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February 5, 2026Psychology and Psychotherapy Theory Research and Practice0 citations

Efficacy and mechanism of activity scheduling with positive imagery for behavioural activation in subclinical depression: A randomized controlled trial

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MLMingfan LiuJDJiaxin DuCCChen Cheng

Key Points

  • To investigate the efficacy and underlying mechanisms of activity scheduling with positive imagery in individuals with subclinical depression.
  • Conducted a randomized controlled trial with 203 participants.
  • Participants were assigned to three groups: activity scheduling with positive imagery, activity scheduling, or wait-list.
  • Assessments measured behavioural activation, depressive symptoms, prospective imagery, and activity ratings at multiple time points.
  • The ASI group showed significant increases in behavioural activation and reductions in depressive symptoms compared to other groups post-treatment.
  • Post-treatment, the ASI group had enhanced positive prospective imagery and reduced negative prospective imagery.
  • At follow-up, the ASI group demonstrated sustained improvement in depressive symptoms and behavioural activation compared to the wait-list group.

Abstract

Abstract Background Like major depressive disorder, subclinical depression involves reduced interest or pleasure in activities. Preliminary evidence suggests imagery‐based episodic simulation of planned activities boosts motivation and engagement, but its effects and underlying mechanisms in individuals with subclinical depression remain unclear. Methods This prospectively registered randomized controlled trial (Registration No.: ChiCTR2400084768) adopted a single‐blind design. A total of, 203 subclinically depressed participants were randomly assigned via computer‐generated random number list to the activity scheduling with positive imagery (ASI) group ( n = 68), activity scheduling (AS) group ( n = 67) or wait‐list (WL) group ( n = 68). Assessments at pre‐treatment, post‐treatment and 2‐month follow‐up measured primary outcomes (behavioural activation, depressive symptoms, prospective imagery) and the secondary outcome (activity ratings). Results At post‐treatment, the ASI group had increased behavioural activation ( d = 0.69–0.99), alleviated depressive symptoms ( d = 1.03–1.16), enhanced positive prospective imagery ( d = 1.74–2.16) and reduced negative prospective imagery ( d = 0.31–0.59) compared to the AS and WL groups. At follow‐up, the ASI group outperformed the WL group in depressive symptom improvement ( d = 1.32) and behavioural activation ( d = 0.51). Additionally, the ASI group demonstrated significantly greater enhancements in anticipated pleasure and anticipated reward for enjoyable activities than the AS group post‐training. Exploratory mediation analyses suggested that ASI training may promote behavioural activation and alleviate depressive symptoms by enhancing positive (rather than reducing negative) prospective imagery. Conclusions The ASI was an appropriate intervention for subclinical depression. Enhanced positive prospective imagery may be a potential mechanism in ASI training, requiring large‐sample validation.

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Cite This Study

Liu et al. (2026) studied this question.

synapsesocial.com/papers/698433a5f1d9ada3c1fb0eefhttps://doi.org/10.1111/papt.70041
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