Positive affect treatment targets reward sensitivity: A randomized controlled trial.

IF 4.5 1区心理学 Q1 PSYCHOLOGY, CLINICAL Journal of consulting and clinical psychology Pub Date : 2023-06-01 Epub Date: 2023-03-09 DOI:10.1037/ccp0000805

Michelle G Craske, Alicia E Meuret, Aileen Echiverri-Cohen, David Rosenfield, Thomas Ritz

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Abstract

Objective: Determine whether a novel psychosocial treatment for positive affect improves clinical status and reward sensitivity more than a form of cognitive behavioral therapy that targets negative affect and whether improvements in reward sensitivity correlate with improvements in clinical status.

Method: In this assessor-blinded, parallel-group, multisite, two-arm randomized controlled clinical superiority trial, 85 treatment-seeking adults with severely low positive affect, moderate-to-severe depression or anxiety, and functional impairment received 15 weekly individual therapy sessions of positive affect treatment (PAT) or negative affect treatment (NAT). Clinical status measures were self-reported positive affect, interviewer-rated anhedonia, and self-reported depression and anxiety. Target measures were eleven physiological, behavioral, cognitive, and self-report measures of reward anticipation-motivation, response to reward attainment, and reward learning. All analyses were intent-to-treat.

Results: Compared to NAT, individuals receiving PAT achieved superior improvements in the multivariate clinical status measures at posttreatment, b = .37, 95% CI [.15, .59], t(109) = 3.34, p = .001, q = .004, d = .64. Compared to NAT, individuals receiving PAT also achieved higher multivariate reward anticipation-motivation, b = .21, 95% CI [.05, .37], t(268) = 2.61, p = .010, q = .020, d = .32, and higher multivariate response to reward attainment, b = .24, 95% CI [.02, .45], t(266) = 2.17, p = .031, q = .041, d = .25, at posttreatment. Measures of reward learning did not differ between the two groups. Improvements in reward anticipation-motivation and in response to reward attainment correlated with improvements in the clinical status measures.

Conclusions: Targeting positive affect results in superior improvements in clinical status and reward sensitivity than targeting negative affect. This is the first demonstration of differential target engagement across two psychological interventions for anxious or depressed individuals with low positive affect. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

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针对奖赏敏感性的积极情绪治疗：随机对照试验

目的确定针对积极情绪的新型社会心理疗法是否比针对消极情绪的认知行为疗法更能改善临床状态和奖赏敏感性，以及奖赏敏感性的改善是否与临床状态的改善相关：在这项评估者盲法、平行组、多地点、双臂随机对照临床优效试验中，85名寻求治疗的成人积极情绪严重低落、中度至重度抑郁或焦虑以及功能障碍患者接受了每周15次的积极情绪治疗（PAT）或消极情绪治疗（NAT）的个体治疗。临床状态测量指标为自我报告的积极情绪、受访者评定的厌世情绪以及自我报告的抑郁和焦虑。目标测量包括 11 项生理、行为、认知和自我报告测量，涉及奖赏预期-动机、获得奖赏的反应和奖赏学习。所有分析均为意向治疗：与 NAT 相比，接受 PAT 治疗的患者在治疗后的多变量临床状态测量中取得了更好的改善，b = .37, 95% CI [.15, .59], t(109) = 3.34, p = .001, q = .004, d = .64。与 NAT 相比，接受 PAT 的个体在治疗后也获得了更高的多变量奖励预期-动机（b = .21，95% CI [.05, .37]，t(268) = 2.61，p = .010，q = .020，d = .32）和更高的多变量奖励获得反应（b = .24，95% CI [.02, .45]，t(266) = 2.17，p = .031，q = .041，d = .25）。两组的奖赏学习测量结果没有差异。奖赏预期-动机和对获得奖赏的反应的改善与临床状态测量的改善相关：结论：针对积极情绪的临床状态和奖赏敏感性的改善效果优于针对消极情绪的临床状态和奖赏敏感性的改善效果。结论：针对积极情绪的临床状态和奖赏敏感性的改善效果优于针对消极情绪的临床状态和奖赏敏感性的改善效果。(PsycInfo Database Record (c) 2023 APA, 版权所有）。

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来源期刊

Journal of consulting and clinical psychology PSYCHOLOGY, CLINICAL-

CiteScore

9.00

自引率

3.40%

发文量

期刊介绍： The Journal of Consulting and Clinical Psychology® (JCCP) publishes original contributions on the following topics: the development, validity, and use of techniques of diagnosis and treatment of disordered behaviorstudies of a variety of populations that have clinical interest, including but not limited to medical patients, ethnic minorities, persons with serious mental illness, and community samplesstudies that have a cross-cultural or demographic focus and are of interest for treating behavior disordersstudies of personality and of its assessment and development where these have a clear bearing on problems of clinical dysfunction and treatmentstudies of gender, ethnicity, or sexual orientation that have a clear bearing on diagnosis, assessment, and treatmentstudies of psychosocial aspects of health behaviors. Studies that focus on populations that fall anywhere within the lifespan are considered. JCCP welcomes submissions on treatment and prevention in all areas of clinical and clinical–health psychology and especially on topics that appeal to a broad clinical–scientist and practitioner audience. JCCP encourages the submission of theory–based interventions, studies that investigate mechanisms of change, and studies of the effectiveness of treatments in real-world settings. JCCP recommends that authors of clinical trials pre-register their studies with an appropriate clinical trial registry (e.g., ClinicalTrials.gov, ClinicalTrialsRegister.eu) though both registered and unregistered trials will continue to be considered at this time.