Anhedonia and the relative reward value of drug and nondrug reinforcers in cigarette smokers

Abstract

Anhedonia-a psychopathologic trait indicative of diminished interest, pleasure, and enjoyment-has been linked to use of and addiction to several substances, including tobacco. We hypothesized that anhedonic drug users develop an imbalance in the relative reward value of drug versus nondrug reinforcers, which could maintain drug use behavior. To test this hypothesis, we examined whether anhedonia predicted the tendency to choose an immediate drug reward (i.e., smoking) over a less immediate nondrug reward (i.e., money) in a laboratory study of non-treatment-seeking adult cigarette smokers. Participants (N = 275, ≥10 cigarettes/day) attended a baseline visit that involved anhedonia assessment followed by 2 counterbalanced experimental visits: (a) after 16-hr smoking abstinence and (b) nonabstinent. At both experimental visits, participants completed self-report measures of mood state followed by a behavioral smoking task, which measured 2 aspects of the relative reward value of smoking versus money: (1) latency to initiate smoking when delaying smoking was monetarily rewarded and (2) willingness to purchase individual cigarettes. Results indicated that higher anhedonia predicted quicker smoking initiation and more cigarettes purchased. These relations were partially mediated by low positive and high negative mood states assessed immediately prior to the smoking task. Abstinence amplified the extent to which anhedonia predicted cigarette consumption among those who responded to the abstinence manipulation, but not the entire sample. Anhedonia may bias motivation toward smoking over alternative reinforcers, perhaps by giving rise to poor acute mood states. An imbalance in the reward value assigned to drug versus nondrug reinforcers may link anhedonia-related psychopathology to drug use.

Conflict of interest statement

The authors report no disclosures or conflicts of interests related to this study.

Figures

Figure 1

Results of mediational analyses examining the extent to which the predictive effects of the baseline anhedonia composite index score on experimental session smoking task outcomes are mediated by acute positive mood state and negative mood state at the experimental session. Values reflect standardized parameter estimates from generalized estimating equations for component paths as well as the estimated indirect (mediated) effect. Values for arrows from anhedonia to smoking task outcomes reflect remaining the direct effect over and above the mediated effect. Significance of component path or indirect effect: * p < .05; ** p < .01; *** p <.001; † p < .0001.

Figure 2

Results of mediational analyses examining the extent to which the predictive effects of the baseline anhedonia composite index score on experimental session smoking task outcomes are mediated by acute urge and nicotine withdrawal symptom level at the experimental session. Values reflect standardized parameter estimates from generalized estimating equations for component paths as well as the estimated indirect (mediated) effect. Values for arrows from anhedonia to smoking task outcomes reflect remaining the direct effect over and above the mediated effect. Significance of component path or indirect effect: * p < .05; ** p < .01; *** p < .001; † p < .0001.