Individuals with depression tend to focus on negativity and interpret neutral situations in a negative light. Cognitive theories commonly posit that depressed persons’ focus on negative stimuli leaves them incapable of prioritizing positive emotional information. Reward Devaluation Theory (RDT; Winer and Salem, 2016 ), which stipulates that depressed persons not only focus on negativity, but also exhibit a systematic and motivated avoidance of positive and potentially rewarding stimuli, offers an alternative theoretical framework to understanding cognitive/affective biases in depression. We here unpack the theoretical underpinnings of RDT, reviewing the empirical evidence surrounding positivity avoidance and depression. Studies using cognitive/behavioral tasks, as well as those examining anticipatory and responsive devaluation strategies, are summarized. Future directions in the measurement of RDT, including expanded investigation of self-referential processing, are introduced for consideration. The clinical implications of RDT, which are potentially profound, are also discussed.

Family psychoeducation plus skill building is a class of interventions considered to be well-established for youth with mood disorders or emotion dysregulation. Psychoeducational psychotherapy (PEP) is an example of this class of interventions. PEP provides psychoeducation for parents and children, skill building to help children better regulate emotions and behaviors, and strategies for parents to better facilitate school-based interventions, develop specific symptom management techniques, and generate coping strategies for the entire family. Evidence is summarized supporting the efficacy of PEP for reducing rage, overall mood symptom severity, disruptive behavior, and executive functioning deficits in youth. Long-term benefits of PEP are discussed.

Depression has been linked to multiple forms of aggressive behavior in college students; however, it is unclear which aspects of depression explain this connection. Anhedonia, defined as the loss of interest and/or pleasure in previously enjoyed activities, may provide unique information about relationships between depression and aggression. Using cross-sectional data from two independent samples of college students (N = 747 and N = 736 for Study 1 and Study 2, respectively), we examined whether anhedonia helped explain the relationship between broader depressive symptoms and different forms of aggressive and antisocial behavior. Anhedonia accounted for variance in both self-directed aggression and antisocial behavior independent of gender, hostility, anger, other depressive symptoms, and cognitive distortions (Study 2). In addition, there were significant indirect effects of depressive symptoms on self-directed aggression (Studies 1 and 2) and antisocial behavior (Study 2) via anhedonia. Hypotheses involving other-directed aggression received mixed support, with anhedonia atemporally associated with other-directed aggression independent of broader depressive symptoms in Study 1, but not in Study 2. The current findings suggest that anhedonia is an important individual difference that helps explain the relationship between depression and aggressive and antisocial acts and that anhedonia may be differentially associated with various types of aggressive and antisocial behavior.

This chapter reviews current information on childhood depression and evidence-based therapies for the treatment of depression in children 12 and under. Depressive disorders in childhood are associated with significant distress and impairment. The prevalence and incidence of childhood depressive disorders and nuances of frequent comorbid conditions are described. Despite the widespread rates and sometimes devastating effects of depressive disorders in children, empirically based treatments for them are few in number. The authors articulate that the profession has limited knowledge about overall treatment efficacy and knows even less about related treatment issues, such as comorbidity, family involvement, group versus individual format, and relapse prevention. They note that many advances have been made in developing and testing psychosocial treatments for children with depressive disorders. This chapter summarizes findings from previous systematic reviews and incorporates new findings published recently. The authors discuss findings from randomized clinical trials of cognitive behavioral therapy, interpersonal therapy, family-based therapy, dialectical behavior therapy, psychodynamic therapy, and parent-–child interaction training for childhood depression. However, much work remains to be done: Different populations of affected children, different styles of therapies, and different treatment methods all need further examination.

Objective Network analysis in psychology has ushered in a potentially revolutionary way of analyzing clinical data. One novel methodology is in the construction of temporal networks, models that examine directionality between symptoms over time. This paper provides context for how these models are applied to clinically-relevant longitudinal data. Methods We provide a survey of statistical and methodological issues involved in temporal network analysis, providing a description of available estimation tools and applications for conducting such analyses. Further, we provide supplemental R code and discuss simulations examining temporal networks that vary in sample size, number of variables, and number of time points. Results The following packages and software are reviewed: graphicalVAR, mlVAR, gimme, SparseTSCGM, mgm, psychonetrics, and the Mplus dynamic structural equation modeling module. We discuss the utility each procedure has for specific design considerations. Conclusion We conclude with notes on resources for estimating these models, emphasizing how temporal networks best approximate network theory.

