4 - (SYM 77) Targeting Anhedonia and Positive Affect Utilizing Positive Event Reminiscing in Transdiagnostic Treatment for PTSD and Depression Delivered via Telehealth

Abstract Body

Anhedonia, or the inability to experience pleasure, and deficits in positive affect (PA) are clinical features of both posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) and are risk factors for suicidality, poorer treatment response, and symptom relapse. However, specific strategies intended to improve anhedonia and PA (e.g., positive reminiscing) are not traditionally included in cognitive behavioral interventions for these disorders, which typically focus on reducing negative affect. Positive Processes and Transition to Health (PATH) is a six-session, novel intervention grounded in evidence-based principles that directly targets symptoms of PTSD and/or MDD by targeting three key, transdiagnostic processes implicated in the onset, maintenance, and relapse of stress-related psychopathology.  Individuals who experienced a destabilizing life event (e.g., a divorce, loss of a loved one) and either PTSD and/or MDD (N = 45) participated in a trial of PATH (NCT04678232). This study examined whether in-session changes in subjective pleasure predicted changes in anhedonia and PA. Participants verbally reported ratings of their subjective feelings of pleasure at 5-min intervals while reminiscing about positive memories in sessions 2-6 using the Subjective Units of Pleasure Scale (SUPs; range = 0-100). Anhedonia (Snaith-Hamilton Pleasure Scale; SHAPS) and PA (Positive and Negative Affect Schedule; PANAS) were measured at each session. Using time-lagged multilevel models to examine the relationships between in-session SUPs and next-session changes in anhedonia and PA, higher within-person peak SUPs ratings in one session were not strongly associated with improvements in anhedonia or PA at next session (all ps > .05). Similarly, between-subjects SUPs ratings did not predict next session changes in anhedonia (p > .05). However, higher peak SUPS were associated with higher next session PA (β = .24, p = .04). The addition of positive event reminiscing may effectively increase general positive affect but did not directly reduce next session anhedonia. This discrepancy may point to a difference in time course of change for PA relative to that of anhedonia. Specifically, anhedonia may take longer to improve and may also follow changes in PA, rather than changing on a week-to-week interval. Future work may examine long-term follow-up data to see whether positive reminiscing plays a role in improvements in anhedonia.