Dimensions

PlumX

How to Cite
Myles, L., & Merlo, E. (2022). Elucidating the Cognitive Mechanisms Underpinning Behavioural Activation. International Journal of Psychological Research, 15(1), 126–132. https://doi.org/10.21500/20112084.5400
License terms
The work that is sent to this journal must be original, not published or sent to be published elsewhere; and if it is accepted for publication, authors will agree to transfer copyright to International Journal of Psychological Research. 

To give up copyright, the authors allow that, International Journal of Psychological Research, distribute the work more broadly, check for the reuse by others and take care of the necessary procedures for the registration and administration of copyright; at the same time, our editorial board represents the interests of the author and allows authors to re-use his work in various forms. In response to the above, authors transfer copyright to the journal, International Journal of Psychological Research. This transfer does not imply other rights which are not those of authorship (for example those that concern about patents). Likewise, preserves the authors rights to use the work integral or partially in lectures, books and courses, as well as make copies for educational purposes. Finally, the authors may use freely the tables and figures in its future work, wherever make explicit reference to the previous publication in International Journal of Psychological Research. The assignment of copyright includes both virtual rights and forms of the article to allow the editorial to disseminate the work in the manner which it deems appropriate. 

The editorial board reserves the right of amendments deemed necessary in the application of the rules of publication.

Abstract

Depression represents a pervasive and devastating psychological difficulty. It affects over 21% of the population at some point in their lives and can have an unimaginable impact on both individuals and society. Behavioural activation represents a popular intervention for depression and is commonly used by psychologists internationally. Despite its popularity, the cognitive mechanisms underpinning the efficacy of behavioural activation remain elusive. This paper will review the literature on this intervention and propose an account of the cognitive mechanisms underlying its therapeutic efficacy. Specifically, it is argued that behavioural activation is effective because it increases both the density of outcomes in ones environment and the density of highly salient action-outcome contingencies, which may otherwise be absent due to reduced motivation. The clinical implications are subsequently discussed, with reference to future research.

Keywords:

References

Abramson, L. Y., Metalsky, G. I., & Alloy, L. B. (1989). Hopelessness depression: A theory-based subtype of depression. Psychological Review, 96 (2), 358–372. https://doi.org/10.1037/0033-295X.96.2.358

Abramson, L. Y., Seligman, M. E., & Teasdale, J. D. (1978). Learned helplessness in humans: Critique and reformulation. Journal of abnormal psychology, 87 (1), 49–74. https://doi.org/10.1037/0021-843X.87.1.49

Alloy, L. B., & Abramson, L. Y. (1979). Judgment of contingency in depressed and nondepressed students: Sadder but wiser? Journal of experimental psychology: General, 108 (4), 441–485. https://doi.org/10.1037/0096-3445.108.4.441

Alloy, L. B., Abramson, L. Y., & Kossman, D. A. (1985). The judgment of predictability in depressed and non-depressed college students. In Affect, conditioning, and cognition: Essays on the determinants of behavior (pp. 229–246). Psychology Press. https://doi.org/10.4324/9781315745718-25

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (Vol. 5). American Psychiatric Association. https://doi.org/10.1176/appi.books.9780890425596

Auerbach, R. P., Mortier, P., Bruffaerts, R., Alonso, J., Benjet, C., Cuijpers, P., & Kessler, R. C. (2018). WHO World Mental Health Surveys International College Student Project: Prevalence and distribution of mental disorders. Journal of abnormal psychology, 127 (7), 623–638. https://doi.org/10.1037/abn0000362

Baker, A. G., Msetfi, R. M., Hanley, N., & Murphy, R. A. (2013). Depressive realism? Sadly not wiser. In Clinical Applications of Learning Theory (pp. 165–190). Psychology Press. https://doi.org/10.4324/9780203803509

Bjørkløf, G. H., Engedal, K., Selbæk, G., Maia, D. B., Borza, T., Benth, J.., & Helvik, A. S. (2018). Can depression in psychogeriatric inpatients at one year follow-up be explained by locus of control and coping strategies? Aging& mental health, 22 (3), 379–388. https://doi.org/10.1080/13607863.2016.1262817

