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Derek R. Hopko - One of the best experts on this subject based on the ideXlab platform.
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Behavioral Activation for moderately depressed university students randomized controlled trial
Journal of Counseling Psychology, 2009Co-Authors: Michael J Gawrysiak, Christopher R N Nicholas, Derek R. HopkoAbstract:Although depression is prevalent among university students, limited and dated research has examined theefficacy of Behavioral interventions in treating this population (C. Lee, 2005). On the basis of a modifiedversion of the Behavioral Activation Treatment for Depression (BATD; D. R. Hopko & C. W. Lejuez,2007; C. W. Lejuez, D. R. Hopko, & S. D. Hopko, 2001) that involved a structured single-sessionintervention and 2-week treatment interval, the authors conducted a randomized controlled trial com-paring individualized BATD and a no-treatment control for university students with moderate depressionsymptoms ( N 30). Outcome measures assessed depression, environmental reward, social support, andsomatic anxiety. Relative to the control group, repeated measures analyses of variance and reliablechange indices indicated that the BATD group had significantly greater reductions in depression andincreased environmental reward at post-treatment that were associated with strong effect sizes. Astatistical trend suggested that BATD also may show promise toward increasing social support. Givencurrent conditions in many academic institutions that include high demand for mental health services,limited personnel, and time restrictions, brief and parsimonious interventions like BATD may representa viable treatment option. Study limitations and future directions are discussed.Keywords: Behavioral Activation, college students, depression, treatment outcome
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Behavioral Activation of a Breast Cancer Patient With Coexistent Major Depression and Generalized Anxiety Disorder
Clinical Case Studies, 2009Co-Authors: Maria E. A. Armento, Derek R. HopkoAbstract:Recently developed Behavioral Activation interventions have shown promise in effectively treating depression through increasing value-based activity levels that elicit response-contingent reinforcement. This case study highlights the implementation of Behavioral Activation to a breast cancer patient with major depression and generalized anxiety disorder, applied within the context of a medical center oncology clinic. Following an eight-session Behavioral Activation protocol, the patient demonstrated notable decreases in self-reported depressive and anxious symptoms and an overall increase in quality of life and medical functioning. These treatment gains were maintained through 6-month follow-up. Consistent with an accumulating literature, these data support Behavioral Activation as an effective and parsimonious intervention for individuals with depression and concurrent medical problems such as breast cancer.
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Sudden Gains in Depressed Cancer Patients Treated With Behavioral Activation Therapy
Behavior therapy, 2008Co-Authors: Derek R. Hopko, Sarah M. C. Robertson, John P. CarvalhoAbstract:Many patients who receive cognitive-Behavioral therapy experience sudden gains that are associated with improved treatment response and decreased risk of relapse. Extending prior research, this study examined sudden gains among depressed cancer patients receiving brief (9-session) Behavioral Activation therapy. Fifty percent of patients experienced sudden gains of large magnitude (M=11.8 BDI-II points), with sudden gains associated with improved treatment response and maintenance of gains at 3-month follow-up. Relative to those without sudden gains, at pretreatment assessment, cancer patients with sudden gains were more likely to present with less severe depression, less somatic anxiety, fewer coexistent anxiety disorders, as well as less bodily pain, better overall physical functioning, and fewer problems with daily activities as a result of emotional problems. These findings provide increasing support for Behavioral Activation with a difficult-to-treat population but raise important questions regarding mechanism of change. Clinical implications for treating depressed cancer patients are discussed.
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Behavioral Activation for anxiety disorders.
