Positive Emotion Promotion for Anhedonia in Children

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: Vanderbilt University

Must not be taking: Antidepressants, others

Disqualifiers: MDD, Bipolar, Psychotic disorders, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 10

Duration: 8 weeks

60 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores how promoting positive emotions can improve children's responses to rewards, particularly when their mothers have a history of depression and anhedonia. The study compares two approaches: a family-focused program that encourages positive feelings (Family Promoting Positive Emotions) and a standard educational approach (Psychoeducation). It seeks children aged 8 to 12 who have not experienced major depression and whose mothers have a history of depression. Participants must speak English and have access to a computer or tablet with internet for online sessions. As an unphased trial, this study offers a unique opportunity to contribute to understanding emotional development in children.

Will I have to stop taking my current medications?

If your child is taking medications for emotional or behavioral problems, they can continue only if they are on SSRIs or psychostimulants and have been on a stable dose for at least 6 weeks before joining the trial.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that treatments involving the family can help children with depression and related issues. One study suggested that including the family in therapy might improve communication and solve common problems. However, specific safety information for this approach remains unavailable, so its direct safety effects are not well-documented yet.

For the psychoeducation treatment, no specific safety information is provided. Psychoeducation typically involves teaching families about depression and how to manage it. This approach is generally considered safe because it focuses on education rather than medication or medical procedures.

In summary, while specific safety data is limited, the methods in this trial are generally well-tolerated and focus on non-invasive, supportive strategies. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about these treatments because they offer a fresh approach to tackling anhedonia in children. Unlike traditional medications or therapies that often focus on treating symptoms of depression more broadly, the "Family Promoting Positive Emotions" technique aims to enhance the child's life by engaging the family in fostering positive emotional experiences. This method could potentially strengthen family bonds and create a supportive environment that encourages a more joyful outlook. Meanwhile, the "Psychoeducation" approach stands out by empowering children and their families with knowledge about emotions and mental health, helping them understand and manage their feelings more effectively. These approaches are distinctive because they target emotional and familial dynamics directly, rather than relying solely on pharmacological interventions.

What evidence suggests that this trial's treatments could be effective for anhedonia in children?

This trial will compare two approaches to addressing anhedonia in children: Family Promoting Positive Emotions and Psychoeducation. Research has shown that activities focusing on positive emotions can help prevent anhedonia, which is the inability to feel pleasure, and related emotional issues in children. One study found that involving families in these activities, such as those in the Family Promoting Positive Emotions arm, effectively addresses symptoms of childhood depression. Other research has shown that positive psychology techniques, similar to those used in this trial, can improve quality of life and reduce feelings of shame among those experiencing anhedonia. By focusing on enjoyable experiences and positive feelings, these activities aim to boost children's emotional well-being. ^{1 2 6 7 8}

Are You a Good Fit for This Trial?

This trial is for children aged 8-12 with mothers who have experienced depression and anhedonia. Both must be fluent in English, live in the U.S., and have internet access for video calls. Excluded are those with psychotic disorders, severe sensory impairments, previous participation by a sibling, certain medication use (except stable SSRIs or psychostimulants), current major depression or anhedonia in children, developmental disabilities, recent mother's substance abuse, or any bipolar disorder history.

Inclusion Criteria

Child and mother have access to a computer or tablet and internet for videoconferencing

Child and biological mother can read and speak fluently in English

For compensation purposes, child and biological mothers must be U.S. citizens

Exclusion Criteria

I have not been diagnosed with major depression or experienced persistent sadness.

If your mother has been in the study with a sibling, you can't participate.

My child is on a stable dose of medication for emotional or behavioral issues, not including SSRIs, for 6 weeks.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive the Family Promoting Positive Emotion (F-PPE) intervention or a psychoeducation comparison condition through 8 telehealth sessions

8 weeks

8 telehealth sessions

Assessment

EEG assessments of neural reward responsiveness are conducted at baseline and halfway through the intervention

8 weeks

2 EEG assessments

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Family Promoting Positive Emotions
• Psychoeducation

Trial Overview The study examines if teaching families to focus on positive emotions can prevent loss of pleasure (anhedonia) in kids whose moms had depression. It involves family-based activities promoting happiness and education about mental health. Participants will engage through online sessions.

How Is the Trial Designed?

Group I: Family Promoting Positive Emotions Experimental Treatment 1 Intervention

Group II: Psychoeducation Active Control 1 Intervention

Who Is Running the Clinical Trial?

Vanderbilt University

Lead Sponsor

Trials

714

Recruited

6,143,000+

Nationwide Children's Hospital

Collaborator

Trials

354

Recruited

5,228,000+

Published Research Related to This Trial

In a study of 134 young adults (66 anhedonic individuals and 68 controls), it was found that low levels of positive emotions in anhedonic individuals lead to decreased motivation, potentially creating a negative cycle of low pleasure and low motivation.

Interestingly, cheerfulness was identified as the most influential positive emotion in the anhedonic group, suggesting that interventions aimed at increasing cheerfulness could effectively enhance overall positive emotions and motivation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Reciprocal associations between positive emotions and motivation in daily life: Network analyses in anhedonic individuals and healthy controls. van Roekel, E., Heininga, VE., Vrijen, C., et al.[2019]

Anhedonia, the inability to feel pleasure, is linked to reduced activity in brain systems related to dopamine and may contribute to the onset and relapse of drug addiction.