Bjørkløf, G. H., Engedal, K., Selbæk, G., Maia, D. B., Coutinho, E. S. F., & Helvik, A. S. (2016). Locus of control and coping strategies in older persons with and without depression. Aging & mental health, 20 (8), 831–839. https://doi.org/10.1080/13607863.2015.1040722

Burns, D., Westra, H., Trockel, M., & Fisher, A. (2013). Motivation and changes in depression. Cognitive therapy and research, 37 (2), 368–379. https://doi.org/10.1007/s10608-012-9458-3

Chartier, I. S., & Provencher, M. D. (2013). Behavioural activation for depression: Efficacy, effectiveness and dissemination. Journal of affective disorders, 145 (3), 292–299. https://doi.org/10.1016/j.jad.2012.07.023

Cheng, C., Cheung, S. F., Chio, J. H. M., & Chan, M. P. S. (2013). Cultural meaning of perceived control: A meta-analysis of locus of control and psychological symptoms across 18 cultural regions. Psychological Bulletin, 139 (1), 152–188. https://doi.org/10.1037/a0028596

Cohen, S., Rothbart, M., & Phillips, S. (1976). Locus of control and the generality of learned helplessness in humans. Journal of Personality and Social Psychology, 34 (6), 1049–1056. https://doi.org/10.1037/0022-3514.34.6.1049

Crandall, A., Allsop, Y., & Hanson, C. L. (2018). The longitudinal association between cognitive control capacities, suicidality, and depression during late adolescence and young adulthood. Journal of adolescence, 65, 167–176. https://doi.org/10.1016/j.adolescence.2018.03.009

Dimidjian, S., Hollon, S. D., Dobson, K. S., Schmaling, K. B., Kohlenberg, R. J., Addis, M. E., & Jacobson, N. S. (2006). Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the acute treatment of adults with major depression. Journal of consulting and clinical psychology, 74 (4), 658–670. https://doi.org/10.1037/0022-006X.74.4.658

Ekers, D., Webster, L., Van Straten, A., Cuijpers, P., Richards, D., & Gilbody, S. (2014). Behavioural activation for depression; an update of metaanalysis of effectiveness and sub group analysis. PloS one, 9 (6), e100100. https://doi.org/10.1371/journal.pone.0100100

Grahek, I., Shenhav, A., Musslick, S., Krebs, R. M., & Koster, E. H. (2019). Motivation and cognitive control in depression. Neuroscience & Biobehavioral Reviews, 102, 371–381. https://doi.org/10.1016/j.neubiorev.2019.04.011

Hamilton, E. W., & Abramson, L. Y. (1983). Cognitive patterns and major depressive disorder: A longitudinal study in a hospital setting. Journal of Abnormal Psychology, 92 (2), 173–184. https://doi.org/10.1037/0021-843X.92.2.173

Haselgrove, M., & Hogarth, L. (Eds.) (2013). Clinical applications of learning theory. Psychology Press. https://doi.org/10.4324/9780203803509

Hopko, D. R., Lejuez, C. W., Ryba, M. M., Shorter, R. L., & Bell, J. L. (2016). Support for the efficacy of behavioural activation in treating anxiety in breast cancer patients. Clinical Psychologist, 20 (1), 17–26. https://doi.org/10.1111/cp.12083

Jacobson, N. S., Martell, C. R., & Dimidjian, S. (2001). Behavioral activation treatment for depression: Returning to contextual roots. Clinical Psychology: Science and Practice, 8 (3), 255–270. https://doi.org/10.1093/clipsy.8.3.255

Johnstone, L., & Dallos, R. (2013). Formulation in psychology and psychotherapy: Making sense of people’s problems. Routledge. https://doi.org/10.4324/9780203380574-10

Kanter, J. W., Puspitasari, A. J., Santos, M. M., & Nagy, G. A. (2012). Behavioural activation: History, evidence and promise. The British Journal of Psychiatry, 200 (5), 361–363. https://doi.org/10.1192/bjp.bp.111.103390

Kleinberg, A., Aluoja, A., & Vasar, V. (2013). Social support in depression: Structural and functional factors, perceived control and help-seeking. Epidemiology and psychiatric sciences, 22 (4), 345–353. https://doi.org/10.1017/s2045796013000504

Lefcourt, H. M. (1991). Locus of control. Academic Press. Mackintosh, N. J. (1975). A theory of attention: Variations in the associability of stimuli with reinforcement. Psychological Review, 82 (4), 276–298. https://doi.org/10.1037/h0076778

