Amplification of positivity for depression and anxiety: Neural prediction of treatment response

Maria Kryza-Lacombe; Isabella Spaulding; Cheuk King Ku; Nana Pearson; Murray B Stein; Charles T Taylor

doi:10.1016/j.brat.2024.104545

Amplification of positivity for depression and anxiety: Neural prediction of treatment response

Behav Res Ther. 2024 Apr 23:178:104545. doi: 10.1016/j.brat.2024.104545. Online ahead of print.

Authors

Maria Kryza-Lacombe¹, Isabella Spaulding¹, Cheuk King Ku², Nana Pearson², Murray B Stein³, Charles T Taylor⁴

Affiliations

¹ San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, USA.
² Department of Psychiatry, University of California, San Diego, USA.
³ San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, USA; Department of Psychiatry, University of California, San Diego, USA.
⁴ San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, USA; Department of Psychiatry, University of California, San Diego, USA. Electronic address: c1taylor@health.ucsd.edu.

PMID: 38714105
DOI: 10.1016/j.brat.2024.104545

Abstract

Psychosocial treatments targeting the positive valence system (PVS) in depression and anxiety demonstrate efficacy in enhancing positive affect (PA), but response to treatment varies. We examined whether individual differences in neural activation to positive and negative valence incentive cues underlies differences in benefitting from a PVS-targeted treatment. Individuals with clinically elevated depression and/or anxiety (N = 88, ages 18 to 55) participated in one of two randomized, waitlist-controlled trials of Amplification of Positivity (AMP; NCT02330627, NCT03196544), a cognitive and behavioral intervention targeting the PVS. Participants completed a monetary incentive delay (MID) task during fMRI acquisition at baseline measuring neural activation to the possibility of gaining or losing money. Change in PA from before to after treatment was assessed using the Positive and Negative Affect Schedule. No significant associations were observed between baseline neural activation during gain anticipation and AMP-related changes in PA in regions of interest (striatum and insula) or whole-brain analyses. However, higher baseline striatal and insula activation during loss anticipation was associated with greater increases in PA post-AMP. This study provides preliminary evidence suggesting neural reactivity to negative valence cues may inform who stands to benefit most from treatments targeting the PVS.

Keywords: Anxiety; Clinical trial; Depression; Neural prediction; Positive affect; fMRI.