Preventive strategies, such as behavioral activation and positive psychology, can help individuals manage anhedonia and reduce the risk of drug misuse, suggesting that school-based programs could be effective in addressing this issue.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Substance misuse prevention: addressing anhedonia. Sussman, S., Leventhal, A.[2021]

Recent approaches to treating anhedonia, a common symptom in depression and anxiety, focus on enhancing positive emotions by targeting the brain's reward systems, showing preliminary effectiveness in improving reward anticipation and responsiveness.

There is a need for more treatments that specifically address positive emotion regulation and to standardize how anhedonia is measured, which could help in understanding and improving long-term outcomes for individuals suffering from this condition.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Psychological Treatments for Anhedonia. Sandman, CF., Craske, MG.[2022]

Anhedonia, a key symptom of depression and other mental health disorders, is linked to poor long-term outcomes and is not effectively treated by current psychological or pharmacological methods, highlighting a significant therapeutic gap.

The paper introduces Positive Affect Treatment (PAT), a novel psychological intervention aimed at improving reward sensitivity and addressing the deficits in the appetitive reward system associated with anhedonia.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Treatment for Anhedonia: A Neuroscience Driven Approach. Craske, MG., Meuret, AE., Ritz, T., et al.[2022]

The study aims to assess the feasibility of adding a positive mental imagery training (PMIT) module to standard inpatient mental health treatment, with a focus on increasing positive affect and reducing anhedonia in up to 90 patients over a 2-week period.

By comparing PMIT with cognitive control training and standard treatment alone, the research will provide insights into the potential effectiveness of PMIT as an adjunct therapy, which could lead to improved recovery outcomes in mental health settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Computerized positive mental imagery training versus cognitive control training versus treatment as usual in inpatient mental health settings: study protocol for a randomized controlled feasibility trial. Blackwell, SE., Westermann, K., Woud, ML., et al.[2022]

A personalized lifestyle advice intervention for young adults with anhedonia showed that changes in how individuals react to negative events may be a key mechanism for improving their positive affect (PA).

The study involved 69 participants and used the Experience Sampling Method to assess changes in pleasure and affect before and after the intervention, but did not find significant changes in reactivity to positive events.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Personalized lifestyle advice alters affective reactivity to negative events in anhedonic young adults. Schmitter, M., van Roekel, E., Heininga, VE., et al.[2021]

The Positive Emotions Programme for Schizophrenia (PEPS) significantly reduces anhedonia in patients with schizophrenia, as shown by improved scores on the Scale for the Assessment of Negative Symptoms (SANS) after 8 weeks and sustained improvements at a 6-month follow-up.

In a study of 80 participants, those receiving PEPS alongside treatment as usual (TAU) demonstrated greater clinical improvements in anhedonia compared to those receiving only TAU, highlighting PEPS as an effective and easily implementable intervention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Improving Pleasure and Motivation in Schizophrenia: A Randomized Controlled Clinical Trial. Favrod, J., Nguyen, A., Chaix, J., et al.[2020]

Citations

1. clinicaltrials.gov clinicaltrials.gov/study/NCT05223842

Family Promoting Positive Emotions Pilot Study This study examines a neuroscience-informed positive emotion intervention to determine its effects on preventing anhedonia and associated emotional disturbances ...

2. withpower.com withpower.com/trial/phase-anhedonia-9-2023-f4489

Positive Emotion Promotion for Anhedonia in Children This trial will test the effects of a positive emotion-focused preventive intervention on reward responsiveness in children of mothers with histories of ...

3. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC6499710/

Neural indicators of anhedonia: Predictors and mechanisms of ... Abstract. Background: Early childhood depression is associated with anhedonia and reduced ERP responses to rewarding or pleasant stimuli.

4. researchgate.net researchgate.net/publication/392320677_The_Effectiveness_of_Positive_Psychology_Based_Intervention_on_Anhedonia_and_Internalized_Stigma_among_Schizophrenic_Patients

The Effectiveness of Positive Psychology Based ... Objectives: This study aimed to evaluate the effectiveness of a psychosocial intervention on internalized stigma and quality of life among ...

5. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC5617640/

Family-Focused Treatment for Childhood Depression A family-based treatment may be optimal in addressing the interpersonal problems and symptoms frequently evident among depressed children during this ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11156432/

Origins of Anhedonia in Childhood and Adolescence - PMC Anhedonia reflects a reduced ability to engage in previously pleasurable activities and has been reported in children as young as 3 years of age.

7. link.springer.com link.springer.com/article/10.1007/s41811-024-00202-7

Targeting Anhedonia in Adolescents: A Single Case Series ... We have adapted a brief imagery-based intervention (IMAGINE), which has shown promising results in reducing symptoms of depression in young people.

8. journals.sagepub.com journals.sagepub.com/doi/10.1177/09731342241237074

Psychotherapy for Families with Adolescent Children Emotionally focused family therapy principles can be used to help families identify attachment needs, express them, and promote positive cycles ...