Martell, C. R., Addis, M. E., & Jacobson, N. S. (2001). Depression in context: Strategies for guided action. WW Norton & Co. https://doi.org/10.1017/s1352465803272118

Martin, D. J., Abramson, L. Y., & Alloy, L. B. (1984). Illusion of control for self and others in depressed and non-depressed college students. Journal of personality and social psychology, 46 (1), 125–136. https://doi.org/10.1037/0022-3514.46.1.125

Martin, F., & Oliver, T. (2019). Behavioral activation for children and adolescents: A systematic review of progress and promise. European child & adolescent psychiatry, 28 (4), 427–441. https://doi.org/10.1007/s00787-018-1126-z

Martínez-Vispo, C., Martínez, Ú., López-Durán, A., Del Río, E. F., & Becoña, E. (2018). Effects of behavioural activation on substance use and depression: A systematic review. Substance abuse treatment, prevention, and policy, 13 (1), 1–13. https://doi.org/10.1186/s13011-018-0173-2

Masterson, C., Ekers, D., Gilbody, S., Richards, D., Toner-Clewes, B., & McMillan, D. (2014). Sudden gains in behavioural activation for depression. Behaviour research and therapy, 60, 34–38. https://doi.org/10.1016/j.brat.2014.06.008

Mazzucchelli, T., Kane, R., & Rees, C. (2009). Behavioral activation treatments for depression in adults: A metaanalysis and review. Clinical Psychology: Science and Practice, 16 (4), 383–411. https://doi.org/10.1111/j.1468-2850.2009.01178.x

Merlo, E., Pappalardo, S., & Myles, L. (2022). The VESPA Project: Virtual Reality Interventions for Neurocognitive and Developmental Disorders. Journal of Mind and Medical Sciences, 9 (1), 16–27. https://doi.org/10.22543/7674.91.P1627

Miller, R. R., Barnet, R. C., & Grahame, N. J. (1995). Assessment of the Rescorla-Wagner model. Psychological Bulletin, 117 (3), 363–386. https://doi.org/10.1037/0033-2909.117.3.363

Moradveisi, L., Huibers, M. J., Renner, F., Arasteh, M., & Arntz, A. (2013). Behavioural activation v. antidepressant medication for treating depression in Iran: Randomised trial. The British Journal of Psychiatry, 202 (3), 204–211. https://doi.org/10.1192/bjp.bp.112.113696

Myles, L. (2020a). ACTing autonomously. The Psychologist, 33 (7). https://thepsychologist.bps.org.uk/acting-autonomously

Myles, L. (2020b). Taking control of mental health. The Psychologist, 33 (4), 7. https://thepsychologist.bps.org.uk/taking-control-mental-health

Myles, L., & Merlo, E. (2021). Alexithymia and physical outcomes in psychosomatic subjects: A cross-sectional study. Journal of Mind and Medical Sciences, 8 (1), 76–85. https://scholar.valpo.edu/jmms/vol8/iss1/12

Myles, L., Merlo, E., & Obele, A. (2021). Desire for Control Moderates the Relationship between Perceived Control and Depressive Symptomology. Journal of Mind and Medical Sciences, 8 (2), 229–305. https://doi.org/10.22543/7674.82.P299305

Myles, L. A. M. (2021a). The Emerging Role of Computational Psychopathology in Clinical Psychology. Mediterranean Journal of Clinical Psychology, 9 (1). https://doi.org/10.6092/2282-1619/mjcp-2895

Myles, L. A. M. (2021b). Using Prediction Error to Account for the Pervasiveness of Mood Congruent Thoughts. Mediterranean Journal of Clinical Psychology, 9 (2). https://doi.org/10.13129/2282-1619/mjcp-3130

Myles, L. A. M., Connolly, J., & Stanulewicz, N. (2020). The Mediating Role of Perceived Control and Desire for Control in the Relationship between Personality and Depressive Symptomology. Mediterranean Journal of Clinical Psychology, 8 (3). https://doi.org/10.6092/2282-1619/mjcp-2589

Orgeta, V., Brede, J., & Livingston, G. (2017). Behavioural activation for depression in older people: Systematic review and meta-analysis. The British Journal of Psychiatry, 211 (5), 274–279. https://doi.org/10.1192/bjp.bp.117.205021

Pearce, J. M., & Hall, G. (1980). A model for Pavlovian learning: Variations in the effectiveness of conditioned but not of unconditioned stimuli. Psychological Review, 87 (6), 532–552. https://doi.org/10.1037/0033-295X.87.6.532

Rescorla, R. A. (1972). A theory of Pavlovian conditioning: Variations in the effectiveness of reinforcement and nonreinforcement. Current research and theory, 64–99.

