Anhedonia in trauma related disorders: The good, the bad, and the shut-down

The present chapter reviews the evidence for anhedonia in trauma-related disorders. Clinical observations and empirical evidence are presented as arguments for distinguishing between two clinical presentations of anhedonia in trauma-related disorders: (1) Hedonic Deficit, defined as an inability to experience positive affect, and (2) Negative Affective Interference, defined as the experience of negative emotions in situations that normally would be considered positive. We situate these two forms of anhedonia within existing models of affective experience, suggest ways in which this formulation may be tested empirically, and argue for the clinical relevance of increasing understanding of positive affect intolerance in trauma-related disorders.