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Cited by 233Psychological Well-being and Life SatisfactionAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychotherapy Techniques and Applications

Upregulating the positive affect system in anxiety and depression: Outcomes of a positive activity intervention: Taylor et al.

Open access
Taylor, Charles T., Lyubomirsky, Sonja, Stein, Murray B.·2017·Depression and Anxiety
DOI 10.1002/da.22593PMC PMC7266488
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Abstract

BACKGROUND: Research suggests that the positive affect system may be an important yet underexplored treatment target in anxiety and depression. Existing interventions primarily target the negative affect system, yielding modest effects on measures of positive emotions and associated outcomes (e.g., psychological well-being). The objective of the present pilot study was to evaluate the efficacy of a new transdiagnostic positive activity intervention (PAI) for anxiety and depression. METHOD: Twenty-nine treatment-seeking individuals presenting with clinically impairing symptoms of anxiety and/or depression were randomly allocated to a 10-session protocol comprised of PAIs previously shown in nonclinical samples to improve positive thinking, emotions, and behaviors (e.g., gratitude, acts of kindness, optimism; n = 16) or a waitlist (WL) condition (n = 13). Participants were assessed at pre- and posttreatment, as well as 3- and 6-month follow-up, on measures of positive and negative affect, symptoms, and psychological well-being. ClinicalTrials.gov Identifier: NCT02330627 RESULTS: The PAI group displayed significantly larger improvements in positive affect and psychological well-being from pre- to posttreatment compared to WL. Posttreatment and follow-up scores in the PAI group were comparable to general population norms. The PAI regimen also resulted in significantly larger reductions in negative affect, as well as anxiety and depression symptoms, compared to WL. Improvements across all outcomes were large in magnitude and maintained over a 6-month follow-up period. CONCLUSIONS: Targeting the positive affect system through a multicomponent PAI regimen may be beneficial for generating improvements in positive emotions and well-being, as well as reducing negative affect and symptoms, in individuals with clinically impairing anxiety or depression.

AI snapshot

Written from the paper’s full text.

TL;DR

In a pilot randomized trial, a 10-session transdiagnostic positive activity intervention (PAI) for treatment-seeking adults with clinically impairing anxiety and/or depression produced significantly greater improvements in positive affect and psychological well-being than waitlist, plus reductions in negative affect and symptoms. Gains were large and maintained through 6-month follow-up, but the study was small and used an assessment-only waitlist control.

Key findings

  • Among 29 randomized participants (PAI n=16; waitlist n=13; 28 analyzed intent-to-treat: PAI n=16, waitlist n=12), the PAI group showed significantly larger pre-to-post improvements in positive affect and psychological well-being than waitlist.
  • The PAI group also had significantly larger reductions in negative affect, anxiety symptoms, and depression symptoms than waitlist; the paper reports these within- and between-group effects as large in magnitude.
  • Treatment gains were maintained over 3- and 6-month follow-up, with post-treatment and follow-up scores in the PAI group comparable to general population norms; at baseline, participants scored more than one standard deviation below normative means on positive affect and life satisfaction.
  • Treatment credibility and expectancy ratings in the PAI group were high: credibility M=7.6, SD=.96; expectancy M=6.8, SD=2.0 (possible range 1–9).

Methods

  • Pilot randomized trial: treatment-seeking individuals aged 18–55 with clinically elevated anxiety or depression (OASIS ≥8 or PHQ-9 ≥10) were randomly assigned to a 10-session, one-hour weekly therapist-delivered PAI protocol or a waitlist condition.
  • Primary outcome was a positive emotions composite (PANAS-PA and mDES-Positive Emotion); secondary composites were negative emotions, psychological well-being, anxiety, and depression.
  • Main analysis used ANCOVA at post-treatment controlling for pre-treatment scores; follow-up maintenance in the PAI group used repeated-measures ANOVA across pre, post, 3-month, and 6-month assessments.

Limitations

  • The paper states the sample was small and compared PAI to an assessment-only waitlist, so results may over- or underestimate true effects and cannot account for common therapeutic effects such as therapist attention or patient expectations.
  • The paper states treatment fidelity/adherence were not formally assessed, outcomes relied on participant report, broad anxiety/depression measures were used rather than disorder-specific symptoms, and no post-treatment diagnostic assessments were conducted.
  • The paper also notes limitations of pre/post/follow-up-only assessments, last-observation-carried-forward handling of missing follow-up data, and lack of formal assessment of adverse effects or person-activity fit; evident from the text, the PAI group was significantly more likely to report prior psychosocial treatment use than waitlist (Fisher’s exact test significant = .044).

