{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T10:49:31Z","timestamp":1785408571866,"version":"3.56.0"},"reference-count":67,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T00:00:00Z","timestamp":1783382400000},"content-version":"unspecified","delay-in-days":187,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Psychol. Med."],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S0033291726104875_sec1\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>While initial anhedonia predicts poor psychotherapy outcomes, little is known about its trajectory during treatment. This study aimed to: (1) identify distinct anhedonia trajectories during high-intensity depression treatment; (2) examine patient and treatment predictors; and (3) compare outcomes across treatment types.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0033291726104875_sec2\" sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Sessional anhedonia scores (PHQ-9 item-1) from 22,605 patients in NHS talking therapies (primarily receiving either cognitive-behavioral therapy [CBT] or counseling for depression [CfD]) were analyzed using latent growth curve (LGC) and growth mixture modeling. Multinomial logistic regression examined predictors of class membership.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0033291726104875_sec3\" sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A quadratic LGC model best fit the data, reflecting a decrease in symptoms before leveling out. Six latent classes emerged. Notably, three \u201cnon-responder\u201d classes characterized by linear-stable or minimal-change patterns comprised over 50% of the sample (51.3%). In contrast, two \u201cresponder\u201d classes (41.4%) exhibited improvement, typically shifting between sessions 4 and 6. This suggests an early \u201cinflection point\u201d where the trajectory of recovery is established. Poorer response was predicted by unemployment, chronic health conditions, psychotropic medication, and longer wait times. There was only a sufficient sample size to compare CBT and CfD treatment types. While CBT was associated with membership in specific classes, the probability of being a \u201cresponder\u201d did not differ significantly between CBT and CfD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0033291726104875_sec4\" sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Most patients followed non-responder trajectories, highlighting a major efficacy gap for anhedonia in standard depression protocols. The 4\u20136 session window suggests that if improvement is not observed early, the treatment strategy may require further evaluation. Further research into targeted anhedonia interventions is essential.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s0033291726104875","type":"journal-article","created":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T05:00:39Z","timestamp":1783400439000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Identifying distinct trajectories of change in anhedonia during psychological treatment for depression"],"prefix":"10.1017","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-5187-4736","authenticated-orcid":false,"given":"Daniel","family":"Pugh","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02jx3x895","id-type":"ROR","asserted-by":"publisher"}],"name":"University College London"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7077-8729","authenticated-orcid":false,"given":"Rob","family":"Saunders","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02jx3x895","id-type":"ROR","asserted-by":"publisher"}],"name":"University College London"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4301-6454","authenticated-orcid":false,"given":"Abbeygail","family":"Jones","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02jx3x895","id-type":"ROR","asserted-by":"publisher"}],"name":"University College London"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0299-0920","authenticated-orcid":false,"given":"Barnaby D.","family":"Dunn","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03yghzc09","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Exeter"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-0962-3850","authenticated-orcid":false,"given":"Jae Won","family":"Suh","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02jx3x895","id-type":"ROR","asserted-by":"publisher"}],"name":"University College London"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1361-053X","authenticated-orcid":false,"given":"Joshua","family":"Stott","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02jx3x895","id-type":"ROR","asserted-by":"publisher"}],"name":"University College London"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3743-5712","authenticated-orcid":false,"given":"Jon","family":"Wheatley","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01zpp3d44","id-type":"ROR","asserted-by":"publisher"}],"name":"Homerton Healthcare NHS Foundation Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7361-8202","authenticated-orcid":false,"given":"Stephen","family":"Pilling","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02jx3x895","id-type":"ROR","asserted-by":"publisher"}],"name":"University College London"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2281-0907","authenticated-orcid":false,"given":"Joshua E. 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