Augmenting Cognitive Behavioral Therapy to Build Positive Mood in Depression

Anhedonia—a loss of interest and pleasure in previously enjoyable activities—is one of the two cardinal symptoms of depression but has until recently been relatively neglected in cognitive behavioral therapy (CBT) for depression. One way to better target anhedonia is to identify in the laboratory what psychological mechanisms drive the reduced pleasure experience in depression and then to develop in the clinic novel CBT techniques that address these mechanisms. This chapter reviews evidence evaluating how well classic CBT repairs anhedonia, provides an overview of recent experimental work characterizing anhedonia and exploring anhedonia maintenance mechanisms, and discusses implications for adapting CBT to better repair anhedonia. While the focus is on depression, implications for the transdiagnostic treatment of anhedonia are discussed.