Building wellbeing in young people with depression: Adapting Augmented Depression Therapy

Adolescence is a pivotal developmental stage marked by rapid change and heightened plasticity, which presents both opportunities and vulnerabilities. Rising mental health challenges among young people, particularly depression, significantly impact lifelong wellbeing. Existing psychological therapies are suboptimal, with only half of those recovering after treatment. One way to improve treatments is to target anhedonia, a core depressive symptom characterized by a diminished interest and pleasure in daily activities, reflecting dysfunction within the positive valence system (PVS). Anhedonia is clinically neglected, associated with poorer outcomes, and rated by young people as high priority to repair. Augmented Depression Therapy (ADepT) is a promising new therapy that targets anhedonia, positive affect and wellbeing. ADepT is currently unexplored in young people. Further, little is known about how ADepT may work in young people.
The thesis comprises four chapters: 1) A systematic review and meta-analysis of how well current psychological treatments improve anhedonia, positive affect, and wellbeing in depression in young people, 2) A mixed-methods multiple baseline case series exploring the feasibility, acceptability, and preliminary effectiveness of augmented depression therapy in young adults (18-24 year olds), 3) An exploration of experiential processing impact on positive affect using ecological momentary assessment during pleasant activities and 4) The development and validation of the brief awareness of sensory experiences scale, examining its psychometric properties and association with anhedonia, positive affect, and wellbeing. Overall, this thesis aims to better understand current treatments effects on positive mental health, whether Augmented depression therapy may improve positive mental health, and which mechanisms may underly treatments effects on positive mental health outcomes.