Engagement in Socially and Interpersonally Rewarding Activities as a Predictor of Outcome in "Engage" Behavioral Activation Therapy for Late-Life Depression.

TitleEngagement in Socially and Interpersonally Rewarding Activities as a Predictor of Outcome in "Engage" Behavioral Activation Therapy for Late-Life Depression.
Publication TypeJournal Article
Year of Publication2019
AuthorsSolomonov N, Bress JN, Sirey JAnne, Gunning FM, Fl├╝ckiger C, Raue PJ, Arean PA, Alexopoulos GS
JournalAm J Geriatr Psychiatry
Volume27
Issue6
Pagination571-578
Date Published2019 06
ISSN1545-7214
KeywordsAged, Aged, 80 and over, Behavior Therapy, Depressive Disorder, Major, Female, Humans, Male, Middle Aged, Outcome Assessment, Health Care, Reward, San Francisco, Social Behavior
Abstract

OBJECTIVE: Loneliness and social isolation are associated with depressive symptoms, cognitive and physical disabilities, and increased risk of mortality among older adults. Socially rewarding activities reduce loneliness, and neurobiological evidence suggests that these activities may activate neural reward systems in older adults to a greater extent than other rewarding experiences. The current study was designed to investigate whether engagement in social and interpersonal activities (i.e., exposure to social rewards) predicts subsequent increase in behavioral activation and reduction in depressive symptoms in reward exposure treatment for late-life depression.

METHODS: Forty-eight older adults without cognitive impairment and with major depression received nine sessions of "Engage" psychotherapy. Behavioral activation and depression severity were assessed by trained raters at baseline and weeks 6 and 9. Patients' weekly behavioral plans were categorized into three groups: 1) solitary activities; 2) social-group activities (attending a social gathering or a social setting such as church or a senior center); and 3) interpersonal-individual activities (engaging in an interpersonal interaction with a specific friend or family member).

RESULTS: Mixed-effects models showed reduction in depression severity and increase in behavioral activation over time. In linear regression models, a higher percentage of interpersonal-individual activities (but not solitary or social-group activities) predicted subsequent increase in behavioral activation and improvement of depression.

CONCLUSION: These findings highlight the importance of understanding the effects of engagement in specific types of rewarding activities in behavioral activation treatments for late-life depression. Exposure to socially rewarding interpersonal interactions could contribute to the efficacy of psychotherapy for late-life depression.

DOI10.1016/j.jagp.2018.12.033
Alternate JournalAm J Geriatr Psychiatry
PubMed ID30797650
PubMed Central IDPMC6511287
Grant ListP50 MH113838 / MH / NIMH NIH HHS / United States
R01 MH102252 / MH / NIMH NIH HHS / United States
T32 MH019132 / MH / NIMH NIH HHS / United States
UL1 TR002384 / TR / NCATS NIH HHS / United States