FRIDAY, May 1, 2026 (HealthDay News) -- Positive affect treatment (PAT) engaging reward systems yields a greater improvement on clinical status than negative affect treatment (NAT) for adults with severely low positive affect and moderate-to-severe depression or anxiety, according to a study published online April 24 in JAMA Network Open.
Alicia E. Meuret, Ph.D., from the Southern Methodist University in Dallas, and colleagues conducted a two-arm randomized clinical superiority trial involving treatment-seeking adults with severely low positive affect and moderate-to-severe depression or anxiety that was functionally impairing. Participants underwent 15 weekly individual therapy sessions of PAT or NAT (51 and 47 patients, respectively).
The researchers found that in analyses of the three clinical status variables as a multivariate outcome (self-reported positive affect, interviewer-rated anhedonia, and self-reported depression and anxiety), clinical status improved more with PAT than NAT, and better (higher) scores on clinical status were seen with PAT than NAT at the one-month follow-up. PAT and NAT had comparable improvement in reward anticipation-motivation and reward attainment targets. Six of seven reward and threat self-reported target measures mediated improvements in clinical status, but behavioral and psychological measures did not.
"There's a difference between feeling helpless and feeling hopeless," Meuret said in a statement. "When you feel helpless, you still have the drive and the will to want to change things. When people feel hopeless, they don't believe anything will change. That's what anhedonia can look like, and taking away negative emotions doesn't fix it."
