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Cited by 53Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesTreatment of Major DepressionPsychotherapy Techniques and Applications

Amplification of Positivity Treatment for Anxiety and Depression: A Randomized Experimental Therapeutics Trial Targeting Social Reward Sensitivity to Enhance Social Connectedness

Open access
Taylor, Charles T., Stein, Murray B., Simmons, Alan N., He, Feng, Oveis, Christopher, Shakya, Holly B., Sieber, William J., Fowler, James H. +1 more·2024·Biological Psychiatry
DOI 10.1016/j.biopsych.2023.07.024PMC PMC12063735
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Abstract

BACKGROUND: Social disconnection is common and causes significant impairment in anxiety and depressive disorders, and it does not respond sufficiently to available treatments. The positive valence system supports social bond formation and maintenance but is often hyporesponsive in people with anxiety or depression. We conducted an experimental therapeutics trial to test the hypothesis that targeting positive valence processes through cognitive and behavioral strategies would enhance responsivity to social rewards, a core mechanism underlying social connectedness. METHODS: Sixty-eight adults who endorsed clinically elevated anxiety and/or depression with social impairment were randomized 1:1:1 to 5 (n = 23) or 10 (n = 22) sessions of amplification of positivity (AMP) treatment or waitlist (n = 23). Pre- to posttreatment change in striatal activity (primary outcome) during social reward anticipation was measured using functional magnetic resonance imaging, and reactivity to a social affiliation task (secondary) and self-reported social connectedness (exploratory) were examined. Primary analyses compared AMP (doses combined) versus waitlist. A second aim was to compare the effects of different doses. RESULTS: AMP engaged the hypothesized treatment target, leading to greater striatal activation during anticipation of social rewards versus waitlist (d = 1.01 [95% CI = 0.42-1.61]; largest striatal volume). AMP yielded larger improvements in positive affect and approach behavior during the affiliation task (but not other outcomes) and social connectedness. Larger striatal and social connectedness increases were observed for 5-session versus 10-session AMP (d range = 0.08-1.03). CONCLUSIONS: Teaching people with anxiety or depression strategies to increase positive thoughts, behaviors, and emotions enhances activity in brain regions that govern social reward processing and promotes social connectedness. Social reward sensitivity may be a transdiagnostic target for remediating social disconnection.

AI snapshot

Written from the paper’s full text.

TL;DR

In a three-arm randomized experimental therapeutics trial, Amplification of Positivity (AMP) engaged the hypothesized social reward target by increasing striatal activation during social reward anticipation versus waitlist in adults with clinically elevated anxiety/depression and social impairment. AMP also improved some social affiliation task outcomes and social connectedness, with larger effects for 5- versus 10-session AMP.

Key findings

  • AMP (doses combined) produced greater pre-to-post striatal activation during social reward anticipation than waitlist, with a large effect: d=1.01 [95% CI 0.42, 1.61], largest striatal volume; significant clusters included left nucleus accumbens, bilateral caudate, and bilateral putamen.
  • AMP showed larger improvements than waitlist on post-conversation positive affect (d=0.62 [0.06, 1.18]) and social approach behavior (d=0.65 [0.09, 1.21]), but not RSA reactivity, positive facial expressions, or future approach motivation.
  • Social connectedness improved more with AMP than waitlist: NIH Friendship b=3.22, se=1.09, t(57)=2.95, p=.005, d=0.80 [0.24, 1.37]; SCSR b=12.24, se=2.98, t(57)=4.11, p<.001, d=1.12 [0.54, 1.70]; loneliness decreased: b=−4.02, se=1.00, t(57)=−4.03, p<.001, d=−1.10 [−1.68, −0.52].
  • The 5-session AMP protocol showed larger increases across all striatal regions than 10-session AMP (d range=0.08–1.03; 5>10-session), with similar dose effects on social affiliation and key social connectedness outcomes.

