The Mechanisms of Behavioral Activation to Depression
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The Mechanisms of Behavioral Activation to Depression

Xueling Du 1*
1 Hunan Institute of Science and Technology
*Corresponding author: 15276197220@163.com
Published on 11 July 2025
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LNEP Vol.105
ISSN (Print): 2753-7056
ISSN (Online): 2753-7048
ISBN (Print): 978-1-80590-251-5
ISBN (Online): 978-1-80590-252-2
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Abstract

Behavioral activation (BA) of depression is a structured treatment method supported by empirical support, which allows individuals to participate more in the pleasure of environmental rewards, increases individual enthusiasm, and breaks the vicious cycle of depression avoidance behavior. Since the 1970 s, BA therapy has been repeatedly compared with cognitive therapy, drug therapy and other depression therapies. Its efficacy has been recognized by the American Psychological Association and the general public, but the current research on the mechanism of behavioral activation is still insufficient. Based on the technical description provided in the latest BA empirical articles, this paper gives a brief overview of the history, effectiveness and applicable population of BA, and then attempts to summarize and describe the BA mechanism from three aspects: behavior, cognition and neurobiology.

Keywords:

behavioral activation, depression, mechanisms of BA

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Du,X. (2025). The Mechanisms of Behavioral Activation to Depression. Lecture Notes in Education Psychology and Public Media,105,82-91.

References

[1]. Li Yingren, , Liu Huijun, Yang Qing, (2019). Behavioral activation therapy: a simple and economical intervention for depression. Chinese Journal of Clinical Psychology 27, 854-857.

[2]. Tolin DF, McKay D, Forman EM, Klonsky ED, & Thombs BD (2015). Empirically supported treatment: Recommendations for a new model. Clinical Psychology: Science and Practice, 22, 317–338.

[3]. Jacobson NS, Dobson KS, Truax PA, Addis ME, Koerner K, Gollan JK, et al. A component analysis of cognitive-behavioral treatment for depression. J Consult Clin Psychol 1996; 64: 295-304.

[4]. Minjee Junga & Kyu-Man Han., (2024). Behavioral Activation and Brain Network Changes in Depression. J Clin Neurol 2024, 20(4): 362-377.

[5]. Cuijpers P, van Straten A, Warmerdam L. Behavioral activation treatments of depression: a meta-analysis. Clin Psychol Rev 2007; 27: 318326.

[6]. Ekers D, Webster L, Van Straten A, Cuijpers P, Richards D, Gilbody S. Behavioral activation for depression; an update of meta-analysis of effectiveness and sub group analysis. PLoS One 2014; 9: e100100.

[7]. Xiaoxia Wang & Zhengzhi Feng, (2022). A Narrative Review of Empirical Literature of Behavioral Activation Treatment for Depression. Frontiers in Psychiatry, 13, Article 845138.

[8]. Wagner, A. W., Jakupcak, M., Kowalski, H. M., Bittinger, J. N., & Golshan, S. (2019). Behavioral activation as a treatment for posttraumatic stress disorder among returning veterans: A randomized trial. Psychiatric Services, 70(10), 867–873. https: // doi.org/10.1176/appi.ps.201800572.

[9]. Kanter, J. W., Santiago-Rivera, A. L., Santos, M. M., Nagy, G., López, M., Hurtado, G. D., & West, P. (2015). A randomized hybrid efficacy and effectiveness trial of behavioral activation for Latinos with depression. Behavior Therapy, 46(2), 177–192. https: //doi. org/10.1016/j.beth.2014.09.011.

[10]. Jacob, M. L., Keeley, M., Ritschel, L., & Craighead, W. E. (2013). Behavioural activation for the treatment of low-income, African American adolescents with major depressive disorder: A case series. Clinical Psychology & Psychotherapy, 20(1), 87–96. https: //doi. org/10.1002/cpp.774.

[11]. 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.

[12]. Dimidjian, S., Goodman, S. H., Sherwood, N. E., Simon, G. E., Ludman, E., Gallop, R. Beck, A. (2017). A pragmatic randomized clinical trial of behavioral activation for depressed pregnant women. Journal of Consulting and Clinical Psychology, 85(1), 26–36. https: //doi.org/10.1037/ccp0000151.

[13]. Daughters, S. B., Braun, A. R., Sargeant, M. N., Reynolds, E. K., Hopko, D. R., Blanco, C., & Lejuez, C. W. (2008). Effectiveness of a brief behavioral treatment for inner-city illicit drug users with elevated depressive symptoms: The life enhancement treatment for substance use (LETS Act!). Journal of Clinical Psychiatry, 69(1), 122. http: // behavioralactivationtech.com/wp-content/uploads/2016/03/Daughters-et-al_2008. pdf.

[14]. Concato J, Horwitz RI. Limited usefulness of meta-analysis for informing patient care. Psychother Psychosom. 2019; 88(5): 257–62. 32

[15]. Guidi J, Brakemeier EL, Bockting CL, Cosci F, Cuijpers P, Jarrett RB, et al. Methodological recommendations for trials of psychological interventions. Psychother Psychosom. 2018; 87(5): 276–84.

