The Sweet Taste Test Relationships with Anhedonia Subtypes,.docx

The Sweet Taste Test: Relationships with Anhedonia Subtypes,
Personality Traits, and Menstrual Cycle Phases
Jeffrey S. Bedwell1 & Christopher C. Spencer1 & Cristina A.
Chirino1 & John P. O’Donnell1
Published online: 15 January 2019
# Springer Science+Business Media, LLC, part of Springer
Nature 2019
Abstract
A better understanding of the etiology and pathology related to
distinct subtypes of anhedonia can lead to more efficacious
personalized treatments. The current study advances knowledge
on consummatory anhedonia - represented in the Research
Domain Criteria (RDoC) subconstruct of Initial Response to
Reward (IRR). The Sweet Taste Test (STT) has promise as a
behavioral paradigm for IRR, as it is sensitive to manipulation
of μ-opioid receptors. However, there is a lack of existing
knowledge of how the STT relates to subtypes of anhedonia,
personality traits, and phases of the menstrual cycle. To address
these questions, we administered the STT to 72 nonpsychiatric
adults (76% women; mean age: 19.11). As predicted, the
hedonic
slope reflecting increasing Blike^ ratings over increasing
concentrations of five sucrose solutions (ranging from 0.05 M
to
0.86 M), was lower in individuals reporting higher
consummatory anhedonia (measured with Temporal Experience
of
Pleasure Scales - Consummatory Subscale) and in women in the
mid-to-late luteal menstrual phase (days 20 to 28). Both effects

were driven by lower hedonic ratings to the sweetest
concentration. The hedonic slope was larger in individuals
scoring higher on
the Flight-Freeze-Avoidance System personality factor from the
Reinforcement Sensitivity Theory Personality Questionnaire -
driven by lower hedonic ratings for the least sweet
concentration. No factor or aspect from the Big Five Aspects
Scale related to
hedonic ratings on the STT. The STT may be a valid and
specific standardized behavioral paradigm to add to IRR,
particularly if
validated in a large transdiagnostic psychiatric sample.
Keywords Sucrose .Reward .Consummatoryanhedonia
.Initialresponsivenesstorewardattainment
.Researchdomaincriteria .
Consummatory pleasure
Introduction
Anhedonia is a transdiagnostic symptom which is particularly
resistant to existing treatments relative to most co-occurring
symptoms (McCabe et al. 2010; Vittengl et al. 2015). While
the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) defines anhedonia as a unitary construct (e.g.,
Bdecreased interest and pleasure in most activities most of
the day;^ American Psychiatric Association 2013), recent ad-
vances in affective neuroscience suggest three distinct sub-
types (Treadway and Zald 2011): motivational (i.e., wanting),
consummatory (i.e., liking), and decisional (i.e., reward learn-
ing). The National Institute of Mental Health’s (NIMH)
Research Domain Criteria (RDoC) Matrix includes
corresponding constructs under the Positive Valence
Systems (PVS) domain (Insel et al. 2010). A better under-

standing of the etiology and pathology related to distinct sub-
types of anhedonia can lead to more efficacious personalized
interventions for this treatment-resistant symptom (Insel and
Cuthbert 2015; Strauss and Cohen 2017).
Consummatory anhedonia is partially represented in the
PVS construct Reward Responsiveness under the
subconstruct of Initial Response to Reward (IRR; as of 10/2/
18), defined by NIMH as: BProcesses evoked by the initial
presentation of a positive reinforcer as reflected by indices
of neuronal activity and verbal or behavioral responses.^
This is reflected by the inclusion of the Consummatory sub-
scale of the Temporal Experience of Pleasure Scales (TEPS-C;
Gard et al. 2007) under Self-Reports in IRR. While IRR cur-
rently names a single paradigm of Bsimple guessing task,^
application of such tasks require physiological measures of
brain response (e.g., Tsypes et al. 2018). Alternatively, the
Sweet Taste Test (STT; Kampov-Polevoy et al. 1997;
Dichter et al. 2010) has promise as a behavioral IRR paradigm
* Jeffrey S. Bedwell
[email protected]
1 Department of Psychology, University of Central Florida,
4111 Pictor
Lane, Orlando, FL 32816-1390, USA
Journal of Psychopathology and Behavioral Assessment (2019)
41:235–248
https://doi.org/10.1007/s10862-019-09717-2
http://crossmark.crossref.org/dialog/?doi=10.1007/s10862-019-
09717-2&domain=pdf
http://orcid.org/0000-0002-1205-5792
mailto:[email protected]

that could be used in clinical settings, as it is does not require
physiological equipment and related expertise. While the STT
is not specifically named under Paradigms for IRR, Btaste
reactivity^ is listed under Behavior. In the STT, the participant
tastes a random order of five trials for each of five concentra-
tions of sucrose, ranging from minimal sweetness to two so-
lutions that are sweeter than beverages such as Coca-Cola®,
and collects subjective ratings of sweetness and liking after
each trial (Kampov-Polevoy et al. 1997).
Individuals whose hedonic Blike^ ratings are highest
for the strongest sucrose concentration have been termed
Bsweet likers,^ a category associated with alcohol use dis-
order (Kampov-Polevoy et al. 2001, 2003; Wronski et al.
2007), cocaine use disorder (Janowsky et al. 2003), binge-
eating disorder (Goodman et al. 2017), impulsive choice
on a delay discounting task (Weafer et al. 2014), better
response to naltrexone treatment for alcohol use disorder
(Garbutt et al. 2009, 2016), and greater amphetamine-
induced euphoria in nonpsychiatric women but not men
(Weafer et al. 2017). Consistent with inclusion of μ-
opioid receptors under IRR Molecules, research has
shown that stimulation of μ-opioid Bhedonic hotspots^
in the nucleus accumbens shell, ventral pallidum, anterior
orbitofrontal cortex, and posterior insula increase sucrose
Bliking^ behavior in rats (Castro and Berridge 2017).
Similarly, a study of nonpsychiatric men found a decrease
in sucrose liking following administration of the μ-opioid
antagonist naltrexone, and increased liking following the
μ-opioid agonist morphine (Eikemo et al. 2016). Both
effects were observed for only dimensional hedonic rat-
ings for the sweetest concentration (0.65 M in that study)
and did not change a slope-based categorical sweet liker
status. This finding is consistent with studies showing that
naltrexone reduced average STT hedonic ratings in non-
psychiatric women (Arbisi et al. 1999) and opioid depen-

