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Motivation, reward and anhedonia

Drive, reward sensitivity and the flattening of both.

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Qurʾān

القرآن1 shown

Verses named for this subject by hand come first. The rest are found by the subject’s own Arabic and English senses and are shown as lexical matches, not as anchors anyone has confirmed.

Qur'ān 2:282Arabic sense: ملل

يَٰٓأَيُّهَا ٱلَّذِينَ ءَامَنُوٓاْ إِذَا تَدَايَنتُم بِدَيۡنٍ إِلَىٰٓ أَجَلࣲ مُّسَمࣰّ ى فَٱكۡتُبُوهُۚ وَلۡيَكۡتُب بَّيۡنَكُمۡ كَاتِبُۢ بِٱلۡعَدۡلِۚ وَلَا يَأۡبَ كَاتِبٌ أَن يَكۡتُبَ كَمَا عَلَّمَهُ ٱللَّهُۚ فَلۡيَكۡتُبۡ وَلۡيُمۡلِلِ ٱلَّذِي عَلَيۡهِ ٱلۡحَقُّ وَلۡيَتَّقِ ٱللَّهَ رَبَّهُۥ وَلَا يَبۡخَسۡ مِنۡهُ شَيۡـࣰٔ اۚ فَإِن كَانَ ٱلَّذِي عَلَيۡهِ ٱلۡحَقُّ سَفِيهًا أَوۡ ضَعِيفًا أَوۡ لَا يَسۡتَطِيعُ أَن يُمِلَّ هُوَ فَلۡيُمۡلِلۡ وَلِيُّهُۥ بِٱلۡعَدۡلِۚ وَٱسۡتَشۡهِدُواْ شَهِيدَيۡنِ مِن رِّجَالِكُمۡۖ فَإِن لَّمۡ يَكُونَا رَجُلَيۡنِ فَرَجُلࣱ وَٱمۡرَأَتَانِ مِمَّن تَرۡضَوۡنَ مِنَ ٱلشُّهَدَآءِ أَن تَضِلَّ إِحۡدَىٰهُمَا فَتُذَكِّرَ إِحۡدَىٰهُمَا ٱلۡأُخۡرَىٰۚ وَلَا يَأۡبَ ٱلشُّهَدَآءُ إِذَا مَا دُعُواْۚ وَلَا تَسۡـَٔمُوٓاْ أَن تَكۡتُبُوهُ صَغِيرًا أَوۡ كَبِيرًا إِلَىٰٓ أَجَلِهِۦۚ ذَٰلِكُمۡ أَقۡسَطُ عِندَ ٱللَّهِ وَأَقۡوَمُ لِلشَّهَٰدَةِ وَأَدۡنَىٰٓ أَلَّا تَرۡتَابُوٓاْ إِلَّآ أَن تَكُونَ تِجَٰرَةً حَاضِرَةࣰ تُدِيرُونَهَا بَيۡنَكُمۡ فَلَيۡسَ عَلَيۡكُمۡ جُنَاحٌ أَلَّا تَكۡتُبُوهَاۗ وَأَشۡهِدُوٓاْ إِذَا تَبَايَعۡتُمۡۚ وَلَا يُضَآرَّ كَاتِبࣱ وَلَا شَهِيدࣱۚ وَإِن تَفۡعَلُواْ فَإِنَّهُۥ فُسُوقُۢ بِكُمۡۗ وَٱتَّقُواْ ٱللَّهَۖ وَيُعَلِّمُكُمُ ٱللَّهُۗ وَٱللَّهُ بِكُلِّ شَيۡءٍ عَلِيمࣱ‏

You who believe, when you contract a debt for a stated term, put it down in writing: have a scribe write it down justly between you. No scribe should refuse to write: let him write as God has taught him, let the debtor dictate, and let him fear God, his Lord, and not diminish [the debt] at all. If the debtor is feeble-minded, weak, or unable to dictate, then let his guardian dictate justly. Call in two men as witnesses. If two men are not there, then call one man and two women out of those you approve as witnesses, so that if one of the two women should forget the other can remind her. Let the witnesses not refuse when they are summoned. Do not disdain to write the debt down, be it small or large, along with the time it falls due: this way is more equitable in God’s eyes, more reliable as testimony, and more likely to prevent doubts arising between you. But if the merchandise is there and you hand it over, there is no blame on you if you do not write it down. Have witnesses present whenever you trade with one another, and let no harm be done to either scribe or witness, for if you did cause them harm, it would be a crime on your part. Be mindful of God, and He will teach you: He has full knowledge of everything

Tafsīr

التفسير2 shown

Commentary on the verses above, at most two editions per verse.

