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Session: Invited Address 1: Reward Sensitivity as a Risk Factor and Treatment Target for Depression and Anxiety
Invited Address 1 - Reward Sensitivity as a Risk Factor and Treatment Target for Depression and Anxiety
Friday, November 17, 2023
10:00 AM – 11:00 AM PST
Location: Columbia A, Level 3
Earn 1 Credit
Keywords: Depression, Anxiety, Treatment Recommended Readings: Craske, M.G., Meuret, A., Ritz, T., Treanor, M., & Dour, H. (2016). Treatment for anhedonia: a neuroscience driven approach. Depression and Anxiety, 33(10), 927-938. https://doi.org/10.1002/da.22490, Craske, M.G., Meuret, A., Ritz, T., Treanor, M., Dour, H., & Rosenfield, D. (2019). Positive
affect treatment for depression and anxiety: a randomized clinical trial for a core feature of
anhedonia. Journal of Consulting and Clinical Psychology, 87(5), 457–471.
https://doi.org/10.1037/ccp0000396
affect treatment for depression and anxiety: a randomized clinical trial for a core feature of
anhedonia. Journal of Consulting and Clinical Psychology, 87(5), 457–471.
https://doi.org/10.1037/ccp0000396
, Craske, M.G., Meuret, A., Echiverri-Cohen, E., Rosenfield, D., & Ritz, T. (in press). Positive affect treatment targets reward sensitivity: a randomized controlled trial. Journal of Consulting and Clinical Psychology. , Sandman, C. F., & Craske, M. G. (2022). Psychological Treatments for Anhedonia. Current topics in behavioral neurosciences, 58, 491–513. https://doi.org/10.1007/7854_2021_291,
Professor of Psychology, Psychiatry and Biobehavioral Sciences University of California Los Angeles Los Angeles, California
Threat and reward sensitivity are fundamental processes that become dysregulated in the context of vulnerability to, or expression of, anxiety and depression. Treatments have traditionally targeted reductions in threat sensitivity with limited effects upon reward mechanisms. Investigation of reward sensitivity is essential for our understanding of anxiety and depression and for targeted treatment approaches. I will present our latest findings regarding neural, behavioral and subjective features of reward hyposensitivity that correlate with and predict anxiety, depression and anhedonia. These findings led us to develop a treatment that specifically targets reward hyposensitivity, termed Positive Affect Treatment, which we have shown to be more effective than cognitive behavioral therapy that specifically targets negative affect and threat sensitivity. I will present our replication study in anxious, depressed and extremely low positive affect individuals, where the symptomatic outcomes occur in parallel with changes in target measures of reward anticipation-motivation and attainment. I will also present findings from virtual reality technologies for delivering aspects of Positive Affect Treatment. I will conclude with evidence for reward-related mechanisms within the context of exposure therapy for fears and anxiety, and potential methods for targeting such mechanisms.
Outline: Topic A: Importance of targeting reward sensitivity to understand and treat anxiety and depression a) Treatments to date have mostly targeted elevated threat sensitivity, and have had limited effect upon positive affect and reward sensitivity b) Evidence for neural, behavioral and subjective features of reward hyposensitivity that correlate with and predict anxiety, depression and anhedonia. Topic B: Positive Affect Treatment directly targets reward sensitivity a) Description of therapeutic strategies included in Positive Affect Treatment b) Evidence for efficacy of Positive Affect treatment relative to active control condition (Negative Affect Treatment) c) Evidence for Positive Affect Treatment to lead to greater improvements in reward sensitivity than Negative Affect Treatment d) Use of virtual reality technologies to augment Positive Affect Treatment Topic C: Relevance of reward processes for exposure therapy a) Reward/relief mechanisms are essential to extinction and thereby relevant to exposure therapy b) Preliminary evidence for relevance of anhedonia/low positive affect to exposure therapy c) Possible therapeutic strategies for increasing reward sensitivity in the context of exposure therapy
Learning Objectives:
At the end of the session, the learner will be able to:
Describe the features of reward hyposensitivity that characterize anhedonia, depression and anxiety.
Explain the evidence that shows that Positive Affect Treatment is an effective treatment for depression, anxiety and anhedonia.
List the different therapeutic strategies that directly target reward sensitivity and describe the ways in which virtual reality technologies can augment such strategies
Long-term Goal: Present the evidence for hyposensitivity to reward as a risk factor and as a treatment target for depression and anxiety.