dent participants (Langleben et al. 2012). Overall, it ap-
pears that the STT partially reflects endogenous opioid
functioning, particularly the dimensional hedonic rating
to the sweetest solution.
Considering this emerging literature, we were interested in
how STT performance relates to subtypes of anhedonia and a
range of personality traits. This will inform investigators and
clinicians regarding which anhedonia measure or subscale
may best assess IRR/consummatory anhedonia, and general
personality research by highlighting particular traits which
may be sensitive to individual differences in the endogenous
opioid system. Finally, there is increasing evidence that the
luteal menstrual cycle phase, via an increase in progesterone,
dampens hedonic responsivity to cocaine in female rhesus
macaques (Carroll et al. 2016) and humans (Evans and
Foltin 2006; Evans et al. 2002). As both progesterone and
estradiol interact with opioid receptors (Schroeder et al.
2003; Lee and Ho 2013), it is possible that estradiol, which
is higher during the follicular menstrual phase, may also effect
reward sensitivity. However, studies in rhesus monkeys found
that administering exogenous estradiol did not alter cocaine
self-administration, while administering progesterone reduced
the cocaine use (Mello et al. 2008, 2011). A recent study
found an amplitude reduction in the event-related potential
of reward positivity in response to monetary gains in women
during the luteal as opposed to follicular phase of the menstru-
al cycle, but this influence was only significant in women with
greater severity of depression (Mulligan et al. 2018).
Examining the relationship between menstrual phases and
STT performance in a nonpsychiatric sample will account
for important individual differences present in menstruating
women and add to our understanding of how these phases
may induce temporary changes in IRR.

It appears that only one existing study examined relation-
ships between a behavioral assessment of sweet taste liking
and anhedonia severity. This study found that, across a
transdiagnostic sample of individuals with major depressive
disorder, schizophrenia, and nonpsychiatric controls, higher
scores on the self-report Chapman Physical, but not Social,
Anhedonia scale was associated with a lower maximum
hedonic rating across all sucrose concentrations on the
STT (Berlin et al. 1998). There appear to be few published
studies on the relationship of a behavioral measure of sweet
liking with personality traits. One reported that individuals
who preferred the sweeter of two blinded samples of the
same white wine scored lower on self-reported openness
and higher on impulsiveness, a facet of neuroticism
(Saliba et al. 2009). A study using five blinded levels of
sweetness of the same red wine found that participants
who preferred sweeter concentrations were higher in neu-
roticism (Sena-Esteves et al. 2018). A study using the STT
reported that categorical sweet likers did not differ from
other participants on self-reported novelty seeking (Lange
et al. 2010). Studies that did not include a behavioral mea-
sure found that higher self-reported generalized liking of
sweet foods and drinks was associated with higher self-
reported agreeableness (Sagioglou and Greitemeyer 2016;
Meier et al. 2012; Ashton et al. 2014), neuroticism (Kikuchi
and Watanabe 2000; Elfhag and Erlanson-Albertsson
2006), and/or openness/intellect (Ashton et al. 2014) scores.
Finally, while some research has found that women con-
sume more sweet foods during the luteal phase (Bowen
and Grunberg 1990; Tucci et al. 2010), one study examined
hedonic rating to varying concentrations of sucrose solu-
tions reported that ratings were lowest in the luteal phase,
236 J Psychopathol Behav Assess (2019) 41:235–248

particularly for the sweetest concentration (Elliott et al.
2015). However, this study did not use the traditional STT,
was limited by a single trial of four sucrose solutions, and
did not include men in the comparison group.
Based on existing findings using behavioral measures of
hedonic response to sweet tastes, and current information in
the IRR domain, we hypothesized that hedonic ratings to the
sweetest STT concentration would be lower in participants
reporting increased consummatory anhedonia, and higher in
participants reporting more neuroticism and/or impulsiveness.
In addition, we predicted that women in the luteal phase of the
menstrual cycle would report a reduced hedonic response to
the sweetest STT concentration as compared to other women
and men.
Methods
Participants
Participants were undergraduate students enrolled in a
Psychology Department course that offered credit in ex-
change for research participation at a large southeastern
public university in the United States. Participants were
screened online (N = 2135) and excluded for: completing
questionnaire either too quickly (< 10th %ile of duration
from sample; N = 122; 5.7%) or slowly (> 90%ile; N =
146; 6.8%), scoring >2 SD above mean on the
Abbreviated Marlow-Crowne Social Desirability Scale
(Reynolds 1982; N = 75; 3.5%), using non-prescribed stim-
ulant or narcotic medication (N = 23; 1.1%), excessive
chronic alcohol use (N = 16; 1.0%), hypothyroidism in self
(N = 30; 1.4%) or first-degree family member (N = 91;
4.3%), significant past head injury or chronic neurological
disorder (N = 50; 2.3%), failure to endorse willingness to

abstain from recreational drugs for 48 h prior to the testing
session (N = 369; 17.3%) or alcohol for 24 h prior to testing
(N = 11; 0.5%), significant uncorrected vision impairment
(N = 51; 2.4%), physical impairment in arms/hands (N = 4;
0.2%), or endorsing more than two items incorrectly on an
8-item Infrequency Scale (Jackson 1984; N = 16; 1.0%).
The remaining 1131 participants received an invitation to
participate in the lab-based portion of the task. However,
only a minority of those participants completed the lab ses-
sion (N = 79), as the online questionnaires were designed
for a larger study examining relationships between those
scales (currently unpublished). On the day of laboratory
testing, all participants denied recent nicotine use, alcohol
in past 24 h, and other recreational drug use in past 48 h.
However, this was based on self-report as we did not have
laboratory tests to confirm.
Of the 79 participants, 77 had valid data for the STT, as two
were excluded for sweetness ratings that did not approximate
a linear increase with increasing concentrations and were sta-
tistical outliers for that slope value (Z < −3.33 for each). An
additional 5 participants were excluded for missing all anhe-
donia measures and bio-demographic data (e.g., menstrual
phase) due to experimenter error (both a priori reasons for
excluding participants). This resulted in 72 participants used
in final analyses (76% women; mean age: 19.11; SD = 2.07;
range 18 to 28). For race, 75.0% identified as BWhite,^ 8.3%
as BBlack,^ 8.3% as BAsian, 4.2% as BOther,^ 2.8% as
BMixed,^ and one participant declined to answer.
Independent of race, 34.7% identified as BHispanic/
Latino(a).^ Two participants reported selective-serotonin re-
uptake inhibitor (SSRI) medication use at the time of testing.
The remaining participants denied current psychotropic and
narcotic medication use.

