Negative affect interference and fear of happiness are independently associated with depressive symptoms. D. Gage Jordan Amanda C. Collins Matthew G. Dunaway Jenna Kilgore E. Samuel Winer. Journal of Clinical Psychology, October 20 2020. https://doi.org/10.1002/jclp.23066
Abstract
Objectives: Reward devaluation theory (RDT) posits that some depressed individuals avoid positivity due to its previous association with negative outcomes. Behavioral indicators of avoidance of reward support RDT, but self‐report indicators have yet to be examined discriminantly. Two candidate self‐report measures were examined in relation to depression: negative affect interference (NAI), or the experience of negative affect in response to positivity, and fear of happiness, a fear of prospective happiness.
Method: Participants completed measures assessing NAI, fear of happiness scale, and depression online via Amazon's Mechanical Turk at three time points (N = 375). Multilevel modeling examined the relationship between NAI, fear of happiness, and depressive symptoms longitudinally.
Results: NAI and fear of happiness were both positively associated with depressive symptoms. They both uniquely predicted depressive symptoms when included within the same model.
Conclusions: These findings suggest that different conceptualizations of positivity avoidance are uniquely associated with depressive symptoms.
Fear of Happiness
A phenomenon relevant to negative affect interference that has been studied in relation to
depressive symptoms specifically is fear of happiness (Gilbert et al., 2012, 2014; Joshanloo et
al., 2013). As noted above, positive emotions, such as safeness, joy, and happiness, may not
necessarily be experienced as pleasurable in clinical populations, but rather as frightening (Şar et
al., 2019). Positive emotions may be associated with previous, negative experiences and have
resulted in disappointment or adverse outcomes, thus the prospect of experiencing happiness
itself may result in negative emotions (Joshanloo & Weijers, 2014). The experience of negative
emotions may be more intense than positive emotion, which may result in individuals being
aversive of positive emotions (Baumeister et al., 2001). Moreover, individuals may have a
“taboo” on happiness as they believe that bad things happen when one is happy or that happiness
never lasts (Arieti & Bemporad, 1980). The repeated disappointment of positivity and
association with previous, negative experiences over time may lead one to be aversive of
happiness and therefore have reduced hope. Thus, the diminished levels of hope related to
positive experiences may result in one developing or maintaining depressive symptoms (Bloore
et al., 2020). In sum, some individuals hold negative views about positive emotions and may thus
actively avoid experiencing them due to their association with negativity.
Examining Negative Affect Interference and Fear of Happiness Through the Lens of RDT
The most basic evidence as to why individuals may avoid and devalue positive emotions
and happiness comes from meta-analyses of the dot-probe task (Winer & Salem, 2016). As noted
briefly above, these meta-analyses demonstrate that depressed individuals discriminantly avoid
positive information in comparison to neutral information on the dot-probe task, and that this
pattern is the opposite of the approach-related reward biases that individuals without symptoms
of psychopathology demonstrate (Pool et al., 2016). The main tenet of RDT posits that
individuals avoid positive emotions because they are frightened of, disgusted by, or disturbed by
previous experiences where positive expectations such as hopefulness resulted in ultimate
disappointment. However, behavioral indicators, such as an attentional bias against positivelyvalenced stimuli, may not capture all features of this specific devaluative process outlined by
RDT. As such, the constructs of negative affect interference and fear of happiness are highly
relevant to advancing understanding of these phenomenological components of RDT.
For example, consider the role negative affect interference may play for someone who is
depressed. The depressed individual may attempt to upregulate their positive affect by engaging
in physical/sensory pleasures (e.g., walking on the beach). When attempting to engage in such
activities, however, this individual may concurrently experience guilt, self-criticalness, or even
shame as a result (e.g., “what’s the point of even trying?”). As negative affect interferes with
attempts to engage in pleasurable activities, the likelihood of engaging in similar activities in the
future diminishes. The negative affect interference construct, then, may provide insight regarding
a possible devaluative process associated with depression, in line with the main tenet of RDT; in
other words, that positivity comes to serve as a marker for negative feelings. A similar process
can take place as one comes to fear happiness. As noted previously, a happiness-averse
individual would hold negative views about positivity as a result of prior experiences (e.g., where initial hope or excitement ultimately led to disappointment). In sum, RDT suggests that
experiences that are potentially index by negative affect interference and fear of happiness are
causing or maintaining symptoms of depression, such as anhedonia. However, these constructs
have yet to be evaluated together in a single study.
The concepts of negative affect interference and fear of happiness thus are not only
related to depressive symptoms, but when viewed through the lens of RDT, would be most likely
to evidence avoidance; however, to our knowledge, there is no work that has examined these
constructs together and whether they are independently related to depressive symptoms.
Therefore, the present study sought to examine whether these potential routes of avoidance of
positivity are independently associated with depressive symptoms when entered into the same
model. To accomplish this, we assessed these variables at three separate time points spanning the
course of approximately nine months, investigating the extent to which these means of restricting
positive affect (i.e., fear of happiness and negative affect interference), relate to depressive
symptoms in a longitudinal sample.
We hypothesized that both negative affect interference and fear of happiness would be
significantly associated with depressive symptoms, replicating previous findings (DePierro et al.,
2018; Gilbert et al., 2012, 2014). Additionally, as an exploratory analysis, we examined the
extent to which fear of happiness and negative affect interference were associated with
depressive symptoms when entered as independent variables into a linear mixed (multilevel)
model to further evaluate their capacity to predict depressive symptoms independently. Further,
given these constructs were measured at various time points, we were also able to examine the
trajectories of these variables, determining the extent to which they were stable over the course
of the study.
Lastly, we included the other subscales of the HDIS, positive emotionality (PE) and
hedonic deficits (HD), to further assess whether fear of happiness and negative affect
interference would discriminate from constructs that are viewed as similar but different in
important ways by RDT. More specifically, PE reflects a frequency of experienced positive
affect, whereas HD specifically refers to a general inability to experience positive feelings
(Frewen, Dean, et al., 2012). Anhedonic experiences likely share a great deal of overlap with fear
of happiness and negative affect interference; indeed, fearing a prospective positive event may
appear as avolition due to the individual actively avoiding the event. However, understanding the
unique predictability of fear of happiness and negative affect interference compared to general
anhedonic symptoms could provide evidence that may ultimately inform future treatments or
conceptualizations of depression. For example, hallmark treatments for depression have often
focused on reducing negative affect and/or assuming the depressed patient suffers from an
inability to experience positive affect (Beck & Bredemeier, 2016). Further, current nosology also
simply emphasizes a “markedly diminished interest” in activities (American Psychiatric
Association, 2013), possibly conflating distinct experiences that can result in this loss of interest
(Winer et al., 2019).
Understanding the processes associated with fearing and actively avoiding positivity and
showing that these experiences are unique from mere reduced positive affect or an inability to
experience positivity would allow for a more nuanced understanding of how depressive
symptoms develop, as well as possibly inform novel interventions that target these fears or
avoidance. Thus, we wished to examine if fear of happiness and NAI would discriminate from
PE and HD, which do not index phenomena that are as precisely theoretically relevant to
avoidance of positivity as stipulated by RDT. Moreover, we also wished to examine whether the fear of happiness and NAI were similar enough that only one would be predictive of depressive
symptoms, or if one or both explained enough unique variance to be independently predictive.