[16]. Lewinsohn, P. M. (1974). Clinical and theoretical aspects of depression. In K. S. Calhoun, H. E. Adams, & K. M. Mitchell (Eds.), Innovative treatment methods of psychopathology. New York: Wiley.

[17]. Lewinsohn PM, Libet J. Pleasant events, activity schedules, and depressions. J Abnorm Psychol. (1972) 79: 291–5. doi: 10.1037/h0033207.

[18]. Lewinsohn PM. Engagement in pleasant activities and depression level. J Abnorm Psychol. (1975) 84: 729–31. doi: 10.1037/0021-843X.84.6.729.

[19]. Lewinsohn, P.M., Sullivan, L.M., Grosscup, S., 1980. Changing reinforcing events: an approach to the treatment to depression. Psychother: Theory Res. Pract. 17, 322–334.

[20]. Dimidjian, S., Barrera Jr., M., Martell, C., Munoz, R.F., Lewinsohn, P.M., 2011. The origins and current status of behavioral activation treatment for depression. Annu. Rev. Clin. Psychol. 7, 1–38.

[21]. Manos, R.C., Kanter, J.W., Busch, A.M., 2010. A critical review of assessment strategies to measure the behavioral activation model of depression. Clin. Psychol. Rev. 30, 547–561.

[22]. Armento, M. E. A., & Hopko, D. R. (2007). The Environmental Reward Observation Scale (EROS): Development, validity, and reliability. Behavior Therapy, 38, 107−119.

[23]. Koki Takagaki, Yasumasa Okamoto, Ran Jinnin, Asako Mori, Yoshiko Nishiyama, Takanao, et al., (2016). Mechanisms of behavioral activation for late adolescents: Positive reinforcement mediate the relationship between activation and depressive symptoms from pre-treatment to post-treatment. Journal of Affective Disorders 204 (2016) 70–73.

[24]. Ferster, C. (1973). A functional analysis of depression. American Psychologist, 28, 857−870.

[25]. Martell CR, Addis ME, Jacobson NS. Depression in context: strategies for guided action. New York: W. W. Norton & Company, 2001.

[26]. David H. Barlow, (2008). Clinical Handbook of Psychological Disorders Fourth Edition, 343-363.

[27]. Lewinsohn PM. A behavioral approach to depression. In: Friedman RJ, Katz MM, editors. The psychology of depression. Oxford: John Wiley & Sons, 1974; 157-174.

[28]. Lewinsohn, P. M., Biglan, A., & Zeiss, A. M. (1976). Behavioral treatment for depression. In P. O. Davidson (Ed.), Behavioral management of anxiety, depression and pain (pp. 91−146). New York: Brunner/Mazel.

[29]. Lewinsohn, P. M., Muñoz, R. F., Youngren, M. A., & Zeiss, A. M. (1978a). Control your depression. Englewood Cliffs, NJ: Prentice-Hall.

[30]. McLean, P. D. (1976). Decision-making in the behavioral management of depression. In P. O. Davidson (Ed.), Behavioral management of anxiety, depression and pain. New York: Brunner/Mazel.

[31]. Wolpe, J., & Lazarus, A. A. (1966). Behavior therapy techniques. New York: Pergamon Press.

[32]. Stringaris, A., Vidal-Ribas Belil, P., Artiges, E., Lemaitre, H., Gollier-Briant, F., Wolke, S. Paillère-Martinot, M.-L. (2015). The brain’s response to reward anticipation and depression in adolescence: Dimensionality, specificity, and longitudinal predictions in a community-based sample. American Journal of Psychiatry, 172(12), 1215–1223. https: //doi.org/10.1176/appi.ajp.2015.14101298.

[33]. Yokoyama S, Okamoto Y, Takagaki K, Okada G, Takamura M, Mori A, et al. Effects of behavioral activation on default mode network connectivity in subthreshold depression: a preliminary resting-state fMRI study. J Affect Disord 2018; 227: 156-163.

[34]. Lewinsohn, P. M., & Graf, M. (1973). Pleasant activities and depression. Journal of Consulting and Clinical Psychology, 41, 261−268.

[35]. Insel, T., Cuthbert, B., Garvey, M., Heinssen, R., Pine, D. S., Quinn, K. Wang, P. (2010). Research domain criteria (RDoC): Toward a new classification framework for research on mental disorders. The American Journal of Psychiatry, 167(7), 748–751. https: //doi.org/10.1176/appi.ajp.2010.09091379.

[36]. National Institute of Mental Health (2018). RDoC changes of the matrix (CMAT) update: Proposed positive valence domain revisions. https: //www.nimh.nih.gov/about/ advisory-boards-and-groups/namhc/reports/cmat-pvs-report-508_157003.pdf.

[37]. PVS Proceedings (2011). NIMH research domain criteria (RDoC) positive valence systems domain workshop, Rockville, Maryland. https: //www.nimh.nih.gov/research/ research-funded-by-nimh/rdoc/positive-valence-systems-workshop-proceedings. shtml.