•We tested depression & affective go/no-go (AGN) performance at two time points•Participants were youth in the Longitudinal Assessment of Manic Symptoms study•Across administrations no clear pattern emerged, mirroring the broader AGN literature•Focus should shift to more robust measures of inhibitory control in depressed youth

The circadian disruption associated with bipolar disorder and the success of social rhythm therapies in ameliorating distress and improving functioning make it clear that “healthy habits”—sufficient sleep, nutritious eating, and plentiful exercise—are important components of successful outcomes for persons with bipolar spectrum disorders. Additionally, evidence for the benefits of nutritional interventions and phototherapy is growing. Finally, mood charting and other self-help strategies are increasingly recognized as important components of recovery. Given that 20 to 50% of adults with bipolar disorder use some form of nonconventional therapy, it is important for mental health providers of all disciplines to be familiar with the literature in this area. This chapter provides an overview of integrative interventions and reviews evidence supporting their use.

In the current literature there is a general lack of research examining the impact of causal explanations on beliefs about psychotherapy, willingness to accept treatment, and treatment expectancies. The present study was aimed at experimentally investigating effects of causal explanations for depression on treatment-seeking behavior and beliefs. Participants at a large Southern university (N = 139; 78% female; average age 19.77) received bogus screening results indicating high depression risk, then viewed an explanation of depression etiology (fixed biological vs. malleable biopsychosocial) before receiving a treatment referral (antidepressant vs. psychotherapy). Participants accepted the cover story at face value, but some expressed doubts about the screening task's ability to properly assess their individual depression. Within the skeptics, those given a fixed biological explanation for depression were relatively unwilling to accept either treatment, but those given a malleable biopsychosocial explanation were much more willing to accept psychotherapy. Importantly, differences in skepticism were not due to levels of actual depressive symptoms. Information about the malleability of depression may have a protective effect for persons who otherwise would not accept treatment.

Biases towards negative information, as well as away from positive information, are associated with psychopathology. Examining biases in multiple processes has been theorised to be more predictive than examining bias in any process alone. Anhedonia is a core symptom of psychopathology and predictive of future psychopathological symptoms. Finding that combined biases are associated with anhedonia would advance knowledge of the nature of emotional processing biases and the value of objective performance-based measures for identifying early risk markers. Participants (N=139) completed tasks that assess latency bias (dot probe) and biased recognition (two-alternative forced-choice) of emotional information, as well as an anhedonia measure. An index was computed for each task's performance reflecting biased processing of positive and negative words. Only combined biases on both tasks were associated with anhedonia. Attentional bias was positively associated with anhedonia, but only when recognition bias for emotional words was high. Thus, assessing biases in multiple domains increased sensitivity to uncover relationships between emotional processing biases and anhedonic symptoms.

Anhedonia, or the loss of interest and/or pleasure, is a core symptom of depression. Individuals experiencing anhedonia have difficulty motivating themselves to pursue rewarding stimuli, which can result in dysfunction. Action orientation is a motivational factor that might interact with anhedonia to potentially buffer against this dysfunction, as action-oriented individuals upregulate positive affect to quickly motivate themselves to complete goals in the face of stress. The Effort-Expenditure for Rewards Task (EEfRT) is a promising new method for examining differences in motivation in individuals experiencing anhedonia. In the EEfRT, participants choose either easier tasks associated with smaller monetary rewards or harder tasks associated with larger monetary rewards. We examined the relationship between action orientation and EEfRT performance following a negative mood induction in a sample with varying levels of anhedonia. There were two competing hypotheses: (1) action orientation would act as a buffer against anhedonia such that action-oriented individuals, regardless of anhedonic symptoms, would be motivated to pursue greater rewards despite stress, or (2) anhedonia would act as a debilitating factor such that individuals with elevated anhedonic symptoms, regardless of action orientation, would not pursue greater rewards. We examined these hypotheses via Generalized Estimating Equations and found an interaction between anhedonia and action orientation. At low levels of anhedonia, action orientation was associated with effort for reward, but this relationship was not present at high levels of anhedonia. Thus, at low levels of anhedonia, action orientation acted as a buffer against stress, but at high levels, anhedonia debilitated action orientation so that it was no longer a promotive factor.

Fear of positive evaluation (FPE) is experiencing dread during real or potential praise. FPE is associated with social anxiety, but its relation to depressive symptoms is unclear. Anhedonia is a core symptom of depression related to symptoms of anxiety in cross-sectional research. The current study investigated the indirect effect of FPE on depressive symptoms via anhedonia over time. One-hundred ninety-six participants completed three waves of questionnaires over a total timespan of approximately four months via Amazon’s Mechanical Turk, including measures of FPE, depressive symptoms, and anticipatory and consummatory anhedonia. Findings indicated that anticipatory anhedonia at Time 2 mediated the relationship between FPE at Time 1 and depressive symptoms at Time 3. Consummatory anhedonia, however, did not. Each model was contextualised by accounting for prospective covarying relationships, such as depressive symptoms predicting the same symptoms at later waves. The constellation of findings is considered within a reward devaluation framework.