The Behavior Analyst Today, 2006Co-Authors: Derek R. Hopko, Sarah M. C. Robertson, Carl W. LejuezAbstract:Abstract Accumulating data suggest that Behavioral Activation interventions may be an effective approach to treating clinical depression. Given the high comorbidity and construct overlap between anxiety and mood disorders, a conceptually and methodologically integrated intervention that addresses symptoms of both conditions is indicated. As a means to this end, two questions are addressed. First, is the construct overlap and functional similarities of anxiety and mood disorders substantial enough to warrant an integrated intervention? Second, are Behavioral Activation treatments conceptually compatible with traditional Behavioral interventions for anxiety disorders? To address these questions, Behavioral Activation interventions and their underlying principles briefly are described, followed by a functional analytic framework in which depressive and anxiety based symptom patterns are viewed as conceptually parallel in the context of a general negative affective syndrome. Finally, practical applications of Behavioral Activation for anxiety are discussed, and a case illustration is presented to highlight how Behavioral Activation may be used to treat a patient with coexistent anxiety and depressive pathology. Key Words: Behavioral Activation, Anxiety, Depression, Emotional Disorders. ********** Behavioral Activation may be defined as a therapeutic process that emphasizes structured attempts at engendering increases in overt behaviors that are likely to bring patients into contact with reinforcing environmental contingencies and produce corresponding improvements in thoughts, mood, and overall quality of life (Hopko, Lejuez, Ruggiero, & Eifert, 2003). Traditional behavior therapy for depressive disorders included an Activation component whereby the objective was to increase access to pleasant events and positive reinforcers and simultaneously decrease the intensity and frequency of aversive events and consequences (Lewinsohn & Atwood, 1969; Lewinsohn & Graf, 1973; Zeiss, Lewinsohn, & Munoz, 1979). Empirical support for these interventions generally was favorable, with such approaches deemed as effective in attenuating depressive behaviors as cognitive and interpersonal skills training methods (Zeiss et al., 1979). Other researchers were less supportive of conventional behavior therapy, however, and it was demonstrated that mildly to moderately depressed college students did not become less depressed following participation in events and behaviors rated as highly pleasurable (Hammen & Glass, 1975). Given equivocal support for pure Behavioral interventions, paradigmatic undercurrents associated with the cognitive revolution, and the contention that more multi-faceted interventions that included cognitive restructuring rendered superior outcomes to pure Behavioral approaches (Blaney, 1981; McLean & Hakstian, 1979), these pioneering Behavioral therapies for depression gradually were replaced by more integrative cognitive-Behavioral therapies (Beck, Rush, Shaw, & Emery, 1979; Lewinsohn, Antonuccio, Breckenridge, & Teri, 1984; Lewinsohn, Munoz, Youngren, & Zeiss, 1986; Lewinsohn, Sullivan, & Grosscup, 1980; Rehm, 1977). Following the publication of a component analysis study indicating that comprehensive cognitive-Behavioral therapy was no more effective than a Behavioral intervention in treating depression, interest in pure Behavioral approaches was revitalized (Gortner, Gollan, Dobson, & Jacobson, 1998; Jacobson et al., 1996). Subsequent to this study, substantial preliminary data have accumulated that support the utility of two new interventions: Behavioral Activation (BA; Addis & Martell, 2004; Martell, Addis, & Jacobson, 2001) and the Brief Behavioral Activation Treatment for Depression (BATD; Lejuez, Hopko, & Hopko, 2001, 2002). These approaches have been effectively used with depressed patients in a community mental health center (Lejuez, Hopko, LePage, Hopko, & McNeil, 2001), an inpatient psychiatric facility (Hopko, Lejuez, LePage, Hopko, & McNeil, 2003), as a supplemental intervention for patients with co-existent Axis I (Hopko, Hopko, & Lejuez, 2004; Jakupak et al. …
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Behavioral Activation as an Intervention for Coexistent Depressive and Anxiety Symptoms
Clinical Case Studies, 2004Co-Authors: Derek R. Hopko, Carl W. Lejuez, Sandra D. HopkoAbstract:In recent years, Behavioral Activation approaches have been used to treat individuals with clinical depression. Extension of these strategies toward individuals presenting with coexistent depressive and anxiety symptoms may represent a parsimonious, practical, and time-and cost-effective treatment method. The present study outlines a case in which coexistent anxiety and depressive symptoms predominate, a clinical presentation made somewhat more complex given an Axis III diagnosis of colitis. A brief Behavioral Activation treatment for depression (BATD) is used to simultaneously incorporate Activation and exposure strategies to ameliorate affective symptoms. Following a 10-session treatment protocol, the patient demonstrated notable decreases in self-reported anxiety and depressive symptoms and increased quality of life. Although these data are preliminary, they suggest some efficacy for BATD as a viable treatment alternative for individuals with a mixed anxiety-depressive disorder presentation.
Gerhard Andersson - One of the best experts on this subject based on the ideXlab platform.