[38]. Furukawa TA, Imai H, Horikoshi M, Shimodera S, Hiroe T, Funayama T, et al. Behavioral activation: is it the expectation or achievement, of mastery or pleasure that contributes to improvement in depression? J Affect Disord. (2018) 238: 336–41. doi: 10.1016/j.jad.2018.05.067.

[39]. Stringaris, A., Vidal-Ribas Belil, P., Artiges, E., Lemaitre, H., Gollier-Briant, F., Wolke, S. Paillère-Martinot, M.-L. (2015). The brain’s response to reward anticipation and depression in adolescence: Dimensionality, specificity, and longitudinal predictions in a community-based sample. American Journal of Psychiatry, 172(12), 1215–1223. https: //doi.org/10.1176/appi.ajp.2015.14101298.

[40]. Treadway, M. T., Buckholtz, J. W., Schwartzman, A. N., Lambert, W. E., & Zald, D. H. (2009). Worth the “EEfRT”? The effort expenditure for rewards task as an objective measure of motivation and anhedonia. PLoS One, 4(8), e6598. https: //doi.org/10. 1371/journal.pone.0006598.

[41]. Courtney N. Forbes, (2020). New directions in behavioral activation: Using findings from basic science and translational neuroscience to inform the exploration of potential mechanisms of change. Clinical Psychology Review. https: //doi.org/10.1016/j.cpr.2020.101860.

[42]. Gotlib, I. H., Hamilton, J. P., Cooney, R. E., Singh, M. K., Henry, M. L., & Joormann, J. (2010). Neural processing of reward and loss in girls at risk for major depression. Archives of General Psychiatry, 67(4), 380–387. https: //doi.org/10.1001/ archgenpsychiatry.2010.13.

[43]. Olino, T. M., McMakin, D. L., Morgan, J. K., Silk, J. S., Birmaher, B., Axelson, D. A. Forbes, E. E. (2014). Reduced reward anticipation in youth at high-risk for unipolar depression: A preliminary study. Developmental Cognitive Neuroscience, 8, 55–64. https: //doi.org/10.1016/j.dcn.2013.11.005.

[44]. Gabriela A. Nagy, Paul Cernasov, Angela Pisoni, Erin Walsh, Gabriel S. Dichter, Moria J. Smoski, (2020). Reward Network Modulation as a Mechanism of Change in Behavioral Activation, HHS Public Access, 44(2): 186–213.

[45]. Eshel, N., & Roiser, J. P. (2010). Reward and punishment processing in depression. Biological Psychiatry, 68(2), 118–124. https: //doi.org/10.1016/j.biopsych.2010.01. 027.

[46]. Pizzagalli, D. A., Jahn, A. L., & O’Shea, J. P. (2005). Toward an objective characterization of an anhedonic phenotype: A signal-detection approach. Biological Psychiatry, 57(4), 319–327. https: //doi.org/10.1016/j.biopsych.2004.11.026.

[47]. Lejuez, C. W., Hopko, D. R., & Hopko, S. D. (2001). A brief behavioral activation treatment for depression: Treatment manual. Behavior Modification, 25(2), 255–286. https: //doi.org/10.1177/0145445501252005.

[48]. Lejuez, C. W., Hopko, D. R., Acierno, R., Daughters, S. B., & Pagoto, S. L. (2011). Ten-year revision of the brief behavioral activation treatment for depression: Revised treatment manual. Behavior Modification, 35(2), 111–161. https: //doi.org/10.1177/ 0145445510390929.

[49]. Jonathan W. Kanter, Rachel C. Manos, William. Bowe, David E. Baruch, Andrew M. Busch, Laura C. Rusch, What is behavioral activation? A review of the empirical literature. Clinical Psychology Review 30 (2010) 608–620.

[50]. Vrieze, E., Pizzagalli, D. A., Demyttenaere, K., Hompes, T., Sienaert, P., de Boer, P. Claes, S. (2013). Reduced reward learning predicts outcome in major depressive disorder. Biological Psychiatry, 73(7), 639–645. https: //doi.org/10.1016/j.biopsych. 2012.10.014.

[51]. Noortje P. Janssen, Gert-Jan Hendriks, Céline T. Baranelli, Peter Lucassen, Richard Oude Voshaar, Jan Spijkera, Marcus J.H. Huibers, How Does Behavioural Activation Work? A Systematic Review of the Evidence on Potential Mediators, Systematic Review Psychother Psychosom 2021; 90: 85–93

Cite this article

Du,X. (2025). The Mechanisms of Behavioral Activation to Depression. Lecture Notes in Education Psychology and Public Media,105,82-91.

Data availability

The datasets used and/or analyzed during the current study will be available from the authors upon reasonable request.

About volume

Volume title: Proceedings of the 2nd International Conference on Global Politics and Socio-Humanities

ISBN: 978-1-80590-251-5(Print) / 978-1-80590-252-2(Online)
Editor: Enrique Mallen
Conference website: https://2024.icgpsh.org/
Conference date: 20 December 2024
Series: Lecture Notes in Education Psychology and Public Media
Volume number: Vol.105
ISSN: 2753-7048(Print) / 2753-7056(Online)