Making the worst of a good job: Induced dampening appraisals blunt happiness and increase sadness in adolescents during pleasant memory recall

How people with major depression adjust their expectations of future life events in response to other patients' reports of the positive effects of psychotherapy

Research proposed the devaluation of positive information, referred to as cognitive immunisation, as a mechanism underlying the persistence of negative expectations in depression. In a pre-registered experimental study, we tested this hypothesis by enhancing vs. inhibiting the engagement in cognitive immunisation and comparing it with a distraction control condition and a no-instruction control condition. In a between-subjects design, we presented participants with major depression (N = 156) with video recordings of other patients in which they reported on the positive effects of psychotherapy. Cognitive immunisation was manipulated by instructing participants to focus on similarities vs. differences between themselves and the persons from the videos. The results show that the other patients' reports led to a significant increase in participants' expectations of future life events and treatment expectations. However, there were no significant differences between the experimental conditions in expectation change, most likely because the manipulation was not powerful enough according to the manipulation check. Only in men the cognitive immunisation-promoting condition effectively blocked expectation change, according to exploratory analyses. This study shows that watching positive reports from other patients helps people with major depression improve their pre-treatment expectations. However, cognitive immunisation does not modulate this process, unless gender is considered.

Experiential processing increases positive affect and decreases dampening appraisals during autobiographical memory recall in an anhedonic sample

Anhedonia is characterized by diminished reward processing, which may be explained in part by dampening appraisals, or thoughts that blunt positive emotions. Experiential processing, or attending to sensory and bodily experience, may curb dampening appraisals, as compared to analytical processing, or conceptually thinking about an event. In this study, 96 participants with elevated anhedonia completed writing tasks, in which they recalled positive autobiographical memories. Participants recalled the first memory as they naturally would to assess spontaneous use of processing mode and were then randomized to recall the second positive memory using either experiential, analytical, or control instructions. Both spontaneous and instructed experiential processing were associated with greater positive affect and less dampening compared to analytical processing. Clinical implications include savoring pleasant sensations to reduce dampening and enhance positive affect in anhedonia.

Fear of Happiness Predicts Concurrent but not Prospective Depressive Symptoms in Adolescents

Background

It is increasingly recognised that the study of responses to positive emotions significantly contributes to our understanding of psychopathology. Notably, positive emotions are not necessarily experienced as pleasurable. Instead, some believe that experiencing happiness may have negative consequences, referred to as fear of happiness (FOH), or they experience a fear of losing control over positive emotions (FOLC). According to reward devaluation theory, such an association of positivity with negative outcomes will result in positive stimuli being devalued over time, contributing to or maintaining depressive symptoms. The prospective relationship between fears of positivity and depressive symptoms is yet to be examined in adolescents. The present longitudinal study investigated whether FOH and FOLC prospectively predict depressive symptoms.

Method

128 adolescents between 16-18 years of age (M = 16.87, SD = 0.80) recruited from two secondary schools in Flanders, Belgium, completed measures of depressive symptoms (Depression Anxiety Stress Scales) including consummatory anhedonia, FOH (Fear of Happiness Scale), and FOLC (Affective Control Scale) in their classroom at baseline and 2-months follow-up. Regression analyses were performed to test the association between FOH, FOLC, and depressive symptoms.

Results

FOH concurrently, but not prospectively, predicted depressive symptoms. There was no significant association between FOH and consummatory anhedonia. FOLC was not a significant predictor of depressive symptoms or consummatory anhedonia.

Conclusion

These findings suggest that FOH may only be concurrently related to depressive symptoms. Considering prior findings in adults, future research should investigate the association of FOH with anticipatory anhedonia in adolescents.

Examining the relationship between anhedonia symptoms and trait positive appraisal style in adolescents: A longitudinal survey study

INTRODUCTION

Anhedonia, defined as a loss of interest and pleasure in previously enjoyable activities, is a core symptom of depression that predicts a poor treatment response in adolescents. We know little about the cognitive vulnerability factors that contribute to the development of anhedonia in youth. This cross-sectional and longitudinal survey study investigated the link between anhedonia symptoms and cognitive appraisal of positive affect.

METHODS

Baseline data were collected from 392 secondary school students in the UK (aged 13-16, 54 % Female), 170 of whom went on to complete the three-month follow-up assessment (a 43 % response rate). Participants rated their anhedonia symptoms and appraisal styles which were measured in terms of use of amplifying appraisals, dampening appraisals, and fear of positive emotion.

RESULTS

At baseline, greater anhedonia was significantly associated with increased levels of dampening and reduced levels of amplifying but was not significantly related to fear of positive emotion. Prospectively, greater baseline levels of amplifying uniquely predicted lower anhedonia severity at three-month follow-up, and vice-versa. There was no evidence for reciprocal prospective associations between anhedonia and, appraisal styles of dampening and fear of positive emotion.

CONCLUSION

These results indicate that cognitive appraisal of positive affect is associated with concurrent and to some extent can predict future symptoms of anhedonia in youth.

A qualitative study exploring adolescents' experience of brief behavioural activation for depression and its impact on the symptom of anhedonia

OBJECTIVES

Anhedonia, the loss of interest and pleasure, is a core symptom of depression and is associated with deficits in reward processing. Behavioural Activation for depression may address this symptom due to its focus on identifying and increasing intrinsically rewarding activities.

DESIGN

This was a qualitative study employing reflexive thematic analysis (TA).

METHODS

Participants were eight treatment-seeking adolescents with a recent primary diagnosis of depression who had received eight sessions of Brief Behavioural Activation. Qualitative semi-structured interviews were conducted after treatment was completed.

RESULTS

Three main themes emerged: (1) connecting, reviewing, and taking action: 'focus on getting better rather than what you're feeling'; (2) struggles, restrictors, and motivators: 'it seemed really unachievable'; and (3) feeling, acting, or seeing things differently: 'looking forwards in a more healthy way'.

CONCLUSIONS

Both specific Brief Behavioural Activation strategies (e.g., connecting with values) and more generic therapeutic strategies (e.g., self-monitoring) may be helpful in treating the symptom of anhedonia in adolescent depression. Motivational aspects of anhedonia, as well as anxiety, fatigue, and academic pressures act as potential barriers to recovery. This highlights the need for psychological treatments for adolescent depression to include explicit and targeted strategies to enhance motivation.

PRACTITIONER POINTS

Young people reported that specific Brief Behavioural Activation strategies (e.g., connecting with values) and more generic therapeutic techniques (e.g., self-monitoring) had a role in treating anhedonia. Barriers to engaging in Brief BA included: motivational anhedonia, fatigue, and academic demands.