Development of a Novel Transdiagnostic Intervention for Anhedonia - R33 Phase
Condition: Anhedonia
MeSH terms: Anhedonia
Study type: Interventional

Summary: 
      The overall goal of this project is to develop a novel transdiagnostic treatment for
      anhedonia, called Behavioral Activation Treatment for Anhedonia (BATA), using ultra-high
      field functional neuroimaging. There is a critical need for a validated treatment that
      specifically targets anhedonia, and this project will evaluate the effects of this new
      treatment on anhedonia and will establish how this treatment impacts brain systems that
      mediate reward processing, clinical symptoms of anhedonia, functional outcomes, and
      behavioral indices of reward processing. This work will also identify brain targets by which
      future novel anhedonia treatment may be evaluated.
    

Detailed description: 
      Deficits in motivation and pleasure, together referred to as anhedonia, are implicated in a
      number of psychiatric illnesses, including mood and anxiety disorders, substance-use
      disorders, schizophrenia, and attention-deficit/hyperactivity disorder. As a result,
      constructs related to anhedonia are central to the NIMH Research Domain Criteria (RDoC)
      project. Anhedonia is often one of the most difficult psychiatric symptoms to treat and thus
      represents a critical endophenotype and vulnerability factor for a range of psychiatric
      disorders. Given the centrality of anhedonia to a large number of psychiatric disorders,
      improved interventions to treat motivation and pleasure are critical for these disorders. The
      overall goal of this R61/R33 project is to develop a novel transdiagnostic treatment for
      anhedonia, called Behavioral Activation Treatment for Anhedonia (BATA). This new intervention
      is designed to treat anhedonia by emphasizing supported engagement with personally relevant
      goals and reducing avoidance behaviors. Consistent with the objectives and milestones
      outlined in RFA-MH-16-406 ("Exploratory Clinical Trials of Novel Interventions for Mental
      Disorders"), in the R61 phase of this trial that lasted from June 22, 2017-July 31, 2019, the
      investigators proposed to use an experimental therapeutics approach to first evaluate
      mesocorticolimbic target engagement by this treatment in a transdiagnostic sample
      characterized by clinically impairing anhedonia (Aim 1). Specifically, the investigators
      examined the effects of this treatment, relative to an active comparison treatment, on
      caudate nucleus activation during reward anticipation and rostral anterior cingulate cortex
      activation during reward outcomes using ultra-high field (7T) functional magnetic resonance
      imaging. The investigators also used fMRI to determine the optimal dose of the intervention
      (Aim 2).

      In the current R33 phase of the study, which begins recruitment 8/1/2019, the investigators
      plan to evaluate the effects of the optimal dose of this new treatment, versus an active
      comparison treatment, on anhedonic symptoms and functional outcomes (Aim 3), behavioral
      indicators of reward sensitivity (Aim 4), and neural indicators of reward processing (Aim 5).
    

Intervention name(s): Behavioral Activation; Mindfulness Treatment
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Treatment will consist of 15 weekly 45-minute sessions.; Treatment will consist of 15 weekly 45-minute sessions.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment