Bogaert Liesbeth, Dunn Barnaby D, Walentynowicz Marta, Raes Filip
Research Unit Behaviour, Health and Psychopathology, KU Leuven, Tiensestraat, Leuven, Belgium.
Mood Disorders Centre, University of Exeter, Perry Road, Prince of Wales Road, Exeter, United Kingdom.
Acta Psychol (Amst). 2023 May;235:103901. doi: 10.1016/j.actpsy.2023.103901. Epub 2023 Apr 3.
The need to further our understanding of positive affect dysregulation in depression has been widely acknowledged. Two related relevant concepts in this realm, are Avoidance Of Positivity (AOP; referring to avoidance behaviour towards positivity) and Fear Of Positivity (FOP; referring to anxious or unpleasant feelings related to positivity). However, traditionally manifestations of AOP and FOP are considered in isolation, and self-report scales used to measure both concepts show considerable content overlap. Therefore, the first study aim was to examine how AOP and FOP relate to one another, depressive symptomatology and anhedonia, through new clearly delineated scales. For exploratory purposes, general and state-specific versions were developed. The second aim was to uncover beliefs that underlie the tendency towards AOP/FOP. An adult community sample (n = 197) completed online measures of AOP, FOP, depressive symptoms and anhedonia, and answered open-ended questions about reasons for AOP and FOP. Cross-sectionally, preliminary evidence was found for AOP and FOP being positively associated with one another, depressive symptomatology and anhedonia. Even after controlling for depressive symptomatology, anhedonia remained positively associated with AOP and FOP. So, AOP and FOP may be viable candidate mechanisms maintaining anhedonia that are worth further investigation and may be appropriate to target during treatment. Answers to the open-ended questions (n = 77) reflected various beliefs underlying AOP/FOP, which were broader than simply anticipating negative consequences of feeling positive and also touched on themes of unworthiness and social inappropriateness of feeling positive. Some theoretical and clinical implications of different beliefs underlying AOP/FOP are discussed.
进一步加深我们对抑郁症中积极情感失调的理解的必要性已得到广泛认可。在这一领域中，两个相关的概念是对积极情绪的回避（AOP；指对积极情绪的回避行为）和对积极情绪的恐惧（FOP；指与积极情绪相关的焦虑或不愉快情绪）。然而，传统上AOP和FOP的表现是被孤立考虑的，用于测量这两个概念的自我报告量表显示出相当大的内容重叠。因此，第一项研究的目的是通过新的明确界定的量表来研究AOP和FOP如何相互关联、与抑郁症状及快感缺失相关。为了探索性目的，开发了一般版本和特定状态版本。第二个目的是揭示AOP/FOP倾向背后的信念。一个成年社区样本（n = 197）完成了关于AOP、FOP、抑郁症状和快感缺失的在线测量，并回答了关于AOP和FOP原因的开放式问题。横断面研究发现，初步证据表明AOP和FOP彼此正相关，与抑郁症状和快感缺失也正相关。即使在控制了抑郁症状之后，快感缺失仍与AOP和FOP正相关。所以，AOP和FOP可能是维持快感缺失的可行候选机制，值得进一步研究，并且可能在治疗过程中作为合适的干预靶点。对开放式问题的回答（n = 77）反映了AOP/FOP背后的各种信念，这些信念比简单地预期感受积极情绪的负面后果更广泛，还涉及到感觉积极情绪不值得以及在社交上不合适等主题。文中讨论了AOP/FOP背后不同信念的一些理论和临床意义。