en-al-jalalayn on 2:282en-al-jalalayncommentary on an ayah this subject surfaced

O you who believe when you contract when you are dealing with a debt such as in prepayment for future delivery of goods or a loan one upon another for a stated a known term write it down as confirmation and security against any dispute; and let a writer write it the contract of debt down between you justly accurately not increasing or decreasing the amount or the terms; and let not any writer refuse to write it down if he is requested for such a task as God has taught him the kāf of ka-mā ‘as’ is semantically connected to the verb ya’ba ‘refuse’ that is just as He has given him the advantage of knowing how to write he should not be niggardly in this respect; so let him write repeated for emphasis and let the debtor dictate to the one writing the contract for he is the one being witnessed and must be fully aware of his obligations; and let him fear God his Lord when dictating and not dimi

en-tafisr-ibn-kathir on 2:282en-tafisr-ibn-kathircommentary on an ayah this subject surfaced

O you who believe! When you contract a debt for a fixed period, write it down. Let a scribe write it down in justice between you. Let not the scribe refuse to write, as Allah has taught him, so let him write. Let him (the debtor) who incurs the liability dictate, and he must have Taqwa of Allah, his Lord, and diminish not anything of what he owes. But if the debtor is of poor understanding, or weak, or is unable to dictate for himself, then let his guardian dictate in justice. And get two witnesses out of your own men. And if there are not two men (available), then a man and two women, such as you agree for witnesses, so that if one of them (two women) errs, the other can remind her. And the witnesses should not refuse when they are called (for evidence). You should not become weary to write it (your contract), whether it be small or big, for its fixed term, that is more just with Allah;

Ḥadīth

الحديث6 shown

Sound narrations only, and never matched by text. A narration appears here because a compiler filed it under a chapter this subject maps to, or because someone read it and anchored it. Each row says which.

Sahih Muslim 2736Heart-Melting Traditionsfiled here by the compiler

حَدَّثَنَا هَدَّابُ بْنُ خَالِدٍ، حَدَّثَنَا حَمَّادُ بْنُ سَلَمَةَ، ح وَحَدَّثَنِي زُهَيْرُ بْنُ حَرْبٍ، حَدَّثَنَا مُعَاذُ بْنُ مُعَاذٍ الْعَنْبَرِيُّ، ح وَحَدَّثَنِي مُحَمَّدُ بْنُ عَبْدِ الأَعْلَى، حَدَّثَنَا الْمُعْتَمِرُ، ح وَحَدَّثَنَا إِسْحَاقُ، بْنُ إِبْرَاهِيمَ أَخْبَرَنَا جَرِيرٌ، كُلُّهُمْ عَنْ سُلَيْمَانَ التَّيْمِيِّ، ح وَحَدَّثَنَا أَبُو كَامِلٍ، فُضَيْلُ بْنُ حُسَيْنٍ - وَاللَّفْظُ لَهُ - حَدَّثَنَا يَزِيدُ بْنُ زُرَيْعٍ، حَدَّثَنَا التَّيْمِيُّ، عَنْ أَبِي عُثْمَانَ، عَنْ أُسَامَةَ بْنِ زَيْدٍ، قَالَ قَالَ رَسُولُ اللَّهِ صلى الله عليه وسلم ‏ "‏ قُمْتُ عَلَى بَابِ الْجَنَّةِ فَإِذَا عَامَّةُ مَنْ دَخَلَهَا الْمَسَاكِينُ وَإِذَا أَصْحَابُ الْجَدِّ مَحْبُوسُونَ إِلاَّ أَصْحَابَ النَّارِ فَقَدْ أُمِرَ بِهِمْ إِلَى النَّارِ وَقُمْتُ عَلَى بَابِ النَّارِ فَإِذَا عَامَّةُ مَنْ دَخَلَهَا النِّسَاءُ ‏"‏ ‏.‏

Usama b. Zaid reported that Allah's Messenger (way peace be upon him) said:I stood at the door of Paradise and I found that the overwhelming majority of those who entered therein was that of poor persons and the wealthy persons were detained to get into that. The denizens of Hell were commanded to get into Hell, and I stood upon the door of Fire and the majority amongst them who entered there was that of women

Sahih Muslim 2737Heart-Melting Traditionsfiled here by the compiler

حَدَّثَنَا أَبُو كُرَيْبٍ، حَدَّثَنَا أَبُو أُسَامَةَ، عَنْ سَعِيدِ بْنِ أَبِي عَرُوبَةَ، سَمِعَ أَبَا رَجَاءٍ، عَنِ ابْنِ عَبَّاسٍ، قَالَ قَالَ رَسُولُ اللَّهِ صلى الله عليه وسلم فَذَكَرَ مِثْلَهُ ‏.‏

