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<p>Psychotherapy as well as pharmacotherapy improve symptoms by reducing negative affect (NA) in patients with depression; however, enhancing positive affect (PA) does not always lead to recovery from depression. The relationships between PA and outcomes are complex. This study examined the relationships between PA/NA and symptoms/quality of life (QOL) in patients with depression who received cognitive behavior therapy (CBT) and moderators of these relationships, based on a hypothesis that the PA and NA routes (dual routes) would be independently involved in recovery from depression. In total, 37 patients with depression participated in this study. Affects, symptoms, QOL, dysfunctional cognition, and behavioral inactivity were assessed before and after a 16-week intervention. Additionally, 45 healthy controls underwent the same assessments and intervention. Cross-sectional analyses of pre-CBT data revealed significant correlations between NA and symptoms/QOL; however, no correlations were observed with PA. The relationships of PA to these outcomes were moderated by both cognition and behaviors; it was associated with symptoms/QOL only in patients with less cognitive dysfunction and more behavioral activation. Longitudinal analyses showed improvements in PA and outcomes, as well as cognition and behaviors. Furthermore, both NA and PA were correlated with symptoms/QOL after CBT. These results support the dual-route hypothesis, and suggest that optimizing the PA route is important in the working mechanism of CBT for depression. Our findings contribute to overcoming the challenges of conventional treatments focusing only on NA, such as relapse and treatment-resistance.</p>

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How does CBT work on recovery from depression through positive affect route?

  • 期刊论文

  • 发表日期：

    2025年6月3日

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  • Yuri Ito,
  • Sadao Otsuka,
  • Taro Suwa,
  • Yujiro Yoshihara,
  • Yusuke Kyuragi,
  • Momoko Hatakoshi,
  • Toshiya Murai

摘要

Psychotherapy as well as pharmacotherapy improve symptoms by reducing negative affect (NA) in patients with depression; however, enhancing positive affect (PA) does not always lead to recovery from depression. The relationships between PA and outcomes are complex. This study examined the relationships between PA/NA and symptoms/quality of life (QOL) in patients with depression who received cognitive behavior therapy (CBT) and moderators of these relationships, based on a hypothesis that the PA and NA routes (dual routes) would be independently involved in recovery from depression. In total, 37 patients with depression participated in this study. Affects, symptoms, QOL, dysfunctional cognition, and behavioral inactivity were assessed before and after a 16-week intervention. Additionally, 45 healthy controls underwent the same assessments and intervention. Cross-sectional analyses of pre-CBT data revealed significant correlations between NA and symptoms/QOL; however, no correlations were observed with PA. The relationships of PA to these outcomes were moderated by both cognition and behaviors; it was associated with symptoms/QOL only in patients with less cognitive dysfunction and more behavioral activation. Longitudinal analyses showed improvements in PA and outcomes, as well as cognition and behaviors. Furthermore, both NA and PA were correlated with symptoms/QOL after CBT. These results support the dual-route hypothesis, and suggest that optimizing the PA route is important in the working mechanism of CBT for depression. Our findings contribute to overcoming the challenges of conventional treatments focusing only on NA, such as relapse and treatment-resistance.