Cognitive theories of depression and anxiety have traditionally emphasized the role of attentional biases in the processing of negative information. The dot-probe task has been widely used to study this phenomenon. Recent findings suggest that biased processing of positive information might also be an important aspect of developing psychopathological symptoms. However, despite some evidence suggesting persons with symptoms of depression and anxiety may avoid positive information, many dot-probe studies have produced null findings. The present review used conventional and novel meta-analytic methods to evaluate dot-probe attentional biases away from positive information and, for comparison, toward negative information, in depressed and anxious individuals. Results indicated that avoidance of positive information is a real effect exhibiting substantial evidential value among persons experiencing psychopathology, with individuals evidencing primary symptoms of depression clearly demonstrating this effect. Different theoretical explanations for these findings are evaluated, including those positing threat-processing structures, even-handedness, self-regulation, and reward devaluation, with the novel theory of reward devaluation emphasized and expanded. These novel findings and theory suggest that avoidance of prospective reward helps to explain the cause and sustainability of depressed states. Suggestions for future research and methodological advances are discussed.

IntroductIon Until recently, the etiopathogeneses and treatment of seemingly disparate conditions such as major depressive disorder (MDD) and cardiovascular disease (CVD) were primarily considered separately. At least as early as the 1950s or 1960s, there was US and international literature suggesting possible relationships between depression and cardiovascular function or CVD. One interesting early study found altered blood–brain barrier (BBB) permeability in depressed cases that returned to normal as the depression resolved.[1] A 1953 case report in the New England Journal of Medicine drew possible connections between depression and cardiac failure.[2] Moreover, some classes of antidepressants, particularly the tricyclic antidepressants (TCAs), have long been understood to have cardiac effects and risks,[3-6] particularly in those with CVD.[4,7,8] (Herein, we define CVD broadly, to encompass any aberrant or pathologic condition or function of the heart or cardiovascular system).

Major depressive disorder is a mood disorder that affects millions of people each year, in many cases leading to disability or even suicide. Its symptoms, as outlined in the DSM ‐5 , include low mood, fatigue, loss of pleasure in previously enjoyable activities, difficulty sleeping or eating normally, trouble concentrating, and thoughts of death or suicide. These symptoms have been described in many forms throughout history, dating back at least to the time of Hippocrates (460–370 BC ) and the ancient Greek diagnosis of melancholia. Modern clinicians and researchers have proposed a variety of cognitive, biological, and social/environmental theories to explain the cause of major depressive disorder. The disorder is commonly assessed via clinical interview and/or self‐report questionnaires. First‐line treatments for major depressive disorder include psychotherapy and antidepressant medications.

STUDY OBJECTIVES:The purpose of the study was to examine whether insomnia symptoms and nightmares mediated the relation between alcohol use and suicide risk. Further, we examined whether this mediation was moderated by gender. DESIGN:The study consisted of questionnaires administered online examining insomnia symptoms, nightmares, alcohol use, and suicide risk. SETTING:University. PATIENTS OR PARTICIPANTS:375 undergraduate students at a large, public university in the southeastern United States. INTERVENTIONS:N/A. MEASUREMENTS AND RESULTS:Results indicated that insomnia symptoms significantly mediated the relation between alcohol use and suicide risk; however, this mediation was moderated by gender. For women, there was both a direct effect of alcohol use on suicide risk as well as an indirect effect of alcohol use through insomnia symptoms increasing suicide risk. For men, there was no direct effect of alcohol use on suicide risk, but there was a significant indirect effect of alcohol use increasing suicide risk through insomnia symptoms. Nightmares were not related to alcohol use, and the association between nightmares and suicide risk was found to be independent of alcohol use. CONCLUSIONS:Insomnia symptoms are an important factor in explaining the mechanism by which alcohol use increases suicide risk.

This study examined the relationship among symptoms of anhedonia and suicidal ideation at baseline, at termination, and over time in 1529 adult psychiatric inpatients. Anhedonia was associated with suicidality cross-sectionally at baseline and at termination. In addition, change in anhedonia from baseline to termination predicted change in suicidality from baseline to termination, as well as level of suicidality at termination; moreover, anhedonia remained a robust predictor of suicidal ideation independent of cognitive/affective symptoms of depression. Symptom-level analyses also revealed that, even after accounting for the physical aspect of anhedonia (e.g., loss of energy), loss of interest and loss of pleasure were independently associated with higher levels of suicidal ideation at baseline, over time, and at discharge. Loss of interest was most highly predictive of suicidal ideation, providing support for recent differential conceptualizations of anhedonia. Taken together, these findings indicate that the manner in which anhedonia is conceptualized is important in predicting suicidal ideation, and that anhedonia symptoms warrant particular clinical attention in the treatment of suicidal patients.