This hadith is narrated likewise through another chain of transmitters

Sahih Muslim 2957Zuhd And Softening Of Heartsfiled here by the compiler

حَدَّثَنَا عَبْدُ اللَّهِ بْنُ مَسْلَمَةَ بْنِ قَعْنَبٍ، حَدَّثَنَا سُلَيْمَانُ، - يَعْنِي ابْنَ بِلاَلٍ - عَنْ جَعْفَرٍ، عَنْ أَبِيهِ، عَنْ جَابِرِ بْنِ عَبْدِ اللَّهِ، أَنَّ رَسُولَ اللَّهِ صلى الله عليه وسلم مَرَّ بِالسُّوقِ دَاخِلاً مِنْ بَعْضِ الْعَالِيَةِ وَالنَّاسُ كَنَفَتَهُ فَمَرَّ بِجَدْىٍ أَسَكَّ مَيِّتٍ فَتَنَاوَلَهُ فَأَخَذَ بِأُذُنِهِ ثُمَّ قَالَ ‏"‏ أَيُّكُمْ يُحِبُّ أَنَّ هَذَا لَهُ بِدِرْهَمٍ ‏"‏ ‏.‏ فَقَالُوا مَا نُحِبُّ أَنَّهُ لَنَا بِشَىْءٍ وَمَا نَصْنَعُ بِهِ قَالَ ‏"‏ أَتُحِبُّونَ أَنَّهُ لَكُمْ ‏"‏ ‏.‏ قَالُوا وَاللَّهِ لَوْ كَانَ حَيًّا كَانَ عَيْبًا فِيهِ لأَنَّهُ أَسَكُّ فَكَيْفَ وَهُوَ مَيِّتٌ فَقَالَ ‏"‏ فَوَاللَّهِ لَلدُّنْيَا أَهْوَنُ عَلَى اللَّهِ مِنْ هَذَا عَلَيْكُمْ ‏"‏ ‏.‏

Jabir b. Abdullah reported that Allah's Apostle (ﷺ) happened to walk through the bazar coming from the side of 'Aliya and the people were on both his sides. There he found a dead lamb with very short ears. He took hold of his ear and said:Who amongst you would like to have this for a dirham? They said: We do not like to have it even for less than that as it is of no use to us. He said: Do you wish to have it (free of any cost)? They said: By Allah, even if it were alive (we would not have liked to possess that), for there is defect in it as its ear is very short; now it is dead also. Thereupon Allah's Messenger (ﷺ) said: By Allah, this world is more insignificant in the eye of Allah than it (this dead lamb) is in your eye

Sahih Muslim 2957Zuhd And Softening Of Heartsfiled here by the compiler

حَدَّثَنِي مُحَمَّدُ بْنُ الْمُثَنَّى الْعَنَزِيُّ، وَإِبْرَاهِيمُ بْنُ مُحَمَّدِ بْنِ عَرْعَرَةَ السَّامِيُّ، قَالاَ حَدَّثَنَا عَبْدُ الْوَهَّابِ، - يَعْنِيَانِ الثَّقَفِيَّ - عَنْ جَعْفَرٍ، عَنْ أَبِيهِ، عَنْ جَابِرٍ، عَنِ النَّبِيِّ صلى الله عليه وسلم ‏.‏ بِمِثْلِهِ غَيْرَ أَنَّ فِي حَدِيثِ الثَّقَفِيِّ فَلَوْ كَانَ حَيًّا كَانَ هَذَا السَّكَكُ بِهِ عَيْبًا ‏.‏

Jabir reported Allah's Apostle (ﷺ) narrating a hadith like this with a slight variation of wording

Sahih al-Bukhari 6412To Make The Heart Tenderfiled here by the compiler

حَدَّثَنَا الْمَكِّيُّ بْنُ إِبْرَاهِيمَ، أَخْبَرَنَا عَبْدُ اللَّهِ بْنُ سَعِيدٍ ـ هُوَ ابْنُ أَبِي هِنْدٍ ـ عَنْ أَبِيهِ، عَنِ ابْنِ عَبَّاسٍ ـ رضى الله عنهما ـ قَالَ قَالَ النَّبِيُّ صلى الله عليه وسلم ‏ "‏ نِعْمَتَانِ مَغْبُونٌ فِيهِمَا كَثِيرٌ مِنَ النَّاسِ، الصِّحَّةُ وَالْفَرَاغُ ‏"‏‏.‏ قَالَ عَبَّاسٌ الْعَنْبَرِيُّ حَدَّثَنَا صَفْوَانُ بْنُ عِيسَى، عَنْ عَبْدِ اللَّهِ بْنِ سَعِيدِ بْنِ أَبِي هِنْدٍ، عَنْ أَبِيهِ، سَمِعْتُ ابْنَ عَبَّاسٍ، عَنِ النَّبِيِّ صلى الله عليه وسلم مِثْلَهُ‏.‏

