Upregulating the positive affect system in anxiety and depression: Outcomes of a positive activity intervention

Abstract

Background: Research suggests that the positive affect system may be an important yet underexplored treatment target in anxiety and depression. Existing interventions primarily target the negative affect system, yielding modest effects on measures of positive emotions and associated outcomes (e.g., psychological well-being). The objective of the present pilot study was to evaluate the efficacy of a new transdiagnostic positive activity intervention (PAI) for anxiety and depression.

Method: Twenty-nine treatment-seeking individuals presenting with clinically impairing symptoms of anxiety and/or depression were randomly allocated to a 10-session protocol comprised of PAIs previously shown in nonclinical samples to improve positive thinking, emotions, and behaviors (e.g., gratitude, acts of kindness, optimism; n = 16) or a waitlist (WL) condition (n = 13). Participants were assessed at pre- and posttreatment, as well as 3- and 6-month follow-up, on measures of positive and negative affect, symptoms, and psychological well-being. ClinicalTrials.gov Identifier: NCT02330627 RESULTS: The PAI group displayed significantly larger improvements in positive affect and psychological well-being from pre- to posttreatment compared to WL. Posttreatment and follow-up scores in the PAI group were comparable to general population norms. The PAI regimen also resulted in significantly larger reductions in negative affect, as well as anxiety and depression symptoms, compared to WL. Improvements across all outcomes were large in magnitude and maintained over a 6-month follow-up period.

Conclusions: Targeting the positive affect system through a multicomponent PAI regimen may be beneficial for generating improvements in positive emotions and well-being, as well as reducing negative affect and symptoms, in individuals with clinically impairing anxiety or depression.

Keywords: anxiety; depression; positive activities; positive affect; positive intervention; randomized controlled trial; transdiagnostic; well-being.

Conflict of interest statement

Conflict of Interest: Charles T. Taylor declares that he has no conflicts of interest. Sonja Lyubomirsky declares that in the past 3 years she has been a paid lecturer for the Cleveland Clinic and Healthworld Ltd., as well as a paid consultant for Biogen Idec. Murray B. Stein declares that in the past 3 years he has been a paid consultant for Janssen, Pfizer, and Resilience Therapeutics, and receives payment for editorial work for UpToDate and the journal Biological Psychiatry.

© 2016 Wiley Periodicals, Inc.

Figures

Figure 1.

CONSORT flow diagram illustrating participants’ progress throughout the study.