Behavioral Activation Techniques Research Articles

Investigating the Impact of Anhedonia on Academic Performance: a Case Report

This case report represents a case of anhedonia in a university student (L) (a sixth-year medical school student at Al-Sham Private University, currently 23 years old, born in 2000). (L)suffered from a significant loss of interest and pleasure in various aspects of her life, which led to academic, emotional, and social difficulties. This study explores the impact of anhedonia on (L)'s academic performance using the Snaith-Hamilton Pleasure Scale, where symptoms of anhedonia were evaluated along with semi-regulated interviews conducted every two weeks, and to monitor her academic performance we relied on her GPA and class attendance rate. The initial interview focused on the onset of anhedonia and its academic consequences, while the follow-up interview aimed to track progress and evaluate Laila's social relationships. Our results indicated a significant decrease in (L)’s ability to experience pleasure, accompanied by a noticeable decrease in her academic performance. Intervention procedures included counseling, cognitive-behavioral therapy (CBT) sessions, and behavioral activation techniques that were implemented by a specialized therapist, Dr. Ghena Najati. (L)’s symptoms gradually improved, leading to positive changes in her engagement, thinking patterns, motivations, and overall well-being. The results highlight the usefulness of the Snaith-Hamilton Pleasure Scale in providing an accurate understanding of the impact of anhedonia and guiding interventions specifically designed to support affected students.

Effects of an internet-delivered behavioral activation program on improving work engagement among Japanese workers: A pre-and post-test study.

To examine the effect of a newly developed internet-delivered behavioral activation (iBA) program on work engagement and well-being among Japanese workers with elevated psychological distress. Participants were recruited via an internet survey company (N = 3299). The eligibility criteria were: 1) Japanese employees aged 20-59 years old, 2) having psychological distress, and 3) not self-employed. This iBA program was a 3-week web-based training course using behavioral activation techniques. Work engagement, psychological distress and eudemonic well-being at work were measured at baseline and post-intervention period. A paired sample t-test was conducted to assess the intervention effect. Of the 568 eligible participants, 120 were randomly selected. A total of 108 participants completed the baseline survey and received the iBA program. Eighty respondents completed the post-intervention survey and were included in analyses. The iBA program did not show a significant intervention effect on work engagement (p = 0.22, Cohen's d = 0.14), while psychological distress (p < 0.01, d = -0.40) and role-oriented future prospects (p = 0.02, Cohen's d = 0.27) were significantly improved. The effect of the iBA program on work engagement may be limited.

80 Examining the Relationship between Burn Injury Acuity and Risk for Developing PTSD and Depression Symptoms

Abstract Introduction Individuals who experience traumatic events are at heightened risk for developing adverse mental health outcomes, specifically posttraumatic stress and depressive symptoms. Those hospitalized following a burn injury experience significant psychological and emotional burden during acute burn treatment. Symptoms of depression and posttraumatic stress are common following a traumatic burn injury; however, little is known about the impact of burn-related intensive care unit (ICU) admission on future risk of developing posttraumatic stress disorder (PTSD) and depression. Thus, the current study examined the associations between burn injury acuity (defined by admission to ICU vs. non-ICU) and risk for developing mental health problems (i.e., depression and PTSD) among burn center patients assessed within the initial 30 days following their injury. Methods Participants included 286 patients admitted to the burn center at a southeastern academic medical center (Mage = 46.79, SD = 17.47; 53% White; 66% Male; 94% Non-Hispanic; 25% admitted to ICU). Patients were assessed by the hospital’s burn behavioral health program. Risk of PTSD and depression was assessed via the Injured Trauma Survivor Screen (ITSS), a validated measure used to determine risk of PTSD and depression following an injury. Results Independent samples t-tests revealed that ICU admission was associated with an increased risk for developing posttraumatic stress (p = .022) and depressive symptoms (p = .016) as compared to non-ICU admitted patients when assessed within the initial 30 days following a burn injury. Conclusions Though preliminary, results highlight the importance of considering burn acuity when evaluating risk of developing psychopathology following a burn injury. Admission to ICU appears to play a key role in individuals’ risk for developing PTSD and depressive symptoms. Both physical and emotional healing are critical components of a patient’s recovery process following a burn injury. Applicability of Research to Practice Given these results, it is important to prioritize promoting psychological recovery following a potentially traumatic burn injury in those admitted to ICU through early screening and intervention. Early intervention should emphasize reducing avoidance of feared stimuli, gradual exposure, relaxation strategies, social support, and behavioral activation techniques particularly for patients admitted to the ICU to help mitigate negative effects of trauma exposure that may lead to increased psychopathology.

