OBJECTIVE Determine whether a novel psychosocial treatment for positive affect improves clinical status and reward sensitivity more than a form of cognitive behavioral therapy that targets negative affect and whether improvements in reward sensitivity correlate with improvements in clinical status. METHOD In this assessor-blinded, parallel-group, multisite, two-arm randomized controlled clinical superiority trial, 85 treatment-seeking adults with severely low positive affect, moderate-to-severe depression or anxiety, and functional impairment received 15 weekly individual therapy sessions of positive affect treatment (PAT) or negative affect treatment (NAT). Clinical status measures were self-reported positive affect, interviewer-rated anhedonia, and self-reported depression and anxiety. Target measures were eleven physiological, behavioral, cognitive, and self-report measures of reward anticipation-motivation, response to reward attainment, and reward learning. All analyses were intent-to-treat. RESULTS Compared to NAT, individuals receiving PAT achieved superior improvements in the multivariate clinical status measures at posttreatment, b = .37, 95% CI [.15, .59], t(109) = 3.34, p = .001, q = .004, d = .64. Compared to NAT, individuals receiving PAT also achieved higher multivariate reward anticipation-motivation, b = .21, 95% CI [.05, .37], t(268) = 2.61, p = .010, q = .020, d = .32, and higher multivariate response to reward attainment, b = .24, 95% CI [.02, .45], t(266) = 2.17, p = .031, q = .041, d = .25, at posttreatment. Measures of reward learning did not differ between the two groups. Improvements in reward anticipation-motivation and in response to reward attainment correlated with improvements in the clinical status measures. CONCLUSIONS Targeting positive affect results in superior improvements in clinical status and reward sensitivity than targeting negative affect. This is the first demonstration of differential target engagement across two psychological interventions for anxious or depressed individuals with low positive affect. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

中文翻译：

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积极影响治疗目标奖励敏感性：一项随机对照试验。

目的 确定针对积极情绪的新型社会心理治疗是否比针对消极情绪的认知行为疗法更能改善临床状态和奖赏敏感性，以及奖赏敏感性的改善是否与临床状态的改善相关。方法 在这项评估者盲法、平行组、多中心、双臂随机对照临床优效性试验中，85 名患有严重低积极情绪、中度至重度抑郁或焦虑以及功能障碍的寻求治疗的成年人每周接受 15 次个体治疗积极影响治疗 (PAT) 或消极影响治疗 (NAT)。临床状态测量是自我报告的积极影响、面试官评定的快感缺乏以及自我报告的抑郁和焦虑。目标措施是十一生理，行为，奖励预期动机的认知和自我报告措施、对奖励获得的反应和奖励学习。所有分析均为意向治疗。结果 与 NAT 相比，接受 PAT 的个体在治疗后的多变量临床状态测量方面取得了显着改善，b = .37, 95% CI [.15, .59], t(109) = 3.34, p = .001, q = .004，d = .64。与 NAT 相比，接受 PAT 的个人也获得了更高的多变量奖励预期动机，b = .21, 95% CI [.05, .37], t(268) = 2.61, p = .010, q = .020, d = .32，以及对获得奖励的更高多元反应，b = .24，95% CI [.02, .45]，t(266) = 2.17，p = .031，q = .041，d = .25，在治疗后。奖励学习的措施在两组之间没有差异。奖励预期动机和对奖励获得的反应的改善与临床状态测量的改善相关。结论 以积极影响为目标比以消极影响为目标更能显着改善临床状态和奖赏敏感性。这是针对具有低积极影响的焦虑或抑郁个体的两种心理干预的差异目标参与的首次证明。（PsycInfo 数据库记录 (c) 2023 APA，保留所有权利）。这是针对具有低积极影响的焦虑或抑郁个体的两种心理干预的差异目标参与的首次证明。（PsycInfo 数据库记录 (c) 2023 APA，保留所有权利）。这是针对具有低积极影响的焦虑或抑郁个体的两种心理干预的差异目标参与的首次证明。（PsycInfo 数据库记录 (c) 2023 APA，保留所有权利）。