Adolescent's anhedonia and association with childhood trauma among Chinese adolescents: a cross-sectional study

Abstract

Objectives: To estimate the level of anhedonia among adolescents and explore the association between anhedonia and childhood trauma (CT).

Design: A stratified random cluster sample of adolescents participated in a survey, which included three questionnaires: Snaith-Pamilton Pleasure Scale, Childhood Trauma Questionnaire and Patient Health Questionnaire-9.

Setting: The study was conducted in 60 classes in 10 primary, middle and high schools in five economically developed cities along the Southeast Coast of China from April to October 2022.

Participants: One thousand seven hundred and forty-five adolescents with ages ranging from 9 to 18 years participated in the study.

Primary and secondary outcomes: The primary outcome was the level of anhedonia, CT and depression among adolescents. The association between anhedonia and CT was determined.

Results: The mean scores of anhedonia, CT and depression were 24.88 (6.18), 36.75 (8.87) and 4.46 (5.36), respectively. Anhedonia scores of boys (24.24±6.12) and girls (25.62±6.16) were different (t=-4.69, p<0.01). After controlling for sex, age, the presence of siblings and depression, CT was associated with adolescent anhedonia. Emotional abuse (β=0.14), emotional neglect (β=0.15) and physical neglect (β=0.10) positively predicted adolescent anhedonia (p<0.01), whereas physical abuse negatively predicted adolescent anhedonia (β=-0.07, p<0.01). Sex had a moderating effect on the relationship between adolescent anhedonia and emotional neglect during childhood, and the negative effect of emotional neglect on adolescent anhedonia in girls was greater than in boys.

Conclusions: CT, including emotional abuse, physical abuse, emotional neglect, and physical neglect, was an independent predictor of adolescents' ability to experience pleasure in daily life. Therefore, awareness of CT should be promoted. Emotional neglect had a more severe effect on anhedonia among girls than among boys, suggesting that emotional neglect should be paid much attention among girls.

Keywords: Child & adolescent psychiatry; Depression & mood disorders; MENTAL HEALTH; PUBLIC HEALTH.