(PS2-39) Savoring Amplifies Clinical Benefits of a Behavioral Activation Activity for Generalized Anxiety Disorder: A Dismantling Experiment

Behavioral activation is an efficacious treatment for depressive disorders (Ekers et al., 2014). In BA, patients are led to monitor, plan, and engage in rewarding activities. Savoring is a technique for amplifying and extending positive emotions from positive experiences, such as the rewarding activities assigned in BA. Adding savoring to BA may not only enhance the benefits of BA for depression, but extend those benefits to Generalized Anxiety Disorder (GAD) as well. In GAD samples, savoring interventions have significantly reduced worry, depression, and motivation to use worry to prevent negative emotional shifts, while also increasing positive emotions and prioritization of positive activities (LaFreniere & Newman, 2023a, 2023b, 2023c; Rosen & LaFreniere 2023). Savoring may increase the reward value of positive reinforcers encountered in BA for both those with depression and those with GAD—disorders that are commonly comorbid (ter Muelen et al., 2021). Yet it is still unclear whether savoring an enjoyable activity has incremental clinical benefits above simply engaging in that enjoyable activity. Consequently, we designed an experiment to compare symptom and emotion change from a savored enjoyable activity to a non-savored enjoyable activity in a GAD analogue sample.

All participants surpassed the GAD clinical cut-off score of the Penn State Worry Questionnaire (preliminary n = 45 with data collection ongoing; Fresco, et al., 2003). These GAD analogues were randomly assigned to savor an enjoyable art activity or simply undergo that same enjoyable art activity without savoring for 15 minutes. Participants took a series of validated self-report questionnaires on BA outcome constructs both before and after their condition: The Depression-Anxiety-Stress Scale 21, The PANAS-X Joviality scale, and The Vitality Scale. In the savoring condition, participants were briefly taught the definition and process of savoring, then directed to savor while painting with watercolor paint. In the non-savored condition, they simply painted with watercolor paint. In the non-savored condition, the instructions for the activity were extended to match the length of the other condition’s savoring training. The direction scripts of both conditions were each 370 words. Analyses used longitudinal multilevel modeling to examine differences in pre- to post-task outcome change between conditions. Simple slopes analyses examined significance of change within conditions.

As hypothesized, the savored activity led to greater reductions in anxiety (t(43) = -2.61, p = .015, d = -0.81) and stress (t(43) = -2.35, p = .027, d = -0.73) than the non-savored activity among GAD analogues. The savoring condition also led to significant increases in vitality (t(21) = 3.06, p = .003), whereas the non-savored activity did not significantly change vitality, t(20) = 1.98, p = .051). Both conditions significantly increased in positive emotions, but the positive emotional change of the savoring condition had over twice the effect size (d = 0.71 vs. 0.37). In contrast to our expectations, the two conditions did not significantly nor meaningfully differ in reduction of depressive symptoms. A notably larger sample size will be available by the time of ABCT 2024.