Narrated Ibn `Abbas:The Prophet (ﷺ) said: "There are two blessings that many people are deceived into losing: health and free time

Sahih al-Bukhari 6414To Make The Heart Tenderfiled here by the compiler

حَدَّثَنِي أَحْمَدُ بْنُ الْمِقْدَامِ، حَدَّثَنَا الْفُضَيْلُ بْنُ سُلَيْمَانَ، حَدَّثَنَا أَبُو حَازِمٍ، حَدَّثَنَا سَهْلُ بْنُ سَعْدٍ السَّاعِدِيُّ، كُنَّا مَعَ رَسُولِ اللَّهِ صلى الله عليه وسلم فِي الْخَنْدَقِ وَهْوَ يَحْفِرُ وَنَحْنُ نَنْقُلُ التُّرَابَ وَيَمُرُّ بِنَا فَقَالَ ‏ "‏ اللَّهُمَّ لاَ عَيْشَ إِلاَّ عَيْشُ الآخِرَهْ، فَاغْفِرْ لِلأَنْصَارِ وَالْمُهَاجِرَهْ ‏"‏‏.‏ تَابَعَهُ سَهْلُ بْنُ سَعْدٍ عَنِ النَّبِيِّ صلى الله عليه وسلم مِثْلَهُ‏.‏

Narrated Sahl bin Sa`d As-Sa`idi:We were in the company of Allah's Messenger (ﷺ) in (the battle of) Al-Khandaq, and he was digging the trench while we were carrying the earth away. He looked at us and said, "O Allah! There is no life worth living except the life of the Hereafter, so (please) forgive the Ansar and the Emigrants

Classical works

كتب التراث6 shown

Arabic originals, reached through the subject’s Arabic senses. Interpretive sources, never proof of a ruling.

mukhtasar-minhaj §321mukhtasar-minhajArabic sense: الفتور, الكسل, فتور, كسل

ومن آدابه: أن لا يمتلئ من الطعام فى الليل، بل يأكل بمقدار، فانه ما ملأ ابن آدم وعاء شرا من بطن. ومتى شبع أول الليل لم ينتفع بنفسه فى باقيه، وكذلك إذا شبع وقت السحر لم ينتفع بنفسه إلى قريب من الظهر، لأن كثرة الأكل تورث الكسل والفتور، ثم يفوت المقصود من الصيام بكثرة الأكل، لأن المراد منه أن يذوق طعم الجوع، ويكون تاركا للمشتهى.

madarij §3757madarijArabic sense: الفتور, الكسل, فتور, كسل

بين القبض والبسط أي ينقطع إلى صحبة الحال وهو الوارد الذي يرد على القلب من تأثيره بالمعاملة السالب لوصف الكسل والفتور الجالب له إلى مرافقة الرفيق الأعلى الذين أنعم الله عليهم فينتقل من مقام العلم إلى مقام الكشف ومن مقام رسوم الأعمال إلى مقام حقائقها وأذواقها ومواجيدها وأحوالها فيترقى من الإسلام إلى الإيمان ومن الإيمان إلى الإحسان

wabil-sayyib §43wabil-sayyibArabic sense: الفتور, الكسل, فتور, كسل

فحقيقة التعظيم للامر والنهي ان لا يعارضا بترخص جاف ولا يعرضا لتشديد غال فان المقصود هو الصراط المستقيم الموصل إلى الله عز وجل بسالكه وما امر الله عز وجل بأمر الا وللشيطان فيه نزغتان اما تقصير وتفريط واما افراط وغلو فلا يبالي بما ظفر من العبد من الخطيئتين فانه ياتي إلى قلب العبد فيستامه فان وجد فيه فتورا وتوانيا وترخيصا اخذه من هذه الخطة فثبطه واقعده وضربه بالكسل والتواني والفتور وفتح له باب التاويلات والرجاء وغير ذلك حتى ربما ترك العبد المامور جملة

fawaid §490fawaidArabic sense: الفتور, الكسل, فتور, كسل

العزيمة فيصدقه في عزمه وفي فعله قال تعالى فإذا عزم الأمر فلو صدقوا الله لكان خيرا لهم فسعادته في صدق العزيمة وصدق الفعل فصدق العزيمة جمعها وجزمها وعدم التردد فيها بل تكون عزيمة لا يشوبها تردد ولا تلوم فإذا صدقت عزيمته بقى عليه صدق الفعل وهو استفراغ الوسع وبذل الجهد فيه وأن لا يتخلف عنه بشيء من ظاهره وباطنه فعزيمة القصد تمنعه من ضعف الإرادة والهمة وصدق الفعل يمنعه من الكسل والفتور ومن صدق الله في جميع أموره صنع الله له فوق ما يصنع لغيره وهذا الصدق معنى يلتئم من صحة الإخلاص وصدق التوكل فأصدق الناس من صح إخلاصه وتوكله

