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

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 Mi...

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Published in:Behaviour research and therapy 2024-11, Vol.182, p.104620, Article 104620
Main Authors: Cernasov, Paul M., Walsh, Erin C., Nagy, Gabriela A., Kinard, Jessica L., Kelley, Lisalynn, Phillips, Rachel D., Pisoni, Angela, Diehl, Joseph, Haworth, Kevin, West, Jessica, Freeman, Louise, Pfister, Courtney, Scott, McRae, Daughters, Stacey B., Gaylord, Susan, Dichter, Gabriel S., Smoski, Moria J.
Format: Article
Language:English
Subjects:
Adult
Anhedonia
Behavior Therapy - methods
Behavioral activation
Cognitive Behavioral Therapy - methods
Female
Humans
Male
Middle Aged
Mindfulness
Mindfulness - methods
SHAPS
Treatment Outcome
Young Adult
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Summary: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 
ISSN:0005-7967
1873-622X
1873-622X
DOI:10.1016/j.brat.2024.104620