Social anxiety disorder (SAD) and major depressive disorder (MDD) are common mental health conditions that lead to impairment in social and occupational functioning (5th ed.; DSM-5; American Psychiatric Association,
2013). These conditions frequently co-occur, and their co-occurrence is associated with stronger symptom severity and impairment, and poorer prognosis and treatment response compared to these disorders in isolation (Adams et al.,
2016; Ballenger,
2000; Gorman,
1997). Thus, it is crucial to understand both shared and distinct features of these conditions. One such feature that is integral to both SAD and MDD is affect. It was initially hypothesized that increased negative affect was shared across anxiety and depressive disorders, whereas diminished positive affect was unique to depression (Clark & Watson,
1991). However, evidence consistently demonstrates that SAD is characterized by positive affect deficits that are comparable in magnitude to those observed in MDD (Brown et al.,
1998) and are not accounted for by co-occurring symptoms of depression (Kashdan,
2007). Despite the growing literature on diminished positive affect in emotional disorders, there is a need for more research to identify which specific positive emotions are associated with these disorders (e.g. joy, gratitude, awe, contentment, pride, love; Vazquez
2017). Studying discrete positive emotions may uncover shared and distinct emotion profiles across SAD and MDD that have been obscured by the prevailing global positive affect perspective – observations that could advance descriptive phenomenology of each condition and the approach to assessment and treatment.
Fredrickson’s (
1998) broaden-and-build theory provides an empirically supported framework for understanding the functional importance of positive emotions in supporting psychological health and well-being (Fredrickson,
2013). Shiota et al., (
2017) expanded on this framework, summarizing evidence that different positive emotions are associated with partially unique patterns of cognition, physiological reactivity, and behavior that facilitate the acquisition of social, intellectual, or material resources. For example, love signifies the opportunity for affiliation and intimacy (Shiota et al.,
2017); it motivates a person to approach others and establish close relationships. Pride, which arises after a personal achievement, acts as an indicator of high social status (Tracy et al.,
2013). It motivates individuals to share their achievements with others, and to seek out intellectual and social resources to accomplish their goals. It may be valuable, therefore, to identify which specific positive emotions are diminished in SAD and MDD so that treatments can target those emotions and their associated behaviors.
A few studies have examined which positive emotion deficits may be related to depressive symptoms. Gruber and colleagues (
2011) found that in college students, current depressive symptoms were most strongly predicted by lower levels of trait pride as opposed to happiness or amusement. The second study had students watch pride-, happy-, and amusement-eliciting films and rate how much pride, happiness, and amusement they experienced during each clip. The depressive symptom group reported significantly less happiness than the non-depressive symptom group after watching the pride film. There were no other significant differences, reinforcing the unique association between pride and depressive symptoms. In another study examining adolescents diagnosed with bipolar disorder, Gruber and colleagues (
2017) found that lower levels of joy were more strongly associated with depressive symptoms compared to interest and surprise. Together these papers suggest that deficits in pride and joy may be particularly associated with depressive symptoms.
Other studies have examined how social anxiety may be associated with certain discrete positive emotions. Cohen & Huppert (
2018) found that pride, joy, love, awe, amusement, and contentment significantly correlated with social anxiety symptoms, whereas compassion did not. Out of these positive emotions, only deficits in pride and love uniquely predicted social anxiety beyond variance accounted for by the remaining positive emotions and symptoms of depression. When including global positive affect in the regression models with pride and joy – and after controlling for depression – only lower levels of pride predicted social anxiety symptoms, whereas global positive affect and joy did not. In their second study, the experience of pride better predicted social anxiety than the expression of pride. The final study revealed that individuals diagnosed with SAD experienced lower levels of pride than low-anxiety control subjects, and pride uniquely predicted SAD diagnostic status beyond variance accounted for by global positive affect and depression. Together, those findings converge with other work demonstrating that social anxiety is inversely associated with pride in clinical samples other than SAD (i.e., MDD; Gilbert
2000) and across a broad range of samples measuring pride and social anxiety (for a recent meta-analysis, see Dickens & Robins
2020).
To summarize, prior studies suggest that deficits in pride are most consistently characteristic of both SAD and MDD, and diminished joy and love may also be associated with these conditions. These studies underscore the potential value of evaluating discrete positive emotions and hint at shared and unique emotion experiences across disorders. However, they assessed a limited number of discrete positive emotions and did not directly compare emotion experiences in SAD versus MDD. The current study thus sought to replicate and extend previous findings by measuring a broader array of positive emotions, by comparing SAD to MDD, and by studying a large, more demographically diverse community sample. The primary research questions were: (1) Do individuals with SAD, MDD, or both SAD and MDD experience specific positive emotions less often than individuals without a history of an anxiety or depression diagnosis? and (2) Does the frequency of positive emotion experiences differ across individuals with SAD, MDD, or comorbid SAD and MDD? Based on Cohen & Huppert (
2018) and Gruber et al., (
2011), we hypothesized that people with a diagnosis of SAD or MDD would experience less pride than the control group; people with a diagnosis of SAD would experience less love than the control group; and those with a diagnosis of MDD would experience less joy than the control group. Given limited research on other positive emotions and comparisons between SAD, MDD, and their comorbidity, we did not have any further predictions. Also, because culture can lead to differences in positive emotion experience (Ishii & Eisen,
2021; Polanco-Roman et al.,
2019; Senft et al.,
2021), we explored whether participant cultural heritage influenced the hypothesized group differences in positive emotions.
Discussion
The current study examined potential differences in discrete positive emotions between individuals meeting diagnostic criteria for SAD, MDD or those without. The SAD, MDD, and comorbid groups displayed deficits relative to controls across all discrete positive emotions – consistent with prior literature pointing to global diminished positive affect in these conditions (Brown et al.,
1998; Kashdan,
2007). Previous studies suggested that pride in particular may be robustly diminished in SAD and MDD, with reduced experiences of love (in SAD) and joy (in MDD) also characterizing these conditions compared to other positive emotions (Cohen & Huppert,
2018; Gruber et al.,
2011). In the current sample, these were the emotions that displayed larger effect sizes relative to most other positive emotions, further buttressing their prominence in these conditions. This study also contributes novel findings regarding amusement, awe, gratitude, hope, inspiration, interest, and contentment, which were experienced less in those diagnosed with SAD or MDD compared to the control group. Direct comparisons between diagnostic groups revealed that awe, inspiration, interest, and joy were experienced less in those diagnosed with MDD (with or without SAD) compared to SAD only, whereas love, pride, contentment, and amusement did not differ between MDD only and SAD only groups but were significantly lower in the comorbid group compared to the SAD only group. These differences in positive emotion experiences between clinical groups highlights the potential value of moving beyond global positive affect assessments, and implies that depression may be characterized by broad positive emotion deficits whereas the most pronounced deficits in social anxiety may lie within specific emotion domains that are further exacerbated by depression comorbidity.
The discrete positive emotions experienced less in both SAD and MDD only groups and to a similar degree (i.e., gratitude, love, and pride) primarily serve social functions. Gratitude is a response to unexpected benefits due to another person’s actions, and it motivates individuals to express kindness and generosity to others (McCullough et al.,
2001; Shiota et al.,
2017). Love is a response to interpersonal connection, affiliation, and intimacy. It motivates individuals to build social bonds (Fredrickson,
2013; Shiota et al.,
2017). Pride is a response to the opportunity of high social status and accomplishing socially valued outcomes. It creates motivation in individuals to aspire for more achievements and to increase their social rank (Williams & DeSteno,
2008). Deficits in these specific positive emotions may be the result of disorder specific symptoms within social contexts (e.g., social avoidance due to fears of negative evaluation in SAD or avolition in MDD). They may also contribute to impairments in social relationship functioning that are common across both conditions. Research is needed to examine those possibilities.
Amusement, contentment, and hope also did not differ significantly between SAD and MDD only groups; however, effect size differences were moderate (0.45 to 0.51; SAD > MDD). Amusement is associated with opportunities for humor and play (Shiota et al.,
2017), and it motivates individuals to share laughter and strengthen social bonds (Gervais & Wilson,
2005). Contentment is a response to when one’s circumstances are perceived as satisfactory (Fredrickson,
2013), and hope serves to build optimism and resilience in response to grim circumstances – motivating people to change their situation (Lazarus,
1991). Deficits in these emotions may reflect limited expression of positive emotions (amusement), general life dissatisfaction (contentment), and ruminative tendencies that hinder positive, future-oriented cognition (hope) associated with MDD and SAD (Dryman & Heimberg,
2018; Eng et al.,
2005; Judd et al.,
2000; Starr & Davila,
2012).
