Trial Outcomes & Findings for Positive Processes and Transition to Health (NCT NCT04678232)

NCT ID: NCT04678232

Last Updated: 2024-10-30

Results Overview

The Affective Updating task (Pe et al., 2013; Pe, Raes, et al., 2013) measures updating of affective information in working memory. The task requires participants to continuously monitor and modify relevant affective information in working memory. Performance is inhibited by rumination. Forty-seven positive and 49 negative words are included. Under high levels of stress, deficits in affective updating predict more depressive symptoms over one year (Pe et al., 2016) and efficiency of reappraisal (Pe et al., 2013). Affective updating in contrast, predicts subjective well-being (Pe et al., 2013). The AUT is scored using the mean proportion of correct responses across 4 types of stimulus sets (positive-positive-positive words, negative-negative-negative, positive-negative-positive, negative-positive-negative). Scores for the AUT range from 0 to 1. Lower scores reflect greater deficits in affecting updating, while higher scores indicate greater abilities with affective updating.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

45 participants

Primary outcome timeframe

Score at 6 weeks (immediately post treatment)

Results posted on

2024-10-30

Participant Flow

Participant milestones

Participant milestones
Measure
Receive PATH Therapy
PATH includes six 60-90 min, weekly sessions, with two booster sessions for partial responders. Session 1 provides the PATH rationale and a review of life events (PATH of life: negative and positive). A rationale for an explicit focus on positive events/emotions will be provided. Sessions 2-4 focus on a verbal narrative of the destabilizing life event, reminiscence and processing of a major positive life event, and real-life practice to enact what was taught. Sessions 5 focuses on constructive processing and provides opportunity for integration and consolidation of learning. Session 6 focuses on future negative and positive events to promote application of new learning and resilience. Booster sessions focus on positive and negative life events since the last session and adaptive processes (constructive processing, approach, and reward). All sessions will include cultivation and elaboration of positive emotions to promote engagement and to build on the benefits of positive emotions. Positive Processes and Transition to Health (PATH): See arm/group description for details regarding this intervention
Overall Study
STARTED
45
Overall Study
COMPLETED
40
Overall Study
NOT COMPLETED
5

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Missing data

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Receive PATH Therapy
n=45 Participants
PATH includes six 60-90 min, weekly sessions, with two booster sessions for partial responders. Session 1 provides the PATH rationale and a review of life events (PATH of life: negative and positive). A rationale for an explicit focus on positive events/emotions will be provided. Sessions 2-4 focus on a verbal narrative of the destabilizing life event, reminiscence and processing of a major positive life event, and real-life practice to enact what was taught. Sessions 5 focuses on constructive processing and provides opportunity for integration and consolidation of learning. Session 6 focuses on future negative and positive events to promote application of new learning and resilience. Booster sessions focus on positive and negative life events since the last session and adaptive processes (constructive processing, approach, and reward). All sessions will include cultivation and elaboration of positive emotions to promote engagement and to build on the benefits of positive emotions. Positive Processes and Transition to Health (PATH): See arm/group description for details regarding this intervention
Age, Categorical
<=18 years
0 Participants
n=45 Participants
Age, Categorical
Between 18 and 65 years
45 Participants
n=45 Participants
Age, Categorical
>=65 years
0 Participants
n=45 Participants
Age, Continuous
35.98 years
STANDARD_DEVIATION 14.06 • n=45 Participants
Sex: Female, Male
Female
33 Participants
n=45 Participants
Sex: Female, Male
Male
12 Participants
n=45 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
6 Participants
n=45 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
39 Participants
n=45 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=45 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=45 Participants
Race (NIH/OMB)
Asian
2 Participants
n=45 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=45 Participants
Race (NIH/OMB)
Black or African American
3 Participants
n=45 Participants
Race (NIH/OMB)
White
35 Participants
n=45 Participants
Race (NIH/OMB)
More than one race
5 Participants
n=45 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=45 Participants
Region of Enrollment
United States
45 participants
n=45 Participants
Affective Updating Task
0.38 units on a scale
STANDARD_DEVIATION 0.23 • n=45 Participants
Idiographic Behavioral Approach Task
55.00 units on a scale
STANDARD_DEVIATION 23.27 • n=45 Participants
Probabilistic Reward Task
-0.08 units on a scale
STANDARD_DEVIATION 0.29 • n=45 Participants
Posttraumatic Cognitions Inventory
151.03 units on a scale
STANDARD_DEVIATION 42.07 • n=40 Participants • Missing data
Behavioral Activation for Depression Scale
71.35 units on a scale
STANDARD_DEVIATION 24.96 • n=40 Participants • Missing data
Snaith-Hamilton Pleasure Scale
25.25 units on a scale
STANDARD_DEVIATION 2.29 • n=40 Participants • Missing data