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1002/da.22593

Cites

Statistics

Nothing to recompute.

Claims the paper makes

0 of 48 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    The PAI group displayed significantly larger improvements in psychological well-being from pre- to post-treatment compared to waitlist.

    “The PAI group displayed significantly larger improvements in positive affect and psychological well-being from pre- to post-treatment compared to waitlist.”
    • Also stated in: § Main Treatment Effects · plain
      “ANCOVA results for our secondary outcomes revealed that the PAI group reported experiencing significantly fewer negative emotions and symptoms of anxiety and depression, as well as significantly greater psychological well-being, at post-treatment relative to participants in the WL group.”
    • Also stated in: § Discussion · plain
      “The PAI protocol resulted in significantly greater increases in positive emotions and psychological well-being compared to a no intervention control group.”
    Quote in the paperSubstantial claim
  • Findingown data

    Post-treatment and follow-up scores in the PAI group were comparable to general population norms.

    “Post-treatment and follow-up scores in the PAI group were comparable to general population norms.”
    • Also stated in: § Discussion · plain
      “Following treatment, and persisting through the follow-up period, the PAI group scored near community normative means”
    Quote in the paperSubstantial claim
  • Findingown data

    Improvements across all outcomes were large in magnitude.

    “Improvements across all outcomes were large in magnitude and maintained over a 6-month follow-up period.”
    • Also stated in: § Main Treatment Effects · plain
      “The magnitude of both within- and between-group treatment effects was large for the PAI group.”
    • Also stated in: § Discussion · plain
      “Treatment effects were large in magnitude and persisted up to 6-months following termination of acute treatment.”
    Quote in the paperSubstantial claim
  • Findingown data

    The PAI regimen resulted in significantly larger reductions in anxiety symptoms compared to waitlist.

    “The PAI regimen also resulted in significantly larger reductions in negative affect, as well as anxiety and depression symptoms, compared to waitlist.”
    • Also stated in: § Main Treatment Effects · plain
      “ANCOVA results for our secondary outcomes revealed that the PAI group reported experiencing significantly fewer negative emotions and symptoms of anxiety and depression, as well as significantly greater psychological well-being, at post-treatment relative to participants in the WL group.”
    Quote in the paperSubstantial claim
  • Findingown data

    The PAI regimen resulted in significantly larger reductions in depression symptoms compared to waitlist.

    “The PAI regimen also resulted in significantly larger reductions in negative affect, as well as anxiety and depression symptoms, compared to waitlist.”
    • Also stated in: § Main Treatment Effects · plain
      “ANCOVA results for our secondary outcomes revealed that the PAI group reported experiencing significantly fewer negative emotions and symptoms of anxiety and depression, as well as significantly greater psychological well-being, at post-treatment relative to participants in the WL group.”
    Quote in the paperSubstantial claim
  • Classified as probably not a substantial claim. 21
  • May combine two claims. 15

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    Credibility and Expectancy Questionnaire ratings obtained from PAI group following first treatment session revealed high treatment rationale credibility (M = 7.6, SD = .96) and expectancy (M = 6.8, SD = 2.0).

    “Credibility and Expectancy Questionnaire ratings obtained from participants in the PAI group following the first treatment session revealed high treatment rationale credibility (M = 7.6, SD = .96) and expectancy (M = 6.8, SD = 2.0; range of possible scores = 1–9).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Follow-up contrasts indicated that the PAI group displayed significant changes on all outcome measures from pre- to post-assessment (all ps < .05), and from pre-assessment to each of the follow-up assessment points (all ps < .05).

    “Follow-up contrasts using the Sidák adjustment for multiple comparisons indicated that the PAI group displayed significant changes on all outcome measures from pre- to post-assessment (all ps < .05), and from pre-assessment to each of the follow-up assessment points (all ps < .05).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    In the waitlist group, changes were medium-sized on the positive and negative emotion outcome measures, but minimal on symptoms and well-being.

