Changes in affect during treatment for depression and anxiety

Kring, Ann M.; Persons, Jacqueline B.; Thomas, Cannon

doi:10.1016/j.brat.2007.02.001

Cited by 63Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychotherapy Techniques and ApplicationsMental Health Research Topics

Changes in affect during treatment for depression and anxiety

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Kring, Ann M., Persons, Jacqueline B., Thomas, Cannon·2007·Behaviour Research and Therapy

DOI 10.1016/j.brat.2007.02.001

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Abstract

We tested the hypothesis that the tripartite model [Clark, L. A., & Watson, D. (1991). Tripartite model of anxiety and depression: Psychometric evidence and psychometric implications. Journal of Abnormal Psychology, 100, 316-336] can be extended to account for change during treatment for anxiety and depression. Forty-one patients treated naturalistically in private practice with cognitive behavior therapy completed weekly measures of depression, anxiety, negative affect (NA), positive affect (PA), and anxious arousal (AA). Consistent with the model, NA was associated with anxiety and depression during treatment, PA was more strongly related to depression than to anxiety, and AA was more strongly related to anxiety than to depression. As predicted, symptoms of depression and anxiety and NA all decreased during treatment. As predicted, AA also decreased, particularly for patients with panic disorder. PA increased during treatment, but only for patients who showed a significant decline in depression and only over an extended period of treatment. Nearly two-thirds of the variance in anxiety change was accounted for by changes in depression and NA, and just over three-fourths of the variance in depression change was accounted for by changes in anxiety and NA, indicating that much of the change in anxiety and depression across the course of treatment is shared in common.

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In some cases, prevailing interventions have failed to show evidence of changes in positive affect following treatment, despite significant reductions in anxiety and depression.
“and in some cases, have failed to show evidence of changes following treatment, despite significant reductions in anxiety and depression63.”
From Upregulating the positive affect system in anxiety and depression: Outcomes of a positive activity intervention: <scp>Taylor et al.</scp> (2017) · cites this paper as [63]
First-line treatments do not sufficiently repair positive valence deficits in individuals with anxiety or depression.
“First-line treatments do not sufficiently repair positive valence deficits in individuals with anxiety or depression,(34–36) which may explain in part why social impairments persist following established treatments.(4, 5)”
From Amplification of Positivity Treatment for Anxiety and Depression: A Randomized Experimental Therapeutics Trial Targeting Social Reward Sensitivity to Enhance Social Connectedness (2024) · cites this paper as [35]
In existing treatments for anxiety and depression, improvement in positive affect tends to be modest and does not always match changes in negative affect or symptoms, nor return to normative levels, on average.
“improvement in positive affect tends to be modest and does not always match changes in negative affect or symptoms, nor return to normative levels, on average (Dunn et al., 2020; Kring et al., 2007; Sewart et al., 2019; Strege et al., 2018).”
From Enhancing social connectedness in anxiety and depression through amplification of positivity: Preliminary treatment outcomes and process of change (2020) · cites this paper as Kring et al., 2007
Some patients who undergo anxiety reduction-based treatments may experience little change in positive emotions, even if their anxiety is substantially reduced.
“some patients who undergo anxiety reduction-based treatments may experience little change in positive emotions, even if their anxiety is substantially reduced (e.g., Kring et al., 2007).”
From The affective tie that binds: Examining the contribution of positive emotions and anxiety to relationship formation in social anxiety disorder (2017) · cites this paper as Kring et al., 2007

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Authors: Kring, A. M., Persons, J. B., & Thomas, C.
Affiliations: University of California, Berkeley (US)
Corresponding author: Kring, Ann M.
ORCID: Kring, Ann M.
Venue: Behaviour Research and Therapy
Publisher: Elsevier BV
Published: 2007-08
Volume: 45
Issue: 8
Pages: 1753-1764
ISSN: 0005-7967 (ISSN-L)
DOI: 10.1016/j.brat.2007.02.001
OpenAlex: W2041522599
Cited by: 63
References: 73
Citations by year: 2025: 2 · 2024: 2 · 2023: 1 · 2022: 4 · 2021: 5 · 2020: 8 · 2019: 6 · 2018: 1 · 2017: 5 · 2016: 7 · 2015: 3 · 2014: 2 · 2013: 3 · 2012: 2
FWCI: 4.26
Type: journal article
Language: en
Open access: green
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Behaviour Research and Therapy (publishedVersion)
PubMed (publishedVersion)
PsyArXiv (OSF Preprints) (submittedVersion)
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
Keywords: negative affect, positive affect, anxious arousal, cognitive behavioral therapy, depression, anxiety, panic disorder, treatment response
MeSH terms: Adult, Affect, Anxiety Disorders, Major Depressive Disorder, Female, Humans, Male, Middle Aged, Models, Psychological, Psychiatric Status Rating Scales, Psychometrics, Cognitive Behavioral Therapy, Treatment Outcome

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Changes in affect during treatment for depression and anxiety

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