The Critical Value of High-Risk Designs and Developmental Psychopathology Frameworks for Understanding Affective Psychopathology: Insights from Research on Anhedonia

Abstract

Developmental psychopathology frameworks view development as a dynamic process that integrates multiple systems, clarifying how psychopathology develops and who develops it. High-risk study designs, such as those investigating progressive changes in youth with familial psychopathological histories, are one developmental research strategy. While much research focuses on clinical symptoms after they emerge, this approach hinders our understanding of when and how clinical symptoms and psychopathology develop and identification of risk factors, neural mechanisms, and clinical correlates. We review the critical value and advantages of using high-risk designs and developmental psychopathology frameworks to understand the emergence of affective psychopathology. We focus on anhedonia, a transdiagnostic affective symptom-defined as diminished experiences of pleasure-which emerges during adolescence, and occurs prior to onset of disorders like depression. We review the phenomenology, behavior, and neural mechanisms of anhedonia. Then we discuss the symptom from a developmental psychopathology perspective, outlining the advantages and disadvantages of using high-risk designs. From there, we synthesize the literature and conclude with clinical implications and considerations for future directions. These approaches are critical for understanding mental health, particularly affective psychopathology, and deserve more attention in the field.

Keywords: adolescent development; affective psychopathology; anhedonia; developmental psychopathology; high-risk designs.

Figure 1.. Anhedonia Development Across Time

Note: Box colors: Grey=early risk factors, blue=anhedonia, orange=new social stressors, white=psychopathology, white (bolded text)=neural reward circuitry; curved line represents changes in the reward system with development/age. This figure illustrates how anhedonia develops across the lifespan. Although it most commonly emerges during adolescence—a period characterized by heightened neural sensitivity to rewards—it can also arise during childhood and is a common symptom of adult psychiatric disorders such as depression and schizophrenia. This figure highlights several examples of contributing factors to anhedonia, including genetic vulnerability, early life stress, social environment, and altered neural reward circuitry. It also depicts that anhedonia can emerge before the onset of psychopathology. Notably, anhedonia can develop even in the absence of a genetic predisposition to mental illness.

Figure 2.. Examples of Equifinality and Multifinality Principles in the Context of Anhedonia

Note. Equifinality: The principle of equifinality suggests that there are multiple pathways that can lead to the same outcome or endpoint. As illustrated in the figure, various pathways can contribute to the development of anhedonia. These include early life experiences, biological and affective mechanisms (such as disrupted neural reward circuitry), and symptoms and problematic behaviors such as suicidal thoughts. Multifinality: In contrast, the principle of multifinality proposes that a single factor or behavior can result in a range of different outcomes. In the case of anhedonia, for example, it may lead to affective symptoms such as depression, contribute to the onset of disorders like schizophrenia, or, in some individuals, may not result in significant clinical or behavioral problems such as suicidal ideation.