The power of positivity: Exploring affective and social processes of change throughout a positive valence treatment for anxiety or depression

Abstract

Objective

Social disconnection is common and disabling in persons with anxiety or depression, yet remains underexplored in treatment research. Proposed mechanisms underlying social disconnection include heightened negative valence system activation (increased negative affect [NA] and sensitivity to social threats) and diminished positive valence system activation (reduced positive affect [PA] and sensitivity to social rewards). Better understanding whether and how changes in affect relate to social connectedness throughout treatment may inform targets for remediation. This study addressed this question among individuals with clinically significant anxiety or depression and impaired social connectedness and functioning who completed a positive valence-targeted psychosocial intervention, Amplification of Positivity (AMP).

Method

A secondary analysis was conducted using data from two trials (NCT03196544; NCT049452390), comprising 98 participants randomized to AMP. Longitudinal cross-lagged panel models, accounting for autoregression, examined the within-person, time-dependent relationships between PA and NA (entered concurrently) and subsequent social connectedness (loneliness and friendship) throughout treatment (Aim 1). Reverse models examined the relationships between connectedness and subsequent PA and NA (Aim 2). An exploratory analysis substituted anxiety and depressive symptoms for NA.

Results

Higher PA predicted greater perceptions of friendship and lower loneliness at the following time point; NA was not significantly related to either outcome when examined concurrently with PA. Greater perceived friendship predicted higher subsequent PA; the effect of loneliness was non-significant. Neither friendship nor loneliness levels predicted subsequent NA. The same patterns were observed in exploratory symptom models, except lower anxiety (as well as higher PA) predicted lower subsequent loneliness.

Conclusions

Higher PA (but not NA) predicted greater subsequent perceived friendship and lower loneliness throughout treatment.