Measures
Self-Report Scales
The Reinforcement Sensitivity Theory of Personality
Questionnaire (RST-PQ; Corr and Cooper 2016) was admin-
istered during the online phase, which consists of 65 state-
ments with a response key asking the participant to rate how
much the statement describes them in general - ranging from
B1 - Not At All^ to B4 - Highly.^ The RST-PQ produces six
scales - four behavioral activation system subscales: Reward
Interest, Goal-Drive Persistence, Reward Reactivity, and
Impulsivity, along with scales for the Behavioral Inhibition
System (BIS) and Flight-Freeze- Avoidance System (FFAS).
The reliability and validity of the RST-PQ have received ad-
ditional recent support in chronic pain samples (Amiri et al.
2017), and through relationships found with event-related po-
tentials from electroencephalogram (Kaye et al. 2018; De
Pascalis et al. 2017). The Big Five Aspect Scales (BFAS;
DeYoung et al. 2007) was also administered online, and con-
sists of 100 statements with a response key asking the partic-
ipant to rate how accurately the statement reflects how they
generally are - ranging from B1 - Very Inaccurate^ to B5 - Very
Accurate.^ The BFAS results in the traditional big five factors
along with two aspects for each factor: Neuroticism
(Volatility, Withdrawal), Agreeableness (Compassion,
Politeness), Conscientiousness (Industriousness,
Orderliness), Extraversion (Enthusiasm, Assertiveness), and
Openness/Intellect (Openness, Intellect). The validity of
BFAS aspect scales have been supported with specific
J Psychopathol Behav Assess (2019) 41:235–248 237
relationships to psychopathology (Allen et al. 2018; Quilty

et al. 2014) and self-reported personality disorder symptoms
(DeYoung et al. 2016).
During the day of STTassessment, we administered three
anhedonia self-report scales - the 18-item Temporal
Experience of Pleasure Scales, which includes subscales
for anticipatory (TEPS-A) and consummatory (TEPS-C)
anhedonia (Gard et al. 2007), the 17-item Anticipatory and
Consummatory Interpersonal Pleasure Scale total score
(ACIPS; Gooding and Pflum 2014), and the 14-item
Snaith-Hamilton Pleasure Scale total score (SHAPS;
Snaith et al. 1995). Unlike the TEPS, factor analysis has
not supported separate factors for anticipatory and consum-
matory anhedonia on the ACIPS (Gooding and Pflum
2014). Increased anhedonia is indicated by lower scores
on the TEPS and ACIPS and higher scores on the SHAPS.
The Cronbach alphas for the anhedonia scales in our sample
were: TEPS-A (.76), TEPS-C (.75), ACIPS (.91), and
SHAPS (.59).
Sweet Taste Test (STT)
The STT is a standardized assessment of hedonic response to
sweet tastes in human participants (Kampov-Polevoy et al.
1997). Powdered sugar and distilled water were used to create
five concentrations of sucrose solutions (approximately
0.05 M, 0.10 M, 0.19 M, 0.42 M, and 0.86 M). As a reference,
Coca-Cola® is a 0.33 M solution. Participants received five
trials of each of the five solutions in a blinded random order.
During each trial, participants drank from a small plastic
opaque cup containing 2 mL of solution, swished the solution
in their mouth for about 5 s, and then expectorated into a
container. Participants were asked to mark an BX^ on a
201 mm analog scale line to indicate perceived sweetness,
from BNot sweet at all^ (left anchor) to BExtremely sweet^
(right anchor), and, on a separate scale, how much they liked it

from BDislike it very much^ (left anchor) to BLike it very
much^ (right anchor). Following the ratings, participants
rinsed with distilled water and proceeded to the next trial.
Ratings were then scored based on distance (in mm) of the
BX^ from the left side of the respective scale line, and then
averaged within the five concentrations.
We used the slope of hedonic ratings by increasing
sucrose concentration (i.e., hedonic slope) as the primary
measure of dimensional hedonic ratings and any statisti-
cally significant relationship with this dependent variable
was then further explored across the separate hedonic rat-
ings for the five concentrations. We also examined rela-
tionships with the categorical Bsweet liker^ status, defined
as having the highest hedonic rating for the sweetest
concentration (Kampov-Polevoy et al. 2001, 2003;
Wronski et al. 2007). Finally, we included the sweet sen-
sitivity slope to clarify specificity of any findings with the
hedonic variables. The hedonic and sweet sensitivity
slopes and the five individual concentration hedonic rat-
ing values all showed relatively normal distributions with
skewness and kurtosis <1.05.
Menstrual Cycle Stage Identification
We asked all female participants to identify the current
day in their menstrual cycle using day one defined by
the start of last menstruation. We also asked women if
they thought they may be pregnant, which all denied.
We created a Bluteal menstrual phase status^ variable
which classified women reporting being in the mid-to-
late luteal menstrual stage during the day of testing, de-
fined as days 20 to 28 from start of last mentruation, with
all remaining women and men combined in the second of
the two categories. Although reward processing studies

