Affect Treatment for Depression and Anxiety

No longer recruiting at 1 trial location

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of California, Los Angeles

Must not be taking: Bupropion, Dopaminergic, Neuroleptic

Disqualifiers: Serious medical conditions, Suicidal ideation, Bipolar, Substance use, others

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

Compensation: Varies

Number of Visits: 14

Duration: 8-13 weeks

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine if individuals who do not improve with Positive Affect Treatment, which focuses on enhancing positive emotions, might benefit from switching to a treatment that addresses negative emotions. It involves two types of psychotherapy: one that boosts positive feelings and another that reduces negative reactions. The trial is ideal for English speakers who frequently feel down or anxious and are willing to try therapy without starting new treatments during the trial. Participants will engage in therapy sessions and complete various assessments over approximately five months. As an unphased trial, this study offers a unique opportunity to explore different therapeutic approaches to enhance emotional well-being.

Will I have to stop taking my current medications?

You may need to stop certain medications, but not all. If you are taking bupropion, dopaminergic, or neuroleptic medications, you must have stopped them at least 6 months ago. Heterocyclics and SSRIs are allowed if you've been stable on them for 3 months, and PRN benzodiazepines and beta-blockers are allowed but discouraged during lab visits.

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

Studies have shown that Positive Affect Treatment (PAT) is generally safe and well-tolerated. Clinical trials have demonstrated PAT's effectiveness in boosting positive feelings and reducing negative ones, with no major safety concerns reported.

For individuals undergoing both Positive and Negative Affect Treatments, research indicates improvements in well-being and emotions compared to those who received no treatment. These therapies primarily focus on enhancing emotional health and typically do not cause significant negative side effects.

Overall, both treatments have proven safe, aiming to enhance emotional health without harmful effects. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about Positive Affect Treatment and its combination with Negative Affect Treatment for depression and anxiety because these approaches focus on enhancing emotional experiences and reducing negative emotional responses. Unlike standard treatments like SSRIs or CBT, which primarily address symptoms by altering brain chemistry or cognitive patterns, these treatments aim to boost the anticipation, attainment, and learning of rewards while diminishing threat responses and avoidance behaviors. This dual focus on positive and negative emotional dynamics offers a novel way to not only alleviate symptoms but potentially transform how individuals with depression and anxiety experience and respond to the world around them.

What evidence suggests that this trial's treatments could be effective for depression and anxiety?

Research has shown that Positive Affect Treatment (PAT), one of the treatments in this trial, can improve symptoms of depression and anxiety. Studies have found that PAT enhances emotional well-being more effectively than other treatments. Specifically, one study noted a significant boost in positive feelings and overall mental health. Other research found that 39% of participants responded well to PAT, a higher rate than those in control groups.

Meanwhile, the combined Positive and Negative Affect Treatment, another option in this trial, addresses both positive and negative emotions, offering a comprehensive approach. Studies suggest this method may improve negative emotions more effectively, leading to balanced mental health. Overall, both treatments in this trial show promising results for individuals dealing with depression and anxiety. ^{2 6 7 8 9}

Are You a Good Fit for This Trial?

This trial is for individuals experiencing anxiety and depression who haven't improved with initial positive affect treatment. Participants will undergo lab tests, psychiatric assessments, and questionnaires over a 5-month period.

Inclusion Criteria

I agree not to start any new mental health or drug treatments until the study ends.

English-speaking

Low positive affect indexed by less than or equal to 24 on the positive affect subscale of the PANAS (PANAS-P); scores of greater than or equal to 11 for depression, greater than or equal to 6 for anxiety, or greater than or equal to 10 for stress on the Depression, Anxiety, and Stress Scale; scores of greater than or equal to 5 on any Sheehan Disability Scale subscale

Exclusion Criteria

I do not consent to being recorded on video or audio.

I do not have any serious, uncontrolled medical conditions.

Willingness to refrain from marijuana use 1 week before laboratory assessments

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2 weeks

2 visits (virtual)

Baseline Assessment

Participants complete a baseline assessment including anhedonia interview and psychosocial questionnaires

2 weeks

4 assessments (virtual)

Treatment

Participants receive Positive Affect Treatment (PAT) with weekly therapy sessions. If no improvement, switch to Negative Affect Treatment (NAT)

8-13 weeks

8-13 sessions (virtual)

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Positive Affect Treatment
• Positive Affect Treatment and Negative Affect Treatment

Trial Overview The study is testing if switching from Positive Affect Treatment (PAT) to Negative Affect Treatment improves outcomes for those not responding well to PAT alone in treating anxiety and depression.

How Is the Trial Designed?

Group I: Positive Affect Treatment Experimental Treatment 1 Intervention

8 sessions of psychotherapy designed to augment reward anticipation, reward attainment, and reward learning.

Group II: Positive Affect Treatment and Negative Affect Treatment Active Control 1 Intervention

8 sessions of psychotherapy. 3-5 sessions of psychotherapy designed to augment reward anticipation, reward attainment, and reward learning. Remaining sessions of psychotherapy designed to decrease threat avoidance, threat appraisal and arousal.

Who Is Running the Clinical Trial?

University of California, Los Angeles

Lead Sponsor

Trials

1,594

Recruited

10,430,000+

Southern Methodist University

Collaborator

Trials

37

Recruited

6,000+

Citations

1. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/30998048/

Positive affect treatment for depression and anxiety Conclusions: Compared to NAT, PAT demonstrated better outcomes (at 6MFU) on positive affect, depression, anxiety, stress, and suicidal ideation, for patients ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC7266488/

Upregulating the Positive Affect System in Anxiety and ... The PAI protocol resulted in significantly greater increases in positive emotions and psychological well-being compared to a no intervention control group.

3. sciencedirect.com sciencedirect.com/science/article/pii/S0165032723006389

Psychological treatment of depression: A systematic ... We found an overall response rate of 39 % in the treatment and 24 % in the control conditions (NNT = 6.2). Clinically significant improvement ...

4. tandfonline.com tandfonline.com/doi/full/10.1080/13284207.2025.2498394?src=exp-la

An evaluation of psychological interventions targeting ... Positive affect treatment (PAT) was found to be effective, with all three RCTs reporting improvement in symptoms (Bryant et al., 2023; Craske et al., 2019, ...

5. psycnet.apa.org psycnet.apa.org/record/2023-21527-000

Positive affect treatment for depression and anxiety Rapid effectiveness of intravenous ketamine for ultraresistant depression in a clinical setting and evidence for baseline anhedonia and bipolarity as ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10213148/

Positive affect treatment targets reward sensitivity Conclusions: Targeting positive affect results in superior improvements in clinical status and reward sensitivity than targeting negative affect. This is the ...

7. clinicaltrials.gov clinicaltrials.gov/study/NCT06978257

NCT06978257 | Digital Positive Affect Intervention Study The study hypothesizes that participants randomized to the digital PAI will experience greater improvement in anxious and depressive symptoms both immediately ...

8. sciencedirect.com sciencedirect.com/science/article/pii/S0165032724000971

Review Article Positive and negative affect change ... Conclusions. Current psychotherapeutic interventions for anxiety-related disorders may not improve PA and NA to comparable levels.

9. clinicaltrials.gov clinicaltrials.gov/study/NCT06488859

Affect Treatment for Depression and Anxiety (TAD Pilot) | ... In clinical trials, PAT has been proven to be clinically effective at increasing positive affect, reducing negative affect, and improving depression, anxiety ...