DALLAS (SMU) – Researchers at SMU and UCLA are enrolling subjects for a five-year study of a treatment for a psychological condition known as anhedonia – the inability to find pleasure in any aspect of life. A grant of approximately $4 million from the National Institute of Mental Health will allow professors Alicia Meuret and Thomas Ritz at SMU and Michelle G. Craske at UCLA to study the effectiveness of their treatment in 168 people suffering from this very specific symptom.
“The goal of this novel therapeutic approach is to train people to develop psychological muscle memory – to learn again how to experience joy and identify that experience when it occurs,” said Meuret, professor of psychology and director of SMU’s Anxiety and Depression Research Center. “Anhedonia is an aspect of depression, but it also is a symptom that really reaches across psychiatric and non-psychiatric disorders. It’s the absence or the lack of experiencing rewards.”
People suffering from depression often report feeling down or blue, loss of appetite and having difficulty sleeping or concentrating, all described generally as “negative affect.” Meuret explained that there is another other side to depression – the reduction of all that is positive. This reveals itself in someone who says he or she is not especially anxious or depressed, but nothing gives them joy anymore.
“They don’t feel motivated to do anything, and when they do things that formerly gave them pleasure, they just don’t enjoy them anymore,” Meuret said. “We call that a deficit in the reward system – a reduction to reward sensitivity.”
Historically, treatments for affective disorders such as anxiety and depression have been aimed at reducing negative affect, Meuret said. Over the next five years, Meuret, Ritz and Craske will treat 168 people using a type of cognitive behavioral therapy aimed at teaching people to seek out and recognize the positive aspects of life – increasing their sensitivity to reward. They will compare their results with a more traditional approach of treating the negative affect side of their problems.
The monitoring of treatment success will include simple biomarkers of enjoyment. “The heart beats faster in joy, something that has been shown to be absent in anhedonia,” said Ritz, an SMU professor of psychology who specializes in studying the relationship between biology and psychology in affective disorders and chronic disease. Other measures will capture immune activity, which is important as an indicator of long-term health.
Clinical psychology graduate students working on the project are Juliet Kroll, Divya Kumar, Natalie Tunnell, Anni Hasration, Andres Roques and Rebecca Kim, a recent SMU alumna, who will coordinate the day-to-day administration of the project.
Those interested in participating in the study may phone Rebecca Kim at 214-768-2188 or fill out the pre-screen form here.
The NIMH-funded study will follow the training framework of an SMU-UCLA pilot study conducted from 2014-2018:
- The first half of the treatments are targeted at changing behavior, using strategies where the patient learns to seek out pleasant activities that they have previously enjoyed. Scheduled “homework” records that they list their mood before and after the activity, savoring the pleasurable moments in these activities. When resuming a session, the patient recalls the activity as if experiencing it in real time, such as, “I see Amy. I feel a connection with her. We walk on the street, and I can see the leaves changing.”
- Cognitive training provides exercises that identify the positive aspects of various activities, taking responsibility for those activities and imagining what they would feel like.
- The last module is compassion training, helping the patient to again learn to share love and kindness with another person, cultivating gratitude and generosity and learning to generate and savor positive feelings in the moment.
“Rather than saying to our patients, ‘Let me help you feel less bad,’ we are saying, ‘Let me help you re-learn how to feel good,” Meuret said. “It’s very rewarding as a researcher psychologist that these patients can feel again – feel something positive. I think there’s nothing worse than losing this sense of reward.”