madarij §6757madarijArabic sense: الفتور, الكسل, فتور, كسل

فالإيمان بالصفات ومعرفتها وإثبات حقائقها وتعلق القلب بها وشهوده لها هو مبدأ الطريق ووسطه وغايته وهو روح السالكين وحاديهم إلى الوصول ومحرك عزماتهم إذا فتروا ومثير هممهم إذا قصروا فإن سيرهم إنما هو على الشواهد فمن كان لا شاهد له فلا سير له ولا طلب ولا سلوك له وأعظم الشواهد صفات محبوبهم ونهاية مطلوبهم وذلك هو العلم الذي رفع لهم في السير فشمروا إليه كما قالت عائشة رضي الله عنها من رأى رسول الله فقد رآه غاديا رائحا لم يضع لبنة على لبنة ولكن رفع له علم فشمر إليه ولا يزال العبد في التواني والفتور والكسل حتى يرفع الله عز وجل له بفضله ومنه علما يشاهده بقلبه فيشمر إليه ويعمل عليه

madarij §1930madarijArabic sense: الفتور, الكسل, فتور, كسل

قال الله تعالى : ففروا إلى الله الذاريات : 50 ] وحقيقة الفرار : الهرب من شيء إلى شيء وهو نوعان : فرار السعداء وفرار الأشقياء ففرار السعداء : الفرار إلى الله عز وجل وفرار الأشقياء : الفرار منه لا إليه وأما الفرار منه إليه : ففرار أوليائه قال ابن عباس في قوله تعالى : ففروا إلى الله الذاريات : 50 ] : فروا منه إليه واعملوا بطاعته وقال سهل بن عبدالله : فروا مما سوى الله إلى الله وقال آخرون : اهربوا من عذاب الله إلى ثوابه بالإيمان والطاعة وقال صاحب المنازل : هو الهرب مما لم يكن إلى من لم يزل وهو على ثلاث درجات : فرار العامة من الجهل إلى العلم عقدا وسعيا ومن الكسل إلى التشمير جدا وعزما ومن الضيق إلى السعة ثقة ورجاء يريد بما لم يكن الخلق وبما لم يزل الحق وقوله : فرار العامة : من الجهل إلى العلم عقدا وسعيا الجهل نوعان : عدم العلم بالحق النافع وعدم العمل بموجبه ومقتضاه فكلاهما جهل لغة وعرفا وشرعا وحقيقة قال موسى : أعوذ بالله أن أكون من الجاهلين البقره : 67 ] لما قال له قومه : أتتخذنا هزوا البقره :

Research library

المكتبة البحثية1,483 works held

Peer-reviewed work held with its DOI and abstract, labelled with the study design its publication types report. None of it has been read or assessed, so nothing here may be cited as showing anything. Retracted work is held for the record but never listed; a review that a later version replaced is listed under its replacement and marked.

10.1016/j.pnpbp.2021.110289Progress in neuro-psychopharmacology & biological psychiatry (2021)MEDLINE-indexed journal, not yet read by us; matched on Anhedonia, Motivation, Reward, Ventral Tegmental Area, anhedonia

Anhedonia as a central factor in depression: Neural mechanisms revealed from preclinical to clinical evidence.: Anhedonia is one of the core symptoms of major depressive disorder (MDD), which is often inadequately treated by traditional antidepressants. The modern framework of anhedonia extends the definition from impaired consummatory pleasure or interest in rewards to a broad spectrum of deficits that impact functions such as reward anticipation, approach motivation, effort expenditure, reward valuation, expectation, and reward-cue association learning. Substantial preclinical and clinical research has

10.1016/j.jad.2024.09.007Journal of affective disorders (2024)MEDLINE-indexed journal, not yet read by us; matched on Anhedonia, Reward, anhedonia, reward sensitivity

How to improve reward sensitivity - Predictors of long-term effects of a randomized controlled online intervention trial.: Background: Reward sensitivity is a central maintaining factor of depression. Current treatments fail at sufficiently and reliably modifying reward processing. Therefore, we employed interventions targeting reward sensitivity and evaluated the long-term efficacy of different online interventions, additionally exploring predictors of changes in reward sensitivity. Methods: This four-arm randomized controlled trial (RCT) tested the long-term stability of treatment effects during a four-month follo

10.1016/j.brat.2023.104455Behaviour research and therapy (2024)MEDLINE-indexed journal, not yet read by us; matched on Reward, Anhedonia, anhedonia, reward sensitivity

