5 - (SYM 66) Positivity Is Powerful: Increasing Positive Affect Accounts for Social Connectedness Improvements Throughout Treatment for Anxiety and Depression

Background: Anxiety and depressive disorders are characterized by loneliness and smaller networks of close others (e.g., friends). Improvements in social functioning following evidence-based treatments are modest and lag behind much larger changes observed for symptoms. Our overarching hypothesis is that social disconnection can be explained by over-activation of the negative valence system (e.g., sensitivity to social threat) and under-activation of the positive valence system (e.g., sensitivity to social reward). Cognitive and behavioral therapies historically emphasize reduction of negative valence processes and symptoms. We developed a cognitive and behavioral intervention designed to upregulate the positive valence system through increasing exposure and responsiveness to positive events, practicing gratitude, and engaging in kind acts towards others. The current study tested the hypothesis that increases in positive affect (PA) would account for subsequent improvements in connectedness throughout treatment beyond reductions in negative affect (NA).

Methods: N=45 participants with clinical levels of anxiety or depression with evidence of social impairment completed 5 or 10-sessions of Amplification of Positivity (AMP) treatment. 69% identified as female; 18% identified as Hispanic; 42% identified with a race category other than White. Measures of PA and NA (Positive and Negative Affect Schedule), anxiety and depression symptoms (PROMIS measures), and social connectedness (NIH Toolbox loneliness, perceived friendships) were assessed bi-weekly throughout treatment. Time-lagged multilevel models examined the process of change in affect and connectedness throughout treatment.

Results: Increases in PA predicted subsequent reductions in loneliness b=-0.083, 95% CI [-0.13, -0.035], t(199)=-3.45, p< .001, and improvements in perceived friendships b=0.11, 95% CI [0.051, 0.17], t(177)=3.64, p< .001,throughout treatment, beyond reductions in NA, which were predictive of subsequent loneliness (p=.008) but not friendships (p=.12). Levels of NA did not moderate the association between PA and connectedness. PA was a robust (p< .05) predictor of subsequent connectedness alongside changes in anxiety and depression symptoms.

Conclusions: Boosting positivity may be a valuable approach for remediating social disconnection in anxiety and depressive disorders, beyond reducing negative valence affect and symptoms.