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Efficacy and mechanism of activity scheduling with positive imagery for behavioural activation in subclinical depression: A randomized controlled trial

Year: 2026

Type: article

Study designs: Randomized Controlled Trial, Clinical Trial

Abstract: BACKGROUND: Like major depressive disorder, subclinical depression involves reduced interest or pleasure in activities. Preliminary evidence suggests imagery-based episodic simulation of planned activities boosts motivation and engagement, but its effects and underlying mechanisms in individuals with subclinical depression remain unclear. METHODS: This prospectively registered randomized controlled trial (Registration No.: ChiCTR2400084768) adopted a single-blind design. A total of, 203 subclinically depressed participants were randomly assigned via computer-generated random number list to the activity scheduling with positive imagery (ASI) group (n = 68), activity scheduling (AS) group (n = 67) or wait-list (WL) group (n = 68). Assessments at pre-treatment, post-treatment and 2-month follow-up measured primary outcomes (behavioural activation, depressive symptoms, prospective imagery) and the secondary outcome (activity ratings). RESULTS: At post-treatment, the ASI group had increased behavioural activation (d = 0.69-0.99), alleviated depressive symptoms (d = 1.03-1.16), enhanced positive prospective imagery (d = 1.74-2.16) and reduced negative prospective imagery (d = 0.31-0.59) compared to the AS and WL groups. At follow-up, the ASI group outperformed the WL group in depressive symptom improvement (d = 1.32) and behavioural activation (d = 0.51). Additionally, the ASI group demonstrated significantly greater enhancements in anticipated pleasure and anticipated reward for enjoyable activities than the AS group post-training. Exploratory mediation analyses suggested that ASI training may promote behavioural activation and alleviate depressive symptoms by enhancing positive (rather than reducing negative) prospective imagery. CONCLUSIONS: The ASI was an appropriate intervention for subclinical depression. Enhanced positive prospective imagery may be a potential mechanism in ASI training, requiring large-sample validation.

Source: Psychology and Psychotherapy Theory Research and Practice

DOI: 10.1111/papt.70041

Authors: Mingfan Liu, Jiaxin Du, Chen Cheng, Dandan Peng, Qinghong Mao

Institution: Jiangxi Normal University

Language: English

Topic: Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Subfield: Experimental and Cognitive Psychology

Field: Psychology

Domain: Social Sciences

SDG: Good health and well-being

Open Access status: bronze

Funder: National Natural Science Foundation of China