Anxiety and anhedonia in depression: Associations with neuroticism and cognitive control

Allen Liao, N R Walker, Thomas J Carmody, Crystal Cooper Cortes, Meredith A. Shaw, Bruce D. Grannemann, Phil Adams, Gerard E. Bruder, Melvin G. McInnis, Christian A. Webb, Daniel G. Dillon, Diego A. Pizzagalli, Mary L. Phillips, Benji T. Kurian, Maurizio Fava, Ramin V. Parsey, Patrick J. McGrath, Myrna M. Weissman, Madhukar H Trivedi

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Background: Despite the fact that higher levels of anxiety and anhedonia in Major Depressive Disorder (MDD) are linked to poorer treatment outcomes, mechanisms contributing to these clinical presentations remain unclear. Neuroticism, impaired cognitive control, and blunted reward learning may be critical processes involved in MDD and may help to explain symptoms of anxiety and anhedonia. Methods: Using baseline data from patients with early-onset MDD (N = 296) in the Establishing Moderators and Biosignatures of Antidepressant Response in Clinical Care (EMBARC) trial, we conducted a path analysis to model relationships between neuroticism, cognitive control, and reward learning to levels of anxiety and anhedonia. Results: Neuroticism was positively associated with both anhedonia (standardized coefficient = 0.26, p <.001) and anxiety (standardized coefficient = 0.40, p <.001). Cognitive control was negatively associated with anxiety (standardized coefficient = -0.18, p <.05). Reward learning was not significantly associated with either anxiety or anhedonia. Limitations: Extraneous variables not included in the model may have even more influence in explaining symptoms of anxiety and anhedonia. Restricted range in these variables may have attenuated some of the hypothesized relationships. Most important, because this was a cross-sectional analysis in a currently depressed sample, we cannot draw any causal conclusions without experimental and longitudinal data. Conclusions: These cross-sectional findings suggest that neuroticism may contribute to anxiety and anhedonia in patients with early onset and either chronic or recurrent MDD, while enhanced cognitive control may protect against anxiety.

Original languageEnglish (US)
Pages (from-to)1070-1078
Number of pages9
JournalJournal of affective disorders
StatePublished - Feb 15 2019


  • Anhedonia
  • Anxiety
  • Cognitive control
  • Depression
  • Neuroticism

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health


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