Positive Affect Treatment for Depression and Anxiety

Individuals with depression or anxiety often experience a loss of pleasure, interest, or joy in usual activities. Low positive affect (a core feature of anhedonia) is a risk factor for poor prognosis and suicidality, yet treatments to date have been relatively ineffective in targeting it. Based on advances in behavioral and neuroscience, Positive Affect Treatment (PAT) was developed to specifically target areas of reward sensitivity that are believed to contribute to anhedonia. These include the anticipation and motivation for reward, the response to reward attainment, and the learning of associations between actions and reward outcomes. 

PAT is a 15-session intervention composed of three modules targeting behaviors (Actions Toward Feeling Better), cognitions (Attending to the Positive), and Building Positivity. Each module has a set of skills that focuses on building the capacity to look forward to, attend to, enjoy, and savor, and learn about positive and rewarding experiences. The premise is that by building capacity for reward, not only will rewarding experiences be felt more strongly (rather than being dismissed), but negative experiences (internal or external) will also become less predominant. Randomized controlled trials comparing PAT to cognitive behavior therapy for individuals with moderate to severe depression or anxiety resulted in higher positive affect, lower negative affect, and superior reduction in symptoms of depression, anxiety, and suicidality.

Learning Objectives

• Describe the efficacy and mechanisms underlying the positive affect treatment (PAT) for anxiety and depression.
• Explain the treatment modules and related techniques of PAT.
• Assess suitability and priority of PAT techniques based on patient's reward sensitivity deficits