A parallel-arm, randomized trial of Behavioral Activation Therapy for anhedonia versus mindfulness-based cognitive therapy for adults with anhedonia.

Anhedonia Behavioral activation Mindfulness SHAPS

Journal

Behaviour research and therapy
ISSN: 1873-622X
Titre abrégé: Behav Res Ther
Pays: England
ID NLM: 0372477

Informations de publication

Date de publication:
23 Aug 2024
Historique:
received: 09 10 2023
revised: 29 07 2024
accepted: 21 08 2024
medline: 31 8 2024
pubmed: 31 8 2024
entrez: 30 8 2024
Statut: aheadofprint

Résumé

Anhedonia, deficits in motivation and pleasure, is a transdiagnostic symptom of psychopathology and negative prognostic marker. In this randomized, parallel-arm clinical trial, a novel intervention, Behavioral Activation Treatment for Anhedonia (BATA), was compared to an individually administered Mindfulness-Based Cognitive Therapy (MBCT) in a transdiagnostic cohort of adults with clinically significant anhedonia (ClinicalTrials.gov Identifiers NCT02874534 and NCT04036136). Participants received 8-15 individual psychotherapy sessions, once weekly, with either BATA (n = 61) or MBCT (n = 55) and completed repeated self-report assessment of anhedonia and other internalizing symptoms. Indicators of treatment feasibility were similar across conditions, though MBCT showed a trend towards greater attrition rates than BATA, with an adjusted odd's ratio of 2.04 [0.88, 4.73]. Treatment effects on the primary clinical endpoint of anhedonia symptoms did not significantly differ, with a 14-week estimated difference on the Snaith Hamilton Pleasure Scale (SHAPS) of -0.20 [-2.25, 1.84] points in BATA compared to MBCT (z = 0.19, p = 0.845, d = 0.05). The expected 14-week change in SHAPS scores across conditions was -7.18 [-8.22, -6.15] points (z = 13.6, p < 0.001, d = 1.69). There were no significant differences in the proportion of participants demonstrating reliable and clinically significant improvements in SHAPS scores, or in the magnitude of internalizing symptom reductions. Limitations included a modest sample size, lack of longer-term follow up data, and non-preregistered analytic plan. There was no evidence to support superior clinical efficacy of BATA over MBCT in a transdiagnostic cohort of adults with elevated anhedonia. Both interventions reduced anhedonia symptoms to a comparable magnitude of other existing treatments.

Sections du résumé

BACKGROUND BACKGROUND
Anhedonia, deficits in motivation and pleasure, is a transdiagnostic symptom of psychopathology and negative prognostic marker.
METHODS METHODS
In this randomized, parallel-arm clinical trial, a novel intervention, Behavioral Activation Treatment for Anhedonia (BATA), was compared to an individually administered Mindfulness-Based Cognitive Therapy (MBCT) in a transdiagnostic cohort of adults with clinically significant anhedonia (ClinicalTrials.gov Identifiers NCT02874534 and NCT04036136). Participants received 8-15 individual psychotherapy sessions, once weekly, with either BATA (n = 61) or MBCT (n = 55) and completed repeated self-report assessment of anhedonia and other internalizing symptoms.
RESULTS RESULTS
Indicators of treatment feasibility were similar across conditions, though MBCT showed a trend towards greater attrition rates than BATA, with an adjusted odd's ratio of 2.04 [0.88, 4.73]. Treatment effects on the primary clinical endpoint of anhedonia symptoms did not significantly differ, with a 14-week estimated difference on the Snaith Hamilton Pleasure Scale (SHAPS) of -0.20 [-2.25, 1.84] points in BATA compared to MBCT (z = 0.19, p = 0.845, d = 0.05). The expected 14-week change in SHAPS scores across conditions was -7.18 [-8.22, -6.15] points (z = 13.6, p < 0.001, d = 1.69). There were no significant differences in the proportion of participants demonstrating reliable and clinically significant improvements in SHAPS scores, or in the magnitude of internalizing symptom reductions.
LIMITATIONS CONCLUSIONS
Limitations included a modest sample size, lack of longer-term follow up data, and non-preregistered analytic plan.
DISCUSSION CONCLUSIONS
There was no evidence to support superior clinical efficacy of BATA over MBCT in a transdiagnostic cohort of adults with elevated anhedonia. Both interventions reduced anhedonia symptoms to a comparable magnitude of other existing treatments.

Identifiants

DOI: 10.1016/j.brat.2024.104620 PMID: 39213738
pubmed: 39213738
pii: S0005-7967(24)00147-5
doi: 10.1016/j.brat.2024.104620
pii:
doi:

Banques de données

ClinicalTrials.gov
['NCT02874534', 'NCT04036136']

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

104620

Informations de copyright

Copyright © 2024 Elsevier Ltd. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest The work described in this manuscript has not been published previously, is not under consideration for publication elsewhere, and the publication of this manuscript is approved by all authors and tacitly or explicitly by the responsible authorities where the work was carried out. If accepted, this work will not be published elsewhere in the same form, in English or in any other language, including electronically, without written consent of the copyright holder. We have no conflicts of interest, financial or otherwise, that would preclude a fair review or publication of this manuscript.

Auteurs

Paul M Cernasov (PM)

Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. Electronic address: paul.cernasov@unc.edu.

Erin C Walsh (EC)

Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.

Gabriela A Nagy (GA)

Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA; Duke University School of Nursing, Durham, NC, USA.

Jessica L Kinard (JL)

Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA; Division of Speech and Hearing Sciences, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.

Lisalynn Kelley (L)

Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.

Rachel D Phillips (RD)

Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

Angela Pisoni (A)

Department of Psychology and Neuroscience, Duke University, Durham, NC, USA.

Joseph Diehl (J)

Department of Psychology and Neuroscience, Duke University, Durham, NC, USA.

Kevin Haworth (K)

Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.

Jessica West (J)

Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.

Louise Freeman (L)

Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

Courtney Pfister (C)

Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

McRae Scott (M)

Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

Stacey B Daughters (SB)

Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

Susan Gaylord (S)

Department of Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.

Gabriel S Dichter (GS)

Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA; Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.

Moria J Smoski (MJ)

Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA; Department of Psychology and Neuroscience, Duke University, Durham, NC, USA.

Classifications MeSH