Reducing Anhedonia in Major Depressive Disorder with Future Event Specificity Training (FEST): A Randomized Controlled Trial

Abstract

Objective: Improving future thinking may be one means to reduce anhedonia, particularly in Major Depressive Disorder (MDD) in which future thinking is impaired. The current study therefore examined whether enhancing future thinking is a viable method of reducing anhedonia in MDD. Methods: Participants (N=177; 80.8% women; M age=43.7, SD=11.8) with a current depressive episode including anhedonia and high symptom severity were randomized to a Future Event Specificity Training (FEST) program or wait-list control. Future thinking characteristics, anhedonia-related variables, and other clinical outcomes were assessed at baseline, one- and three-month follow-up. Results: The FEST group showed significantly improved future thinking characteristics compared to the control group, as expected. Relative to the control group, FEST was also associated with a reduced likelihood of anhedonia (35.1% vs 61.1%, p = .015), improvements on other anhedonia-related variables such as anticipatory (d = 0.63, p = .004) and anticipated pleasure (d = 0.77, p < .001), and desirable clinical outcomes such as less people meeting criteria for MDD (37.8% vs 64.8%, p = .011), lower symptom severity (d = 0.41, p = .048), higher behavioural activation (d = 0.71, p = .001) and improved global functioning (d = 0.52, p = .017). Changes in future thinking characteristics were found to mediate the effect of FEST on anhedonia.Conclusions: Future thinking can be enhanced in MDD, and this leads to a substantially reduced likelihood of anhedonia, other significant clinical effects and functional gains. Future research might examine FEST’s effects on other diagnostic groups with anhedonia and the utility of FEST as an adjunct to other treatments.

Direct accessibility for overgeneral memory predicts a worse course of depression: Re-analysis of the online computerized Memory Specificity Training (c-MeST) for major depression study

“…An e-PASS diagnosis corresponds well with the Mini-International Neuropsychiatric Interview (MINI; Sheehan et al, 1998;Nguyen et al, 2015). Specifically, a concordance of 96.2% has been found among adults (Hallford et al, 2021b) and a concordance of 91.9% among youth (Hallford et al 2021a).…”

Selective effects of focusing on spatial details in episodic future thinking for self-relevant positive events

“…In particular, focusing on spatial details might be one method through which to increase anticipated pleasure (the expectation of enjoyment) and anticipatory pleasure (the feeling of pleasure from preexperiencing) for positive events, the perceived control we have over them, and our behavioural intentions. Previous research has indicated that detail and vividness is correlated with more use of mental imagery (Hallford et al, 2020b), and that both detail and vividness and mental imagery are related to higher anticipatory and anticipated pleasure (Hallford et al 2020a), a stronger sense of perceived control (Jing et al, 2016) Trials in clinical groups (Hallford et al, 2020c(Hallford et al, , 2021 and non-clinical groups (Hallford et al, 2020d) have already shown that training in enhancing the ability to produce detail and specificity in future thinking can influence such processes. Distinguishing the effects of particular types of details would provide a more nuanced understanding of their benefit in functioning.…”