with rhesus macaques typically chose a late luteal window
around days 24 to 27 to optimally isolate the rise in pro-
gesterone (Carroll et al. 2016), we chose a wider mid-to-
late luteal phase window to allow for inherent error in
estimating the current day of cycle based on self-report/
memory, and to allow for inclusion of a sufficient number
of females in this subgroup for statistical analyses.
Similarly, we created a Bfollicular menstrual phase status^
variable which classified women being in the mid-to-late
follicular phase during the day of testing, which we de-
fined as days 5 to 12 following the onset of menstruation.
This window is also somewhat wider than the follicular
window typically used in the rhesus monkey studies (7 to
10 days following menstruation; Carroll et al. 2016),
based on the same rationale.
Procedures
This study was approved by the Institutional Review Board of
the authors’ university. Research followed ethical principles
described in the Declaration of Helsinki. Participants provided
informed consent at the beginning of both online and lab-
based sessions. During the lab-based session, participants
completed demographic information, including questions
about current medication and supplement use, the anhedonia
questionnaires, and the STT, as part of a larger study. No data
resulting from the larger study have been published at this
time.
Statistical Analyses
For self-report measures, one participant was missing the

TEPS and ACIPS. Across measures, if either one or two
items for a subscale/factor were skipped by a particular
participant, the respective score was then based on the
average of the remaining items for that factor. IBM
SPSS Statistics (Version 25) was used for all analyses.
Initial regressions examined relationships of the STT he-
donic and sweet sensitivity slopes and sweet liker catego-
ry with simultaneous entry of: age, sex, luteal menstrual
phase status, follicular menstrual phase status, birth con-
trol medication use, race, ethnicity, and time of day during
testing (variance inflation factor [VIF] < 1.60). Time of
day during testing was rounded to nearest hour (mode =
4:00 p.m.; range = 9:00 a.m. to 4:00 p.m.). This was ex-
amined as an approximation of fluctuations in the circa-
dian system (e.g., hormone levels), which can influence
behavioral responses to rewards (DePoy et al. 2017).
Additional regressions were used to examine sets of
predictors on each of the three STT variables, the: 1) four
anhedonia scales: TEPS-A, TEPS-C, ACIPS, and SHAPS,
2) six factor scores from the RST-PQ, 3) five BFAS fac-
tors, and 4) ten BFAS aspects. Simultaneous entry was
used for all predictor sets (VIF < 3.10 for all sets). If a
predictor showed a significant relationship with the he-
donic slope, this was followed by an exploratory analysis
of the five concentration hedonic ratings that comprised
the slope, using stepwise entry, regressed on the respec-
tive predictor. All regressions involving the sweet liker
category used binary logistic regressions, while the re-
maining analyses on dimensional STT variables used
linear regression. Across all regressions, there were no
statistical outliers, as defined by a Studentized residual
>3.0.
Results

See Fig. 1 for a depiction of the hedonic slope by sweet liker
status. Descriptive statistics and zero-correlations for STT var-
iables with each of the predictor sets can be found in Tables 1
(anhedonia scales), 2 (RST-PQ scales), 3 (BFAS factors), and
4 (BFAS aspects). Thirty participants (42%) were classified as
Bsweet likers.^ Excluding the two participants taking SSRI
medications did not change the pattern of significant findings
across all analyses. They were therefore retained in all results
presented below.
STT Relationships with Menstrual Phase Status,
Demographic Variables, and Time of Day
during Testing
We examined the three STT variables using regressions with
simultaneous entry of sex, luteal menstrual phase status (N =
13), follicular menstrual phase status (N = 13), birth control
medication use (N = 19), age, race, ethnicity, and time of day
during testing. As shown in Table 5, women in the mid-to-late
luteal menstrual phase had a smaller hedonic slope, driven by
lower hedonic ratings to the sweetest concentration (see
Fig. 2), and were less likely to be categorical sweet likers
(15%), as compared to the combination of the remaining
women and men (47.5%). Results also revealed that women
had a larger sweet sensitivity slope than men (see Table 5).
There were no other significant relationships across these re-
gressions. Therefore, we included covariates of luteal men-
strual phase status and sex in the first block of all remaining
regressions.
STT Relationships with Anhedonia
See Table 5 for summary of all findings, including unstan-
dardized beta values with standard error and level of statis-
tical significance. For anhedonia, the hedonic slope was

predicted by only the TEPS-C subscale, which was driven
by a positive relationship between the TEPS-C scores and
hedonic rating scores to the sweetest concentration (see
Fig. 3). Thus, individuals self-reporting more consummato-
ry anhedonia (i.e., a lower TEPS-C score) had a smaller
hedonic slope and rated the sweetest concentration as less
pleasant. The SST sweet sensitivity slope and sweet liker
status did not relate to anhedonia scales. Removal of the
Fig. 1 Hedonic slope lines from hedonic rating scores by
sucrose
concentration for sweet likers and sweet dislikers. Error bars
represent
the 95% confidence interval
SHAPS from the regressions, which had poor internal reli-
ability (α = .59), did not change the pattern of significance.
To examine specificity of consummatory vs. anticipa-
tory anxiety, we conducted regressions in which sex, lu-
teal phase status, and TEPS-A were entered in the first
block, followed by TEPS-C in the second block. TEPS-
C remained statistically significant for both hedonic slope,
unstandardized B = 36.81, SE = 18.15, p = .047, and the
hedonic rating to the sweetest concentration, unstandard-
ized B = 25.25, SE = 8.80, p = .006. As all four measures
of anhedonia were not significantly related to these STT
variables in zero-order correlations (see Table 1), we also
explored specificity of TEPS-C by entering each anhedo-
nia scale in individual regressions, after entering sex and
luteal phase status in block 1 – thus removing the effect of
multicollinearity among the anhedonia measures. These