    “It is notable that the waitlist group displayed medium-sized changes on the positive and negative emotion outcome measures, but minimal changes on symptoms and well-being.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    Targeting the positive affect system through a multi-component PAI regimen may be beneficial for generating improvements in positive emotions and well-being, as well as reducing negative affect and symptoms, in individuals with clinically impairing anxiety or depression.

    “Targeting the positive affect system through a multi-component PAI regimen may be beneficial for generating improvements in positive emotions and well-being, as well as reducing negative affect and symptoms, in individuals with clinically impairing anxiety or depression.”
    • Also stated in: § Discussion · hedged
      “Thus, the current preliminary findings underscore the potential value of directly targeting the positive affect system in treatment19–21, and add to a nascent empirical literature99, 100 suggesting that PAIs may be beneficial for individuals with clinically impairing symptoms of anxiety or depression.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Therapists met weekly to review ongoing cases to ensure that treatment material outlined in the manual was being appropriately covered.

    “Therapists met weekly to review ongoing cases to ensure that treatment material outlined in the manual was being appropriately covered and to discuss issues that arose in treatment.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    Analyses were conducted on an intent-to-treat basis.

    “Analyses were conducted on an intent-to-treat (ITT) basis (PAI, n=16; WL, n=12).”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    For the one participant who discontinued treatment following session 7, measures completed at mid-treatment were used for post-treatment data.

    “For the one participant who discontinued treatment following session 7, we used measures completed a mid-treatment (i.e., the last available assessment point) for post-treatment data”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductown data

    Participants were randomly allocated to PAI or waitlist using a random number generator.

    “Condition assignment was determined using a random number generator and revealed at the conclusion of the MRI session.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    The positive affect system fosters approach-oriented behaviors that increase exposure to potentially rewarding outcomes, thereby facilitating the acquisition of social, physical, and intellectual resources that promote resilience and overall well-being.

    “The positive affect system also fosters approach-oriented behaviors, such as exploration and social initiation, that increase exposure to potentially rewarding outcomes,31 thereby facilitating the acquisition of social, physical, and intellectual resources9, 10, 32 that promote resilience during stress and overall well-being33.”
    Quote in the paperSubstantial claim0 of 5 sources checked
    • cites [9] Fredrickson BL. Positive emotions broaden and build. Adv Exp Soc Psychol 2013; 47: 1– 53.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [10] Lyubomirsky S, King L, Diener E. The benefits of frequent positive affect: Does happiness lead to success? Psychol Bull 2005; 131(6): 803– 55. 16351326 source

      Not checked in the free run.

    • cites [31] Gable SL, Reis HT, Elliot AJ. Behavioral activation and inhibition in everyday life. J Pers Soc Psychol 2000; 78(6): 1135– 49. 10870914 source

      Not checked in the free run.

    • cites [32] Gable SL, Berkman ET. Making connections and avoiding loneliness: Approach and avoidance social motives and goals In: Elliot AJ, editor. Handbook of approach and avoidance motivation. New York, NY: Psychology Press; 2008 p. 203– 16.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [33] Fredrickson BL, Cohn MA, Coffey KA, Pek J, Finkel SM. Open hearts build lives: Positive emotions, induced through Loving-Kindness Meditation, build consequential personal resources. J Pers Soc Psychol 2008; 95(5): 1045– 62. 18954193 PMC3156028 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    The unique link between positive emotions and subjective well-being above and beyond negative affect and psychopathology symptoms suggests that interventions targeting the positive emotion system may fill a particularly important gap left by extant treatments.

    “The unique link between positive emotions and subjective well-being above and beyond negative affect and psychopathology symptoms34, 35 suggests that interventions targeting the positive emotion system may fill a particularly important gap left by extant treatments.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [34] Keyes CL. Mental illness and/or mental health? Investigating axioms of the complete state model of health. J Consult Clin Psychol 2005; 73(3): 539. 15982151 source

      Not checked in the free run.

    • cites [35] Kuppens P, Realo A, Diener E. The role of positive and negative emotions in life satisfaction judgment across nations. J Pers Soc Psychol 2008; 95(1): 66– 75. 18605852 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Studies supporting the efficacy of positive activity interventions have been primarily conducted in unselected (non-clinical) community samples and examined single positive activities in isolation.

