Limpächer Cara, Kindt Tordis, Hoyer Jürgen
Behavioral Psychotherapy, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany.
University Clinic and Outpatient Clinic for Psychiatry, Psychotherapy and Psychosomatics, University Hospital Halle (Saale), Halle, Germany.
Clin Psychol Eur. 2024 Jun 28;6(2):e13751. doi: 10.32872/cpe.13751. eCollection 2024 Jun.
Anhedonia is a risk factor for a severe course of depression but is often not adequately addressed in psychotherapy. This study presents the Training to Enhance Reward Experience (T-REx), a novel self-help approach that uses savoring and mental imagery to target impairments in reward experience associated with anhedonia. We aimed to examine feasibility and acceptability of T-REx and exploratively investigated its effects on anhedonia and other clinical variables.
In an online, randomized controlled trial, 79 subjects participated for five days in T-REx or the active control condition Gratitude Writing (GW). We assessed changes in anhedonia, depression, and active behavior at inclusion, after the waiting period, post-intervention and at follow-up. The intervention effects were examined for the full sample and an anhedonic sub-sample.
T-REx and GW were equally feasible and clearly accepted by the sample. Both interventions significantly reduced depressive symptoms and increased behavioral activation. Although there was no significant main effect of the interventions, between-group differences were observed for depressive symptoms and active behavior at post-intervention and follow-up, favoring T-REx. Further, within-group changes for T-REx were larger than for GW. The observed effects had a greater magnitude in the anhedonic sub-sample, suggesting that individuals with more pronounced anhedonic symptoms derived greater benefit from the interventions.
This first study of T-REx provides promising results that should prompt further investigations of T-REx in clinical samples. The results suggest that T-REx has a positive effect on depression symptoms and active behavior. Further, its potential as a valuable adjunct to behavioral activation interventions is discussed.
快感缺失是抑郁症严重病程的一个危险因素，但在心理治疗中往往未得到充分解决。本研究介绍了增强奖励体验训练（T-REx），这是一种新颖的自助方法，它运用品味和心理意象来针对与快感缺失相关的奖励体验受损问题。我们旨在检验T-REx的可行性和可接受性，并探索性地研究其对快感缺失和其他临床变量的影响。
在一项在线随机对照试验中，79名受试者参加了为期五天的T-REx或积极对照条件感恩写作（GW）。我们在入组时、等待期后、干预后和随访时评估了快感缺失、抑郁和积极行为的变化。对整个样本和快感缺失亚样本进行了干预效果检查。
T-REx和GW同样可行，且样本对其接受度良好。两种干预措施均显著减轻了抑郁症状并增加了行为激活。虽然干预措施没有显著的主效应，但在干预后和随访时观察到了抑郁症状和积极行为的组间差异，T-REx更具优势。此外，T-REx的组内变化大于GW。在快感缺失亚样本中观察到的效果幅度更大，这表明快感缺失症状更明显的个体从干预措施中获益更多。
这项关于T-REx的首次研究提供了有前景的结果，应促使在临床样本中对T-REx进行进一步研究。结果表明，T-REx对抑郁症状和积极行为有积极影响。此外，还讨论了其作为行为激活干预有价值辅助手段的潜力。