Methods

  • N=68 adults with clinically elevated anxiety and/or depression plus social impairment were randomized 1:1:1 to 5-session AMP (n=23), 10-session AMP (n=22), or waitlist (n=23); enrollment occurred April 2018–July 2019.
  • Primary outcome was pre-to-post change in striatal activity during social reward anticipation on a Social Incentive Delay fMRI task; secondary outcomes came from an 18-minute social affiliation task, and exploratory outcomes included social connectedness, symptoms, functioning, and well-being.
  • Primary analyses compared AMP (doses combined) vs. waitlist using a voxel-wise generalized linear model within a striatum mask (AFNI 3dLME; voxel-wise p=.005, corrected cluster-wise p=.05); secondary/exploratory outcomes used linear mixed models, with Cohen’s d and 95% CIs reported.

Limitations

  • The paper states the trial was small, not powered to test clinical efficacy, and compared AMP primarily against waitlist; it calls for replication in a larger sample with a control condition accounting for common therapeutic effects.
  • The paper notes the sample was majority female, treatment target measures used static smiling faces and a contrived social context, and social connectedness/symptom outcomes relied on self-report; dose was limited to two levels and it remains unknown for whom 5- vs. 10-session AMP is optimal.
  • The paper also states there was no correction for multiple comparisons for secondary or exploratory outcomes; evident from the text, treatment assignment was blinded to experimental personnel but not to participants or clinicians, and AMP participants had higher baseline PHQ-9 scores than waitlist (p=.037).

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

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Registry

Crossref · 10.1016/j.biopsych.2023.07.024

Cites

74 of 74 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

0 of 83 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    AMP yielded significantly larger pre- to post-treatment increases in social approach behaviors compared to waitlist (d=0.65, 95% CI [0.09, 1.21]).

    “Group x Time interaction terms revealed significantly larger pre- to post-treatment increases in post-conversation positive affect, d=0.62, 95% CI [0.06, 1.18] and social approach behaviors, d=0.65, 95% CI [0.09, 1.21] for AMP vs. waitlist participants.”
    Quote in the paperSubstantial claim
  • Findingown data

    AMP yielded significantly larger pre- to post-treatment increases in post-conversation positive affect compared to waitlist (d=0.62, 95% CI [0.06, 1.18]).

    “Group x Time interaction terms revealed significantly larger pre- to post-treatment increases in post-conversation positive affect, d=0.62, 95% CI [0.06, 1.18] and social approach behaviors, d=0.65, 95% CI [0.09, 1.21] for AMP vs. waitlist participants.”
    Quote in the paperSubstantial claim
  • Findingown data

    The largest cluster emerging from the Group x Time analysis was in the right putamen (86 voxels, x=25, y=1, z=2).

    “Figure 2 illustrates activation differences by group within the largest cluster emerging from this analysis (right putamen, 86 voxels, x=25, y=1, z=2).”
    Quote in the paperNot a substantial claim
  • Findingown data

    The Group x Time interaction was not significant for RSA reactivity (d=0.50, 95% CI [−0.06, 1.05]).

    “The Group x Time interaction was not significant for RSA reactivity, d=0.50, 95% CI [−0.06, 1.05], positive facial expressions, d=−0.07, 95% CI [−0.62, 0.47], or future approach motivation, d=−0.23, 95% CI [−0.78, 0.31].”
    Quote in the paperNot a substantial claim
  • Findingown data

    AMP yielded significantly larger increases in social connectedness on the SCSR compared to waitlist (b=12.24, se=2.98, t(57)=4.11, p<.001, d=1.12, 95% CI [0.54, 1.70]).

    “Group x Time interactions revealed significantly larger AMP vs. waitlist increases in social connectedness (NIH Friendship: b=3.22, se=1.09, t(57)=2.95, p=.005, d=0.80, 95% CI [0.24, 1.37]; SCSR: b=12.24, se=2.98, t(57)=4.11, p<.001, d=1.12, 95% CI [0.54, 1.70]) and decreases in loneliness, b=−4.02, se=1.00, t(57)=−4.03, p<.001, d=−1.10, 95% CI [−1.68, −0.52].”
    Quote in the paperSubstantial claim
  • The quote only partly states this claim. 2
  • May combine two claims. 28
  • Classified as probably not a substantial claim. 24

  • The quote only partly states this claim.

