Heininga, V. E., Van Roekel, E., Ahles, J. J., Oldehinkel, A. J., & Mezulis, A. H. (2017). Positive affective functioning in anhedonic individuals' daily life: Anything but Flat and Blunted. Journal of Affective Disorders, 218, 437-445. DOI: 10.1016/j.jad.2017.04.029

Waarom dit onderzoek?

Anhedonie, ofwel verlies van plezier, wordt vaak beschreven als 'afgevlakt' of 'afgestompt' in hun positieve gevoelens. Er is echter weinig bekend over hoe positieve gevoelens zich ontvouwen in het dagelijkse leven van mensen met anhedonie.


We vergeleken mensen met en zonder anhedonie op drie aspecten van plezierbeleving: • hoe plezierig ze positieve gebeurtenissen vonden; • in hoeverre die gebeurtenis hun stemming positief beïnvloedde; • hoe stabiel de positieve stemming was.

Hoe werd dit onderzocht?

Via hun smartphone kregen 138 jongvolwassenen, 69 met en 69 zonder anhedonie, een maand lang driemaal daags een kleine vragenlijst voorgeschoteld. Door middel van een gestructureerde dagboektechniek werden ze gevraagd naar hun activiteiten, gevoelens en de omgeving waarin ze zich bevonden. Met behulp van deze gegevens onderzochten we verschillen in beloninggerelateerd functioneren in het dagelijks leven van mensen met en zonder anhedonia.

Belangrijke uitkomsten
  • Mensen met anhedonie bleken positieve gebeurtenissen gemiddeld als iets minder plezierig te ervaren dan mensen zonder anhedonie.
  • Als reactie op een plezierige gebeurtenis lieten zij echter eenzelfde stijging van positieve emoties zien.
  • Met betrekking tot het zich enthousiast of energiek voelen lieten mensen met anhedonie zelfs een sterkere stijging zien dan mensen zonder anhedonie.
  • De stabiliteit van de positieve emoties was bij mensen met anhedonie relatief laag: zij fluctueerden meer.
Gevolgen voor de praktijk

Deze bevindingen wijzen erop dat mensen met anhedonie best in staat zijn om positieve emoties te ervaren, maar dat zij een verminderd vermogen hebben om die positieve emoties stabiel te houden.

Open Publicatie

Van Roekel, E., Vrijen, C., Heininga, V. E., Masselink, M., Bos, E. H., & Oldehinkel, A. J. (2017). An Exploratory Randomized Controlled Trial of Personalized Lifestyle Advice and Tandem Skydives as a Means to Reduce Anhedonia. Behavior Therapy, 48(1), 76-96. DOI: 10.1016/j.beth.2016.09.009


Anhedonia is a major public health concern and has proven particularly difficult to counteract. It has been hypothesized that anhedonia can be deterred by engagement in rewarding social and physical events. The aims of the present study were to examine (1) the effects of personalized lifestyle advice based on observed individual patterns of lifestyle factors and experienced pleasure in anhedonic young adults; and (2) whether a tandem skydive can enhance the motivation to carry out the recommended lifestyle changes. Participants (N = 69; Mage = 21.5, SD = 2.0; 79.7% female) were selected through an online screening survey among young adults. Inclusion criteria were persistent anhedonia and willingness to perform a tandem skydive. Participants filled out questionnaires on their smartphones for 2 consecutive months (3 times per day). After the first month, they were randomly assigned to one of three groups: (1) no intervention, (2) lifestyle advice, and (3) lifestyle advice and tandem skydive. The momentary questionnaire data were analyzed using interrupted time series analyses (ITSA) in a multilevel model and monthly pleasure and depression questionnaires by repeated measures ANOVA. No group differences were found in monthly depression and pleasure scores, but the momentary data showed higher positive affect (PA) and pleasure ratings in the month following the intervention in the two intervention groups than in the control group. The tandem skydive did not have any effects above the effects of the lifestyle advice. Our results indicate that providing personalized lifestyle advice to anhedonic young adults can be an effective way to increase PA and pleasure.

