Positive Affect as a Transdiagnostic Target for Reducing Adolescent Depression & Suicide Risk: Do Mindfulness, Savoring, & Gratitude Help?

Introduction: Despite its known contribution to adolescent depression and suicide risk, low positive affect (PA) remains underemphasized in clinical interventions, with limited evidence on how to best enhance it. Using data from a pilot randomized controlled trial of a brief PA-enhancing intervention for high-risk youth, we hypothesized that increases in PA over the intervention period would prospectively predict lower depressive symptoms and suicide ideation (SI). We also hypothesized that increases in mindfulness, savoring, and gratitude would prospectively predict higher PA and lower depressive symptoms and SI.

Methods: Participants were 52 adolescents, ages 12-18 (62% female, 31% male, 8% transgender) hospitalized for suicide-related reasons in the northeastern U.S.

Results: PA increases (using an anhedonia measure, where lower scores reflect greater PA) predicted lower T2 depressive symptoms, B = 1.00, p < 0.01, and lower T2 SI, B = 3.04, p < 0.01. Mindfulness increases predicted lower T2 depressive symptoms, B = -14.55, p < 0.01, and were marginally associated with lower T2 SI, B = -23.93, p = 0.08. Savoring increases predicted lower T2 depressive symptoms, B = -3.68, p < 0.05, and lower T2 SI, B = -17.50, p < 0.01. Gratitude increases were marginally associated with T2 depressive symptoms, B = -0.68, p = 0.07, but not T2 SI. Mindfulness, savoring, and gratitude increases were significant predictors of higher T2 PA. All analyses adjusted for T1 scores.

Conclusion: Findings support PA as a transdiagnostic target for adolescent depression and suicide risk. When developmentally tailored, mindfulness, savoring, and gratitude strategies may help enhance PA. Larger studies are needed to confirm these preliminary findings.