    Findingown data

    AMP participants displayed significantly greater pre- to post-treatment activation increases in several striatal regions, including the left NAcc, bilateral caudate, and bilateral putamen compared to waitlist (d=1.01 [95% CI 0.42, 1.61]).

    “The Group x Time linear mixed effects analysis revealed that AMP participants displayed significantly greater pre- to post-treatment activation increases in several striatal regions, including the left NAcc, bilateral caudate, and bilateral putamen compared to waitlist.”
    • Also stated in: § Results: · plain
      “AMP engaged the hypothesized treatment target – leading to greater striatal activation during anticipation of social rewards versus waitlist (d=1.01 [95% CI 0.42, 1.61]; largest striatal volume).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    AMP yielded significantly larger improvements than waitlist on measures of anxiety, depression, positive and negative affect, functional interference, satisfaction with social roles and activities, and meaning and purpose (all p<.05).

    “Significantly larger AMP vs. waitlist improvements were observed on measures of anxiety, depression, positive and negative affect, functional interference, satisfaction with social roles and activities, and meaning and purpose (all p<.05).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Groups did not significantly differ on changes in satisfaction with discretionary social activities, perceived emotional support, or general life satisfaction (p>.05), though mean improvements favored AMP vs. waitlist.

    “Groups did not significantly differ on changes in satisfaction with discretionary social activities, perceived emotional support, or general life satisfaction (p>.05), though mean improvements favored AMP vs. waitlist.”
    Quote in the paperNot a substantial claim

  • The quote only partly states this claim.

    Findingown data

    Similar dose effects (5>10) were observed across social affiliation task outcomes and key social connectedness exploratory outcomes.

    “Similar dose effects were observed across social affiliation task outcomes and key social connectedness exploratory outcomes.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    AMP increased positive affect and social approach behavior during a dyadic affiliation task compared to waitlist, with medium-to-large effect size differences.

    “AMP also increased positive affect and social approach behavior during a dyadic affiliation task compared to waitlist (medium-to-large effect size differences)”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    AMP-related improvements were observed across measures of positive and negative affect, anxiety and depression symptoms, functional interference, and psychological well-being.

    “AMP-related improvements were also observed across measures of positive and negative affect, anxiety and depression symptoms, functional interference, and psychological well-being.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Groups did not differ on change in RSA reactivity, positive facial expressions, or desire for future interaction, despite medium (RSA) and small (other) group differences.

    “Groups did not differ, however, on change in RSA reactivity (medium sized group difference; AMP>WL), positive facial expressions or desire for future interaction (small group differences).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Social disconnection is common and impairing in anxiety and depressive disorders.

    “Social disconnection – both perceived and actual – is a common and disabling feature of anxiety and depressive disorders(1) that diminishes quality of life.(2, 3)”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [1] Saris, 2017, Social functioning in patients with depressive and anxiety disorders, Acta Psychiatr Scand source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Approach behaviors elicit affiliative reactions from others that generate positive emotions and increase motivation to connect with others in the future.

    “Approach behaviors elicit affiliative reactions from others(9, 12, 13) that generate positive emotions and increase motivation to connect with others in the future.(14, 15)”
    Quote in the paperSubstantial claim0 of 5 sources checked
    • cites [9] Laurenceau, 1998, Intimacy as an interpersonal process: The importance of self-disclosure, partner disclosure, and perceived partner responsiveness in interpersonal exchanges, J Pers Soc Psychol source

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    • cites [12] Maisel, 2008, Responsive behaviors in good times and in bad, Pers Relationship source

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    • cites [13] Taylor, 2011, To see ourselves as others see us: An experimental integration of the intra and interpersonal consequences of self-protection in social anxiety disorder, J Abnorm Psychol source

      Not checked in the free run.

    • cites [14] Taylor, 2017, The affective tie that binds: Examining the contribution of positive emotions and anxiety to relationship formation in social anxiety disorder, J Anxiety Disord source

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    • cites [15] Vittengl, 2000, Getting acquainted: The relationship of self-disclosure and social attraction to positive affect, J Soc Pers Relat source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    Social approach motivation encourages behavior directed toward pursuing social connection, including displays of active engagement and responsiveness.

