Increasing Anticipatory Pleasure in Major Depression through Enhancing Episodic Future Thinking: a Randomized Single-Cas
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Increasing Anticipatory Pleasure in Major Depression through Enhancing Episodic Future Thinking: a Randomized Single-Case Series Trial D. J. Hallford 1,2
&
M. K. Sharma 3 & D. W. Austin 1
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Individuals with depression have difficulty anticipating pleasure, which can negatively impact motivation and functioning. One factor in this may be impairments in their episodic future thinking (EFT). This study examined whether enhancing EFT through increasing detail/vividness and mental imagery would increase anticipatory pleasure among individuals with Major Depressive Disorder. A randomized start-point, single case series design was used. Depressed outpatients (N = 7) completed surveys throughout the day over 2 wks to nominate upcoming positive events and rate them on EFT detail/vividness, mental imagery, and anticipatory pleasure. At a randomized start-point, activities to enhance the detail/vividness and mental imagery for these upcoming events were introduced. Significant increases in detail and imagery were observed when EFT activities were introduced, which correlated with increases in how pleasurable it was thought the activities would be and how pleasurable it was thinking about them. Enhancing EFT may be a mechanism to increase anticipatory pleasure in depression. Implications for treatment are discussed. Keywords Major depression . Anticipatory pleasure . Anhedonia . Episodic future thinking
Anhedonia refers to difficulty feeling pleasure as a response to experiences that might otherwise elicit a pleasurable, hedonic response, and is a core diagnostic feature of depressive disorders (American Psychiatric Association 2013; Word Health Organization 1992). Some evidence-based psychological therapies, such as cognitive therapy (Beck 2011), behavioural activation (Hopko et al. 2003) and acceptance and commitment therapy (Hayes et al. 2011), put a particular emphasis on increasing rewarding and meaningful activities as a way of increasing hedonic responses and addressing anhedonia. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10862-020-09820-9) contains supplementary material, which is available to authorized users. * D. J. Hallford [email protected] 1
School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, Victoria 3220, Australia
2
School of Psychology, Deakin University, 221 Burwood Highway, Burwood, Melbourne, Victoria 3125, Australia
3
Department of Clinical Psychology, National Institute of Mental Health and Neurosciences, Hosur Road, Bangalore, Karnataka, India
Recently, anhedonia has been increasingly conceptualised as a deficit in the ability to not only experience pleasure from behaviour that would usually be rewarding, but also as a deficit in anticipating the experience of pleasure (Gard et al. 2006; Gard et al. 2007; Treadway and Zald 2011). Indeed, evidence has accumulated that indicates large, significant deficits in self-reported levels of antic
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