PRIMARY outcome

Timeframe: Score at 6 weeks (immediately post treatment)

The Affective Updating task (Pe et al., 2013; Pe, Raes, et al., 2013) measures updating of affective information in working memory. The task requires participants to continuously monitor and modify relevant affective information in working memory. Performance is inhibited by rumination. Forty-seven positive and 49 negative words are included. Under high levels of stress, deficits in affective updating predict more depressive symptoms over one year (Pe et al., 2016) and efficiency of reappraisal (Pe et al., 2013). Affective updating in contrast, predicts subjective well-being (Pe et al., 2013). The AUT is scored using the mean proportion of correct responses across 4 types of stimulus sets (positive-positive-positive words, negative-negative-negative, positive-negative-positive, negative-positive-negative). Scores for the AUT range from 0 to 1. Lower scores reflect greater deficits in affecting updating, while higher scores indicate greater abilities with affective updating.

Outcome measures

Outcome measures
Measure
Receive PATH Therapy
n=40 Participants
PATH includes six 60-90 min, weekly sessions, with two booster sessions for partial responders. Session 1 provides the PATH rationale and a review of life events (PATH of life: negative and positive). A rationale for an explicit focus on positive events/emotions will be provided. Sessions 2-4 focus on a verbal narrative of the destabilizing life event, reminiscence and processing of a major positive life event, and real-life practice to enact what was taught. Sessions 5 focuses on constructive processing and provides opportunity for integration and consolidation of learning. Session 6 focuses on future negative and positive events to promote application of new learning and resilience. Booster sessions focus on positive and negative life events since the last session and adaptive processes (constructive processing, approach, and reward). All sessions will include cultivation and elaboration of positive emotions to promote engagement and to build on the benefits of positive emotions. Positive Processes and Transition to Health (PATH): See arm/group description for details regarding this intervention
Affective Updating Task (Pe et al., 2013; Pe, Raes, et al., 2013)
0.54 units on a scale
Standard Deviation 0.23

PRIMARY outcome

Timeframe: Score at 6 weeks (immediately post treatment)

The Idiographic Behavioral Approach Task (BAT; Mori \& Aermendariz, 2001; Haynes, 2001) will use in vivo confrontation with feared or avoided stimuli measuring avoidance behavior. Each BAT is unique to each participant (e.g., news/videos of similar events, pictures of loved one). A general list of idiographic stimuli will be developed with participants, who will then approach the stimuli. The task requires participants to rate their subjective units of distress (SUDs) on a scale of 0-100 (0 = no distress, 100 = extreme distress). The primary outcome measured is mean peak SUDs. The mean peak SUDs is calculated by averaging together all of the participant's reported SUDs measured at their highest level of distress. Higher scores indicate a higher average level of distress across all items, and lower scores indicate less distress on average across all items.