    “Social approach motivation is characterized by the desire to connect with others; it encourages behavior directed toward pursuing social connection,(7) including displays of active engagement and responsiveness(9) (e.g., self-disclosure,(10) positive emotional expressions(11)).”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [7] Gable, 2008, Making connections and avoiding loneliness: Approach and avoidance social motives and goals

      Not checked in the free run.

    • cites [9] Laurenceau, 1998, Intimacy as an interpersonal process: The importance of self-disclosure, partner disclosure, and perceived partner responsiveness in interpersonal exchanges, J Pers Soc Psychol source

      Not checked in the free run.

    • cites [10] Aron, 1997, The experimental generation of interpersonal closeness: A procedure and some preliminary findings, Pers Soc Psychol Bull source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    People diagnosed with anxiety or depression experience social anhedonia, which is associated with greater social impairments, even controlling for anxiety and depression severity.

    “People diagnosed with these conditions also experience social anhedonia – loss of interest in pursuing or pleasure in response to social activities – which is associated with greater social impairments,(31) even controlling for anxiety and depression severity.(32)”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [31] Barkus, 2019, A transdiagnostic perspective on social anhedonia, Front Psychiatry source

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    • cites [32] Olson, 2021, Social anhedonia is associated with low social network diversity in trauma-exposed adults, J Trauma Stress source

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  • May combine two claims.

    Premisecitation

    Hypo-responsivity of the positive valence system characterizes depression and some forms of anxiety, evidenced by low positive affect, diminished approach motivation and behavior, and reduced activation in mesolimbic circuits during reward processing, including anticipation of social rewards.

    “Hypo-responsivity of the positive valence system characterizes depression(22) and some forms of anxiety(23) (most notably social anxiety disorder(24) and post-traumatic stress disorder(25)) – evidenced by low positive affect,(24) diminished approach motivation and behavior,(26, 27) and reduced activation in mesolimbic circuits during reward processing,(25, 28) including anticipation of social Rewa”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [22] Whitton, 2022, Anhedonia in depression and bipolar disorder, Curr Top Behav Neurosci source

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    • cites [23] Taylor, 2022, Anhedonia in anxiety disorders, Curr Top Behav Neurosci source

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    • cites [24] Kashdan, 2007, Social anxiety spectrum and diminished positive experiences: Theoretical synthesis and meta-analysis, Clin Psychol Rev source

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  • May combine two claims.

    Premisecitation

    Engaging in kind acts and savoring positive memories activate the striatum.

    “For example, engaging in kind acts (charitable donation)(41) and savoring positive memories(42) activate the striatum.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [41] Moll, 2006, Human fronto-mesolimbic networks guide decisions about charitable donation, Proc Natl Acad Sci USA source

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    • cites [42] Speer, 2014, Savoring the past: Positive memories evoke value representations in the striatum, Neuron source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    Amplification of Positivity comprises cognitive and behavioral strategies targeting positive valence thoughts, behaviors, and emotions through repeated practices.

    “Amplification of Positivity (AMP) was developed to address this gap.(37) It comprises cognitive and behavioral strategies (i.e., Positive Activity Interventions)(38–40) targeting positive valence thoughts, behaviors, and emotions through repeated practices, including noticing and amplifying responsivity to positive events (e.g., savoring, reminiscing, disclosing positive events to others),”
    Quote in the paperSubstantial claim0 of 4 sources checked
    • cites [37] Taylor, 2017, Upregulating the positive affect system in anxiety and depression: Outcomes of a positive activity intervention, Depress Anxiety source

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    • cites [38] Layous, 2014, Positive activities as protective factors against mental health conditions, J Abnorm Psychol source

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    • cites [39] Lyubomirsky, 2013, How do simple positive activities increase well-being?, Curr Dir Psychol Sci source

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    • cites [40] Seligman, 2005, Positive psychology progress: Empirical validation of interventions, Am Psychol source

      Not checked in the free run.

    • Rests on an assumption: AMP strategies are not routinely part of extant evidence-based treatments for anxiety or depression.

  • May combine two claims.

    Premisecitation

    Reliability of difference scores is always lower than reliability of their individual parts, which has been shown to diminish reliability of task-based fMRI and hinder mechanistic research.