The effect of intervention using an emotional recognition coaching companion robot on the elderly people with depression

IntroductionDuring the COVID-19 pandemic, care for the elderly in the community was greatly limited. Accordingly, the demand for alternative community care have increased to cope with changing situations.ObjectivesIn this study, we tried to find out whether the companion robot improved mood state and related problem in depressive or isolated community dwelling elderlyMethodsFor 186 community dwelling elderly who have received social welfare service due to depression or social isolation, we provided companion robot that could support their daily living. The robot was equipped with special program that could recognize and respond to the participant’s own emotion. It was part of behavioral activation techniques which is one of powerful treatment for depression. The self-report questionnaires were used to measure changes in cognitive function, depression, suicidality, loneliness, resilience and satisfaction of life. Outcomes were measured before using companion robot and after 3 months, and we compared them.ResultsThe elderly using companion robot for 3 months showed improved cognitive function (45.7% to 30.1%), depression (p&lt;0.001), suicidality(p&lt;0.001), and loneliness (p=0.033) in the self-report questionnaire. Resilience(p=0.749) and satisfaction of life (p=0.246) were also improved but not reached significance.Image:Image 2:Image 3:ConclusionsThese findings showed that the use of companion robot with emotional recognition coaching program could help improve depression, cognitive function, loneliness and suicidal ideation. In particular, this effect was also useful for those who were diagnosed with depression. Also if we can put more techniques of behavioral activation programs into robot, it could be useful in community care for depressive and isolated elderly.Disclosure of InterestNone Declared

Resistance training for Black men with depressive symptoms: a pilot randomized controlled trial to assess acceptability, feasibility, and preliminary efficacy

BackgroundDepression is under-recognized in Black men, who are less likely to seek or have access to psychiatric treatment. Resistance training (RT; i.e., weight lifting) can improve depressive symptoms and may be more acceptable to Black men, but its effects have not been examined for Black men with depressive symptoms.MethodsFifty Black men with depressive symptoms were randomized to either (a) 12 weeks of RT (coupled with Behavioral Activation techniques to promote adherence) or (b) an attention-control group (Health, Wellness, and Education; HWE). Both groups met twice/week for 12 weeks, and follow-up assessments were done at end-of-treatment (EOT) and 6 months after enrollment. Changes in physical activity and muscular strength were collected as a manipulation check. The primary outcome was interviewer assessed symptoms of depression using the Quick Inventory of Depression Symptomology (QIDS). Secondary outcomes included self-reported depressive symptoms, anxiety, and stress. The association between change in QIDS from baseline to EOT and concurrent changes in physical activity and muscular strength in the RT group were explored as an initial assessment of mechanism. Longitudinal mixed effects regression models with subject-specific intercepts were used to examine intervention effects.ResultsA sample with high rates of medical comorbidities (e.g., 44% HIV positive), substance use (e.g., 34% smoking), and negative social determinates of health (e.g., 50% unemployed) was enrolled. Recruitment, engagement, and retention data indicate that the intervention and design were feasible. The RT group showed greater gains in self-reported exercise (b = 270.94, SE = 105.69, p = .01) and muscular strength (b = 11.71, SE = 4.23, p = .01 for upper body and b = 4.24, SE = 2.02, p = .04 for lower body) than the HWE group. The RT group had greater reductions in QIDS scores at both EOT (b = -3.00, SE = 1.34, p = .01) and 6 months (b = -2.63, SE = 1.81, p = .04). The RT group showed a greater reduction in anxiety at EOT (b = -2.67, SE = 1.06, p = .02). Findings regarding self-reported depressive symptoms and stress were non-significant, but in the expected direction with effect sizes in the small to medium range. In the RT group, improvement on the QIDS between baseline and EOT was associated with concurrent improvements in physical activity (b = 21.03, SE = 11.16, p = .02) and muscular strength (b = 1.27, SE = .44, p = .03 for upper body and b = .75, SE = .14, p = .03 for lower body). ConclusionsResults suggest that RT is feasible and may be efficacious for reducing depressive symptoms among underserved urban Black men.Trial RegistrationClinicalTrial.gov #: NCT03107039 (Registered 11/04/2017).

Stuck in Stage 3: The Case of an Effective Depression Intervention for African American Older Adults

Beat the Blues (BTB) is a culturally tailored depression program for older African Americans. Tested in an NIA Stage 3 efficacy trial, findings showed statistically and clinically significant benefits, including decreased depressive symptoms, improved depression knowledge and symptom recognition, and behavioral activation. The multi-component intervention was co-constructed in partnership with a large senior center. Drawn from previously tested depression programs and tailored to preferences/needs of the targeted population, its five components included care management, depression education and symptom recognition, resources/referrals, and stress reduction and behavioral activation techniques. Despite significant findings, strong effect sizes and high acceptability, moving BTB to NIA Stage 4 (effectiveness) or 5 (dissemination) has been challenging. Challenges that will be discussed include lack of senior center funding to support training and delivery and infrastructure to embed BTB in community-based programs, and reluctance of health systems to adopt BTB because of its focus on one racial group.

