventral striatum in apathy and anticipatory anhedonia, future trials of dopamine-eliciting activities (e.g., exercise and other non-pharmacologic methods) appear to be warranted to improve these symptoms in patients with hypohedonia and Parkinsonism. NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.
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