    “This contrast was used (cf. anticipation of social reward minus neutral outcomes) because reliability of difference scores is always lower than reliability of their individual parts,(53) which has been shown to diminish reliability of task-based fMRI(54) (see also(55)) and hinder mechanistic research.(56)”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [53] Hedge, 2018, The reliability paradox: Why robust cognitive tasks do not produce reliable individual differences, Behav Res Methods source

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    • cites [54] Infantolino, 2018, Robust is not necessarily reliable: From within-subjects fMRI contrasts to between-subjects comparisons, NeuroImage source

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    • cites [55] Elliott, 2020, What is the test–retest reliability of common task-functional MRI measures? New empirical evidence and a meta-analysis, Psychol Sci source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Initial evidence in those seeking treatment for anxiety or depression revealed large increases in positive affect and social connectedness following 10 sessions of AMP compared to waitlist.

    “Initial evidence in those seeking treatment for anxiety or depression revealed large increases in positive affect(37) and social connectedness(45) following 10-sessions of AMP compared to waitlist, with session-by-session improvements in connectedness”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [37] Taylor, 2017, Upregulating the positive affect system in anxiety and depression: Outcomes of a positive activity intervention, Depress Anxiety source

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    • cites [45] Taylor, 2020, Enhancing social connectedness in anxiety and depression through amplification of positivity: Preliminary treatment outcomes and process of change, Cognit Ther Res source

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  • May combine two claims.

    Premisecitation

    Gratitude has positive dyadic effects: its experience induces social approach behaviors toward one's benefactor, while its expression elicits approach behaviors from the benefactor toward the expressor.

    “Gratitude has positive dyadic effects: its experience induces social approach behaviors toward one’s benefactor,(43) while its expression elicits approach behaviors from the benefactor toward the expressor.(44)”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [43] Bartlett, 2012, Gratitude: Prompting behaviours that build relationships, Cogn Emot source

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    • cites [44] Williams, 2015, Warm thanks: Gratitude expression facilitates social affiliation in new relationships via perceived warmth, Emotion source

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

    Study design and conductnone given

    The study was a priori powered assuming 15% attrition and alpha=0.05 using a two-sided, two-sample t-test, planning to enroll 71 subjects to have an evaluable sample size of 60 (40 AMP, 20 WL), which would provide 80% power to detect a standardized change between groups of 78%.

    “The study was a priori powered assuming 15% attrition and alpha=0.05 using a two-sided, two-sample t-test. We therefore planned to enroll 71 subjects to have an evaluable sample size of 60 (40 AMP, 20 WL), which would provide 80% power to detect a standardized change between groups of 78%.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductown data

    Participants were randomized 1:1:1 to AMP (5 or 10 sessions) or waitlist using a randomly permuted block design.

    “Participants were then randomized 1:1:1 to AMP (5 or 10 sessions) or waitlist using a randomly permuted block design.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    All randomized participants who had baseline and at least one post-baseline measurement were included in the analysis (modified intent-to-treat).

    “All randomized participants who had baseline and at least one post-baseline measurement were included in the analysis (modified intent-to-treat).”
    Quote in the paperSubstantial claim

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

    Study design and conductown data

    There were 37/45 (82%) AMP completers and 21/23 (91%) waitlist completers.

    “There were 37/45 (82%) AMP completers and 21/23 (91%) waitlist completers.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    Groups did not differ on baseline characteristics (all ps>.10), except AMP participants had higher PHQ-9 scores vs. waitlist (p=.037).

    “Groups did not differ on baseline characteristics (all ps>.10), except AMP participants had higher PHQ-9 scores vs. waitlist (p=.037).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    The 5- and 10-session AMP arms did not differ significantly on treatment credibility, expectancy, homework compliance from weeks 2-5, or working alliance.

    “The 5- and 10-session AMP arms did not differ significantly on treatment credibility (p=.60) or expectancy (p=.81), homework compliance from weeks 2–5 (p>.05) or working alliance (all p>.05).”
    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 assignment was blinded to experimental personnel (e.g., confederates, fMRI operators) though not to participants or clinicians.