Open Publicatie

Vrijen, C., Schenk, H. M., Hartman, C. A., & Oldehinkel, A. J. (2017). Measuring BDNF in saliva using commercial ELISA: Results from a small pilot study. Psychiatry Research, 254, 340-346. DOI: 10.1016/j.psychres.2017.04.034


Brain-derived neurotrophic factor (BDNF) is a protein often studied in psychiatric populations. Commercial ELISA kits have been validated for measuring BDNF in blood plasma and serum, but blood collection is an invasive method which cannot always be used. The aim of this pilot study was to explore the noninvasive alternative of measuring BDNF in saliva. Three different commercial ELISA kits were used to analyze parallel plasma and saliva samples from six healthy adults. In total 33 plasma and 33 saliva samples were analyzed according to manufacturers’ standard protocols. BDNF was successfully measured in plasma in two of the three kits, of which the results correlated highly (rs =.88). BDNF could not be measured reliably in saliva. The results of this pilot study suggest that techniques of commercial BDNF kits may not be ready for noninvasive saliva measurements, which limits the sampling frequency and settings.

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van Roekel, E., Masselink, M., Vrijen, C., Heininga, V. E., Bak, T., Nederhof, E., & Oldehinkel, A. J. (2016). Study protocol for a randomized controlled trial to explore the effects of personalized lifestyle advices and tandem skydives on pleasure in anhedonic young adults. BMC psychiatry, 16(1), 182.



Anhedonia is generally defined as the inability to feel pleasure in response to experiences that are usually enjoyable. Anhedonia is one of the two core symptoms of depression and is a major public health concern. Anhedonia has proven particularly difficult to counteract and predicts poor treatment response generally. It has often been hypothesized that anhedonia can be deterred by a healthy lifestyle. However, it is quite unlikely that a one-size-fits-all approach will be effective for everyone. In this study the effects of personalized lifestyle advice based on observed individual patterns of lifestyle behaviors and experienced pleasure will be examined. Further, we will explore whether a tandem skydive following the personalized lifestyle advice positively influences anhedonic young adults’ abilities to carry out the recommended lifestyle changes, and whether this ultimately improves their self-reported pleasure.


Our study design is an exploratory intervention study, preceded by a cross-sectional survey as a screening instrument. For the survey, 2000 young adults (18–24 years old) will be selected from the general population. Based on survey outcomes, 72 individuals (36 males and 36 females) with persistent anhedonia (i.e., more than two months) and 60 individuals (30 males and 30 females) without anhedonia (non-anhedonic control group) will be selected for the intervention study. The non-anhedonic control group will fill out momentary assessments of pleasure and lifestyle behaviors three times a day, for one month. The anhedonic individuals will fill out momentary assessments for three consecutive months. After the first month, the anhedonic individuals will be randomly assigned to (1) no intervention, (2) lifestyle advice only, (3) lifestyle advice plus tandem skydive. The personalized lifestyle advice is based on patterns observed in the first month.


The present study is the first to examine the effects of a personalized lifestyle advice and tandem skydive on pleasure in anhedonic young adults. Results of the present study may improve treatment for anhedonia, if the interventions are found to be effective.

Open Publicatie

Vrijen, C., Hartman, C. A., Lodder, G. M., Verhagen, M., de Jonge, P., & Oldehinkel, A. J. (2016). Lower sensitivity to happy and angry facial emotions in young adults with psychiatric problems. Frontiers in psychology, 7.


Many psychiatric problem domains have been associated with emotion-specific biases or general deficiencies in facial emotion identification. However, both within and between psychiatric problem domains, large variability exists in the types of emotion identification problems that were reported. Moreover, since the domain-specificity of the findings was often not addressed, it remains unclear whether patterns found for specific problem domains can be better explained by co-occurrence of other psychiatric problems or by more generic characteristics of psychopathology, for example, problem severity. In this study, we aimed to investigate associations between emotion identification biases and five psychiatric problem domains, and to determine the domain-specificity of these biases. Data were collected as part of the ‘No Fun No Glory’ study and involved 2,577 young adults. The study participants completed a dynamic facial emotion identification task involving happy, sad, angry, and fearful faces, and filled in the Adult Self-Report Questionnaire, of which we used the scales depressive problems, anxiety problems, avoidance problems, Attention-Deficit Hyperactivity Disorder (ADHD) problems and antisocial problems. Our results suggest that participants with antisocial problems were significantly less sensitive to happy facial emotions, participants with ADHD problems were less sensitive to angry emotions, and participants with avoidance problems were less sensitive to both angry and happy emotions. These effects could not be fully explained by co-occurring psychiatric problems. Whereas this seems to indicate domain-specificity, inspection of the overall pattern of effect sizes regardless of statistical significance reveals generic patterns as well, in that for all psychiatric problem domains the effect sizes for happy and angry emotions were larger than the effect sizes for sad and fearful emotions. As happy and angry emotions are strongly associated with approach and avoidance mechanisms in social interaction, these mechanisms may hold the key to understanding the associations between facial emotion identification and a wide range of psychiatric problems.

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