analyses showed that of the four anhedonia scales, only
the TEPS-C related to the hedonic slope or hedonic rating
to the sweetest concentration.
STT Relationships with Personality Factors
For the RST-PQ, the hedonic slope was predicted by the
Flight-Freeze-Avoidance System (FFAS) score, which was
driven by a negative relationship between the FFAS score
and the hedonic rating to the least sweet concentration (see
Fig. 4). In addition, the sweet sensitivity slope was predict-
ed by RST-PQ Goal-Drive Persistence and BFAS
Extraversion and Conscientiousness factors (all in the pos-
itive direction). The BFAS aspect scales did not relate to any
STT variable when entered simultaneously in the
regressions.
Examination of Change in Results with Retention
of Excluded Participants
When repeating all analyses with inclusion of the seven
participants who were excluded (N = 79), the pattern of
significance across analyses did not change with two mi-
nor exceptions: For the RST-PQ FFFS, the hedonic slope
relationship changed to a trend level (p = .065), although
the FFFS relationship with the hedonic rating to the least
sweet concentration remained significant (p = .003). For
the BFAS factor relationships with the sweet sensitivity
slope, Conscientiousness remained significant (p = .04),
but Extraversion was no longer significant (p = .31). In
these analyses, all seven of the previously excluded par-
ticipants had RST-PQ and BFAS data, but five were miss-
ing all anhedonia measures and bio-demographic data
(e.g., menstrual phase), and two had sweet sensitivity
slopes >3.00 SD below the sample mean.Ta

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13
.1
0
−.

84
**
*
−.
6
1*
*
*
−.
56
**
*
89
.6
2
(5
1
.5
1
)
9.
S
S
T
S
w
ee
t
S
en
si
ti

vi
ty
S
lo
pe
.0
5
.1
9
.1
2
−.
21
−.
01
.0
2
.0
9
.1
2
18
6
.4
2
(4

0.
77
)
D
es
cr
ip
ti
v
e
st
at
is
ti
cs
o
n
th
e
o
u
te
r
d
ia
g
o
n
al
in
fo
rm

at
:
m
ea
n
(s
ta
nd
ar
d
d
ev
ia
ti
o
n
),
w
it
h
th
e
ex
ce
pt
io
n
o
f
a
p
er
ce
n
ta
g

e
fo
r
S
T
T
C
at
eg
o
ri
ca
l
S
w
ee
t
L
ik
er
;
re
m
ai
n
in
g
v
al
u
es
ar
e
P
ea

rs
o
n
’s
o
r
p
o
in
t-
b
is
er
ia
l
r
v
al
u
es
T
E
P
S
T
em
p
o
ra
l
E
x
p

er
ie
n
ce
o
f
P
le
as
u
re
S
ca
le
s,
A
C
IP
S
A
n
ti
ci
p
at
o
ry
an
d
C
on
su
m

m
at
o
ry
In
te
rp
er
so
n
al
P
le
as
u
re
S
ca
le
,
SH
A
P
S
S
n
ai
th
-H
am
il
to

n
P
le
as
u
re
S
ca
le
,
ST
T
S
w
ee
t
T
as
te
T
es
t
*
p
<
.0
5
,
*
*
p
<
.0

1
,
*
*
*
p
<
.0
0
1
^
D
ef
in
ed
b
y
h
ig
h
es
t
h
ed
on
ic
ra
ti
n
g
fo
r
sw

ee
te
st
co
n
ce
n
tr
at
io
n
Ta
b
le
2
D
es
cr
ip
ti
v
e
st
at
is
ti
cs
an
d

ze
ro
-o
rd
er
co
rr
el
at
io
n
s
am
o
n
g
R
ei
n
fo
rc
em
en
t
S
en
si
ti
v
it
y
P
er

so
n
al
it
y
Q
u
es
ti
o
n
n
ai
re
S
ca
le
sc
o
re
s
an
d
sw
ee
t
ta
st
e
te
st
v
ar
ia

b
le
s
1
2
3
4
5
6
1
.
R
S
T
-P
Q
R
ew
ar
d
In
te
re
st
2
.8
3
(0
.6
6

)
2
.
R
S
T
-P
Q
R
ew
ar
d
R
ea
ct
iv
it
y
.5
6
*
**
2
.9
7
(0
.4
8
)
3
.

R
S
T
-P
Q
G
o
al
-D
ri
v
e
P
er
si
st
en
ce
.5
1
*
**
.2
6
*
3
.4
8
(0
.4
6
)

4
.
R
S
T
-P
Q
Im
p
u
ls
iv
it
y
.4
9
*
**
.5
8
*
*
*
.1
8
2
.2
2
(0
.6

0
)
5
.
R
S
T
-P
Q
B
eh
av
io
ra
l
In
h
ib
it
io
n
S
y
st
em
−.
0
9
.2
5
*
−.

0
7
.2
3
2
.5
0
(0
.6
8
)
6
.
R
S
T
-P
Q
F
li
g
h
t-
F
re
ez
e-
A
v
o
id
an
ce

S
y
st
em
−.
0
7
.1
1
.1
3
.1
0
.5
4
*
*
*
2
.5
2
(0
.6
6
)
7
.
S

S
T
H
ed
o
n
ic
S
lo
p
e
.0
1
.1
8
.1
1
.0
8
−.
0
3
.1
6
8
.
S
S
T

C
at
eg
o
ri
ca
l
S
w
ee
t
L
ik
er
−.
0
4
.1
2
.0
2
.1
1
.1
4
.2
5
*
9

.
S
S
T
H
ed
o
n
ic
R
at
in
g
to
S
w
ee
te
st
.0
3
.1
4
.1
7
.0
7
−.
0
9

.0
2
1
0
.
S
S
T
H
ed
o
n
ic
R
at
in
g
to
L
ea
st
S
w
ee
t
−.
0
2
−.
1
7

−.
0
3
−.
06
−.
02
−.
2
7
*
11
.
S
S
T
S
w
ee
t
S
en
si
ti
v
it
y
S
lo
p
e

.1
4
.0
7
.4
3
*
*
*
.0
0
4
.0
1
−.
0
0
3
D
es
cr
ip
ti
v
e
st
at
is
ti

cs
o
n
th
e
o
u
te
r
d
ia
g
o
n
al
in
fo
rm
at
:
m
ea
n
(s
ta
n
d
ar
d
de
v
ia
ti

o
n
);
re
m
ai
n
in
g
v
al
u
es
ar
e
P
ea
rs
o
n’
s
o
r
po
in
t-
b
is
er
ia
l
r
v
al
u

es
D
es
cr
ip
ti
v
e
st
at
is
ti
cs
fo
r
th
e
R
S
T
-P
Q
ar
e
fo
r
th
e
av
er
ag
e
it
em