    “Treatment assignment was blinded to experimental personnel (e.g., confederates, fMRI operators) though not to participants or clinicians.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductcitation

    Permutation testing within AFNI's 3dClustSim was used to mitigate identifying false positive activations within the striatum mask.

    “Permutation testing within AFNI’s 3dClustSim(63) was used to mitigate identifying false positive activations within the striatum mask (voxel-wise a priori probability of .005 with corrected cluster-wise activation probability of 0.05).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [63] Cox, 1996, AFNI: Software for analysis and visualization of functional magnetic resonance neuroimages, Comput Biomed Res source

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    Study design and conductreasoning

    There was no correction for multiple comparisons for secondary or exploratory outcomes because this early phase trial was intended to inform measurement decisions in future work.

    “There was no correction for multiple comparisons for secondary or exploratory outcomes because this early phase trial was intended to inform measurement decisions in future work.”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    Treatment adherence was uniformly high.

    “Treatment adherence was uniformly high (see Supplemental Results).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    There were two adverse events - both mild (presence of suicidal ideation without intent) occurring in 10-session AMP and deemed unrelated to the intervention.

    “There were two adverse events – both mild (presence of suicidal ideation without intent) occurring in 10-session AMP and deemed unrelated to the intervention.”
    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

    Since all baseline demographic variables were balanced between the arms, they were not included in the model as covariates.

    “Since all baseline demographic variables were balanced between the arms, they were not included in the model.”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    Randomization was stratified by sex assigned at birth and social connectedness (SCSR ≥ 60 vs. ≤ 59).

    “Stratification factors were sex assigned at birth and social connectedness (SCSR ≥ 60 vs. ≤ 59).”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    Data from n=4 participants was removed (blind to treatment assignment) due to poor quality.

    “Data from n=4 participants was removed (blind to treatment assignment) due to poor quality (see Supplemental Materials).”
    Quote in the paperNot a substantial claim

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

    Premisecitation

    The ventral striatum (nucleus accumbens) codes the value of stimuli, shaping reward expectations and approach motivation.

    “The ventral striatum (comprised of the nucleus accumbens) codes the value of stimuli – shaping reward expectations and approach motivation”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [16] Bhanji, 2014, The social brain and reward: Social information processing in the human striatum, Wiley Interdiscip Rev Cogn Sci source

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    Teaching people with anxiety or depression strategies to increase positive thoughts, behaviors, and emotions enhances activity in brain regions governing social reward processing and promotes social connectedness.

    “Teaching people with anxiety or depression strategies to increase positive thoughts, behaviors, and emotions enhances activity in brain regions governing social reward processing and promotes social connectedness.”
    Quote in the paperSubstantial claim

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

    Premisecitation

    Social reward processing is multifaceted, involving different phases (e.g., anticipation, responsiveness) and brain regions outside of the striatum (e.g., anterior insula, anterior cingulate cortex).

    “social reward processing is multifaceted, involving different phases (e.g., anticipation, responsiveness) and brain regions outside of the striatum (e.g., anterior insula, anterior cingulate cortex).(18)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [18] Martins, 2021, Mapping social reward and punishment processing in the human brain: A voxel-based meta-analysis of neuroimaging findings using the social incentive delay task, Neurosci Biobehav Rev source

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    AMP may offer a new approach for remediating social disconnection in anxiety and depressive disorders, and possibly other psychiatric conditions characterized by diminished social reward responsivity.

    “AMP may therefore offer a new approach for remediating social disconnection in anxiety and depressive disorders, and possibly other psychiatric conditions characterized by diminished social reward responsivity.(31)”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [31] Barkus, 2019, A transdiagnostic perspective on social anhedonia, Front Psychiatry source

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  • Probably not a substantial claim: may not pass S2 (checkable).

    Premisecitation

    The experimental therapeutics framework necessitates focus on a central treatment target to inform next step decisions about treatment evaluation.

    “the experimental therapeutics framework necessitates focus on a central treatment target to inform next step decisions about treatment evaluation,(46)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [46] Insel, 2015, The NIMH experimental medicine initiative, World Psychiatry source

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

    Premisecitation

    The dorsal striatum (caudate and putamen) is involved in action selection and motor behavior, guiding pursuit of anticipated reward outcomes.