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The relative effects of Behavioral Activation vs. physical exercise in the treatment of mild to moderate depression
2016Co-Authors: Per Carlbring, Markus B. T. Nyström, Philip Lindner, Peter Hassmén, Gerhard AnderssonAbstract:The relative effects of Behavioral Activation vs. physical exercise in the treatment of mild to moderate depression
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The effects on depression of Internet-administered Behavioral Activation vs. physical exercise
2015Co-Authors: Per Carlbring, Christopher R. Martell, Markus B. T. Nyström, Philip Lindner, Lars Forsberg, Lars Ström, Gerhard Andersson, Peter HassménAbstract:Despite their potential as low-threshold, low-cost and high-flexibility treatments of depression, Behavioral Activation and physical exercise have not yet been directly compared. This study has examined the effects of these interventions, administered via the Internet. In this randomized controlled trial a total of 312 participants meeting the diagnostic criteria for mild to moderate major depression, recruited in multiple cycles and randomized to either a waiting list control group with delayed treatment, or one of the four active treatment groups: (1) physical exercise without a clear psychological treatment rationale; (2) physical exercise with a psychological treatment rationale; (3)Behavioral Activation a la Lewinsohn; or (4) Behavioral Activation a la Martel. A total of 72% were women and the average age of the participants were M=42.3 years (SD=13,5). More than half (53,9%) had a history of previous psychological treatment. Primary outcome measure was the 9-item Patient Health Questionnaire. Assessments were made on a weekly basis for the full duration of the acute treatment which was 12 weeks. The preliminary results are in line with previous online studies showing that all active treatment groups were superior to the waitlist (large effect sizes) and that only minor differences could be identified between the four active groups (large within effect sizes). At the time of the conference 6-month follow-up data will be available in addition to the already collected post-assessment data (analyzed according to the intention-to-treat principle).
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Behavioral Activation vs physical exercise in the treatment of mild to moderate depression
2015Co-Authors: Per Carlbring, Christopher R. Martell, Markus B. T. Nyström, Philip Lindner, Lars Forsberg, Lars Ström, Gerhard Andersson, Peter HassménAbstract:Despite their potential as low-threshold, low-cost and high-flexibility treatments of depression, Behavioral Activation and physical exercise have not yet been directly compared. This study has examined the effects of these interventions, administered via the Internet. In this randomized controlled trial a total of 312 participants meeting the diagnostic criteria for mild to moderate major depression, recruited in multiple cycles and randomized to either a waiting list control group with delayed treatment, or one of the four active treatment groups: (1) physical exercise without a clear psychological treatment rationale; (2) physical exercise with a psychological treatment rationale; (3) Behavioral Activation a la Lewinsohn; or (4) Behavioral Activation a la Martel. A total of 72% were women and the average age of the participants were M=42.3 years (SD=13,5). More than half (53,9%) had a history of previous psychological treatment. Primary outcome measure was the 9-item Patient Health Questionnaire. Assessments were made on a weekly basis for the full duration of the acute treatment which was 12 weeks. The preliminary results are in line with previous online studies showing that all active treatment groups were superior to the waitlist (large effect sizes) and that only minor differences could be identified between the four active groups (large within effect sizes). At the time of the conference 6-month follow-up data will be available in addition to the already collected post-assessment data (analyzed according to the intention-to-treat principle).
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Internet-based Behavioral Activation and acceptance-based treatment for depression: A randomized controlled trial
Journal of Affective Disorders, 2013Co-Authors: Per Carlbring, Malin Hägglund, Anne Luthström, Mats Dahlin, Åsa Kadowaki, Kristofer Vernmark, Gerhard AnderssonAbstract:Background: Internet-based cognitive behavior therapy for depression has been tested in several trials but there are no internet studies on Behavioral Activation (BA), and no studies on BA over the ...
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Behavioral Activation based guided self help treatment administered through a smartphone application study protocol for a randomized controlled trial
Trials, 2012Co-Authors: Per Carlbring, Gerhard AnderssonAbstract:Background: The need for cost-effective interventions for people suffering from major depressive disorders is essential. Behavioral Activation is an intervention that can largely benefit from the use of new mobile technologies (for example smartphones). Therefore, developing smartphone-based Behavioral Activation interventions might be a way to develop cost-effective treatments for people suffering from major depressive disorders. The aim of this study will be to test the effects of a smartphone-delivered Behavioral Activation treatment. Methods: The study will be a randomized controlled trial with a sample size of 120 participants, with 60 patients in each group. The treatment group includes an 8-week smartphone-based Behavioral Activation intervention, with minimal therapist contact. The smartphone-based intervention consists of a web-based psychoeducation, and a smartphone application. There is also a back-end system where the therapist can see reports from the patients or activities being reported. In the attention control group, we will include brief online education and then recommend use of a smartphone application that is not directly aimed at depression (for example, ‘Effective meditation’). The duration of the control condition will also be 8 weeks. For ethical reasons we will give the participants in the control group access to the Behavioral Activation treatment following the 8-week treatment period. Discussions: We believe that this trial has at least three important implications. First, we believe that smartphones can be integrated even further into society and therefore may serve an important role in health care. Second, while Behavioral Activation is a psychological treatment approach for which there is empirical support, the use of a smartphone application could serve as the therapist’s prolonged arm into the daily life of the patient. Third, as we have been doing trials on guided Internet treatment for more than 10 years it is now time to move to the next generation of information technology - smartphones - which are not only relevant for Swedish conditions but also for developing countries in the world which are increasingly empowered by mobile phones with Internet connection. Trial registration: ClinicalTrials.gov NCT01463020
Shigeto Yamawaki - One of the best experts on this subject based on the ideXlab platform.