    “Studies supporting the efficacy of positive activity interventions (PAIs) have been primarily conducted in unselected (non-clinical) community samples and examined single positive activities in isolation (for a meta-analysis, see66, 67).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [66] Sin NL, Lyubomirsky S. Enhancing well-being and alleviating depressive symptoms with positive psychology interventions: A practice-friendly meta-analysis. J Clin Psychol 2009; 65(5): 467– 87. 19301241 source

      Not checked in the free run.

    • cites [67] Bolier L, Haverman M, Westerhof GJ, Riper H, Smit F, Bohlmeijer E. Positive psychology interventions: a meta-analysis of randomized controlled studies. BMC Public Health 2013; 13. PMC3599475 23390882 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    28 participants (n=16 PAI, n=12 waitlist) were included in the intent-to-treat analysis after exclusions.

    “Thus, 28 participants (n=16 in the PAI group and n=12 in the waitlist group) were included in the intent-to-treat analysis.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    Treatment adherence was closely monitored during weekly supervision; however, it was not formally evaluated.

    “Treatment adherence was closely monitored during weekly supervision; however, it was not formally evaluated.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    Participants completed a battery of reliable and valid self-report measures.

    “Participants completed a battery of reliable and valid self-report measures at pre-, post-, and follow-up assessment points (3 and 6 months following the post-assessment).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductown data

    Groups did not differ on gender, age, years of education, race, ethnicity, or past psychotropic medication use (all ps > .10).

    “Groups did not differ on gender, age, years of education, race, ethnicity, or past psychotropic medication use (all ps > .10).”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductnone given

    We administered broad measures of anxiety and depression, rather than assessing disorder-specific symptoms, and we did not conduct diagnostic assessments following treatment.

    “It should be noted, however, that we administered broad measures of anxiety and depression, rather than assessing disorder-specific symptoms (e.g., panic, worry), and we did not conduct diagnostic assessments following treatment.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Treatment outcomes relied on participant report.

    “Third, treatment outcomes relied on participant report.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    Missing data at a given follow-up assessment point were substituted using data from a participant's last available assessment point (i.e., last observation carried forward).

    “Missing data at a given follow-up assessment point were substituted using data from a participant’s last available assessment point (i.e., last observation carried forward).”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    Outcomes were only examined at pre- and post-treatment, and during follow-up.

    “Fourth, outcomes were only examined at pre- and post-treatment, and during follow-up.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Treatment fidelity and adherence were not formally assessed.

    “Second, although therapists followed a structured manual and were monitored closely during weekly supervision, treatment fidelity and adherence were not formally assessed.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    All treatment completers (n=15) finished at least one follow-up assessment [n=14 at 3- and 6-month follow-up sessions].

    “All treatment completers (n=15) finished at least one follow-up assessment [n=14 at 3- and 6-month follow-up sessions].”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductnone given

    Small sample sizes are prone to sampling biases such that the chosen sample may not be representative of the target population, and may produce outcomes that over- or underestimate the true treatment effect.

    “Small sample sizes are prone to sampling biases such that the chosen sample may not be representative of the target population, and may produce outcomes that over- or underestimate the true treatment effect.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The benefits of positive emotions and their potential clinical utility for psychopathology are increasingly well-documented.

    “The benefits of positive emotions9, 10 and their potential clinical utility for psychopathology19–21 are increasingly well-documented.”
    Quote in the paperNot a substantial claim0 of 5 sources checked
    • cites [9] Fredrickson BL. Positive emotions broaden and build. Adv Exp Soc Psychol 2013; 47: 1– 53.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [10] Lyubomirsky S, King L, Diener E. The benefits of frequent positive affect: Does happiness lead to success? Psychol Bull 2005; 131(6): 803– 55. 16351326 source

      Not checked in the free run.

    • cites [19] Dunn BD. Helping depressed clients reconnect to positive emotion experience: Current insights and future directions. Clin Psychol Psychother 2012; 19(4): 326– 40. 22674611 source

      Not checked in the free run.

    • cites [20] Garland EL, Fredrickson B, Kring AM, Johnson DP, Meyer PS, Penn DL. Upward spirals of positive emotions counter downward spirals of negativity: Insights from the broaden-and-build theory and affective neuroscience on the treatment of emotion dysfunctions and deficits in psychopathology. Clin Psychol Rev 2010; 30(7): 849– 64. 20363063 PMC2908186 source

      Not checked in the free run.

