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

Autor: Cernasov PM; Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. Electronic address: paul.cernasov@unc.edu., Walsh EC; Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA., Nagy GA; Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA; Duke University School of Nursing, Durham, NC, USA., 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., Kelley L; Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA., Phillips RD; Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA., Pisoni A; Department of Psychology and Neuroscience, Duke University, Durham, NC, USA., Diehl J; Department of Psychology and Neuroscience, Duke University, Durham, NC, USA., Haworth K; Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA., West J; Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA., Freeman L; Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA., Pfister C; Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA., Scott M; Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA., Daughters SB; Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA., Gaylord S; Department of Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA., 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., 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.
Jazyk: angličtina
Zdroj: Behaviour research and therapy [Behav Res Ther] 2024 Nov; Vol. 182, pp. 104620. Date of Electronic Publication: 2024 Aug 23.
DOI: 10.1016/j.brat.2024.104620
Abstrakt: Background: Anhedonia, deficits in motivation and pleasure, is a transdiagnostic symptom of psychopathology and negative prognostic marker.
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: 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: Limitations included a modest sample size, lack of longer-term follow up data, and non-preregistered analytic plan.
Discussion: 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.
Competing Interests: 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.
(Copyright © 2024 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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