Abstract
Previous studies have categorized depression into three major symptoms (depressed mood, somatic complaints, and anhedonia); thus, it becomes necessary to examine each symptom separately rather than depression as a syndrome. The behavioral theory of depression suggests that it is exacerbated by reduced environmental rewards caused due to avoidance. However, the relationship between the three symptoms and avoidance, as mediated by environmental rewards has not been sufficiently examined. The purpose of this study was to use the three-symptom classification of depression and clarify how avoidance and reduced environmental rewards worsen these symptoms using a mediation analysis. The participants were 101 clinical patients diagnosed with major depressive disorder in Japanese adults, who completed a questionnaire to measure their depressive symptoms, avoidance, and environmental rewards. The mediation analysis showed that somatic complaints were significantly associated with the direct effect of avoidance and the indirect effect of environmental rewards, and anhedonia was significantly associated with the indirect effect of environmental rewards, whereas depressed mood was not associated with avoidance and environmental rewards. Therefore, the present study revealed that the relationship between avoidance, environmental rewards, and symptoms of depression differed depending on the individual symptom type.
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Data Availability
The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.
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This work was supported in part by the Japan Society for the Promotion of Science KAKENHI Grant Number JP 16 J11293.
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SA conceived the study, conducted the statistical analysis, and wrote and edited the manuscript. SD, SH, KT, AK, RU, MF, and NK conducted the data collection and edited the manuscript. YS provided overall supervision of the study and the manuscript. The final manuscript has been approved by all the authors.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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Aoki, S., Doi, S., Horiuchi, S. et al. Differences in the association between avoidance and environmental rewards by three symptoms of depression. Curr Psychol 42, 7990–7997 (2023). https://doi.org/10.1007/s12144-021-02127-2
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DOI: https://doi.org/10.1007/s12144-021-02127-2