How personalized behavioral activation interventions improve the behaviors of individuals with anhedonia

Background. Interventions for anhedonia (loss of pleasure) often focus on re-engagement in pleasurable activities (i.e., behavioral activation). Using the Experience Sampling Method, we aimed to examine how anhedonic individuals changed their lifestyle behavior (i.e., physical activity, time outside, worrying, and social activity) after a personalized lifestyle advice session, and how these changes in behavior where associated with improvement. Methods. Participants were 69 young adults (aged 18-24 years) with persistent anhedonia, who filled out 3 assessments per day about lifestyle behaviors and affect for 3 months. After an observation month, participants received personalized lifestyle advice, based on observed associations between lifestyle behaviors and pleasure. Results. Results showed that, without taking into account whether participants followed up on the advice, there was not one specific type of advice more effective than others. When examining behavior changes, we found that changes in social interaction, physical activity, and worrying were associated with improvement in PA and pleasure. Further exploration of the reciprocal associations between these behaviors and PA and pleasure showed that physical activity and worrying were reciprocally associated with PA or pleasure, indicating a positive feedback loop. Limitations. As we included a non-clinical sample, our findings are not generalizable to clinical populations. We only used self-reports, whereas more objective measures may be better for some of our measures (e.g., accelerometers for physical activity). Conclusions. Physical activity and worrying play an important role in the path to improvement in individuals with anhedonia. Results indicate that momentary assessments are an effective tool to detect mechanisms of change in interventions.

背景。针对快感缺失（即愉悦感的丧失）的干预措施通常聚焦于重新参与愉悦活动（例如，行为激活）。采用经验抽样法，本研究旨在探讨快感缺失个体在接受个性化生活方式建议会议后，其生活方式行为（即身体活动、户外时间、忧虑和社交活动）的变化，以及这些行为变化与改善之间的关联。方法。参与者为69名（年龄在18-24岁之间）患有持续快感缺失的年轻人，他们在三个月内每日完成三次关于生活方式行为和情感的调查。在观察一个月后，参与者根据观察到的生活方式行为与愉悦之间的关联，接受了个性化的生活方式建议。结果。结果显示，不考虑参与者是否遵循建议，没有一种具体的建议比其他建议更有效。在考察行为变化时，我们发现社交互动、身体活动和忧虑的变化与PA和愉悦感的改善相关。进一步探究这些行为与PA和愉悦感之间的相互关联性表明，身体活动和忧虑相互关联，表明存在正反馈循环。局限性。由于我们包括了一组非临床样本，我们的发现不能推广到临床人群。我们仅使用了自我报告，而对于某些测量（例如，使用加速度计进行身体活动）而言，可能需要更为客观的测量方法。结论。身体活动和忧虑在快感缺失个体的改善之路上发挥着重要作用。结果表明，瞬时评估是检测干预措施中变化机制的有效工具。