Outcome measures

Outcome measures
Measure
Receive PATH Therapy
n=37 Participants
PATH includes six 60-90 min, weekly sessions, with two booster sessions for partial responders. Session 1 provides the PATH rationale and a review of life events (PATH of life: negative and positive). A rationale for an explicit focus on positive events/emotions will be provided. Sessions 2-4 focus on a verbal narrative of the destabilizing life event, reminiscence and processing of a major positive life event, and real-life practice to enact what was taught. Sessions 5 focuses on constructive processing and provides opportunity for integration and consolidation of learning. Session 6 focuses on future negative and positive events to promote application of new learning and resilience. Booster sessions focus on positive and negative life events since the last session and adaptive processes (constructive processing, approach, and reward). All sessions will include cultivation and elaboration of positive emotions to promote engagement and to build on the benefits of positive emotions. Positive Processes and Transition to Health (PATH): See arm/group description for details regarding this intervention
Idiographic Behavioral Approach Task
25.65 score on a scale
Standard Deviation 22.47

PRIMARY outcome

Timeframe: Score at 6 weeks (immediately post treatment)

The Probabilistic Reward Task (PRT) assesses reward responsivity (e.g., Der-Avakian et al. 2013; Pizzagalli et al., 2005, 2008, 2008). In each trial, participants choose which of 2 difficult-to-differentiate stimuli was presented. Stimuli are groups of bunnies or dogs (diameter: 25 mm; eyes: 7 mm). Unknown to them, correct identification of the "rich stimulus" is rewarded 3 times more frequently ("Correct! You won 20 cents"). Reward propensity is calculated by increase in response bias during the final block relative to the first. Degree of response bias toward the frequently reinforced alternative is a robust measure of reward sensitivity (Pizzagalli et al., 2005, 2008; Vrieze et al., 2013). The PRT is administered online through Inquisit Lab on Millisecond. PRT scores range between -.75 to .65 (-.75 = lower reward sensitivity, .65 = greater reward sensitivity).

Outcome measures

Outcome measures
Measure
Receive PATH Therapy
n=40 Participants
PATH includes six 60-90 min, weekly sessions, with two booster sessions for partial responders. Session 1 provides the PATH rationale and a review of life events (PATH of life: negative and positive). A rationale for an explicit focus on positive events/emotions will be provided. Sessions 2-4 focus on a verbal narrative of the destabilizing life event, reminiscence and processing of a major positive life event, and real-life practice to enact what was taught. Sessions 5 focuses on constructive processing and provides opportunity for integration and consolidation of learning. Session 6 focuses on future negative and positive events to promote application of new learning and resilience. Booster sessions focus on positive and negative life events since the last session and adaptive processes (constructive processing, approach, and reward). All sessions will include cultivation and elaboration of positive emotions to promote engagement and to build on the benefits of positive emotions. Positive Processes and Transition to Health (PATH): See arm/group description for details regarding this intervention
Probabilistic Reward Task (Pizzagalli et al., 2005)
-.03 score on a scale
Standard Deviation .25

SECONDARY outcome

Timeframe: Score at 6 weeks (immediately post treatment)

The Posttraumatic Cognitions Inventory (PTCI; Foa et al., 1999) is a self-report that measures negative posttraumatic stressor-related thoughts that can contribute to the development and maintenance of PTSD. The measure includes 33 items grouped into three subscales. The 21-item Negative Cognitions about Self scale measures negative self-perception since the traumatic event. The 7-item Negative Cognitions about the World subscale evaluates mistrust of others and perceptions of danger. The 5-item Self Blame scale measures self-blame since the traumatic incident. All items are measured on a scale from 1-7 with 1 indicating "totally disagree" and 7 indicating "totally agree." The total score for the PTCI ranges from 33 to 231 and is determined by summing the scores of each subscale. Higher scores reflect more rigid negative cognitions. Total scores were used.

Outcome measures

Outcome measures
Measure
Receive PATH Therapy
n=38 Participants
PATH includes six 60-90 min, weekly sessions, with two booster sessions for partial responders. Session 1 provides the PATH rationale and a review of life events (PATH of life: negative and positive). A rationale for an explicit focus on positive events/emotions will be provided. Sessions 2-4 focus on a verbal narrative of the destabilizing life event, reminiscence and processing of a major positive life event, and real-life practice to enact what was taught. Sessions 5 focuses on constructive processing and provides opportunity for integration and consolidation of learning. Session 6 focuses on future negative and positive events to promote application of new learning and resilience. Booster sessions focus on positive and negative life events since the last session and adaptive processes (constructive processing, approach, and reward). All sessions will include cultivation and elaboration of positive emotions to promote engagement and to build on the benefits of positive emotions. Positive Processes and Transition to Health (PATH): See arm/group description for details regarding this intervention
Posttraumatic Cognitions Inventory (Foa et al., 1999)
102.05 score on a scale
Standard Deviation 43.14

