Changes in Positive and Negative Affect in Psychotherapy for Depression and Anxiety

• Published in: Journal of consulting and clinical psychology 2024-04, Vol.92 (4), p.249-259
• Main Authors: Barnes-Horowitz, Nora M., Metts, Allison, Rosenfield, David, Yarrington, Julia S., Treanor, Michael, Echiverri-Cohen, Aileen, Ritz, Thomas, Meuret, Alicia E., Craske, Michelle G.
• Format: Article
• Language: English
• Subjects: Affect (Psychology); Anxiety; Anxiety - complications; Anxiety - therapy; Anxiety Disorders; Changes; Depression - complications; Depression - therapy; Human; Humans; Major Depression; Mental depression; Negative Emotions; Positive Emotions; Psychotherapy; Symptoms
• ISSN: 0022-006X; 1939-2117
• DOI: 10.1037/ccp0000865

Objective: Positive and negative affect play critical roles in depression and anxiety treatment, but the dynamic processes of how affect changes over treatment in relation to changes in symptoms is unclear. The study goal was to examine relationships among changes in positive and negative affect with changes in depression and anxiety symptoms. Method: This secondary analysis used a combined sample (N = 196) of two trials (Craske et al., 2019, 2023) comparing positive affect treatment (PAT) to negative affect treatment. Longitudinal cross-lag panel models explored whether changes in positive and negative affect (Positive and Negative Affect Schedule; Watson et al., 1988) predicted subsequent changes in depression and anxiety symptoms (Depression Anxiety Stress Scales; Lovibond & Lovibond, 1995), whether symptoms predicted subsequent changes in affect, and whether treatment condition moderated these relationships. Results: Increases in positive affect predicted subsequent decreases in depression and anxiety symptoms, regardless of treatment condition. Symptoms did not reciprocally predict changes in positive affect. For individuals in PAT, decreases in negative affect predicted subsequent decreases in symptoms. Moreover, decreases in symptoms predicted subsequent decreases in negative affect, regardless of treatment condition. Conclusions: Results did not support a reciprocal relationship between positive affect and symptoms of depression and anxiety since positive affect predicted depression and anxiety symptoms but not vice versa. Results supported a reciprocal relationship between negative affect and symptoms of depression and anxiety since negative affect predicted depression and anxiety symptoms in PAT, and depression and anxiety symptoms predicted negative affect in both treatment conditions. What is the public health significance of this article? This study highlights the importance of considering the different and dynamic ways in which changes in positive affect and negative affect contribute to subsequent changes in depression and anxiety symptoms and vice versa over the course of psychotherapy.