Types of Utilization and Types of Treatment Response in a Collaborative Care Approach for Depressive Disorders in Old Age in Primary Care.

Background: Treatment of depressive disorders in old age is hindered by several barriers. Most common are time pressure in primary care and latency for specialized therapeutic care. To improve treatment, the collaborative care approach GermanIMPACT was evaluated in a cluster-randomized controlled trial. Care managers offered a complex stepped-care intervention of monitoring, psychoeducation, and behavioral activation techniques. Twenty-six percent of the intervention group responds with a remission of depressive symptoms compared with 11% who received treatment as usual (TAU). The low-threshold intervention was more successful than TAU. Nevertheless, three-quarters did not respond with a remission. The aim of this study is to identify and describe the different types of utilization and of treatment response to understand what constitutes an effective intervention.Methods: Of 64 patients from the intervention group, we carried out problem-centered interviews with 26 patients from the intervention group. We analyzed the interviews using a qualitative type-building content analysis. For type construction, we performed a contrasting case comparison, regarding inductive and deductive categories of the intervention utilization and the symptom development.Results: The 26 participants' ages ranged from 62 to 87 years (mean = 72 years). Three participants were male. We identified five types of utilization, which differ primarily in the realization of pleasant activations, depending on own activity at the beginning and during the therapy: “activatable relief seekers,” “active relief seekers,” “active relaxation seekers,” “passive problem-solving seekers,” and “passive relief seekers.” In the second typology, we analyzed four deductively determined types of treatment response responders, slight improvers, constant moderates, and non-responders. Patient-specific characteristics are a recent history of depression, an affinity for activities, supportive contacts, and limited comorbidity. In contrast, non-responders report contrary characteristics.Conclusion: Our two typologies emphasize that an effective intervention requires a match between intervention components and patient characteristics. We saw no intersections between utilization and treatment response. GermanIMPACT is an effective low-threshold intervention for moderately burdened patients, who are still capable of self-activation. An expansion of the intervention, especially for depression with a long history and comorbidities impairing mobility, could increase the effectiveness and improve the care situation of older people suffering from depression.

Effects of resistance training on depression and cardiovascular disease risk in black men: Protocol for a randomized controlled trial

BackgroundDepression is severely undertreated in Black men. This is primarily because Black men are less likely to seek traditional psychiatric treatment, have less access and more barriers to treatment, and perceive more stigma associated with treatment. Depression contributes to cardiovascular disease (CVD), and Black men have the highest rate of mortality from CVD. Resistance training (RT) can have beneficial effects on both depression and CVD. This study will be the first randomized controlled trial to test the effects of RT on depression and cardiovascular health in a sample of depressed Black men. MethodFifty Black men with clinically significant symptoms of depression will be randomized to either (a) a 12-week RT or (b) an attention control group. Behavioral Activation techniques will be used to support adherence to home-based RT goals. Both groups will meet on-site twice/week during the 12-week program, and follow-up assessments will occur at the end-of-treatment and 3 months post-treatment. Qualitative interviews will be conducted after the 3-month follow-up. The objectives of this study are (1) to assess the feasibility and acceptability of recruitment, retention, and intervention procedures, (2) to obtain preliminary evidence of efficacy, and (3) to explore potential mediators of the effects of RT on depression. DiscussionThis study will advance the field of minority men's health by producing new data on the effects of RT for depression, the potential mechanisms of action that may support its use, and its effects on markers of CVD risk in Black men. Trial registrationClinicalTrials.gov (NCT03107039);

A Treatment-Refractory Case of Social Anxiety Disorder: Lessons Learned From a Failed Course of Cognitive-Behavioral Therapy

Over the past 25 years researchers have made enormous strides in the implementation of cognitive-behavioral therapy (CBT) for social anxiety disorder (SAD), although considerable work remains to be done. The present paper discusses a treatment refractory case seen in our clinic. The young man presented numerous interrelated obstacles, such as low treatment expectations, poor homework compliance, and comorbid depression and alcohol dependence. We highlight the challenges presented by this complex presentation, as well as issues that arose over the course of treatment. We then elaborate on techniques that could have improved his outcome. The promise of motivational interviewing and behavioral activation techniques for these complex clients is discussed. Future research and treatment directions for refractory cases are considered.

Behavioral Activation and Rehabilitation

Rehabilitation from a mental or physical disorder can become complicated when patients feel overwhelmed by symptoms and unable to make progress. Newer behavioral approaches have been developed that can help these patients. This article describes behavioral activation techniques designed to address depression.