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Social AnhedoniaNCT07697001

Clinical and Neurocomputational Effects of Behavioral Activation in Veterans With Impaired Social Functioning

A study testing Behavioral Activation (BA) and Supportive Care Therapy (SCT) in people with Social Anhedonia and Social Function Impairment, run by VA Office of Research and Development at 1 site in United States.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

Poor psychosocial functioning, including social disconnection, is common and disabling among Veterans, and often fails to improve following the best available evidence-based treatments, particularly if more severe pathology is present. Read more about this study

Who is it for?
Ages 18 to 65 years
Conditions the study is for
Social Anhedonia, Social Function Impairment
What is being tested?
Behavioral Activation (BA) and Supportive Care Therapy (SCT)
Could I receive a placebo?
No, everyone receives an active treatment
How many people
136 participants
Where
1 siteUnited States
Study dates
1 Jan 2027to 31 Dec 2030
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 65 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • being a Veteran
  • having moderate to high levels of social disconnection (Social Connectedness Scale-Revised/SCS-R score < 90)
  • having moderate to high levels of social functioning impairments (Sheehan Disability Scale/SDS-social domain score >=5)
  • having moderate to high levels of social anhedonia (Specific Loss of Interest and Pleasure Scale/SLIPS score >= 6)

Who cannot join

  • lifetime history of psychotic or bipolar disorder
  • neurological conditions, neurodevelopmental disorders, or sensory deficits that may impact cognitive functioning to preclude understanding/completion of study procedure
  • regular use of certain psychotropic medications that may significantly impact goal-directed performance on the task (i.e., benzodiazepines, sedative hypnotics, and opioid analgesics); pre-existing stable doses of psychotropic medications, such as SSRIs, will be allowed (if same regimen has been taken for at least 30 days)
  • current severe alcohol or substance use disorders (AUD/SUD) necessitating prioritization of substance use treatment
  • suicidal or homicidal ideation within the past month necessitating urgent higher-level care
  • concurrent individual cognitive-behavioral psychotherapy specifically targeting depression, anhedonia, and/or PTSD

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Katia Harle, MD contact

(858) 642-3657

Katia.Harle@va.gov

United States1 site
  • VA San Diego Healthcare System, San Diego, CA

    San Diego, California, 92161-0002

    Katia Harle, MD, (858) 642-3657, Katia.Harle@va.gov

    Katia Harle, MD

Other trials in United States

About this study

Poor psychosocial functioning, including social disconnection, is common and disabling among Veterans, and often fails to improve following the best available evidence-based treatments, particularly if more severe pathology is present. Behavioral activation (BA) is a promising, low-burden intervention, which could help improve social functioning impairments in Veterans, as this treatment targets social reward sensitivity, an important driving mechanism of social functioning. Thus, the proposed research will test whether BA can specifically improve social functioning in Veterans. Leveraging a neurocomputational framework of social reward seeking behavior, this research will help to improve the treatment and assessment of social function and the prediction of psychosocial treatment needs in Veterans, while providing neurobehavioral targets to develop new interventions that can restore social functioning.

Read the detailed description

Perceived social disconnection and social isolation are disabling and common among Veterans. Yet, these psychosocial impairments can fail to improve following the best available evidence-based treatments. Behavioral activation (BA), an evidence-based treatment for depression has shown promise in improving social functioning. However, most of this research was conducted in primarily non-Veteran populations and has typically relied on patients' subjective symptoms and self-report, in contrast to objective behavioral probes, to assess social functioning. Moreover, the cognitive mechanisms promoting social behavior remain poorly understood, particularly in Veterans. For instance, social anhedonia, i.e., a reduced sensitivity to social rewards, such as positive human interactions, has been implicated as an important driving mechanism of poor social functioning. Yet, the degree to which BA successfully target social reward sensitivity remains unclear and has not been evaluated in Veterans. This lack of understanding limits the ability to develop more targeted and effective interventions for psychosocial recovery. To address these gaps, this study aims to test the clinical and neurobehavioral effectiveness of BA in targeting social dysfunction in Veterans.

Computational models of reward learning (RL), particularly Bayesian RL learning models, can offer an important bridge to link in-vivo behavior, such as social reward sensitivity, and recovery outcomes like psychosocial functioning, by providing a rich quantitative representation of reward learning and its dynamic updating during reward exploration. This proposal aims to capitalize on this approach, combining a translational behavioral paradigm, Bayesian reinforcement learning modeling, and neuroscientific evaluation of change processes, in order to assay social anhedonia and improve prediction of social functioning as well as understanding and effective dissemination of BA treatment.

