| Popis: |
Objective: Behavioral Activation (BA) is a brief intervention for depression encouraging gradual and systematic re-engagement with rewarding activities and behaviors. Given this treatment focus, BA may be particularly beneficial for adolescents with prominent anhedonia, a predictor of poor treatment response and common residual symptom. We applied group iterative multiple model estimation (GIMME) to ecological momentary assessment (EMA) treatment data to investigate common and person-specific processes of change during BA for anhedonic adolescents.Method: Thirty-nine adolescents (Mage = 15.7 years old, 67% female, 81% White) with elevated anhedonia (Snaith Hamilton Pleasure Scale) were enrolled in a 12-week BA trial, with weekly anhedonia assessments. EMA surveys were triggered every other week (2-3 surveys per day) throughout treatment assessing current positive affect (PA) and negative affect (NA), engagement in pleasurable activities and social interactions, anticipatory pleasure, rumination, and recent pleasurable and stressful experiences. Results: Multilevel models revealed significant decreases in anhedonia (t(25.5) = -4.65, p < 0.001) over the 12-week trial. GIMME results indicated substantial heterogeneity in symptom networks across patients. Within-patient change in PA was the variable with the greatest number (21% of all paths vs. 11% for NA) of predictive paths to other symptoms (i.e., out-degree). Higher PA (but not NA) out-degree was associated with greater anhedonia improvement (t(25.8) = -2.22, p = 0.035).Conclusions: Results revealed substantial heterogeneity in symptom relations across patients, which may obscure the search for common processes of change in BA. PA may be a particularly important treatment target for anhedonic adolescents in BA. |