    “the dorsal striatum (comprised of the caudate and putamen) is involved in action selection and motor behavior – guiding pursuit of anticipated reward outcomes.(16)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [16] Bhanji, 2014, The social brain and reward: Social information processing in the human striatum, Wiley Interdiscip Rev Cogn Sci source

      Not checked in the free run.

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

    Interpretationcitation

    Parsimony may have facilitated deeper learning of core skills with greater opportunities to personalize them.

    “Parsimony may have facilitated deeper learning of core skills with greater opportunities to personalize them.(65)”
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    • cites [65] Cougle, 2012, What makes a quality therapy? A consideration of parsimony, ease, and efficiency, Behav Ther source

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    Premisecitation

    Desire for future interaction is likely influenced by multiple factors, including general motivational tendencies, specific qualities of the interaction partner, subjective affect following the encounter, and the future social context being considered.

    “desire for future interaction is likely influenced by multiple factors, including general motivational tendencies (e.g., approach vs. avoidance), specific qualities of the interaction partner, subjective affect following the encounter(14) and the future social context being considered (e.g., asking for advice vs. becoming friends).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [14] Taylor, 2017, The affective tie that binds: Examining the contribution of positive emotions and anxiety to relationship formation in social anxiety disorder, J Anxiety Disord source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductnone given

    This trial is limited by how dose was conceptualized and by comparing only two dosing levels.

    “This trial is of course limited by how dose was conceptualized and by comparing only two dosing levels.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable).

    Premisecitation

    Evaluating the requisite dose or duration of treatment could help develop interventions with potential for maximal clinical impact.

    “doing so could help develop interventions with potential for maximal clinical impact.(65)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [65] Cougle, 2012, What makes a quality therapy? A consideration of parsimony, ease, and efficiency, Behav Ther source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    The primary AMP comparison was against waitlist.

    “the primary AMP comparison was against waitlist.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductreasoning

    Measures of the treatment target were limited by presenting participants static images of smiling faces and having them engage in a contrived, circumscribed social context.

    “Measures of the treatment target were limited by presenting participants static images of smiling faces (cf. dynamic social cues encountered in real-life) and having them engage in a contrived, circumscribed social context.”
    Quote in the paperNot a substantial claim

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

    Premisecitation

    There is evidence of sex differences in sensitivity to social reward cues.

    “evidence pointing to sex differences in sensitivity to social reward cues(52)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [52] Spreckelmeyer, 2009, Anticipation of monetary and social reward differently activates mesolimbic brain structures in men and women, Soc Cogn Affect Neurosci source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    Measurement of social connectedness and symptom outcomes relied on self-report.

    “Measurement of social connectedness and symptom outcomes relied on self-report.”
    Quote in the paperSubstantial claim

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

    Premisecitation

    Heightened sensitivity to aversive social outcomes may be a more influential mechanism in others.

    “heightened sensitivity to aversive social outcomes may be a more influential mechanism in others.(3)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [3] Taylor, 2020, A tale of two systems: Testing a positive and negative valence systems framework to understand social disconnection across anxiety and depressive disorders, J Affect Disord source

      Not checked in the free run.

46 of 46

  • The paper relies on this without support.

    AMP strategies are not routinely part of extant evidence-based treatments for anxiety or depression.

    “These strategies are not routinely part of extant evidence-based treatments for anxiety or depression.”

  • The paper relies on this without support.

    Anticipatory processing of social reward cues sets into motion the chain of events supporting the pursuit of valued outcomes, including social connection.

    “Anticipatory processing of social reward cues was chosen as the primary outcome because it sets into motion the chain of events supporting the pursuit of valued outcomes, including social connection.”

  • The paper relies on this without support.

    Social disconnection is common in anxiety and depressive disorders.

    “Social disconnection is common in anxiety and depressive disorders”

  • The paper relies on this without support.

    Social disconnection does not improve sufficiently following first-line treatments.

    “does not improve sufficiently following first-line treatments.”

  • The paper relies on this without support.

