Elsevier

Behavior Therapy

Volume 48, Issue 1, January 2017, Pages 76-96
Behavior Therapy

An Exploratory Randomized Controlled Trial of Personalized Lifestyle Advice and Tandem Skydives as a Means to Reduce Anhedonia

https://doi.org/10.1016/j.beth.2016.09.009Get rights and content

Highlights

  • We examined the effects of two interventions on pleasure in anhedonic young adults

  • Personalized lifestyle advice was effective in increasing pleasure and PA

  • No additional effects were found of the tandem skydive

  • Our findings are promising for the treatment of anhedonia

  • Momentary interventions could be implemented as an addition to treatment as usual

Abstract

Anhedonia is a major public health concern and has proven particularly difficult to counteract. It has been hypothesized that anhedonia can be deterred by engagement in rewarding social and physical events. The aims of the present study were to examine (1) the effects of personalized lifestyle advice based on observed individual patterns of lifestyle factors and experienced pleasure in anhedonic young adults; and (2) whether a tandem skydive can enhance the motivation to carry out the recommended lifestyle changes. Participants (N = 69; Mage = 21.5, SD = 2.0; 79.7% female) were selected through an online screening survey among young adults. Inclusion criteria were persistent anhedonia and willingness to perform a tandem skydive. Participants filled out questionnaires on their smartphones for 2 consecutive months (3 times per day). After the first month, they were randomly assigned to one of three groups: (1) no intervention, (2) lifestyle advice, and (3) lifestyle advice and tandem skydive. The momentary questionnaire data were analyzed using interrupted time series analyses (ITSA) in a multilevel model and monthly pleasure and depression questionnaires by repeated measures ANOVA. No group differences were found in monthly depression and pleasure scores, but the momentary data showed higher positive affect (PA) and pleasure ratings in the month following the intervention in the two intervention groups than in the control group. The tandem skydive did not have any effects above the effects of the lifestyle advice. Our results indicate that providing personalized lifestyle advice to anhedonic young adults can be an effective way to increase PA and pleasure.

Section snippets

the present study

The first aim of this exploratory study was to examine whether personalized lifestyle advice, based on observed patterns of pleasure and lifestyle factors, can increase pleasure and PA and decrease depressive symptoms and negative affect (NA) in anhedonic young adults. Secondly, we explored the provoking idea that a free fall may foster the implementation of the lifestyle advice, by testing whether lifestyle advice combined with a tandem skydive had a more positive effect than lifestyle advice

participants

Participants were selected through an online screening survey among 2,937 young adults (M age = 21.4 years, SD = 1.9, 78% female) from the northern part of the Netherlands. Inclusion criteria were persistent anhedonia and willingness to perform a skydive. Persistent anhedonia was defined as a pleasure level below the 25th percentile, which was experienced as lower than normal, and lasted for at least 2 months. Hence, the criteria involved not only a low level of pleasure, but also that this low

participant flow

In total, 71 participants started with the momentary assessments (see Figure 2 for a flowchart). Two participants dropped out from the study: one due to problems with mobile data subscription and another because she stopped filling out the momentary assessments. One participant did not partake in the skydive due to the possibility of panic attacks related to skydiving. She only received the lifestyle advice but was maintained in the tandem skydive group in the analyses, in line with the

Discussion

The main aim of this exploratory study was to examine whether personalized lifestyle advice and tandem skydiving could reduce anhedonia in young adults. Although the small sample size warrants prudence, we showed that the lifestyle advice can increase pleasure and PA in young adults with persistent anhedonia. Despite previous literature suggesting that a free-fall may reboot the reward system and could therewith provide additional benefits, we found no evidence of such an additional effect of

Conflict of Interest Statement

The authors declare that there are no conflicts of interest.

References (51)

  • American Psychiatric Association

    Diagnostic and statistical manual of mental disorders

    (2013)
  • I.M. Anderson et al.

    Mechanism of action of ECT

  • E.C. Bennik et al.

    Anhedonia and depressed mood in adolescence: course, stability, and reciprocal relation in the TRAILS study

    European Child & Adolescent Psychiatry

    (2014)
  • P.T. Brandt et al.

    Multiple Time Series Models

    (2007)
  • R.T. Chatterton et al.

    Hormonal Responses to Psychological Stress in Men Preparing for Skydiving

    The Journal of Clinical Endocrinology & Metabolism

    (1997)
  • J. Cohen

    Statistical Power Analysis for the Behavioral Sciences

    (1988)
  • A. Emerencia et al.

    Automating vector autoregression on electronic patient diary data

    IEEE Journal of Biomedical and Health Informatics

    (2015)
  • J. Favrod et al.

    Anticipatory Pleasure Skills Training: A New Intervention to Reduce Anhedonia in Schizophrenia

    Perspectives in Psychiatric Care

    (2010)
  • J. Favrod et al.

    Positive Emotions Program for Schizophrenia (PEPS): A pilot intervention to reduce anhedonia and apathy

    BMC Psychiatry

    (2015)
  • P. Fusar-Poli et al.

    Treatments of Negative Symptoms in Schizophrenia: Meta-Analysis of 168 Randomized Placebo-Controlled Trials

    Schizophrenia Bulletin

    (2015)
  • V. Gabbay et al.

    Anhedonia, but not Irritability, Is Associated with Illness Severity Outcomes in Adolescent Major Depression

    Journal of Child and Adolescent Psychopharmacology

    (2015)
  • L. Grillo

    A Possible Role of Anhedonia as Common Substrate for Depression and Anxiety

    Depression Research and Treatment

    (2016)
  • Z. Gutkovich et al.

    Anhedonia and Pessimism in Hospitalized Depressed Adolescents. Depression Research and Treatment

    (2010)
  • B.L. Hankin et al.

    Development of gender differences in depression: An elaborated cognitive vulnerability-transactional stress theory

    Psychological Bulletin

    (2001)
  • D.P. Hartmann et al.

    Interrupted time-series analysis and its application to behavioral data

    Journal of Applied Behavior Analysis

    (1980)
  • Cited by (0)

    Research reported in this publication was supported by a Vici grant (016.001/002) from the Netherlands Organization for Scientific Research to Albertine J. Oldehinkel. We would like to specifically thank Ando Emerencia and Rob Wanders for their help with the analyses and graphical representations, Tom Bak for coordinating all data collection activities, and Sanne van der Ploeg, Grejanne Dijkstra, and Nicole Snippen for their assistance in data collection.

    View full text