    • cites [21] Layous K, Chancellor J, Lyubomirsky S. Positive activities as protective factors against mental health conditions. J Abnorm Psychol 2014; 123(1): 3– 12. 24661154 source

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    The PAI protocol resulted in large reductions in negative affect and symptoms, changes that were comparable to those observed with prevailing empirically established interventions.

    “However, the PAI protocol resulted in large reductions in negative affect and symptoms, changes that were comparable to those observed with prevailing empirically established interventions14, 15.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [14] Hofmann SG, Smits JA. Cognitive-behavioral therapy for adult anxiety disorders: a meta-analysis of randomized placebo-controlled trials. J Clin Psychiatry 2008; 69(4): 621– 32. 18363421 PMC2409267

      Not checked in the free run.

    • cites [15] Norton PJ, Price EC. A meta-analytic review of adult cognitive-behavioral treatment outcome across the anxiety disorders. J Nerv Ment Dis 2007; 195(6): 521– 31. 17568301

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Participants in the PAI group were significantly more likely to have reported prior psychosocial treatment use compared to participants in the waitlist group (Fisher's exact test significant = .044).

    “However, participants in the PAI group were significantly more likely to have reported prior psychosocial treatment use compared to participants in the waitlist group, Fisher’s exact test significant = .044”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Participant reactions to the individual positive activities were not formally assessed.

    “Although we did not formally assess participant reactions to the individual positive activities”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Interpretationcitation

    The current findings have clinical implications for emerging dimensional classification systems wherein the positive affect system is hypothesized to play a role across various forms of psychopathology, including anxiety and depression.

    “The current findings have clinical implications for emerging dimensional classification systems wherein the positive affect system is hypothesized to play a role across various forms of psychopathology, including anxiety and depression7, 8.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [7] Insel T, Cuthbert B, Garvey M, Heinssen R, Pine DS, Quinn K, Research domain criteria (RDoC): Toward a new classification framework for research on mental disorders. Am J Psychiatry 2010; 167(7): 748– 51. 20595427 source

      Not checked in the free run.

    • cites [8] Dillon DG, Rosso IM, Pechtel P, Killgore WDS, Rauch SL, Pizzagalli DA. Peril and pleasure: An RDoC-inspired examination of threat responses and reward processing in anxiety and depression. Depress Anxiety 2014; 31(3): 233– 49. 24151118 PMC3951656 source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    The efficacy of the PAI protocol was evaluated in a small treatment-seeking sample in comparison to an assessment only condition.

    “First, the efficacy of the PAI protocol was evaluated in a small treatment-seeking sample in comparison to an assessment only condition.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing). May combine two claims.

    Interpretationown data

    Additional PAI sessions or alternative treatment may be needed for some people.

    “suggesting that additional PAI sessions or alternative treatment may be needed for some people.”
    Quote in the paperNot a substantial claim
29 of 29

  • The paper relies on this without support.

    No studies have examined PAIs in psychiatric treatment-seeking samples.

    “Although some evidence suggests that integrated, multi-session PAIs may be beneficial for individuals with mild-to-moderate depression68 or other health-related conditions (e.g., cardiovascular disease69, suicide70, and HIV71), to our knowledge, no studies have examined PAIs in psychiatric treatment-seeking samples.”
1 of 1

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Only one study that evaluated the efficacy of a new transdiagnostic treatment focuses on positive affect, but it is a pilot study rather than a randomized controlled trial.

    “Only one study that evaluated the efficacy of a new transdiagnostic treatment focuses on PA, but it is a pilot study rather than a randomized controlled trial (RCT) [53].”

    From Negative and positive affect regulation in a transdiagnostic internet-based protocol for emotional disorders: Randomized controlled trial (2021) · cites this paper as [53]

    The Abstract (Background) identifies this as a pilot study of a transdiagnostic positive-affect intervention. But the Method (Procedure; page unavailable) says participants were randomly assigned to the intervention or a waitlist control, contrary to the claim that it was not a randomized controlled trial. The paper does not establish the citing sentence’s broader claim that it was the only such study. (LLM, conf=0.89)

    Checked by a reasoning model — may be wrong.

    Experimental — accuracy not yet measured

  • The 6-week iMAP protocols in sleep, exercise, diet, or social connection were grounded in evidence-based intervention protocols for these lifestyle domains in depression.

