Summary

for people ages 18-65 (full criteria)
at UCLA
study started
estimated completion
Michelle G. Craske(ucla)

Description

Summary

Affect, or the tendency to experience a given emotion, often is subdivided into two domains. Positive affect is the tendency to experience positive emotions, such as happiness, excitement, elation, and enthusiasm. Negative affect is the tendency to experience negative emotions, such as anger, resentment, sadness, anxiety, and fear. Humans exhibit a range of emotions that span across positive and negative affect domains with some individuals experiencing more of one type of affect than another. Recent research and developing theories have suggested that mental health disorders can be conceptualized as the tendency for an individual to fall into one or more extremes on these categories. Therefore, treatments should not be based on targeting a conglomeration of symptoms (as we have been doing for the past century) but rather they should be treating the underlying dysregulation (e.g., high or low positive and negative affect). In an effort to address this gap, the current study plans to recruit participants for a treatment trial consisting of two psychotherapies: (a) positive affect treatment (PAT), and (b) negative affect treatment (NAT). The overarching goal of this project are to evaluate the target (i.e. potential mechanisms) of PAT. Participants will be randomized to either a 15-week positive (PAT) or negative affect treatment (NAT). Participants will also complete four laboratory visits (before treatment, during treatment (two times), and at post-treatment) to measure potential targets or mediators of PAT. These laboratory-based assessments will included measures of the positive affect system such as behavioral, subjective, and psychophysiological responses to reward, anticipation and motivation, reward attainment, and reward learning.

Official Title

Reward Sensitivity as a Mechanism of Positive Affect Treatment of Anhedonia

Details

Anhedonia, or loss of interest or pleasure in usual activities, is characteristic of depression, some types of anxiety, as well as substance abuse and schizophrenia. Anhedonia is a predictor of poor long-term outcomes, including suicide, and poor treatment response. Extant psychological and pharmacological treatments are relatively ineffective for anhedonia. Thus, there is an unmet therapeutic need for this high-risk symptom. Recent advances in affective neuroscience have elucidated processes that may underlie anhedonia and should be targeted in therapy. Specifically, anhedonia is associated with deficits in the appetitive reward system, including (1) reward approach-motivation, (2) initial responsiveness to reward attainment, and (3) learning of reward. We have developed a novel transdiagnostic psychosocial treatment for anhedonia, Positive Affect Treatment (PAT), designed to improve deficits in reward sensitivity. The goal of the current study is to evaluate the targets of this new treatment, PAT, and whether the targets are specific to PAT relative to traditional cognitive behavioral therapy designed to reduce negative affect, called Negative Affect Treatment (NAT), in individuals with depression or anxiety.

Keywords

Anhedonia Depression Anxiety Positive Affect Treatment Negative Affect Treatment

Eligibility

You can join if…

Open to people ages 18-65

  • seeking treatment for emotional distress and demonstration of elevated scores on standardized scales for depression and anxiety (i.e., Depression, Anxiety, and Stress Scale, anhedonia (i.e., PANAS-P)) and standardized scales for functional impairment (i.e., Sheehan Disability Scale)
  • either stabilized on psychotropic medications (1 month for benzodiazepines and beta blockers) or medication-free
  • English-speaking

You CAN'T join if...

  • patient report of serious medical conditions - such as respiratory (e.g., chronic obstructive pulmonary disease), cardiovascular, pulmonary, neurological, muscular-skeletal diseases, uncontrolled hyper- or hypothyroidism, uncontrolled high blood pressure, and history of seizures or epilepsy)
  • intellectual disability or organic brain damage
  • history of bipolar I or II disorder, schizophrenia-spectrum disorder, or suicide attempt
  • active suicidal ideation or self-harm within the past year
  • substance use disorder within the last six months
  • pregnancy

Locations

  • University of California, Los Angeles accepting new patients
    Los Angeles California 90095 United States
  • Southern Methodist University accepting new patients
    Dallas Texas 75205 United States

Lead Scientist

Details

Status
accepting new patients
Start Date
Completion Date
(estimated)
Sponsor
University of California, Los Angeles
ID
NCT03439748
Study Type
Interventional
Last Updated