Anhedonia, Apathy, Pleasure, and Effort-Based Decision-Making in Adult and Adolescent Cannabis Users and Controls

Martine Skumlien, Claire Mokrysz, Tom P Freeman, Vincent Valton, Matthew B Wall, Michael Bloomfield, Rachel Lees, Anna Borissova, Kat Petrilli, Manuela Giugliano, Denisa Clisu, Christelle Langley, Barbara J Sahakian, H Valerie Curran, Will Lawn

Research output: Contribution to journalArticlepeer-review


BACKGROUND: Cannabis use may be linked with anhedonia and apathy. However, previous studies have shown mixed results, and few have examined the association between cannabis use and specific reward sub-processes. Adolescents may be more vulnerable than adults to harmful effects of cannabis. This study investigated (1) the association between non-acute cannabis use and apathy, anhedonia, pleasure, and effort-based decision-making for reward; and (2) whether these relationships were moderated by age group.

METHODS: We used data from the "CannTeen" study. Participants were 274 adult (26-29 years) and adolescent (16-17 years) cannabis users (1-7 d/wk use in the past 3 months) and gender- and age-matched controls. Anhedonia was measured with the Snaith-Hamilton Pleasure Scale (n = 274), and apathy was measured with the Apathy Evaluation Scale (n = 215). Effort-based decision-making for reward was measured with the Physical Effort task (n = 139), and subjective wanting and liking of rewards was measured with the novel Real Reward Pleasure task (n = 137).

RESULTS: Controls had higher levels of anhedonia than cannabis users (F1,258 = 5.35, P = .02, η p2 = .02). There were no other significant effects of user-group and no significant user-group*age-group interactions. Null findings were supported by post hoc Bayesian analyses.

CONCLUSION: Our results suggest that cannabis use at a frequency of 3 to 4 d/wk is not associated with apathy, effort-based decision-making for reward, reward wanting, or reward liking in adults or adolescents. Cannabis users had lower anhedonia than controls, albeit at a small effect size. These findings are not consistent with the hypothesis that non-acute cannabis use is associated with amotivation.

Original languageEnglish
Pages (from-to)9-19
Number of pages11
JournalInternational Journal of Neuropsychopharmacology
Issue number1
Early online date24 Aug 2022
Publication statusPublished - 19 Jan 2023

Bibliographical note

This work was supported by a grant from the Medical Research Council (MRC), MR/P012728/1, to H.V.C. and T.P.F. M.S. is funded by an Aker Scholarship from the Aker Foundation. V.V. was funded by a fellowship from the National Institute for Health Research (NIHR) UCLH Biomedical Research Centre. A.B. was funded by a fellowship from the NIHR UCLH Biomedical Research Centre. B.J.S. receives funding from the Wallitt Foundation, Eton College, and a Wellcome Trust Collaborative Award (200181/Z//15/Z). C.L. is funded by a Wellcome Trust Collaborative Award (200181/Z//15/Z), and their research is conducted within the NIHR Cambridge Biomedical Research Centre (Mental Health Theme and Neurodegeneration Theme) and the NIHR Brain Injury MedTech and in vitro diagnostics Co-operative (MIC), Cambridge. H.V.C. is supported by grants from the UK MRC (MR/P012728/1) UK Department of Health and by the NIHR UCLH Biomedical Research Centre.


  • Humans
  • Adult
  • Adolescent
  • Anhedonia
  • Cannabis
  • Decision Making
  • Apathy
  • Pleasure
  • Bayes Theorem
  • Motivation
  • Cannabinoid Receptor Agonists/pharmacology
  • Hallucinogens/pharmacology
  • Reward


Dive into the research topics of 'Anhedonia, Apathy, Pleasure, and Effort-Based Decision-Making in Adult and Adolescent Cannabis Users and Controls'. Together they form a unique fingerprint.

Cite this