    Functions served by each striatal subdivision are engaged during the social incentive delay task and social connection opportunities more broadly.

    “Functions served by each subdivision are engaged during the social incentive delay task as well as social connection opportunities more broadly.”

  • The paper relies on this without support.

    The mechanisms underlying social functioning impairments likely vary across individuals.

    “the mechanisms underlying those impairments likely vary across individuals.”
6 of 6

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?

  • Physical activity/exercise, dietary modification, adequate sleep, social interaction, and mindfulness-based meditation have shown treatment efficacy in separate clinical trials of depression.

    “These include physical activity/exercise, dietary modification, adequate sleep and social interaction, as well as mindfulness-based meditation, all of which have shown treatment efficacy in separate clinical trials of depression [4–16].”

    From Personalized machine learning guided intervention for optimizing lifestyle behaviors in depression: a pilot study (2026) · cites this paper as [8]

    The Results (Other Exploratory Outcomes; page unavailable) report significantly greater improvement in depression with Amplification of Positivity (AMP) than with a waitlist. The Methods (Treatment; page unavailable) describe AMP as a multi-component intervention that includes socially oriented acts of kindness, not a trial of social interaction alone. This paper therefore supports efficacy for AMP, but not the claim that social interaction independently showed treatment efficacy. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

  • Lifestyle targeted behavioral interventions in depression have typically shown small-to-medium effect sizes of ~0.3-0.5, while the placebo effect of behavioral interventions is even smaller ~0.2 in RCTs.

    “Lifestyle targeted behavioral interventions in depression have typically shown small-to-medium effect sizes of ~0.3–0.5 [4–16], while the placebo effect of behavioral interventions are even smaller ~0.2 in RCTs [101, 102].”

    From Personalized machine learning guided intervention for optimizing lifestyle behaviors in depression: a pilot study (2026) · cites this paper as [8]

    The Treatment and Other Exploratory Outcomes sections describe a behavioral intervention and report greater improvement in depression symptoms than with waitlist. But the paper does not establish that such interventions typically have effect sizes of 0.3–0.5: the d=0.4 in Current Study was a prespecified criterion for comparing treatment lengths, not an observed depression effect. The placebo estimate is attached to different citations in the citing sentence. (LLM, conf=0.82)

    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 [8]

Statistics recomputed

Every reported test result, recomputed from its test statistic and degrees of freedom. A result shows as not adding up only once an independent check has confirmed it.

  • Consistentt(57) = 2.95reported p = .005 · recomputed p = .005

    “t(57)=2.95, p = .005”

  • Consistentt(57) = 4.11reported p < .001 · recomputed p < .001

    “t(57)=4.11, p < .001”

  • Consistentt(57) = -4.03reported p < .001 · recomputed p < .001

    “t(57)=−4.03, p < .001”

3 of 3

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Self-check results appear here once an independent check has confirmed them.

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Related

Authors
Taylor, C. T., Stein, M. B., Simmons, A. N., He, F., Oveis, C., Shakya, H. B., Sieber, W. J., Fowler, J. H., & Jain, S.
Affiliations
University of California San Diego (US)
Corresponding author
Taylor, Charles T.
ORCID
Venue
Biological Psychiatry
Publisher
Elsevier BV
Published
2024-03
Volume
95
Issue
5
Pages
434-443
ISSN
0006-3223 (ISSN-L)
DOI
10.1016/j.biopsych.2023.07.024
PMC
PMC12063735
OpenAlex
W4386013388
Cited by
53
References
74
Citations by year
2026: 20 · 2025: 16 · 2024: 15 · 2023: 2
FWCI
13.67
Type
journal article
Language
en
Open access
Licence
Locations
  • Biological Psychiatry (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Funders
  • National Institute of Mental Health (R33MH113769)
  • ACADIA Pharmaceuticals (NCT03196544)
  • National Institutes of Health (ULTR001442)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Keywords
anxiety, depression, social connectedness, positive valence systems, striatal activation, social affiliation, treatment dose comparison, social disconnection
MeSH terms
Adult, Anxiety, Anxiety Disorders, Brain, Depression, Humans, Reward

About these checks

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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