A Proposed Model for the Role of Fear of Intimacy and Social Support in Behavioral Activation: A Cross-Sectional Analysis.

Behavioral theories of depression posit that depression results from the environment not adequately reinforcing non-depressive behaviors. One commonly used treatment based on the behavioral model of depression is Behavioral Activation. While many implementations of Behavioral Activation emphasize social interactions, there is limited empirical investigation into the contribution of specific facets of social engagement in the behavioral model of depression. Fear of intimacy, an indicator of willingness to engage in specific types of social interactions, may play an important role in understanding at a functional level what aspects of social engagement are important in behavioral activation. The current study (N = 353) proposes a model, anchored in functional outcomes of behavioral interactions, to explain the development and utilization of social support as environmental enrichment. The proposed model accounted for 55% of the variance of depressive symptoms. Findings were consistent with a model where fear of intimacy was directly and indirectly associated with depression via activation, social support, and environmental enrichment. Notably, social support was not directly associated with depression. Findings suggest the importance of incorporating vulnerable self-disclosure in behavioral activation treatments to foster environmental enrichment.

Escala de Percepción de Reforzamiento Medioambiental (EROS): evidencias de validez en una muestra colombiana

Introducción: El objetivo de esta investigación fue confirmar la estructura interna de la Environmental Reward Observation Scale (EROS) y recoger evidencias de su relación con otros constructos en una muestra colombiana de 902 adultos que consintieron participar voluntariamente. Método: Se realizaron análisis psicométricos con Teoría Clásica de los Test y el modelo de Rasch. Se recolectaron evidencias de validez de la estructura interna y de la relación de las puntuaciones con otras variables. Resultados: Se obtuvieron buenos índices en los coeficientes alfa y omega de McDonald, nueve de los 10 ítems tuvieron buenos ajustes en los índices infit y outfit, y el ítem ocho presentó DIF en el nivel educativo. Se confirmó la estructura unidimensional de la EROS y fue invariante respecto al sexo y nivel educativo. Los puntajes tuvieron correlaciones de magnitud alta con sintomatología emocional y variables afines a la Activación Conductual. Conclusiones: La EROS presentó altas calidades psicométricas para su uso en población colombiana; sin embargo, se recomienda su uso solo para evaluación de tamizaje, porque los niveles de información están centrados en un área reducida a lo largo de la métrica logit.

Introduction: The aim of this research was to confirm the internal structure of the Environmental Reward Observation Scale (EROS) and to collect evidence of its relationship with other constructs in a Colombian sample of 902 adults who voluntarily consented to participate. Method: Psychometric analyses were performed using Classical Test Theory and the Rasch model. Evidence of validity based on internal structure and relations of scores with other variables was collected. Results: Good indexes were obtained in McDonald's Alpha and Omega coefficients, 9 of the 10 items had good adjustments in the Infit and Outfit indexes, and item 8 presented DIF in the educational level. The unidimensional structure of the EROS was confirmed and was invariant with respect to sex and educational level. Scores had high magnitude correlations with emotional symptomatology and variables related to Behavioral Activation. Conclusions: The EROS presented high psychometric qualities for its use in the Colombian population; however, its use is recommended only for screening assessment because the levels of information are centered in a reduced area along the Logit scaling.

Intersections between environmental reward availability, loss aversion, and delay discounting as potential risk factors for cigarette smoking and other substance use.

Behavioral theory suggests that density of environmental rewarding activities and biases in decision making influence risk for substance use disorder (SUD). To better understand intersections of these potential risk factors, this study examined whether environmental reward predicted smoking status or other drug use and whether such associations were independent of two decision-making biases known to predict SUD risk, namely loss aversion and delay discounting. Individuals that reported current daily cigarette smoking (n = 186; >10 cigarettes/day) and never-smoking (n = 241; <100 cigarettes lifetime) were recruited with standard crowdsourcing methods. Participants answered questions on alcohol and other drug use. Environmental reward was assessed using the Reward Probability Index (RPI), and loss aversion (LA) and delay discounting (DD) using a gamble-acceptance task and monetary choice questionnaire, respectively. Associations of RPI, LA, and DD with cigarette smoking, alcohol use, other drug use, and combinations of co-use were examined with logistic regression controlling for sociodemographic variables (educational attainment, gender, age). Low RPI (odds ratio[OR] = 0.97, p = .006), low LA (OR = 1.22, p < .001), and high DD (OR = 1.12, p = .03), were each independently associated with increased risk for cigarette smoking, as well as other substance use, and use combinations. We saw no evidence that RPI was significantly influencing associations between LA and DD with smoking status or other substance use. Finally, RPI, but not LA or DD, was significantly associated with depressed mood and sleep disturbance. These results provide new evidence on associations of RPI with smoking status and other substance use while further documenting independent associations between LA and DD and those outcomes.

