Looking beyond depression: a meta-analysis of the effect of behavioral activation on depression, anxiety, and activation

Abstract

Background Depression is a prevalent and impairing condition. Behavioral activation (BA) is a parsimonious, cost-effective, and easily disseminated psychological intervention for depression. The current meta-analysis expands on the existing literature supporting the efficacy of BA for depression by examining the effects of BA on additional relevant outcomes for patients with depression, namely the reduction in anxiety symptoms and increase in activation. Methods Randomized controlled trials of BA for depression compared to active and inactive control were identified via a systematic review. Effect sizes using Hedges's g were calculated for each outcome compared to both active and inactive control using random effects models. Subgroup analyses were used to examine the inclusion of a discussion of values as a moderator of depression symptom outcome in BA. Results Twenty-eight studies were included. Meta-analyses of symptom change between groups from baseline-to-post intervention indicated that BA outperformed inactive control conditions for improvements in depression (g = 0.83), anxiety (g = 0.37), and activation (g = 0.64). The difference between BA and active control conditions was not significant for improvements in depression (g = 0.15), anxiety (g = 0.03), and activation (g = 0.04). There was no evidence for a discussion of values augmenting BA efficacy. Study quality was generally low, and there was evidence of publication bias. Conclusions In addition to improving depression, BA shows efficacy for reducing symptoms of anxiety and increasing activation. BA may not offer better outcomes relative to other active interventions. There is room for improvement in the quality of research in this area.

Eating disorders in times of the COVID‐19 pandemic—Results from an online survey of patients with anorexia nervosa

“…Our findings may have some implications for treating patients with AN during the pandemic. For example, strategies for learning to control the ED mindset such as described by Fairburn (2008) (Stein, Carl, Cuijpers, Karyotaki, & Smits, 2020). In addition, elements from acceptance and commitment therapy (ACT) (Hayes, Strosahl, & Wilson, 1999) might be applied to help patients better cope with intolerance of uncertainty.…”

“…Given the increases in symptoms of depression and anxiety, interventions aimed at helping patients cope with these symptoms might help manage their ED symptoms. As Cooper et al (2020) have suggested, behavioral activation (such as activity monitoring and scheduling or assessment of goals and values) might be indicated to treat increased depressive symptoms and also holds promise in treating anxiety (Stein, Carl, Cuijpers, Karyotaki, & Smits, 2020). In addition, elements from acceptance and commitment therapy (ACT) (Hayes, Strosahl, & Wilson, 1999) might be applied to help patients better cope with intolerance of uncertainty.…”

Scaling Up Maternal Mental healthcare by Increasing access to Treatment (SUMMIT) through non-specialist providers and telemedicine: a study protocol for a non-inferiority randomized controlled trial

“…Key strategies include: psychoeducation, behavioral assessment, values-based activity monitoring and structuring, interpersonal effectiveness, and problem solving. Unlike cognitive behavioral interventions for depression, BA explicitly targets avoidant coping [49] and has been effective in reducing anxiety symptoms [50].…”

Ativação Em Casa: Princípios De Ativação Comportamental Para Minimização Dos Efeitos Do Isolamento Social

“…Isso não significa que os seus protocolos não possam ser adaptados para a realidade de pessoas que estão confinadas em suas casas em função das medidas sanitárias de quarentena e isolamento social. Destaca-se ainda que resultados de meta-análises recentes têm sugerido a eficácia da Ativação Comportamental para além do tratamento da depressão, abrangendo também o tratamento de sintomas de ansiedade (Stein, Carl, Cuijpers, Karyotaki, & Smits, 2020). A aplicação desses seus princípios terapêuticos pode ser particularmente útil para um cenário da pandemia no qual as pessoas ficaram mais ansiosas (Brooks et al, 2020).…”