Verbal memory impairments predict social connection via anhedonia: a transdiagnostic, population-based study.

Background

Anhedonia and verbal memory impairments are transdiagnostic features of psychopathology, contributing to poorer clinical and functional outcomes. Verbal memory supports the simulation of future events critical for anticipatory pleasure and motivation, suggesting impairments may increase anhedonia, and poorer outcomes, such as social isolation. Work from our group found that negative symptoms, including anhedonia, mediate the relation between verbal memory and social-occupational functioning in early psychosis. This study tested whether a similar pathway linking verbal memory, anhedonia, and social connection is evident in a population-based transdiagnostic sample.

Methods

We analyzed 8575 individuals with or without lifetime psychiatric diagnoses, matched on age, sex, and socioeconomic status. Verbal memory was assessed using the Paired Associate Learning task, anhedonia using self-reported frequency of little interest/pleasure, and social connection using self-reported frequency of social visits. Mediation analyses tested indirect effects of verbal memory on social connection through anhedonia. Moderated mediation analyses tested whether this indirect effect differed by group, sex, or broad symptom dimensions.

Results

Anhedonia significantly mediated the association between verbal memory and social connection, though the indirect effect was small (a × b = 0.0024, 95% CI [0.0012, 0.0036], p < 0.001). No significant direct effect of verbal memory on social connection, or moderation was observed.

Conclusion

These findings support a subtle population-level pathway linking verbal memory, anhedonia, and social connection across individuals with and without lifetime psychiatric diagnoses. Ultimately, anhedonia may act as a symptom-level bridge between verbal memory and functional outcomes across the spectrum of mental health.