Positive affect treatment targets reward sensitivity: A randomized controlled trial.
Positive affect treatment targets reward sensitivity: A randomized controlled trial.
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积极情感治疗目标奖励敏感性：一项随机对照试验。
DOI：
10.1037/ccp0000805
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发表时间：
2023
影响因子：
5.9
通讯作者：
Ritz,Thomas
中科院分区：
文献类型：
--
作者：
Craske,MichelleG;Meuret,AliciaE;Echiverri-Cohen,Aileen;Rosenfield,David;Ritz,Thomas
确定一种新的积极情感的心理社会治疗是否比一种针对消极情感的认知行为疗法更能改善临床状态和奖励敏感性，以及奖励敏感性的改善是否与临床状态的改善相关。中度至重度抑郁或焦虑以及功能障碍患者接受15次每周一次的积极情感治疗（PAT）或消极情感治疗（NAT）。临床状态的措施是自我报告的积极影响，面试官评定的快感缺乏，和自我报告的抑郁和焦虑。目标措施是11个生理，行为，认知和自我报告措施的奖励预期动机，奖励实现的反应，奖励学习。所有分析均为意向治疗。结果与NAT相比，接受PAT的个体在治疗后的多变量临床状态指标方面取得了上级改善，B=。37，95% CI [. 15,. 59]，t（109）= 3.34，p=. 001，q=. 004，d=. 64.与NAT相比，接受PAT的个体也实现了更高的多元奖励预期-动机，B=。21，95% CI [. 05,. 37]，t（268）= 2.61，p=. 010，q=. 020，d=. 32，和更高的多变量响应奖励实现，B=。24，95% CI [. 02,. 45]，t（266）= 2.17，p=. 031，q=. 041，d=. 25、治疗后奖励学习的衡量标准在两组之间没有差异。奖励预期-动机和对奖励获得的反应的改善与临床状态指标的改善相关。结论与针对负面影响相比，针对积极影响会导致临床状态和奖励敏感性的上级改善。这是第一次展示了两种心理干预对焦虑或抑郁的低积极影响个体的不同目标参与。（PsycInfo数据库记录（c）2023阿帕，保留所有权利）
ObjectiveDetermine 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.MethodIn 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.ResultsCompared 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.ConclusionsTargeting 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)