(PS3-33) Sense of Meaning in Behavioral Activation: Depression Moderates Meaning Benefits of Active versus Passive Activities

Classic Behavioral Activation (BA) effectively treats Major Depressive Disorder (MDD) by monitoring and scheduling client engagement in activities associated with pleasure and/or mastery (Ekers et al., 2014; Martell, Dimidjian, & Herman-Dunn, 2021). Yet “third-wave” forms of BA also prescribe and rate activities associated with a sense of personal meaning (e.g., Hayes, Strosahl, & Wilson, 1999; Lejuez et al., 2011). Greater depression severity is clearly associated with lower perceived meaning (Heyadati & Khazaei, 2014). The rationale of classic BA theorizes that active activities with participatory engagement will lead to more pleasure and mastery than passive, non-participatory activities (Martell et al., 2021). Yet no study has examined differences in perceived sense of meaning from engagement in participatory versus non-participatory activities. Accordingly, we designed an experiment to study differential meaning benefits of active versus passive activities, moderated by depression severity. To control for the confound of physical exercise (Kval et al., 2016), our conditions included active and passive forms of engagement with art.

114 participants were randomly assigned to either an active art creating condition or a passive art viewing condition for 15 minutes each. Participants first took the Beck Depression Inventory II (BDI-II) before their art task. In the active condition, participants were directed to paint with watercolor paint. In the passive condition, they were directed to view the 113 contemporary professional watercolor paintings from the Splash “best in watercolor” competition in hard copy (20^th published collection; Wolf, 2019). After their condition’s task, they rated their resulting sense of meaning on a scale of 0 to 10 in the manner of classic BA: “Please rate how much meaning (sense of purpose) you felt from this activity.” We used multiple regression to examine moderation of rated meaning between conditions by participants’ continuous BDI-II scores.

As hypothesized, the active condition led to greater reported perceived meaning than the passive condition, t(112) = -2.89, p = .005, d = -0.54. This significant difference also held true in a subsample of MDD analogues who surpassed the clinical cut-off score for MDD (t(31) = -3.69, p = .001, d = -1.31). The MDD sample had over twice the effect size of the unselected sample (d = -0.54 versus d = -1.31). As expected, continuous depression scores also significantly moderated the effect of active versus passive activities on sense of meaning, t(112) = 2.82, p = .006, d = 0.53. Within the passive condition, those with higher depression experienced much less meaning than those with lower depression (a depressive gap; M = 3.7 vs. 6). Yet within the active condition, level of perceived meaning was similarly high between those with higher and lower depression severity (a negligible gap; M = 5.5 versus 5.9). Those with lower depression had little difference in meaning between passive and active activities, but those with higher depression had a notable difference. Thus, participatory, actively-engaging activities may hold greater potential to promote meaning for those with depression than non-participatory, passive activities.