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Effects of Behavioral Activation program without psychotropic medication treatment for depression in late adolescence: case report
Neuropsychiatric disease and treatment, 2018Co-Authors: Koki Takagaki, Yasumasa Okamoto, Ran Jinnin, Satoshi Yokoyama, Atsuo Yoshino, Fumi Kagawa, Yuri Okamoto, Yoshie Miyake, Shigeto YamawakiAbstract:Background A Japanese study revealed that 20.7% of first-year undergraduate students had a major depressive episode during the previous 12 months: first-year undergraduate students with depression need early support. Reportedly, antidepressant medication use during adolescence is associated with modestly increased risk of suicidality. This case study of a late-adolescent woman with depression illustrates the effects of Behavioral Activation without psychotropic medication. Case presentation A first-year undergraduate student was diagnosed as having major depressive disorder. From earlier studies, we developed a Behavioral Activation program for late-adolescent people with major depressive disorder. Behavioral Activation administered in 10 weekly 60-minute sessions decreased depressive symptoms, avoidant behaviors, and rumination. Moreover, the Beck Depression Inventory, second version score was 1 at 1-year follow-up. Conclusion Results of this case study show that Behavioral Activation is effective without psychotropic medication. Future studies of large samples must be conducted to assess the effectiveness of Behavioral Activation without psychotropic medication for depression in late adolescence.
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Effects of Behavioral Activation on default mode network connectivity in subthreshold depression: A preliminary resting-state fMRI study.
Journal of affective disorders, 2017Co-Authors: Satoshi Yokoyama, Koki Takagaki, Asako Mori, Yasumasa Okamoto, Go Okada, Ran Jinnin, Masahiro Takamura, Syouichi Shiota, Naho Ichikawa, Shigeto YamawakiAbstract:Abstract Background Subthreshold depression is a risk factor for major depressive disorder, and it is known to have a negative impact on quality of life (QOL). Although Behavioral Activation, which is one type of cognitive Behavioral therapy, is an effective psychological intervention for subthreshold depression, neural mechanisms of Behavioral Activation are unclear. Enhanced functional connectivity between default mode network (DMN) and the other regions has been demonstrated in participants with subthreshold depression. The purpose of this study was to examine the effects of Behavioral Activation on DMN abnormalities by using resting-state functional MRI (rs-fMRI). Methods Participants with subthreshold depression (N =40) were randomly assigned to either an intervention group or a non-intervention group. They were scanned using rs-fMRI before and after the intervention. Independent component analysis indicated three subnetworks of the DMN. Results Analyzing intervention effects on functional connectivity of each subnetwork indicated that connectivity of the anterior DMN subnetwork with the dorsal anterior cingulate was reduced after the intervention. Moreover, this reduction was correlated with an increase in health-related QOL. Limitations We did not compare the findings with healthy participants. Further research should be conducted by including healthy controls to verify the results of this study. Conclusions Mechanisms of Behavioral Activation might be related to enhanced ability to independently use the dACC and the DMN, which increases an attention control to positive external stimuli. This is the first study to investigate neural mechanisms of Behavioral Activation using rs-fMRI.
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Behavioral Activation can normalize neural hypoActivation in subthreshold depression during a monetary incentive delay task.