Effectiveness of behavioral activation and mindfulness in increasing reward sensitivity and reducing depressive symptoms - A randomized controlled trial.: Reward insensitivity is a potential key mechanism regarding the maintenance of depression. However, there is a lack of research examining and comparing the effectiveness of different psychological interventions in modifying reward insensitivity. This four-arm randomized controlled trial (RCT) investigated a two-week online intervention. After screening for eligibility, a total of 336 participants were randomized, and 224 participated per-protocol. Participants were assigned to either a) behavior

10.1371/journal.pone.0203265PloS one (2018)MEDLINE-indexed journal, not yet read by us; matched on Motivation, Reward, intrinsic motivation

'We pledge to improve the health of our entire community': Improving health worker motivation and performance in Bihar, India through teamwork, recognition, and non-financial incentives.: Background: Motivation is critical to health worker performance and work quality. In Bihar, India, frontline health workers provide essential health services for the state's poorest citizens. Yet, there is a shortfall of motivated and skilled providers and a lack of coordination between two cadres of frontline health workers and their supervisors. CARE India developed an approach aimed at improving health workers' performance by shifting work culture and strengthening teamwork and motivation. Th

10.1016/j.jpsychores.2016.10.003Journal of psychosomatic research (2016)MEDLINE-indexed journal, not yet read by us; matched on Motivation, Reward

A systematic review and meta-analysis of the effort-reward imbalance model of workplace stress with indicators of immune function.: Objective: Despite considerable research into associations between the effort reward imbalance (ERI) model and various health outcomes over the past 20years, the underlying mechanisms responsible for the association remain unclear. Recently, ERI investigations have examined associations with immune sub-systems (e.g., leukocytes, cytokines and immunoglobulins). Synthesis of the amalgamated research evidence will aid clarity to this field of enquiry. We conducted a meta-analysis and reviewed the a

10.1080/17437199.2015.1030685Health psychology review (2015)MEDLINE-indexed journal, not yet read by us; matched on Motivation, Reward

The utility of monetary contingency contracts for weight loss: a systematic review and meta-analysis.: Financial incentives to improve health have received increasing attention, but are subject to ethical concerns. Monetary Contingency Contracts (MCCs), which require individuals to deposit money that is refunded contingent on reaching a goal, are a potential alternative strategy. This review evaluates systematically the evidence for weight loss-related MCCs. Randomised controlled trials testing the effect of weight loss-related MCCs were identified in online databases. Random-effects meta-analyse

Research library, full list

126 to 150 of 1,483
Brewer GA, Lau KKH, Wingert KM, Ball BH, Blais C (2017)randomised controlled trialMEDLINE-indexed journal, not yet read by usJournal of experimental psychology. General9 citations

Examining depletion theories under conditions of within-task transfer.

In everyday life, mental fatigue can be detrimental across many domains including driving, learning, and working. Given the importance of understanding and accounting for the deleterious effects of mental fatigue on behavior, a growing body of literature has studied the role of motivational and executive control processes in mental fatigue. In typical laboratory paradigms, participants complete a task that places demand on these self-control processes and are later given a subsequent task. Generally speaking, decrements to subsequent task performance are taken as evidence that the initial task created mental fatigue through the continued engagement of motivational and executive functions. Several models have been developed to account for negative transfer resulting from this "ego depletion." In the current study, we provide a brief literature review, specify current theoretical approache

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Edbrooke L, Aranda S, Granger CL, McDonald CF, Krishnasamy M, Mileshkin L, Irving L, Braat S, Clark RA, Gordon I, Denehy L (2017)randomised controlled trialMEDLINE-indexed journal, not yet read by usBMC cancer19 citations

Benefits of home-based multidisciplinary exercise and supportive care in inoperable non-small cell lung cancer - protocol for a phase II randomised controlled trial.

Background: Lung cancer is one of the most commonly diagnosed cancers, and is a leading cause of cancer mortality world-wide. Due to lack of early specific symptoms, the majority of patients present with advanced, inoperable disease and five-year relative survival across all stages of non-small cell lung cancer (NSCLC) is 14%. People with lung cancer also report higher levels of symptom distress than those with other forms of cancer. Several benefits for survival and patient reported outcomes are reported from physical activity and exercise in other tumour groups. We report the protocol for a study investigating the benefits of exercise, behaviour change and symptom self-management for patients with recently diagnosed, inoperable, NSCLC. Methods: This multi-site, parallel-group, assessor-blinded randomised controlled trial, powered for superiority, aims to assess functional and patient-r

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Heron N, Kee F, Mant J, Reilly PM, Cupples M, Tully M, Donnelly M (2017)randomised controlled trialMEDLINE-indexed journal, not yet read by usBMC cardiovascular disorders22 citations

Stroke Prevention Rehabilitation Intervention Trial of Exercise (SPRITE) - a randomised feasibility study.