The specific aims are to: 1) test the effectiveness of BA in improving social functioning outcomes in Veterans (Aim 1); 2) examine the impact of BA on neurocomputational markers of social reward sensitivity and their relationship to social functioning improvement in Veterans (Aim 2); and 3) assess the degree to which neurocomputational markers of social reward sensitivity predict social functioning recovery in Veterans undergoing BA (Aim 3). This project will also explore whether the relationships between neurocomputational markers of social function and clinical outcomes are moderated by primary diagnosis (exploratory Aim 4).

Veterans (N=136) with impaired social functioning and anhedonia will be recruited and randomized to either behavioral activation (BA) or supportive care therapy (SCT; active control) over 12 weeks. At baseline, immediately post-treatment, and 12-weeks post-treatment (24-weeks follow-up), participants will complete a computerized task aimed at probing social reward-seeking behavior, in which they must choose between unknown partners with the goal of maximizing the number of compliments they receive from these partners. Concurrent brain activity will be collected with functional magnetic resonance imaging (fMRI) in a subset of participants (N=68; at baseline and post-treatment). Therapy sessions and follow-up (24-weeks) assessments will be administered through VA-approved telehealth methods. Computational modeling will be used to derive individual parameters of social reward (i.e., compliments) learning and maximization, and to extract associated neural activity, e.g., neural responses to prediction error signals (discrepancies between expected and actually obtained reward/compliment). Randomization of participants to treatment arms will be be stratified based on fMRI eligibility status, sex, and primary psychiatric diagnosis.

This project is expected to 1) determine if BA offers an effective, low-burden option to improve social functioning in Veterans; 2) identify potential neurocognitive targets, which could be used in future research to develop and test novel treatments to improve psychosocial functioning in Veterans, such as computerized neurocomputational training protocols to boost social reward sensitivity; and 3) help identify precise markers of BA responsiveness for functional recovery.

Being tested
Behavioral Activation (BA), Supportive Care Therapy (SCT)
Keywords
Social Functioning, Social Reward, Anhedonia, Reinforcement Learning, Magnetic Resonance Imaging
Medical subject headings
Anhedonia, Social Adjustment

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Behavioral Activation (BA)Behavioural

    BA is a structured behavioral protocol for depression, designed to help individuals increase engagement in meaningful and rewarding activities, thereby breaking the cycle of avoidance and inactivity that often accompanies depression. The protocol teaches patients to increase a) engagement in pleasant, reinforcing activities, with a strong emphasis on social engagement and social connection, b) exploration of values, and c) goal-setting and goal-directed behavior, while monitoring their mood and daily activities

  • Supportive Care Therapy (SCT)Behavioural

    SCT is a Rogerian non-directive approach and employs techniques to convey a deep understanding of emotions, thoughts, and behaviors of the Veterans receiving this treatment. Specific techniques include content-focused paraphrasing, exploration through open-ended questions (with a goal of empathic understanding), and emotion-focused reflection and validation. Consistent with the SCT model, the therapist will be explicitly instructed not to provide advice, assign activities, or suggest strategies and techniques employed in the BA intervention.

Study groups in NCT07697001
Study groupRoleWhat they receive
Behavioral Activation (BA)ExperimentalThis arm provides the experimental treatment, i.e., Behavioral Activation therapy.
Receives: Behavioral: Behavioral Activation (BA)
Supportive Care Therapy (SCT)Active comparatorThis arm provides the active control treatment, i.e., Supportive Care Therapy.
Receives: Behavioral: Supportive Care Therapy (SCT)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Social Connectedness Scale - Revised (SCS-R)

    Measures the degree to which individuals feel connected to others in their social environment. Scores range from 20 to 120, where higher scores indicate a stronger, healthier sense of social connectedness.

    Measured: Baseline, Post-Treatment (12 weeks), Follow-Up (24 weeks)

  2. Inventory of Psychosocial Functioning (IPF)

    The scale measures the degree of impairment in ability to interact effectively with others, fulfill social roles (e.g., work), and meet personal and societal expectations. It is comprised of 7 subscales. Each item ranges from 0 to 6. Higher scores indicate greater degree of impairment in psychosocial functioning.

