Background: The efficacy of behavioural activation (BA) treatments for depression has been demonstrated in various clinical trials (e.g. Dimidjian et al., 2006). Although a single session of BA intervention has shown significant changes in symptoms of depression in a college student population (Gawrysiak et al., 2009), this has not been evaluated with a clinical population. Despite a clear behavioural rationale and research evidence underlying BA treatments, questions regarding mechanisms of change remain unanswered. From a BA perspective, a key aim is to reduce depressive avoidance behaviours and increase healthy non-avoidance behaviours (Trew, 2011).
Method: This study investigated the impact of one treatment session of Brief Behavioural Activation Treatment for Depression (Lejuez et al., 2001) on depressive symptomatology, self-reported avoidance and behavioural approach and avoidance tendencies measured using the Approach Avoidance Task (AAT; Rinck & Becker, 2007). A sample of 40 depressed participants from primary care psychological therapies services were randomised to either treatment or control group. Self-reports of symptoms and cognitive factors were assessed before (Time 1) and after the one-week intervention phase (Time 2), and at one-month follow-up (Time 3). Approach and avoidance behavioural tendencies were assessed at Times 1 and 2 using the AAT.
Results: There was a significant decrease in depressive symptoms between Time 1 and Time 2 for the treatment group but not the control group. Performance on the AAT showed the expected pattern, with increases in approach to positive valence stimuli (happy faces), although effects failed to reach significance. Meditational analyses indicated small indirect effects of self reported change in activation and avoidance as mediators of the effect of condition on depressive symptoms.
Discussion: This is the first study to demonstrate the efficacy of one session of BA for depression using a clinical sample. There was preliminary support for the hypothesis that reduced avoidance may mediate treatment effect. The theoretical and clinical implications of the study findings are discussed. Further replication of this study is needed, with changes in avoidance measured prior to changes in symptom outcomes to help establish a causal relationship.
Investigating mechanisms of Behavioural Activation for Depression
Nasrin, F. (Author). 2014
Student thesis: Doctoral Thesis › Doctor of Clinical Psychology