Background: The value of cardiac rehabilitation (CR) after a transient ischaemic attack (TIA) or minor stroke is untested despite these conditions sharing similar pathology and risk factors to coronary heart disease. We aimed to evaluate the feasibility of conducting a trial of an adapted home-based CR programme, 'The Healthy Brain Rehabilitation Manual', for patients following a TIA/minor stroke, participants' views on the intervention and, to identify the behaviour change techniques (BCTs) used. Methods: Clinicians were asked to identify patients attending the Ulster Hospital, Belfast within 4 weeks of a first TIA or minor stroke. Those who agreed to participate underwent assessments of physical fitness, cardiovascular risk, quality of life and mental health, before random allocation to: Group (1) standard/usual care; (2) rehabilitation manual or (3) manual plus pedometer. All particip

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Casey LM, Oei TPS, Raylu N, Horrigan K, Day J, Ireland M, Clough BA (2017)randomised controlled trialMEDLINE-indexed journal, not yet read by usJournal of gambling studies55 citations

Internet-Based Delivery of Cognitive Behaviour Therapy Compared to Monitoring, Feedback and Support for Problem Gambling: A Randomised Controlled Trial.

The aim of this study was to investigate the efficacy of an Internet-based cognitive behavioural therapy program (I-CBT) for the treatment of problem gambling, when compared to a waitlist control and an active comparison condition consisting of monitoring, feedback, and support (I-MFS). Participants (N = 174) were randomly allocated to the three conditions. Variables of interest were gambling outcome and related mental health measures. Participants in the active conditions (I-CBT and I-MFS) completed six online modules. Both I-CBT and I-MFS conditions resulted in significant treatment gains on gambling severity. However, I-CBT was also associated with reductions in a range of other gambling-related and mental health outcomes. Compared with I-MFS, I-CBT produced greater effects across seven outcomes measures, relating to gambling urges, cognitions, stress, and life satisfaction. I-CBT par

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Reedman SE, Boyd RN, Elliott C, Sakzewski L (2017)randomised controlled trialMEDLINE-indexed journal, not yet read by usBMJ open21 citations

ParticiPAte CP: a protocol of a randomised waitlist controlled trial of a motivational and behaviour change therapy intervention to increase physical activity through meaningful participation in children with cerebral palsy.

Introduction: Children with cerebral palsy (CP) participate in leisure-time physical activities (PA) less often, with less intensity and reduced diversity than their typically developing peers. Participation in leisure-time physical activities may be an important source of habitual physical activity (HPA) for children with CP, who as a group have lower levels of HPA and increased sedentary time compared with their typically developing peers. The proposed study aims to compare the efficacy of a participation focused therapy (ParticiPAte CP) to usual care in a pragmatic, randomised waitlist controlled trial. Methods and analysis: Thirty-six children with CP (18 in each group), classified as Gross Motor Function Classification System levels I to III, aged between 8 and 12 years will be recruited across South East Queensland, Australia. Children will be randomised to receive either ParticiPA

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Gregersen J, Hatzigeorgiadis A, Galanis E, Comoutos N, Papaioannou A (2017)randomised controlled trialMEDLINE-indexed journal, not yet read by usJournal of sport & exercise psychology8 citations

Countering the Consequences of Ego Depletion: The Effects of Self-Talk on Selective Attention.

This study examined the effects of a self-talk intervention on selective attention in a state of ego depletion. Participants were 62 undergraduate students with a mean age of 20.02 years (SD = 1.17). The experiment was conducted in four consecutive sessions. Following baseline assessment, participants were randomly assigned into experimental and control groups. A two-session training was conducted for the two groups, with the experimental group using self-talk. In the final assessment, participants performed a selective attention test, including visual and auditory components, following a task inducing a state of ego depletion. The analysis showed that participants of the experimental group achieved a higher percentage of correct responses on the visual test and produced faster reaction times in both the visual and the auditory test compared with participants of the control group. The re

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Lubans DR, Smith JJ, Morgan PJ, Beauchamp MR, Miller A, Lonsdale C, Parker P, Dally K (2016)randomised controlled trialMEDLINE-indexed journal, not yet read by usThe Journal of adolescent health : official publication of the Society for Adolescent Medicine54 citations

Mediators of Psychological Well-being in Adolescent Boys.

Purpose: The aim of this study was to explore the effect of the Active Teen Leaders Avoiding Screen-time (ATLAS) intervention on psychological well-being in adolescent boys and to examine the potential mediating mechanisms that might explain this effect. Methods: ATLAS was evaluated using a cluster randomized controlled trial in 14 secondary schools located in low-income communities (N = 361 adolescent boys, mean age = 12.7 ± .5 years). The 20-week intervention was guided by self-determination theory and involved: professional development for teachers, provision of fitness equipment to schools, enhanced school sport sessions, researcher-led seminars, a smartphone application, and parental strategies for reducing screen time. Assessments were conducted at baseline and immediately post intervention (8 months). Psychological well-being was measured using the Flourishing Scale. Motivational

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Haynes A, Kemps E, Moffitt R (2016)randomised controlled trialMEDLINE-indexed journal, not yet read by usApplied psychology. Health and well-being8 citations

Too Depleted to Try? Testing the Process Model of Ego Depletion in the Context of Unhealthy Snack Consumption.

