Psychopathology and positive emotions in daily life

Vera E Heininga,Peter Kuppens

doi:10.1016/j.cobeha.2020.11.005

Abstract

• Aside from notable exceptions, Positive Affect (PA) is low in mood disorders. • Evidence from laboratory settings versus daily life appears paradoxical. • Little is known about anticipatory PA (‘wanting’) in daily life. • Therapeutic efficacy of PA-focused EMA Interventions has not materialized (yet). In this short review, we describe recent trends from Ecological Momentary Assessment (EMA) research investigating positive affect (PA) in relation to mood disorders. Aside from notable exceptions (e.g. mania), most mood disorders involve relatively lower levels of PA in daily life, often combined with a larger level of variability in PA. In reaction to positive events, studies show a puzzling ‘mood brightening’ effect in individuals with mood disorder symptoms that suggests hyper responsiveness to real-life rewards. Studies into anhedonia (i.e. lack of, or lower levels of PA) suggest that high-arousal PA and anticipatory PA are potential targets for intervention. Despite PA-focused EMA-interventions bear promises of greater therapeutic effectiveness, so far, these promises have not materialized yet.

Highlights

In mood disorders feelings or emotions are distorted or inconsistent with its context to such an extent that it interferes with one’s ability to function [1]
We describe recent trends from Ecological Momentary Assessment (EMA) research investigating positive affect (PA) in relation to mood disorders
Positive Affect (PA) in daily life In EMA studies, PA is typically operationalized as the mean of a set of adjective rating scales

Summary

Introduction

In mood disorders feelings or emotions are distorted or inconsistent with its context to such an extent that it interferes with one’s ability to function [1]. For NA, depressed individuals’ tendency to ruminate (i.e. focused attention to negative events and moods) might be lowered by the experience of a positive event to an extent that they ruminate less than controls, and the subsequent lower level of NA presents itself as a mood brightening effect [33] Another explanation for the discrepancy between theory and EMA results on reward responsiveness could be that PA reactivity to the self-reported pleasantness of an event is a suboptimal operationalization. Combination with specific recommendations for lifestyle changes effectively increased participants’ PA levels throughout daily life, suggesting evaluative feedback may be an effective way to augment the efficacy of regular depression treatment In line with these findings, recent advances on Behavioral Activation treatments suggest that these treatments may work by targeting (low) reward responsiveness directly [42,58]. The PA-focused EMI did not go beyond the efficacy of medication and psychotherapy, Bastiaansen et al, conclude that it may be worthwhile to investigate whether EMIs can be blended with routine mental health services as they have the potential to make psychotherapy treatments more time-efficient for therapists without sacrificing efficacy

Conclusions

American Psychiatric Association

Carver CS

42. Pizzagalli DA

Findings

58. Forbes CN