Posttraumatic stress disorder–related anhedonia as a predictor of psychosocial functional impairment among United States veterans

• Published in: Journal of traumatic stress 2022-10, Vol.35 (5), p.1334-1342
• Main Authors: May, Casey L., Wisco, Blair E., Fox, Victor A., Marx, Brian P., Keane, Terence M.
• Format: Article
• Language: English
• Subjects: Anhedonia; Anxiety - psychology; Cross-Sectional Studies; Humans; Post traumatic stress disorder; Stress Disorders, Post-Traumatic - psychology; United States - epidemiology; Veterans - psychology
• ISSN: 0894-9867; 1573-6598; 1573-6598
• DOI: 10.1002/jts.22832

Prior research suggests that anhedonia symptoms related to posttraumatic stress disorder (PTSD; i.e., diminished interest, detachment from others, and difficulty experiencing positive emotions) are consistently associated with a higher degree of impairment in psychosocial functioning beyond that associated with other PTSD symptoms. Unfortunately, much of this research has used cross‐sectional study designs; relied upon outdated DSM diagnostic criteria; and failed to control for potentially confounding variables, such as the presence of co‐occurring depression. This study used data from Waves 2 and 4 (n = 1,649) of the Veterans’ After‐Discharge Longitudinal Registry (Project VALOR), a longitudinal dataset of U.S. Army and Marine veterans. As measured using the Inventory of Psychosocial Functioning, Wave 4 psychosocial functioning was regressed on seven PTSD symptom factors at Wave 2 (i.e., intrusions, avoidance, negative affect, anhedonia, externalizing behaviors, anxious arousal, and dysphoric arousal) and potential Wave 2 confounds. The Anhedonia factor, β = .123, most strongly predicted later psychosocial functional impairment beyond the impact of other PTSD symptom factors, βs = −.076–.046. Clinical implications of these findings are also discussed.