How well do Cognitive Behavioural Therapy and Behavioural Activation for depression repair anhedonia? A secondary analysis of the COBRA randomized controlled trial

Batool Alsayednasser, Emily Widnall, Heather O'Mahen, Kim Wright, Fiona Warren, Asha Ladwa, Gabriela Kattan Khazanov, Sarah Byford, Willem Kuyken, Ed Watkins, David Ekers, Nigel Reed, Emily Fletcher, Dean McMillian, Paul Farrand, David Richards, Barnaby D. Dunn*

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

22 Citations (Scopus)
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Abstract

A secondary analysis of the COBRA randomized controlled trial was conducted to examine how well Cognitive Behavioural Therapy (CBT) and Behavioural Activation (BA) repair anhedonia. Patients with current major depressive disorder (N = 440) were randomized to receive BA or CBT, and anhedonia and depression outcomes were measured after acute treatment (six months) and at two further follow up intervals (12 and 18 months). Anhedonia was assessed using the Snaith Hamilton Pleasure Scale (SHAPS; a measure of consummatory pleasure). Both CBT and BA led to significant improvements in anhedonia during acute treatment, with no significant difference between treatments. Participants remained above healthy population averages of anhedonia at six months, and there was no further significant improvement in anhedonia at 12-month or 18-month follow up. Greater baseline anhedonia severity predicted reduced repair of depression symptoms and fewer depression-free days across the follow-up period following both BA and CBT. The extent of anhedonia repair was less marked than the extent of depression repair across both treatment arms. These findings demonstrate that CBT and BA are similarly and only partially effective in treating anhedonia. Therefore, both therapies should be further refined or novel treatments should be developed in order better to treat anhedonia.
Original languageEnglish
Article number104185
JournalBehaviour Research and Therapy
Volume159
Early online date27 Sept 2022
DOIs
Publication statusPublished - 1 Dec 2022

Bibliographical note

Funding Information:
The original COBRA trial was funded by the UK National Institute for Health Research (NIHR) Health Technology Assessment Programme . The views expressed in this publication are those of the authors and not necessarily of the NIHR or UK Department of Health.

Publisher Copyright:
© 2022 The Authors

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