3 - (SYM 60) the Influence of Positivity Avoidance on Depression Treatment Preferences

Research indicates that those who fear happiness rate psychodynamic therapy (PD) as a greater treatment fit, preference, and more effective than positive affect treatment (PAT), which focuses on savoring positive emotions (Bryant et al., 2023). We examined if these findings would expand across other treatments: behavioral activation (BA), which includes engaging in pleasant events but not a savoring component, and cognitive therapy (CT), which focuses on reducing negative thoughts and emotions. This study included two samples. Study 1 consisted of 416 participants (Mage = 19.34, SDage = 2.41; 61% female; 35% identified as a race other than White; 3% Hispanic or Latino). Study 2 consisted of 281 participants (Mage = 20.7, SDage = 4.47; 75% female; 28% identified as a race other than White; 2% Hispanic or Latino). Participants rated four depression treatments: PD, PAT, CT, BA on perceived fit, preference, and effectiveness, and completed the Fear of Happiness Scale (FHS; Joshanloo, 2013).
We conducted three mixed model ANOVAs to examine treatment ratings; FHS was entered as a continuous covariate. We also conducted correlations between variables. We hypothesized that FHS would demonstrate the following relationships with the four ratings, ranging from strong positive to negative in this order: PD, CT, BA, and PAT.
In Study 1, the interaction of treatment type and FHS was significant for fit, F(3, 412) = 4.91, p = .002, preference, F(3, 412) = 2.76, p = .04, and effectiveness, F(3, 412) = 3.18, p = .02. All correlations were in the hypothesized direction. PAT and BA evidenced negative relationships with FHS scores, with BA demonstrating a slightly weaker relationship. CT and PD evidenced positive relationships with FHS scores, with PD demonstrating the strongest relationship.
In Study 2, the interaction of treatment fit ratings and FHS was marginally significant F(3, 277) = 2.51, p = .06. The interaction of treatment type and FHS was not significant for preference, F(3, 277) = 1.84, p = .14, nor effectiveness, F(3, 277) = 2.00, p = .12. However, the correlations revealed similar trends to Study 1. PAT and BA demonstrated no relationship or a negative relationship with FHS scores, whereas CT and PD displayed positive relationships with FHS scores.
Results reveal that those who fear happiness rate less explicitly positive treatments (PD and CT) as stronger fits, whereas treatments that include aspects of positivity (BA and PAT) are rated as worse fits. Thus, these treatments may be avoided by those who would benefit the most from pleasant events and savoring positivity.