SECONDARY outcome

Timeframe: Score at 6 weeks (immediately post treatment)

Behavioral Activation for Depression Scale (Secondary Measure; BADS; Kanter et al., 2006) is a 25- item self-report of approach and avoidance in cognitive and behavioral domains not specific to depression. Items are rated from 0 = Not at all to 6 = Completely. The measure contains four subscales which include Activation, Avoidance/Rumination, Work/School Impairment, and Social Impairment. Total scores, which range from 0-150 are calculated by summing the four subscales. A higher score indicates higher behavioral activation and lower scores indicate more depressive symptoms. The BADS has good factor structure, internal consistency, construct, and predictive validity (Kanter et al., 2009; Manos et al, 2011) and sensitivity to change (d =.86; CBT for depression, O'Mahen et al., 2017).

Outcome measures

Outcome measures
Measure
Receive PATH Therapy
n=38 Participants
PATH includes six 60-90 min, weekly sessions, with two booster sessions for partial responders. Session 1 provides the PATH rationale and a review of life events (PATH of life: negative and positive). A rationale for an explicit focus on positive events/emotions will be provided. Sessions 2-4 focus on a verbal narrative of the destabilizing life event, reminiscence and processing of a major positive life event, and real-life practice to enact what was taught. Sessions 5 focuses on constructive processing and provides opportunity for integration and consolidation of learning. Session 6 focuses on future negative and positive events to promote application of new learning and resilience. Booster sessions focus on positive and negative life events since the last session and adaptive processes (constructive processing, approach, and reward). All sessions will include cultivation and elaboration of positive emotions to promote engagement and to build on the benefits of positive emotions. Positive Processes and Transition to Health (PATH): See arm/group description for details regarding this intervention
Behavioral Activation for Depression Scale (Kanter et al., 2006)
106.5 score on a scale
Standard Deviation 24.97

SECONDARY outcome

Timeframe: Score at 6 weeks (immediately post treatment)

Snaith-Hamilton Pleasure Scale (SHAPS; Snaith et al., 1995). The SHAPS is a 14- item self-report measuring the capacity to experience pleasure. On a four-point scale (1 = Strongly Agree to 4 = Strongly Disagree), varying statements are rated (e.g., "I would find pleasure in small things"; "I would find pleasure in a telephone call from a friend"). The measure has good convergent and discriminant validity and reflects a unidimensional construct of anhedonia (Leventhal et al., 2006; Nakonezny et al., 2010). Total scores are measured on a scale from 14 to 56 (14 = severe anhedonia, 56 = no anhedonia).

Outcome measures

Outcome measures
Measure
Receive PATH Therapy
n=38 Participants
PATH includes six 60-90 min, weekly sessions, with two booster sessions for partial responders. Session 1 provides the PATH rationale and a review of life events (PATH of life: negative and positive). A rationale for an explicit focus on positive events/emotions will be provided. Sessions 2-4 focus on a verbal narrative of the destabilizing life event, reminiscence and processing of a major positive life event, and real-life practice to enact what was taught. Sessions 5 focuses on constructive processing and provides opportunity for integration and consolidation of learning. Session 6 focuses on future negative and positive events to promote application of new learning and resilience. Booster sessions focus on positive and negative life events since the last session and adaptive processes (constructive processing, approach, and reward). All sessions will include cultivation and elaboration of positive emotions to promote engagement and to build on the benefits of positive emotions. Positive Processes and Transition to Health (PATH): See arm/group description for details regarding this intervention
Snaith-Hamilton Pleasure Scale (Snaith et al., 1995)
21.79 score on a scale
Standard Deviation 2.69

Adverse Events

Receive PATH Therapy

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Norah Feeny, PhD

Case Western Reserve University

Phone: (216) 368-2695

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place