Functioning of the EROS-R Scale in a Clinical Sample of Psychiatric Patients: New Psychometric Evidence from the Classical Test Theory and the Item Response Theory.

Reliable and valid assessment instruments that can be applied briefly and easily in clinical and outpatient settings that provide information about the sources of reinforcement that the patient finds in his life are especially relevant in therapy. The study aimed to evaluate the psychometric properties of the Environmental Reward Observation Scale (EROS-R) in a sample of psychiatric patients. A sample of 228 psychiatric patients of both sexes (56.1% men and 43.9% women) aged between 18 and 70 years was selected. Along with the EROS-R, other instruments were administered to assess depression and anxiety. The results show that the scale fits a unidimensional model, presenting adequate fit indices (RMSEA = 0.077 (IC 90% 0.055−0.100); SRMR = 0.048; CFI = 0.98; TLI = 0.98). It was also shown that the degree of reward provided by the environment (EROS-R) correlates negatively with the level of depression (ρ = −0.54; p < 0.01) and anxiety (ρ = −0.34; p < 0.01). From the IRT perspective, all the items present adequate discrimination indices, where item 4 is the most precise indicator to measure the degree of environmental reward. All this leads us to conclude that the EROS-R is an instrument with robust psychometric guarantees from TCT and IRT's perspectives, making it suitable for use in clinical contexts.

Psychometric Properties of the Environmental Reward Observation Scale: Study on Its Internal Structure, Factor Invariance, and Method Effect Associated With Its Negative Items.

The aim of this study was to assess the factorial structure of the scale, the method's effect associated with its negative items, its temporal invariance, and factorial invariance according to sex. For this purpose, three samples were collected, an initial sample of 200 participants, a second sample of 461 participants and a third sample of 107 participants; making a total of 768 Peruvian university students. Other instruments were applied together with the EROS scale in order to measure satisfaction with life, anxiety, stress and depression. Regarding the results, in the initial sample it was found that the original scale containing positive and negative items does adequately fit the data (RMSEA = .19; CFI = .77; TLI = .71) and also evidence was found supporting the existence of a methodological effect associated with the negative items. It was also found that version B of the scale which only has positive items data fits the data (RMSEA = .13; CFI = .96; TLI = .95). In the second sample it was found that version B still had a good fit to the data in a larger sample (RMSEA = .07; CFI = .98; TLI = .98). In addition, it was found that the scale can be considered invariant according to sex and presents validity based on other constructs. In the third sample it was found that the test-retest reliability of the scale was adequate (.70 [CI95% .593-.788]) and also evidence was found in favor of the temporal invariance of the scale. It is concluded that the scale formed only by positive items presents more robust psychometric properties and constitutes a better alternative to measure the level of reward provided by the environment.

Behavioral Activation Augmented With Mobile Technology for Depression and Anxiety in Chronic Moderate-Severe Traumatic Brain Injury: Protocol for a Randomized Controlled Trial.

OBJECTIVE: To describe and provide the rationale for a randomized controlled trial for depression or anxiety after moderate to severe traumatic brain injury (TBI), which will test 2 treatments based on behavioral activation (BA), a promising model to promote both positive mood and increased activity in this population. DESIGN: Randomized controlled trial with masked outcome assessment. SETTING: Outpatient catchment area of 1 TBI treatment center. PARTICIPANTS: Community-dwelling persons (N=60) with moderate-severe TBI at least 6 months prior to enrollment and greater than mild depression or anxiety. INTERVENTIONS: Participants will be randomized 2:1 into an 8-session treatment, behavioral activation with technology, consisting of 6 face-to-face sessions and 2 via phone, with mood and activity monitoring conducted via ecological momentary assessment on a smartphone; or a single session incorporating BA principles followed by 8 weeks of activity reminders in the form of implementation intentions, delivered as text messages. MAIN OUTCOME MEASURES: Brief Symptom Inventory-18 (primary outcome); Environmental Reward Observation Scale, Behavioral Activation for Depression Scale, Participation Assessment with Recombined Tools-Objective, Diener Satisfaction With Life Scale, Quality of Life after Brain Injury scale, Patient Global Impression of Change. Outcomes are measured midway through intervention, after treatment cessation (primary outcome), and at 2-month follow-up. A treatment enactment interview is administered after the follow-up to ascertain to what extent participants continue to engage in activities and use strategies promoted during trial participation. RESULTS: N/A. CONCLUSIONS: N/A.

