title: Mechanisms of behavioral activation for late adolescents: Positive reinforcement mediate the relationship between activation and depressive symptoms from pre-treatment to post-treatment.
abstract: It is suggested that there is some support for notion that frequency of activity can lead to improved mood in behavioral activation, but this research is relatively imprecise. We investigated whether positive reinforcement mediates the relationship between activation and alleviation of depressive symptoms
  
  
  
  Late adolescents with sub-threshold depressive symptoms participated in the study. We conducted an intervention using behavioral activation with the participants. Then, pre-and post-treatment results of behavioral activation were compared. We used mediation analysis using the bootstrapping method to examine whether changes in reinforcement mediated the relationship between changes in activation and improvements in depressive symptoms.
  
  
  
  Participants improved significantly at the post-intervention assessment, compared to the baseline assessment. Results of mediation analysis indicated that reinforcement significantly mediated the relationship between activation and depressive symptoms, whereas activation alone had no a direct effect on depressive symptoms.
  
  
  
  Further studies with more diverse samples of participants are required in order to generalize the results of this study to more diverse populations.
  
  
  
  The study provides the first full mediational test of behavioral activation model including both measures of activation and positive reinforcement, and we found support for behavioral activation's presumed mechanism of action that contact with positive reinforcement mediates the relation between activity and depression.
authors.affiliation: Department of Psychiatry and Neurosciences, Hiroshima University, Japan.
authors.forename: Koki
authors.initials: K
authors.lastname: Takagaki
authors.affiliation: Department of Psychiatry and Neurosciences, Hiroshima University, Japan. Electronic address: oy@hiroshima-u.ac.jp.
authors.forename: Yasumasa
authors.initials: Y
authors.lastname: Okamoto
authors.affiliation: Department of Psychiatry and Neurosciences, Hiroshima University, Japan.
authors.forename: Ran
authors.initials: R
authors.lastname: Jinnin
authors.affiliation: Department of Psychiatry and Neurosciences, Hiroshima University, Japan.
authors.forename: Asako
authors.initials: A
authors.lastname: Mori
authors.affiliation: Department of Psychiatry and Neurosciences, Hiroshima University, Japan.
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Nishiyama
authors.affiliation: Department of Psychiatry and Neurosciences, Hiroshima University, Japan.
authors.forename: Takanao
authors.initials: T
authors.lastname: Yamamura
authors.affiliation: Department of Psychiatry and Neurosciences, Hiroshima University, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yokoyama
authors.affiliation: Department of Psychiatry and Neurosciences, Hiroshima University, Japan.
authors.forename: Syouichi
authors.initials: S
authors.lastname: Shiota
authors.affiliation: Health Service Center, Hiroshima University, Japan.
authors.forename: Yuri
authors.initials: Y
authors.lastname: Okamoto
authors.affiliation: Health Service Center, Hiroshima University, Japan.
authors.forename: Yoshie
authors.initials: Y
authors.lastname: Miyake
authors.affiliation: Department of Psychology, Hiroshima University, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Ogata
authors.affiliation: Department of Mental Health, The University of Tokyo, Japan.
authors.forename: Haruki
authors.initials: H
authors.lastname: Shimoda
authors.affiliation: Department of Mental Health, The University of Tokyo, Japan.
authors.forename: Norito
authors.initials: N
authors.lastname: Kawakami
authors.affiliation: Departments of Health Promotion and Human Behavior and of Clinical Epidemiology, Kyoto University Graduate school pf Medicine/School of Public Health, Japan.
authors.forename: Toshi A
authors.initials: TA
authors.lastname: Furukawa
authors.affiliation: Department of Psychiatry and Neurosciences, Hiroshima University, Japan.
authors.forename: Shigeto
authors.initials: S
authors.lastname: Yamawaki
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D001521:Behavior Therapy / Q000379:methods*; D003863:Depression / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008960:Models, Psychological; D011569:Psychiatric Status Rating Scales; D012054:Reinforcement, Psychology; D016896:Treatment Outcome; D055815:Young Adult
keywords: Behavioral activation; Mediation analysis; Reinforcement