-l
ev
el
sc
o
re
in
a
g
iv
en
fa
ct
or
(r
an
g
in
g
fr
o
m
1
to
4
)
In
te
rc

o
rr
el
at
io
n
s
am
o
n
g
S
S
T
v
ar
ia
b
le
s
d
ep
ic
te
d
in
T
ab
le
1
R
ST
-P

Q
R
ei
n
fo
rc
em
en
t
S
en
si
ti
v
it
y
T
h
eo
ry
P
er
so
n
al
it
y
Q
u
es
ti
o
n
n

ai
re
,
ST
T
S
w
ee
t
T
as
te
T
es
t
*
p
<
.0
5
,
*
*
p
<
.0
1
,
*
*
*
p
<
.0

0
1
^
D
ef
in
ed
b
y
h
ig
h
es
t
h
ed
on
ic
ra
ti
n
g
fo
r
sw
ee
te
st
co
n
ce
n
tr

at
io
n
Discussion
As hypothesized, participants who self-reported more con-
summatory anhedonia (i.e., lower TEPS-C scores) had a re-
duced hedonic slope that was driven by a reduction in the
hedonic rating for the sweetest solution (see Fig. 3). This find-
ing was specific to consummatory anhedonia as the TEPS-C
continued to show these significant relationships after entering
TEPS-A in the first block of the regression. In addition, indi-
vidual exploratory regressions with each of the other anhedo-
nia measures were not significant. This finding with the TEPS-
C is broadly consistent with a previous study which found
reduced hedonic ratings to the STT in a transdiagnostic psy-
chiatric sample related to increased anhedonia from the
Chapman Physical Anhedonia Scale, although that study fo-
cused on the maximum hedonic rating across all concentra-
tions (Berlin et al. 1998). Physical anhedonia is lack of plea-
sure from physical sensations, which partially overlaps the
TEPS as it assesses lack of pleasure across a wider variety of
stimuli. The current finding extends this earlier work by find-
ing the relationship in a nonpsychiatric sample, and supports
the current inclusion of the TEPS-C and Btaste reactivity^ in
the RDoC IRR domain. As both the TEPS-A and the ACIPS
contain items regarding anticipatory anhedonia, the specificity
of our finding to the TEPS-C suggests that questions regarding
consummatory pleasure more precisely reflect IRR. Although
the SHAPS questions also reflect consummatory pleasure, the
directions to the SHAPS asks participants to answer based on

the Blast few days,^ while the TEPS-C asks participants to
answer how they feel Bin general.^ Therefore, it may be the
more trait-like aspects of consummatory pleasure that correlate
with individual differences in IRR.
Also consistent with our hypotheses, women who report-
ed being in the mid-to-late luteal menstrual cycle phase
(days 20 to 28), had a lower hedonic slope, driven by lower
hedonic ratings for the sweetest concentration (see Fig. 2),
and were less likely to be categorical sweet likers, as com-
pared to the remaining women and men (see Table 5). This
finding is similar to the one other study that examined this
relationship (Elliott et al. 2015), but extends their limited
methodology of using one sample of four sucrose solutions
and no male participants, to the use of the standardized and
validated STT and a sample containing both women and
men. These findings provide further support for the STT
representing IRR, as earlier work has found decreased he-
donic ratings following smoked cocaine in women during
the luteal, compared with follicular, phase (Evans et al.
2002; Sofuoglu et al. 1999). We did not find any STT rela-
tionships with the follicular menstrual phase (days 5–12),
consistent with a report that exogenously-administered es-
tradiol, which is naturally higher in the follicular phase, did
not affect self-administration of cocaine in either intact or
ovariectomized rhesus monkeys (Mello et al. 2008).
Our hypotheses regarding the relationship between STT
hedonic ratings and personality traits of neuroticism and im-
pulsivity were not supported, as there were no statistically
significant relationships between STT hedonic ratings and
BFAS Neuroticism and RST-PQ Impulsivity factor scores.
While this is somewhat inconsistent with the existing research
on sweet tastes and personality traits, none of the previous

Table 3 Descriptive statistics and
zero-order correlations among
Big Five Aspect Scale factor
scores and sweet taste test
variables
1 2 3 4 5
1. BFAS Neuroticism Factor 2.78 (0.64)
2. BFAS Agreeableness Factor .01 4.07 (0.47)
3. BFAS Conscientiousness Factor −.37** .23 3.61 (0.52)
4. BFAS Extraversion Factor −.28* .29* .30* 3.47 (0.62)
5. BFAS Openness/Intellect Factor −.25* .27* .32** .56***
3.75 (0.48)
6. SST Hedonic Slope −.05 .07 .08 .12 .21
7. SST Categorical Sweet Liker^ .16 .21 −.03 .01 .11
8. SST Hedonic Rating to Sweetest −.05 −.01 .07 .15 .25*
9. SST Hedonic Rating to Least Sweet .06 −.17 −.09 −.09 −.13
10. SST Sweet Sensitivity Slope .10 .13 .32** .30* .21
Descriptive statistics on the outer diagonal in format: mean
(standard deviation); remaining values are Pearson’s or
point-biserial r values
Descriptive statistics for the BFAS are for the average item-
level score in a given factor (ranging from 1 to 5)
Intercorrelations among SST variables depicted in Table 1
BFAS Big Five Aspects Scale, STT Sweet Taste Test
* p < .05, ** p < .01, *** p < .001
^ Defined by highest hedonic rating for sweetest concentration

