Relationship between anhedonia, separation anxiety, attachment style and suicidality in a large cohort of individuals with mood and anxiety disorders
Relationship between anhedonia, separation anxiety, attachment style and suicidality in a large cohort of individuals with mood and anxiety disorders
Background: anhedonia is psychopathological dimension conceptualized as loss of pleasure in several activities. Although typically viewed as a characteristic feature of depressive episodes, anhedonic experience is also seen in other mental disorders. We aimed to investigate the relationship between anhedonia, separation anxiety, and attachment style in a large cohort of outpatients with mood and anxiety disorders, also considering its ties to suicidality.
Methods: 384 consecutively recruited outpatients with mood or anxiety disorders were recruited and assessed with the Structured Clinical Interview for Mood Spectrum–Self Report (MOODS-SR) for anhedonia and suicidality, the Adult Separation Anxiety–Checklist (ASA-27), the Assessment of Adult Attachment Style Questionnaire (ASQ), the Hamilton Rating Scale for Depression (HAM[sbnd]D) and for Anxiety (HAM-A). Anhedonia score was calculated using eight items of the MOODS-SR encompassing the definition of anhedonia.
Results: 84 patients were diagnosed with adult separation anxiety disorder only (A-SAD), 32 patients had separation anxiety disorder only during childhood (C-SAD), 77 had both A-SAD and C-SAD, and 191 had no A-SAD/C-SAD. No differences were found in HAM-A and HAM-D scores between the diagnostic groups. Anhedonia score was significantly worse in the two groups with A-SAD. Regression analyses showed that HAM-D (p < .024), ASA-27 (p < .002) total scores and the ASQ domains of Confidence (p < .001) and Discomfort with Closeness (p < .002) were significant predictors of anhedonia. Anhedonia score (p < .001) and ASA-27 (p < .041) total score were significant predictors of suicidal thoughts and behaviors.
Conclusions: adult separation anxiety is associated with anhedonia and suicide risk in outpatients with mood and anxiety disorders.
Anhedonia, Anxiety, Attachment, Depression, Separation anxiety, Suicide
421-428
Pini, Stefano
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Milrod, Barbara
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Nardi, Benedetta
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Massimetti, Gabriele
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Bonelli, Chiara
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Baldwin, David S.
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Domschke, Katharina
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Schiele, Miriam
3ed65c71-24c9-44ba-a32d-33d630901959
Dell'Osso, Liliana
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Carpita, Barbara
c28fe313-5f15-49ee-8a94-db77c4a7a09a
15 March 2025
Pini, Stefano
7a849c15-0faa-4853-acd5-ed7d0faf90d0
Milrod, Barbara
9ec104f5-8927-4123-bbd7-12f56c79a6b2
Nardi, Benedetta
25cf8113-4b7e-4c48-8f76-a813b5ce1c65
Massimetti, Gabriele
03cd35f7-2547-4b0b-95ac-f815a0dc3cff
Bonelli, Chiara
73eda626-2dc6-4329-8fab-bb2466108002
Baldwin, David S.
1beaa192-0ef1-4914-897a-3a49fc2ed15e
Domschke, Katharina
7c6913b2-7906-4a9e-b3ee-003437dce668
Schiele, Miriam
3ed65c71-24c9-44ba-a32d-33d630901959
Dell'Osso, Liliana
09b2034e-0fb8-4db6-a705-b7b70305d03f
Carpita, Barbara
c28fe313-5f15-49ee-8a94-db77c4a7a09a
Pini, Stefano, Milrod, Barbara, Nardi, Benedetta, Massimetti, Gabriele, Bonelli, Chiara, Baldwin, David S., Domschke, Katharina, Schiele, Miriam, Dell'Osso, Liliana and Carpita, Barbara
(2025)
Relationship between anhedonia, separation anxiety, attachment style and suicidality in a large cohort of individuals with mood and anxiety disorders.
Journal of Affective Disorders, 379, .
(doi:10.1016/j.jad.2025.02.108).
Abstract
Background: anhedonia is psychopathological dimension conceptualized as loss of pleasure in several activities. Although typically viewed as a characteristic feature of depressive episodes, anhedonic experience is also seen in other mental disorders. We aimed to investigate the relationship between anhedonia, separation anxiety, and attachment style in a large cohort of outpatients with mood and anxiety disorders, also considering its ties to suicidality.
Methods: 384 consecutively recruited outpatients with mood or anxiety disorders were recruited and assessed with the Structured Clinical Interview for Mood Spectrum–Self Report (MOODS-SR) for anhedonia and suicidality, the Adult Separation Anxiety–Checklist (ASA-27), the Assessment of Adult Attachment Style Questionnaire (ASQ), the Hamilton Rating Scale for Depression (HAM[sbnd]D) and for Anxiety (HAM-A). Anhedonia score was calculated using eight items of the MOODS-SR encompassing the definition of anhedonia.
Results: 84 patients were diagnosed with adult separation anxiety disorder only (A-SAD), 32 patients had separation anxiety disorder only during childhood (C-SAD), 77 had both A-SAD and C-SAD, and 191 had no A-SAD/C-SAD. No differences were found in HAM-A and HAM-D scores between the diagnostic groups. Anhedonia score was significantly worse in the two groups with A-SAD. Regression analyses showed that HAM-D (p < .024), ASA-27 (p < .002) total scores and the ASQ domains of Confidence (p < .001) and Discomfort with Closeness (p < .002) were significant predictors of anhedonia. Anhedonia score (p < .001) and ASA-27 (p < .041) total score were significant predictors of suicidal thoughts and behaviors.
Conclusions: adult separation anxiety is associated with anhedonia and suicide risk in outpatients with mood and anxiety disorders.
Text
Anhedonia - 22 aug 2024 (BN 3)_KD-DSB-030924
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e-pub ahead of print date: 7 March 2025
Published date: 15 March 2025
Keywords:
Anhedonia, Anxiety, Attachment, Depression, Separation anxiety, Suicide
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Local EPrints ID: 501715
URI: http://eprints.soton.ac.uk/id/eprint/501715
ISSN: 0165-0327
PURE UUID: a0613936-ea28-4bb6-a087-ad912ef92eb7
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Date deposited: 06 Jun 2025 16:53
Last modified: 07 Jun 2025 01:35
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Contributors
Author:
Stefano Pini
Author:
Barbara Milrod
Author:
Benedetta Nardi
Author:
Gabriele Massimetti
Author:
Chiara Bonelli
Author:
Katharina Domschke
Author:
Miriam Schiele
Author:
Liliana Dell'Osso
Author:
Barbara Carpita
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