Psychosocial factors associated with treatment outcomes in women with obesity and major depressive disorder who received behavioral activation for depression.

Behavioral activation is an empirically supported treatment for depression, but much is unknown about factors associated with treatment response. The present study aimed to determine whether baseline levels and subsequent changes in psychosocial factors were associated with improvement in depression in women with comorbid obesity who received behavioral activation treatment for depression and a lifestyle intervention. Multilevel modeling was used to estimate the associations between psychosocial factors and change in depression scores during the first 10 weeks of treatment and associations between changes in psychosocial factors from baseline to 6-month follow-up and change in depression over the same time period. No baseline psychosocial factors were associated with depression improvement during treatment (p = 0.110-0.613). However, greater improvement in hedonic capacity (p = 0.001), environmental reward (p = 0.004), and social impairment (p = 0.012) were associated with greater reductions in depression over 6 months. Findings highlight the differential relationship specific psychosocial factors have with depression treatment outcomes.

Validación de la Environmental Reward Observation Scale (EROS) en población colombiana / Validation of the Environmental Reward Observation Scale (EROS) in Colombian population

Se estimaron las propiedades psicométricas de la Environmental Reward Observation Scale (EROS) en población colombiana, con dos muestras: población comunitaria y clínica. Para la primera, se evaluaron 507 personas en 22 departamentos del país, con edades entre 18 y 72 años, 60.5 % mujeres y el restante hombres; la segunda muestra estuvo compuesta por 68 personas, con edades comprendidas entre 18 y 72 años, atendidas en el momento de la evaluación por profesionales en salud mental. Se realizó la aplicación de los instrumentos (Enviromental Reward Observation Scale y Escala Autoaplicada de Depresión de Zung), a través de redes sociales y correos electrónicos, con el fin de tener una muestra más amplia y una mayor variabilidad de la misma. Se encontraron niveles apropiados de consistencia interna (alfa de 0.87) e importantes evidencias de validez de constructo (agrupación en un factor que explica el 46.82 % de la varianza total) y discriminante ( r = -0.67).

In the present study the psychometric properties of the Environmental Reward Observation Scale (EROS) in Colombian population were estimated with two different samples: population and clinic. For the first sample 517 people were evaluated in 22 departments of the country aged 18 to 72, 60.5% are women and the remaining men, the second sample was composed of 68 people aged between 18 and 72 years who They are served at present by mental health professionals. Based on the above, the application of the instruments (Environmental Observation Reward Scale Y Auto Scale Applied Zung Depression) was made through social networks and emails in order to have a larger sample and greater variability the same in relation to the general population. Appropriate levels of internal consistency (alpha of 0.87) and significant evidence of construct validity (grouping by a factor that explains the 46.815% of the total variance) and discriminant ( r = -0.67).

Validation and Psychometric Properties of the French Versions of the Environmental Reward Observation Scale and of the Reward Probability Index.

Background: Low levels of environmental rewards have been related to depression on a number of occasions in the scientific literature. Two scales have been created to assess environmental rewards: the Environmental Reward Observation Scale (EROS) and the Reward Probability Index (RPI). This study aims to validate the French versions of these two scales. Method: 466 non-clinical adults completed an online survey assessing environmental rewards, depression, anxiety, activation, avoidance and behavioural systems. Confirmatory factor analyses were performed to assess the factorial structures of the French EROS and RPI. Results: A one-factor solution for the EROS and a two-factor solution for the RPI best fitted the data. High levels of internal consistency were found for both the EROS and the RPI. Convergent validity was also examined, revealing that high environmental rewards appear to be related to activation and behavioural activation system. Conclusion: The French versions of the EROS and the RPI appear to be reliable assessments of environmental rewards.