Richards, D. A., Ekers, D., McMillan, D., Taylor, R. S., Byford, S., Warren, F. C., & Finning, K. (2016). Cost and Outcome of Behavioural Activation versus Cognitive Behavioural Therapy for Depression (COBRA): a randomised, controlled, non-inferiority trial. The Lancet, 388 (10047), 871–880. https://doi.org/10.1016/S0140-6736(16)31140-0

Seligman, M. E. (1975). Helplessness: On depression, development, and death. Henry Holt & Co. https://doi.org/10.1192/s0007125000042616

Sherdell, L., Waugh, C. E., & Gotlib, I. H. (2012). Anticipatory pleasure predicts motivation for reward in major depression. Journal of Abnormal Psychology, 121 (1), 51–60. https://doi.org/10.1037/a0024945

Tarrier, N., Wells, A., Haddock, G., & Davidson, J. (2000). Treating complex cases: The cognitive behavioural therapy approach. John Wiley & Sons. https://doi.org/10.1891/0889-8391.14.4.410

Tindall, L., MikockaWalus, A., McMillan, D., Wright, B., Hewitt, C., & Gascoyne, S. (2017). Is behavioural activation effective in the treatment of depression in young people? A systematic review and metaanalysis. Psychology and Psychotherapy: Theory, Research and Practice, 90 (4), 770–796. https://doi.org/10.1111/papt.12121

Tobin, S. J., & Raymundo, M. M. (2010). Causal uncertainty and psychological well-being: The moderating role of accommodation (secondary control). Personality and Social Psychology Bulletin, 36 (3), 371–383. https://doi.org/10.1177/0146167209359701

Vallée-Tourangeau, F., Hollingsworth, L., & Murphy, R. A. (1998). “Attentional bias” in correlation judgments? Smedslund (1963) revisited. Scandinavian Journal of Psychology, 39 (4), 221–233. https://doi.org/10.1111/1467-9450.00082

Vázquez, C. (1987). Judgment of contingency: Cognitive biases in depressed and nondepressed subjects. Journal of personality and social psychology, 52 (2), 419–431. https://doi.org/10.1037/0022-3514.52.2.419

Veale, D. (2008). Behavioural activation for depression. Advances in Psychiatric Treatment, 14 (1), 29–36. https://doi.org/10.1192/apt.bp.107.004051

Visdómine-Lozano, J. C. (2015). Afunctional-contextualist account of locus of control: Generalized control expectancies as derived relational responding. Journal of contextual behavioral science, 4 (4), 312–323. https://doi.org/10.1016/j.jcbs.2015.06.005

Volz, M., Voelkle, M. C., & Werheid, K. (2018). General self-efficacy as a driving factor of post-stroke depression: A longitudinal study. Neuropsychological rehabilitation, 29 (9), 1–13. https://doi.org/10.1080/09602011.2017.1418392

Wagner, A. R. (2014). SOP: A model of automatic memory processing in animal behavior. In Information processing in animals (pp. 15–58). Psychology Press.

Wasserman, E. A., Dorner, W. W., & Kao, S. F. (1990). Contributions of specific cell information to judgments of interevent contingency. Journal of Experimental Psychology: Learning, Memory, and Cognition, 16 (3), 509–521. https://doi.org/10.1037/0278-7393.16.3.509

Welsh, P., Kitchen, C. E., Ekers, D., Webster, L., & Tiffin, P. A. (2016). Behavioural activation therapy for adolescents ‘at risk’ for psychosis? Early intervention in psychiatry, 10 (2), 186–188. https://doi.org/10.1111/eip.12155

Westbrook, D., Kennerley, H., & Kirk, J. (2011). An introduction to cognitive behaviour therapy: Skills and applications. Sage. https://doi.org/10.1017/s1352465808004165

Downloads

Download data is not yet available.

Cited by