Inspiration, interest, joy, and awe were experienced less in the MDD and comorbid groups compared to the SAD only group (effect size differences were medium to large). Inspiration is an emotion that pushes people to challenge themselves and to grow (Algoe & Haidt,
2009; Thrash & Elliot,
2004). Interest similarly prompts people to learn, explore, and expand their knowledge within novel circumstances (Izard,
1977; Silvia,
2008). Joy is associated with play, experiential learning, and unexpected good fortune (Fredrickson,
2013). Awe is an emotion tied to expanding one’s worldview to accommodate vast, information-rich stimuli (Griskevicius et al.,
2010; Keltner & Haidt,
2003). These emotions may relate in part to anhedonia, which is a defining characteristic of MDD. Anhedonia is the inability to experience pleasure, and it leads to less motivation to pursue goals and seek out novel or enjoyable experiences. Inspiration and interest are goal- or future-oriented, and joy is related to pleasure – features that may explain why the experience of these emotions is particularly reduced in individuals with MDD compared to SAD alone. This pattern may also suggest that high arousal positive emotions are diminished to a greater extent in MDD than in SAD.
The secondary dimensional analyses largely converged with the primary results. All positive emotions significantly correlated with both depression and social anxiety. When accounting for shared variance in symptoms, all positive emotions remained correlated with depression after controlling for social anxiety; in contrast, amusement, gratitude, and interest no longer significantly correlated with social anxiety after controlling for depression. These findings further suggest that overall deficits in positive emotions may be associated with depression, whereas social anxiety appears to be characterized by specific positive emotion deficits. Further research is needed on the association between discrete positive emotions and continuous measures of social anxiety and depression, as participants in this study were recruited for distinct diagnostic groups as opposed to dimensional symptomology.
Overall, the findings are largely consistent with previous studies (Cohen & Huppert,
2018; Gruber et al.,
2011,
2017) – demonstrating that pride and love are reliably diminished in both SAD and MDD, whereas joy appears most prominently diminished in MDD. Also consistent with prior work were associations between awe and contentment with both social anxiety and depression (Cohen & Huppert,
2018), and amusement with social anxiety (Cohen & Huppert,
2018) and depression (Gruber et al.,
2011). Amusement did not, however, correlate with depression in Cohen & Huppert (
2018), and interest did not correlate with depression in Gruber et al., (
2017). Inconsistent positive emotion findings across studies may be attributed to differences in samples (e.g., clinical vs. student; adults vs. adolescents) or scales used to measure discrete positive emotions. Nevertheless, the consistency of some positive emotion findings across studies (e.g., pride, love, joy) further underscores their potential importance in understanding the pathophysiology of these conditions.
The exploratory analyses indicated that culture did not interact with diagnosis nor contribute to differences in positive emotions. Further investigation is needed, since participants were not recruited with these characteristics in mind. Race and ethnicity alone do not wholly reflect culture, and Hispanic and Latin heritage are not synonymous with each other. There are also other cultural aspects that may interact with diagnosis and positive emotions, such as degree of acculturation and identification with one’s native culture, or the desirability and appropriateness of certain emotions in different communities (Koneru et al.,
2007; Polanco-Roman et al.,
2019; Senft et al.,
2021). Additionally, culture and language are embedded in the construction of emotions, which can lead to different emotional experiences (Ishii & Eisen,
2021). The current study is limited by the mDES, since it was developed and validated within English-speaking, American samples. Thus, future studies should recruit larger and more representative samples to study how aspects of race, ethnicity, and culture may influence the experience of positive emotions in affective disorders, and consider different methods of measuring emotion.
Beyond cultural considerations, using the mDES to measure emotions has other limitations. It utilizes single-item, self-report ratings, and therefore requires individuals to identify and communicate their emotions. Since there are ways to process emotion other than verbally (e.g., somatically; Villanueva et al.,
2021), and single-item ratings can limit how much information is gathered, future studies should measure emotions in ways better able to capture their complexity. Behavioral tasks (i.e., emotion challenges) may also yield more ecologically valid findings than self-reports. Another limitation is that participants were recruited separately for different parent studies – yielding uneven sample sizes across groups. Despite these limitations, the current findings suggest that moving beyond a global positive affect perspective has the potential to advance a more precise understanding of positive emotion deficits in social anxiety and depression – findings that could inform greater treatment specificity and personalization.
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.