Journal of affective disorders, 2015Co-Authors: Asako Mori, Koki Takagaki, Yasumasa Okamoto, Go Okada, Ran Jinnin, Masahiro Takamura, Makoto Kobayakawa, Shigeto YamawakiAbstract:Abstract Background Late adolescents are under increased risk of developing depressive symptoms. Behavioral Activation is an effective treatment for subthreshold depression, which can prevent the development of subthreshold depression into a major depressive disorder. However, the neural mechanisms underlying the efficacy of Behavioral Activation have not been clearly understood. We investigated neural responses during reward processing by individuals with subthreshold depression to clarify the neural mechanisms of Behavioral Activation. Methods Late adolescent university students with subthreshold depression (n=15, age 18–19 years) as indicated by a high score on the Beck's Depression Inventory-ll (BDI-ll) and 15 age-matched controls with a low BDI-ll score participated in functional magnetic resonance imaging scanning conducted during a monetary incentive delay task on two occasions. The Individuals in the subthreshold depression group received five, weekly Behavioral Activation sessions between the two scanning sessions. Moreover, they did not receive any medication until the study was completed. Results Behavioral Activation significantly reduced depressive symptoms. Moreover, compared to the changes in brain functions in the control group, the Behavioral Activation group showed functional changes during loss anticipation in brain structures that mediates cognitive and emotional regulation, including the left ventrolateral prefrontal cortex and angular gyrus. Limitations Replication of the study with a larger sample size is required to increase the generalizability of these results. Conclusions Behavioral Activation results in improved functioning of the fronto-parietal region during loss anticipation. These results increase our understanding of the mechanisms underlying specific psychotherapies.
José Muñiz - One of the best experts on this subject based on the ideXlab platform.
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Validity evidence of the Behavioral Activation for Depression Scale-Short Form among depressed smokers.
International journal of clinical and health psychology : IJCHP, 2018Co-Authors: Alba González-roz, Roberto Secades-villa, José MuñizAbstract:Abstract Background/Objective A measure of Behavioral Activation (BA) is highly recommended when evaluating BA treatment effects for smokers with depression. Recently, a short version of the Behavioral Activation for Depression scale (BADS-SF) has been developed as a means of assessing changes in Activation and avoidance patterns. To date there is no validated version of this questionnaire in Spanish. This study sought to adapt the BADS-SF to a Spanish population of depressed smokers. Method A sample of 169 smokers (72.2% female) with elevated depressive symptomatology completed the BADS-SF. Results A bi-factorial structure was obtained: Activation and Avoidance. Results indicated an acceptable internal consistency for both the Activation (ω = .85) and the Avoidance subscales (ω =.70). Overall, convergent validity was obtained with Activation and Avoidance subscales being related to other depression-related measures such as depressive symptomatology (Activation r = −.29; Avoidance r = .35), environmental reward (Activation r = .40; Avoidance r = −.41) and, nicotine dependence (Avoidance r = .23). This latter variable was the only one not showing a statistically significant association with the Activation factor (r = −.12). Conclusions The Spanish BADS-SF can be considered as a reliable and valid instrument when assessing Behavioral Activation among clinically depressed smokers.
Tatsuya Yamamoto - One of the best experts on this subject based on the ideXlab platform.
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Assessing the relationship between quality of life and Behavioral Activation using the Japanese Behavioral Activation for Depression Scale-Short Form.
PloS one, 2017Co-Authors: Yusuke Shudo, Tatsuya YamamotoAbstract:Quality of life (QOL) is an important health-related concept. Identifying factors that affect QOL can help develop and improve health-promotion interventions. Previous studies suggest that Behavioral Activation fosters subjective QOL, including well-being. However, the mechanism by which Behavioral Activation improves QOL is not clear. Considering that QOL improves when depressive symptoms improve post-treatment and that Behavioral Activation is an effective treatment for depression, it is possible that Behavioral Activation affects QOL indirectly rather than directly. To clarify the mechanism of the influence of Behavioral Activation on QOL, it is necessary to examine the relationships between factors related to Behavioral Activation, depressive symptoms, and QOL. Therefore, we attempted to examine the relationship between these factors. Participants comprised 221 Japanese undergraduate students who completed questionnaires on Behavioral Activation, QOL, and depressive symptoms: the Japanese versions of the Behavioral Activation for Depression Scale-Short Form (BADS-SF), WHO Quality of Life-BREF (WHOQOL-26), and Center for Epidemiologic Studies Depression Scale (CES-D). The BADS-SF comprises two subscales, Activation and Avoidance, and the WHOQOL-26 measures overall QOL and four domains, Physical Health, Psychological Health, Social Relationships, and Environment. Mediation analyses were conducted with BADS-SF Activation and avoidance as independent variables, CES-D as a mediator variable, and each WHO-QOL as an outcome variable. Results indicated that depression completely mediated the relationship between Avoidance and QOL, and partially mediated the relationship between Activation and QOL. In addition, analyses of each domain of QOL showed that Activation positively affected all aspects of QOL directly and indirectly, but Avoidance had a negative influence on only part of QOL mainly through depression. The present study provides Behavioral Activation strategies aimed at QOL enhancement.