    Measured: Baseline, Post-Treatment (12 weeks), Follow-Up (24 weeks)

  3. Specific Loss of Interest and Pleasure Scale (SLIPS)

    This is a measure of social anhedonia, i.e., hypo-responsiveness to social rewards, such as positive human interactions. Scores range from 0 to 69. Higher scores indicate greater severity of social anhedonia.

    Measured: Baseline, Post-Treatment (12 weeks), Follow-Up (24 weeks)

  4. Social Reward Maximization

    Computational parameter derived from behavioral social functioning probe (behavioral reinforcement learning task), capturing the degree to which individuals select social partners they predict to be more rewarding (to offer the most compliments).

    Measured: Baseline, Post-Treatment (12 weeks), Follow-Up (24 weeks)

  5. Neural Activation to Social Reward Prediction Errors (RPEs)

    Average BOLD (Blood-Oxygenation-Level Dependent) % signal change (i.e., activation) associated with individuals' model-based RPE (difference between expected probability of reward/compliment and actual outcome received. i.e., compliment vs no-compliment).

    Measured: Baseline, Post-Treatment (12 weeks), Follow-Up (24 weeks)

Secondary outcomes (6)
  1. Primary Psychiatric Diagnosis

    Primary diagnostic category (i.e., depressive vs traumatic stress/anxiety disorder)

    Measured: Baseline, Post-Treatment (12 weeks), Follow-Up (24 weeks)

  2. World Health Organization Quality of Life Scale (WHOQOL-BREF)

    Measures quality of life and life satisfaction. Includes 4 domain subscales: physical health (range 7-35), psychological health (range 6-30), social relationships (range 3-15), and environment (range 8-42). Higher scores indicate higher quality of life.

    Measured: Baseline, Post-Treatment (12 weeks), Follow-Up (24 weeks)

  3. Patient Health Questionnaire-9 (PHQ-9)

    Measures depression severity. Scores range from 0 to 27. Higher scores indicate greater depression severity.

    Measured: Baseline, Post-Treatment (12 weeks), Follow-Up (24 weeks)

  4. PTSD Checklist-5 (PCL-5)

    Measures post-traumatic stress disorder (PTSD) severity. Scores range from 0 to 80, with higher scores indicating greater PTSD severity.

    Measured: Baseline, Post-Treatment (12 weeks), Follow-Up (24 weeks)

  5. Beck Anxiety Inventory (BAI)

    This scale measures anxiety severity. Scores range from 0 to 63, with higher scores indicating greater anxiety severity.

    Measured: Baseline, Post-Treatment (12 weeks), Follow-Up (24 weeks)

  6. Snaith-Hamilton Pleasure Scale (SHAPS)

    Measure of anhedonia. Score range from 14 to 56, with higher scores indicating greater anhedonia severity.

    Measured: Baseline, Post-Treatment (12 weeks), Follow-Up (24 weeks)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted10 Jul 2026
  2. Study start1 Jan 2027 (estimated)
  3. Primary completion31 Dec 2030 (estimated)
  4. Study completion31 Dec 2030 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
In this double-blind randomized clinical trials, participants will be randomized to complete one of 2 treatment arms: 1) behavioral activation or 2) supportive care therapy. Participants will complete 8 treatment sessions in either treatment arm.
Masking
Double blind
Who is masked
Participant, Outcomes assessor
Enrolment
136 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07697001
Sponsor's protocol ID
RRD4-009-25W
Status last verified
Jul 2026
First submitted
29 Jun 2026
Last updated
16 Jul 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: One or more data sets without personal identifiers will be generated during the data analysis phase of this study. The data sets will include all data underlying any publications generated by this study as well as statistical code, and therefore these will be sufficient to reproduce or verify any published findings. Any HIPAA identifiers, or combinations of variables that could be used for re-identification, will be excluded, as will any proprietary information. The plan does not include any access to individually identifiable or proprietary data. Therefore, this plan will ensure the protection of personal privacy, the confidentiality of individually identifiable private information, and the security of proprietary data and information.

Questions about this trial

What is this clinical trial studying?

A study testing Behavioral Activation (BA) and Supportive Care Therapy (SCT) in people with Social Anhedonia and Social Function Impairment, run by VA Office of Research and Development at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 16 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Katia Harle, MD ((858) 642-3657, Katia.Harle@va.gov), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Social Connectedness Scale - Revised (SCS-R) (time frame: Baseline, Post-Treatment (12 weeks), Follow-Up (24 weeks)). The study lists 5 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 16 Jul 2026.

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