    “Description of each 6-week iMAP in either sleep/ exercise/ diet/ social connection domain is provided in Supplementary Methods section S.5 and is grounded in evidence-based intervention protocols in these lifestyle domains in the context of depression [5, 6, 8, 11, 16, 68–70].”

    From Personalized machine learning guided intervention for optimizing lifestyle behaviors in depression: a pilot study (2026) · cites this paper as [70]

    The Method > Treatment section (page unavailable) describes a literature-based positive activity intervention for people with anxiety or depression, and the paper identifies acts of kindness among its activities. That provides some relevant grounding for social activity in depression, but the paper does not establish that the citing authors’ 6-week iMAP protocols for sleep, exercise, diet, or social connection were based on evidence-based protocols in those domains. (LLM, conf=0.82)

    Experimental — accuracy not yet measured

  • Improvements in all lifestyle domains targeted are associated with improvements in the QOL mental component summary measure.

    “This is aligned with evidence showing that improvements in all lifestyle domains that we targeted is associated with improvements in the QOL mental component summary measure [5, 6, 70, 81, 82].”

    From Personalized machine learning guided intervention for optimizing lifestyle behaviors in depression: a pilot study (2026) · cites this paper as [70]

    The Results > Main Treatment Effects section reports greater psychological well-being after the positive activity intervention, and Method > Measures identifies a quality-of-life questionnaire as one measure of that outcome (pages unavailable). The paper does not report improvements in all targeted lifestyle domains or an association with a QOL mental component summary measure. (LLM, conf=0.82)

    Experimental — accuracy not yet measured

  • Positive emotions alleviate the effects of negative emotions that are considered the root of anxiety and depressive disorders and promote resilience and positive mental health.

    “They alleviate the effects of negative emotions that are considered the root of anxiety and depressive disorders and promote resilience and positive MH [70-72].”

    From Optimization of a Transdiagnostic Mobile Emotion Regulation Intervention for University Students: Protocol for a Microrandomized Trial (2023) · cites this paper as [71]

    The passage labeled Abstract > Conclusions says positive emotions mitigate the effects of negative emotions and promote resilience and psychological well-being. It calls negative emotions defining features of anxiety and depressive disorders, but does not identify them as the root cause of those disorders. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

  • Positive emotions play an important role in people's well-being.

    “Positive emotions play an important role in people’s well-being.”

    From Optimization of a Transdiagnostic Mobile Emotion Regulation Intervention for University Students: Protocol for a Microrandomized Trial (2023) · cites this paper as [71]

The citation lists haven’t been fetched yet

References 134 · Cited by 233

Research works printed but not linked: 2

  1. Dillon, 2014, Peril and pleasure: An RDoC-inspired examination of threat responses and reward processing in anxiety and depression, Depression and Anxiety, 31, 233
  2. Watson, 1988, Development and validation of brief measures of positive and negative affect: The PANAS scales, Journal of Personality and Social Psychology, 54, 1063, 10.1037/0022-3514.54.6.1063 · DOI · Paper page

Authors
Taylor, C. T., Lyubomirsky, S., & Stein, M. B.
Affiliations
  • University of California San Diego (US)
  • University of California, Riverside (US)
Corresponding author
Taylor, Charles T.
ORCID
Venue
Depression and Anxiety
Publisher
Wiley
Published
2017-01-06
Volume
34
Issue
3
Pages
267-280
ISSN
1091-4269 (ISSN-L)
DOI
10.1002/da.22593
PMC
PMC7266488
OpenAlex
W2570189350
Cited by
233
References
134
Citations by year
2026: 18 · 2025: 26 · 2024: 45 · 2023: 28 · 2022: 27 · 2021: 33 · 2020: 25 · 2019: 15 · 2018: 11 · 2017: 5
FWCI
21.94
Type
journal article
Language
en
Open access
Licence
Locations
  • Depression and Anxiety (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
  • University of California, San Diego
  • National Institutes of Health (UL1TR001442)
Topics
  • Social Sciences › Psychology › Social Psychology › Psychological Well-being and Life Satisfaction
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Keywords
anxiety, depression, positive emotions, psychological well-being, negative affect, gratitude, optimism, acts of kindness, transdiagnostic treatment
MeSH terms
Adult, Affect, Anxiety Disorders, Depressive Disorder, Female, Humans, Male, Pilot Projects, Psychotherapy, Up-Regulation, Treatment Outcome

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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-09.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-09.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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