Treatment for Affect Dimensions
| Status: | Recruiting |
|---|---|
| Conditions: | Anxiety, Anxiety, Depression |
| Therapuetic Areas: | Psychiatry / Psychology |
| Healthy: | No |
| Age Range: | 18 - 65 |
| Updated: | 10/13/2018 |
| Start Date: | November 1, 2018 |
| End Date: | August 30, 2020 |
| Contact: | Michelle G Craske, PhD |
| Email: | craske@psych.ucla.edu |
| Phone: | 310-206-9191 |
Reward Sensitivity as a Mechanism of Positive Affect Treatment of Anhedonia
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.
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.
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.
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.
Inclusion Criteria:
- 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
Exclusion Criteria:
- 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
We found this trial at
2
sites
Los Angeles, California 90095
310-825-4321
Principal Investigator: Michelle G. Craske, Ph.D
Phone: 310-206-9191
University of California at Los Angeles The University of California, Los Angeles (UCLA) is an...
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Dallas, Texas 75206
Principal Investigator: Alicia E Meuret, PhD
Phone: 214-768-3422
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