Ta
b
le
4
D
es
cr
ip
ti
v
e
st
at
is
ti
cs
an
d
ze
ro
-o
rd
er
co
rr
el
at
io

ns
am
on
g
B
ig
F
iv
e
A
sp
ec
t
S
ca
le
as
pe
ct
sc
or
es
an
d
sw
ee
t
ta
st
e
te
st

v
ar
ia
bl
es
1
2
3
4
5
6
7
8
9
1
0
1
.
B
FA
S
V
o
la
ti
li
ty
A

sp
ec
t
2
.6
4
(0
.7
0
)
2
.
B
FA
S
W
it
h
d
ra
w
al
A
sp
ec
t
.6
2
*
*
*

2
.9
4
(0
.7
1
)
3
.
B
FA
S
C
o
m
p
as
si
o
n
A
sp
ec
t
−.
01
.0
1
4
.1
1

(0
.5
9
)
4
.
B
FA
S
P
o
li
te
ne
ss
A
sp
ec
t
−.
20
.1
2
.5
5
*
*
*
4

.0
3
(0
.4
6
)
5
.
B
FA
S
In
du
st
ri
o
u
sn
es
s
A
sp
ec
t
−.
45
*
*
*
−.
5
1

*
*
*
.1
2
.1
8
3
.4
6
(0
.6
6
)
6
.
B
FA
S
O
rd
er
li
n
es
s
A
sp
ec
t

−.
02
−.
0
7
.2
0
.2
2
.4
7
*
*
*
3
.7
7
(0
.5
4
)
7
.
B
FA
S
E
n
th

u
si
as
m
A
sp
ec
t
−.
02
−.
2
5
*
.5
0
*
*
*
.2
2
.2
2
.0
9
3
.6
6

(0
.7
0
)
8
.
B
FA
S
A
ss
er
ti
v
en
es
s
A
sp
ec
t
−.
01
−.
3
4
*
*
.3
1
*

*
−.
2
6*
.3
5
*
*
.0
9
.5
0
*
*
*
3
.3
1
(0
.7
1
)
9
.
B
FA
S
O
p

en
n
es
s
A
sp
ec
t
−.
10
−.
0
0
3
.3
5
*
*
.0
9
.0
5
.1
6
.2
4
*
.1

7
3
.8
1
(0
.6
1
)
1
0
.
B
FA
S
In
te
ll
ec
t
A
sp
ec
t
−.
18
−.
4
1
*
*
*

.2
9
*
−.
1
3
.5
0
*
*
*
.1
4
.4
5
*
*
*
.6
6
*
*
*
.1
9
3
.6
7

(0
.6
2
)
11
.
S
S
T
H
ed
on
ic
S
lo
p
e
−.
00
1
−.
0
9
.0
5
.0
8
.0
7

.0
6
.1
2
.1
2
.2
0
.1
1
1
2
.
S
S
T
C
at
eg
o
ri
ca
l
S
w
ee
t
L
ik
er

.1
3
.1
4
.1
8
.1
9
−.
0
8
.0
3
.0
3
.0
4
.1
2
.0
2
1
3
.
S
S

T
H
ed
o
n
ic
R
at
in
g
to
S
w
ee
te
st
.0
0
4
−.
0
6
.0
3
−.
0
6
.0
6

.0
5
.0
9
.2
0
.1
6
.2
0
1
4
.
S
S
T
H
ed
o
n
ic
R
at
in
g
to
L
ea
st
S

w
ee
t
.0
4
.1
4
−.
0
5
−.
2
8*
−.
1
0
−.
0
5
−.
14
−.
02
−.
2
1

.0
0
3
1
5
.
S
S
T
S
w
ee
t
S
en
si
ti
v
it
y
S
lo
p
e
.1
3
.0
7
.1
8
.0

4
.2
5
*
.3
0
*
.2
3
.3
1
*
*
.2
0
.1
3
D
es
cr
ip
ti
v
e
st
at
is
ti
cs

o
n
th
e
o
u
te
r
d
ia
g
o
n
al
in
fo
rm
at
:
m
ea
n
(s
ta
n
d
ar
d
de
v
ia
ti
o

n
);
re
m
ai
n
in
g
v
al
u
es
ar
e
P
ea
rs
o
n’
s
o
r
po
in
t-
b
is
er
ia
l
r
v
al
u
es

D
es
cr
ip
ti
v
e
st
at
is
ti
cs
fo
r
th
e
B
FA
S
ar
e
fo
r
th
e
av
er
ag
e
it
em
-l

ev
el
sc
o
re
in
a
g
iv
en
as
p
ec
t
(r
an
g
in
g
fr
o
m
1
to
5
)
In
te
rc
o
rr

el
at
io
n
s
am
o
n
g
S
S
T
v
ar
ia
b
le
s
d
ep
ic
te
d
in
T
ab
le
1
B
FA
S
B

ig
F
iv
e
A
sp
ec
ts
S
ca
le
,
ST
T
S
w
ee
t
T
as
te
T
es
t
*
p
<
.0
5
,
*
*
p

<
.0
1
,
*
*
*
p
<
.0
0
1
^
D
ef
in
ed
b
y
h
ig
h
es
t
h
ed
on
ic
ra
ti
n
g
fo
r

sw
ee
te
st
co
n
ce
n
tr
at
io
n
Ta
b
le
5
R
es
u
lt
s
of
li
n
ea
r
an
d

lo
g
is
ti
c
re
g
re
ss
io
n
an
al
ys
es
S
T
T
D
ep
en
de
nt
V
ar
ia
b
le
s
S
ex
an

d
L
ut
ea
l
M
en
st
ru
al
P
h
as
e
S
ta
tu
s
P
re
d
ic
to
rs
#
A
n
h
ed
o
ni
a
P
re
d

ic
to
rs
#
#
R
S
T
-P
Q
P
re
d
ic
to
rs
#
#
B
FA
S
F
iv
e
F
ac
to
r
P
re
d
ic
to

rs
#
#
H
ed
o
n
ic
S
lo
p
e
L
u
te
al
(l
o
w
er
th
an
o
th
er
s)
T
E
P
S
-C

F
FA
S
N
o
n
e
B
=
−
8
0
.3
2
,
S
E
=
3
6
.5
0
*
B
=
4
4
.1
1
,
S
E

=
1
9
.9
1
*
B
=
4
7
.7
4
,
S
E
=
2
3
.1
5
*
S
u
cr
o
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studies used the STT or controlled for sex/luteal menstrual
phase, but instead used behavioral tests involving varying
sweetness levels of wine (Saliba et al. 2009; Sena-Esteves
et al. 2018) or general self-reported tendencies to like sweet
food and beverages (Kikuchi and Watanabe 2000; Elfhag and
Erlanson-Albertsson 2006).

