Department of Psychology, University of Toledo, Mail Stop 948, 2801 West Bancroft Street, Toledo, OH 43606, USA.
Clin Psychol Rev. 2020 Jul;79:101860. doi: 10.1016/j.cpr.2020.101860. Epub 2020 May 5.
Interest in behavioral activation treatments for depression has increased over the past two decades. Behavioral activation treatments have been shown to be effective in treating depression across a variety of populations and settings. However, little is known about the mechanisms of change that may bring about symptom improvement in behavioral activation treatments. Recent developments in the theoretical and empirical literature on behavioral activation treatments have coincided with advances in basic science and translational neuroscience regarding the mechanisms underlying individual differences in responsiveness to reward. Attenuated reward responsiveness has been associated with depression and related clinical outcomes at the self-report, behavioral, and neural levels of analysis. Given that behavioral activation treatments are focused on increasing individuals' contact and engagement with sustainable sources of reward in their environment, it is plausible that behavioral activation treatments bring about improvements in depression symptoms by targeting (low) reward responsiveness directly. This paper integrates findings from the clinical research literature on behavioral activation treatments with insights drawn from basic science and translational neuroscience in order to propose hypotheses about potential mechanisms of change in behavioral activation. Conceptual issues and recommendations for future research on behavioral activation treatments are discussed.
在过去的二十年中，人们对行为激活治疗抑郁症的兴趣日益增加。行为激活治疗已被证明在各种人群和环境中对治疗抑郁症有效。然而，对于可能导致行为激活治疗中症状改善的变化机制知之甚少。行为激活治疗的理论和实证文献的最新发展与基础科学和转化神经科学关于奖励反应个体差异的机制的进展相吻合。在自我报告、行为和神经分析水平上，奖励反应减弱与抑郁和相关的临床结果有关。鉴于行为激活治疗的重点是增加个体与环境中可持续奖励源的接触和参与，因此通过直接针对（低）奖励反应来改善抑郁症状是合理的。本文将行为激活治疗的临床研究文献中的发现与基础科学和转化神经科学的见解相结合，提出关于行为激活可能的变化机制的假设。本文还讨论了行为激活治疗的概念问题和未来研究建议。
