Van Roekel, E., Heininga, V. E., Vrijen, C., Snippe, E., & Oldehinkel, A. J. Reciprocal associations between positive emotions and motivation in daily life: Network analyses in anhedonic individuals and healthy controls. Emotion. DOI: 10.1037/emo0000424


Anhedonia reflects a dysfunction in the reward system, which can be manifested in an inability to enjoy pleasurable situations (i.e., lack of positive emotions), but also by a lack of motivation to engage in pleasurable activities (i.e., lack of motivation). Little is known about the interrelations between positive emotions and motivation in daily life, and whether these associations are altered in anhedonic individuals. In the present study, we used a network approach to explore the reciprocal, lagged associations between positive emotions and motivation in anhedonic individuals (N=66) and controls (N=68). Participants (aged between 18-24 years) filled out momentary assessments of affect 3 times per day for 30 consecutive days. Our results showed that (1) anhedonic individuals and controls had similar moment-tomoment transfer of positive emotions; (2) in the anhedonic network feeling cheerful was the node with the highest outstrength, both within this group and compared to the control group; (3) feeling relaxed had the highest outstrength in the control network, and (4) anhedonic individuals had stronger pathways from positive emotions to motivation than controls. Taken together, our findings suggest that low levels of positive emotions lead to decreased motivation in the anhedonic group, which could instigate a negative spiral of low pleasure and low motivation. On a more positive note, we showed that cheerfulness had the highest outstrength in the network of anhedonic participants. Hence, interventions may focus on increasing cheerfulness in anhedonic individuals, as this will likely have the greatest impact on other positive emotions and motivations.


Vrijen, C., Van Roekel, E., & Oldehinkel, A. J. Alpha-amylase reactivity and recovery patterns in anhedonic young adults performing a tandem skydive. PLoS ONE 13(9): e0204556.



Anhedonia (loss of pleasure) is characterized by low responsiveness to rewards and, by virtue of being one of the two core symptoms of depression, by altered responses to stress. We investigated the effect of an acute stress experience (i.e., a tandem skydive) that was expected to elicit both intense fear and intense euphoria in a sample of anhedonic young adults.


(1) To examine individual differences in alpha-amylase reactivity to and recovery from a tandem skydive in anhedonic young adults; (2) to investigate whether trait depressive and anxiety problems, trait positive affect (PA), i.e., level of pleasure and reward responsiveness, and state anxiety, PA and self-esteem prior to the skydive were associated with alpha-amylase reactivity and recovery patterns; (3) to investigate whether alpha-amylase reactivity and recovery patterns were associated with pre- to post-jump changes in state anxiety, PA, and self-esteem.


Participants were 61 individuals with persistent anhedonia (Mage = 21.38, 78.7% female), who filled out a baseline questionnaire at the start of the study, and momentary questionnaires (3 times per day) before and after the tandem skydive. Alpha-amylase was measured at four time points by means of salivettes (2 before and 2 after the skydive).


Alpha-amylase reactivity and recovery patterns were highly similar across individuals, although mean levels varied greatly. No associations were found between any of the trait and state measures and reactivity and recovery. Only state self-esteem was affected by the reactivity and recovery patterns, in that individuals who showed high reactivity and low recovery experienced decreases in self-esteem after the skydive.


Alpha-amylase patterns following a tandem skydive in anhedonic individuals are highly similar to patterns previously found in healthy individuals. Although replication is warranted, our findings tentatively suggest that a strong stress response that cannot be downregulated well predicts a decrease in self-esteem.

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Heininga V.E. (2017).The happy, the sad, and the anhedonic: Towards understanding altered reward function from a micro-level perspective [Groningen]: University of Groningen


Anhedonia, the loss of pleasure, is highly prevalent in both clinical and non-clinical populations but far from fully understood. Anhedonia was recently reconceptualized into an impaired ability to pursue, experience, and learn about pleasure. Although plausible, a major caveat of this reconceptualization is that it is almost exclusively based on studies that use a nomothetic approach to knowledge (macro-level perspective), largely neglecting how altered reward function in anhedonia takes shape idiographically (micro-level perspective). This PhD thesis sheds a first light on altered reward function in anhedonia from a micro-level perspective. The perspective is provided by the use of recent technologies (e.g., smartphones) and Experience Sampling Methods (ESM). ESMs allow for reliable sampling of moment-to-moment experiences, and holds considerable promise for improving the current understanding of anhedonia. In Part I, we investigated anhedonic individuals´ ability to pursue pleasure (chapter 2), to experience pleasure (chapter 3), and to learn from pleasurable experiences (chapter 4). Differences were found in some, but not all, aspects of reward function. Scientific studies often contradict each other, and Part II of this PhD thesis addresses two problems related to research reproducibility: Different operationalizations of the same construct (chapter 5) and chance capitalization (chapter 6).

Heininga V.E., van Roekel E., Wichers M., Oldehinkel A. (2017). Reward and punishment learning in daily life: A replication study. PLoS One, 12 (10).


Day-to-day experiences are accompanied by feelings of Positive Affect (PA) and Negative Affect (NA). Implicitly, without conscious processing, individuals learn about the reward and punishment value of each context and activity. These associative learning processes, in turn, affect the probability that individuals will re-engage in such activities or seek out that context. So far, implicit learning processes are almost exclusively investigated in controlled laboratory settings and not in daily life. Here we aimed to replicate the first study that investigated implicit learning processes in real life, by means of the Experience Sampling Method (ESM). That is, using an experience-sampling study with 90 time points (three measurements over 30 days), we prospectively measured time spent in social company and amount of physical activity as well as PA and NA in the daily lives of 18-24-year-old young adults (n = 69 with anhedonia, n = 69 without anhedonia). Multilevel analyses showed a punishment learning effect with regard to time spent in company of friends, but not a reward learning effect. Neither reward nor punishment learning effects were found with regard to physical activity. Our study shows promising results for future research on implicit learning processes in daily life, with the proviso of careful consideration of the timescale used. Shortterm retrospective ESM design with beeps approximately six hours apart may suffer from mismatch noise that hampers accurate detection of associative learning effects over time.

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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


Anhedonia, the decreased interest and pleasure, is often described as ‘flat’ or ‘blunted’ positive affect (PA). Yet, little is known about PA functioning in anhedonic individuals’ daily lives. The current study investigates PA reactivity to pleasurable experiences in anhedonia together with its relevant temporal dynamics (i.e., variability, instability, and inertia), and expands current knowledge by exploring the role of arousal therein. Methods: Using the Experience Sampling Method (ESM), we collected 90 assessments of real-life PA experiences across 30 days in 18–24 year old individuals with anhedonia (N=69) and without anhedonia (N=69). Results: Multilevel analyses showed that anhedonia was associated with less intense pleasure experience, and lower levels of PA. Contrary to predictions from laboratory research and depression theory, individuals with anhedonia showed more variability and less stability in PA, and no signs of blunted PA reactivity. In fact, when exploring high and low arousal PA, individuals with anhedonia showed a slightly stronger reactivity to pleasurable experiences in high-arousal PA but not low-arousal PA. Limitations: We did not control for previous pleasure experiences and, instead of the last positive event, accumulation of positive events may have determined the change in high-arousal PA. Conclusions: Individuals with anhedonia are likely less ‘flat’ or ‘blunted’ than generally thought. Although replication is warranted, impairments in high-arousal positive emotions may be of particular interest in the clinical treatment of anhedonia.

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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.

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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.

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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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