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

Michelle G Craske1, Alicia E Meuret2, Aileen Echiverri-Cohen1

  • 1Department of Psychology, University of California, Los Angeles.

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Summary

Positive affect treatment (PAT) significantly improved clinical status and reward sensitivity more than negative affect treatment (NAT) in adults with depression or anxiety. These findings highlight the benefits of targeting positive emotions for mental health recovery.

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Area of Science:

  • Psychiatry and Psychology
  • Clinical Psychology
  • Affective Science

Background:

  • Individuals with moderate-to-severe depression or anxiety often experience severely low positive affect and functional impairment.
  • Cognitive behavioral therapy (CBT) typically targets negative affect, but its impact on positive affect and reward sensitivity is less understood.

Purpose of the Study:

  • To compare a novel positive affect treatment (PAT) with a negative affect treatment (NAT) in improving clinical status and reward sensitivity.
  • To investigate the correlation between improvements in reward sensitivity and clinical status.

Main Methods:

  • An assessor-blinded, randomized controlled trial involving 85 adults with low positive affect, depression, or anxiety.
  • Participants received 15 weekly sessions of either PAT or NAT.
  • Clinical status and reward sensitivity (physiological, behavioral, cognitive, self-report measures) were assessed.

Main Results:

  • PAT demonstrated superior improvements in multivariate clinical status compared to NAT (p = .001).
  • PAT also led to significantly higher multivariate reward anticipation-motivation (p = .010) and response to reward attainment (p = .031) than NAT.
  • Improvements in reward anticipation-motivation and response to reward attainment were correlated with improvements in clinical status.

Conclusions:

  • Targeting positive affect is more effective than targeting negative affect for improving clinical status and reward sensitivity in individuals with anxiety or depression.
  • This study provides the first evidence of differential target engagement between psychological interventions for individuals with low positive affect.