We found one unexpected personality trait predicted STT
hedonic ratings, a positive relationship between the hedonic
slope with RST-PQ FFAS factor scores, driven by a negative
relationship between the hedonic rating to the least sweet
concentration and the FFAS score (see Fig. 4). The Flight-
Freeze-Avoidance System (FFAS) factor from the RST-PQ
is intended to represent a punishment sensitivity system
which controls fear-related behaviors to avoidable aversive
stimuli, such as fleeing, active avoidance, and freezing
(Corr and Cooper 2016). While speculative, our finding is
similar to a report that individuals with a family history of
alcoholism had greater amygdala fMRI activation after tast-
ing a sucrose solution than those without a family history,
which was significant for the low (0.10 M), but not high
(0.83 M), concentration (Eiler et al. 2017). As the amygdala
is a primary region for processing fear (Davis and Reijmers
2018), and fear is reflected by the FFAS, this specificity of
amygdala activation to the least sweet solution is broadly
similar to our finding that individuals with greater FFAS had
lower ratings to the least sweet solution.
We found exploratory personality traits that predicted the
sweet sensitivity slope, which is thought to reflect gustatory
sensory processes rather than IRR (Eikemo et al. 2016). These
included positive relationships with RST-PQ Goal-Drive
Persistence and BFAS Extraversion and Conscientiousness
factor scores. Interestingly, the BFAS aspect scales constitut-
ing the Extraversion and Conscientiousness factors did not
relate to the sweet sensitivity slope. This may be due to the
two aspects of a given factor showing similar relationships
and the resulting shared variance being removed due to use
of simultaneous entry in the regressions. From inspection of
the zero-order correlations on Table 4, both aspects of
Conscientiousness (i.e., Industriousness and Orderliness)

showed significant positive relationships with the sweet sen-
sitivity slope. For aspects of Extraversion, Assertiveness was
statistically significant (p = .007), while Enthusiasm was a
similar effect size but at a statistical trend level (p = .055). It
is possible that individuals higher in conscientiousness and/or
goal drive persistence were more thoughtful and reliable in
recording the sweetness level which then resulted in a stronger
slope value. Similarly, it is possible that individual differences
Fig. 2 Hedonic slope lines from hedonic rating scores by
sucrose
concentration for women in the mid-to-late luteal menstrual
phase and
the combination of the remaining women and men. Error bars
represent
the 95% confidence interval
Fig. 3 Scatterplot of the
consummatory subscale score
from the temporal experience of
pleasure scales (unstandardized
residuals after covarying for sex
and luteal phase) by the hedonic
rating scores for the sweet
concentration. Shaded region
represents 95% confidence
interval
in brain mechanisms related to extraversion also confer in-
creased gustatory discrimination of sweetness concentrations.
As these were exploratory findings, replication is needed be-
fore such speculation can be translated into detailed theory.

The study is limited by a moderate sample size, use of
undergraduate students as participants, and a larger number
of women than men. We also did not ask participants about
self-reported hunger or time since last meal, which can affect
hedonic responses to sweet stimuli (Cabanac and Lafrance
1990). Other limitations are inherent in the pre-existing stan-
dardized STT methods, such as the lack of a control solution
(e.g., water with no sucrose) and use of analog scales that
introduce confounds instead of a scale such as the generalized
Labeled Magnitude Scale (Bartoshuk et al. 2004).
Additionally, it would be optimal to measure the same women
longitudinally across their menstrual phases to avoid potential
confounds. However, a strength is assessing and accounting
for female menstrual phase status in the analyses. The study
provides what appears to be the first evidence that the STT,
particularly hedonic ratings of the sweetest concentration, are
reduced in individuals with elevated consummatory anhedo-
nia and in women who are in the mid-to-late luteal phase of
their menstrual cycle. If replicated, the current results and the
recent finding regarding μ-opioid specificity (Eikemo et al.
2016), suggest that Btaste reactivity,^ currently listed under
the RDoC IRR BBehaviors,^ be replaced with a more specific
inclusion of the hedonic rating to the sweetest concentration
from the STT under BParadigms.^ Our finding also supports
the validity of the TEPS-C as an index of individual differ-
ences in consummatory anhedonia/IRR, which, given that it is
a brief self-report scale, has considerable translational value
for clinical and research applications. Similarly, our findings
suggest that future research on IRR/consummatory anhedonia
account for the potential influence of menstrual cycle phase in
female participants.
Acknowledgments The authors would like to thank the
following research

assistants for their help on this project: Ashley Lee Lum,
Pamela Askins,
Doniya Milani, Jasmine Montero, Nicholas Picanso, and Brooke
Fenton.
Compliance with Ethical Standards
Conflict of Interest Jeffrey S. Bedwell, Christopher C. Spencer,
Cristina
A. Chirino, and John P. O’Donnell report no conflicts of
interest related to
this manuscript and study.
Experiment Participants Research followed ethical principles
described
in the Declaration of Helsinki.
Ethical Approval This study was approved by the Institutional
Review
Board of the University of Central Florida (IRB #: SBE-16-
12,678).
Informed Consent All participicipants provided informed
consent for
both the online and laboratory portions of this study.
Publisher’s Note Springer Nature remains neutral with regard to
jurisdic-
tional claims in published maps and institutional affiliations.
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https://doi.org/10.1093/alcalc/agl097.The Sweet Taste Test:
Relationships with Anhedonia Subtypes, Personality Traits, and
Menstrual Cycle
PhasesAbstractIntroductionMethodsParticipantsMeasuresSelf-
Report ScalesSweet Taste Test (STT)Menstrual Cycle Stage
IdentificationProceduresStatistical AnalysesResultsSTT
Relationships with Menstrual Phase Status, Demographic
Variables, and Time of Day during TestingSTT Relationships
with AnhedoniaSTT Relationships with Personality
FactorsExamination of Change in Results with Retention of
Excluded ParticipantsDiscussionReferences

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