Background: The process model proposes that the ego depletion effect is due to (a) an increase in motivation toward indulgence, and (b) a decrease in motivation to control behaviour following an initial act of self-control. In contrast, the reflective-impulsive model predicts that ego depletion results in behaviour that is more consistent with desires, and less consistent with motivations, rather than influencing the strength of desires and motivations. The current study sought to test these alternative accounts of the relationships between ego depletion, motivation, desire, and self-control. Methods: One hundred and fifty-six undergraduate women were randomised to complete a depleting e-crossing task or a non-depleting task, followed by a lab-based measure of snack intake, and self-report measures of motivation and desire strength. Results and conclusions: In partial support of the proc

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Stapinski LA, Edwards AC, Hickman M, Araya R, Teesson M, Newton NC, Kendler KS, Heron J (2016)randomised controlled trialMEDLINE-indexed journal, not yet read by usPrevention science : the official journal of the Society for Prevention Research40 citations

Drinking to Cope: a Latent Class Analysis of Coping Motives for Alcohol Use in a Large Cohort of Adolescents.

Alcohol consumption during adolescence is widespread, although there is considerable variation in patterns of use. The aim of this study was to identify patterns of coping-motivated alcohol use in a UK birth cohort and examine individual and family characteristics associated with the resulting drinker profiles. At age 17, participants (n = 3957; 56 % female) reported their alcohol and drug use, internalising symptoms and use of alcohol to cope with a range of emotions. Socio-demographic data were collected via maternal report. Latent class analysis identified drinker subtypes based on the coping motives reported. Association between these profiles and socio-demographic characteristics and internalising disorders was examined. The vast majority (92 %) of adolescents reported alcohol consumption in the past year, and 26 % of those drank weekly or more often. Four distinct motive profiles w

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Storr SM, Sparks P (2016)randomised controlled trialMEDLINE-indexed journal, not yet read by usPsychology & health8 citations

Does self-affirmation following ego depletion moderate restrained eaters' explicit preferences for, and implicit associations with, high-calorie foods?

Objective: The difficulty for chronic dieters (i.e. restrained eaters) in regulating their food intake is a conflict between two apparently incompatible goals: eating enjoyment and weight control. The latter goal consistently relies on the deployment of cognitive resources, and very often on a significant amount of self-control. This study investigated whether self-affirmation might counteract the effect of ego depletion on restrained eaters' motivation to consume high-calorie foods. Design: Participants (N = 183) were assigned to one of four conditions in a 2 × 2 (Ego depletion × Self-Affirmation) experimental design and were subsequently exposed to images of high- and low-calorie foods. Main outcome measures: Participants completed tasks assessing their implicit and explicit preferences for high vs. low-calorie foods, along with a measure of the perceived self-control required to resis

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Tan KK, Chan SW, Wang W, Vehviläinen-Julkunen K (2016)randomised controlled trialMEDLINE-indexed journal, not yet read by usPatient education and counseling53 citations

A salutogenic program to enhance sense of coherence and quality of life for older people in the community: A feasibility randomized controlled trial and process evaluation.

Objective: To determine the feasibility of a salutogenesis-based self-care program on quality of life, sense of coherence, activation and resilience among older community dwellers. Methods: This is a feasibility randomized controlled trial. Sixty-four older community-dwellers were recruited from a Singapore senior activity center and randomly assigned to intervention and control groups. The intervention group attended a 12-week Resource Enhancement and Activation Program. The outcomes were assessed with the Chinese versions of World Health Organization Quality of Life Scale, Sense of Coherence, Patient Activation Measure, and Connor-Davidson Resilience Scale. Process evaluation was conducted using focus groups with the intervention group. Results: At the end of the program, the intervention group showed significant improvement in the Sense of Coherence scale and the psychological subscal

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Koutoukidis DA, Beeken RJ, Manchanda R, Burnell M, Knobf MT, Lanceley A (2016)randomised controlled trialMEDLINE-indexed journal, not yet read by usTrials14 citations

Diet and exercise in uterine cancer survivors (DEUS pilot) - piloting a healthy eating and physical activity program: study protocol for a randomized controlled trial.

Background: Endometrial cancer survivors comprise a high-risk group for obesity-related comorbidities. Healthy eating and physical activity can lead to better health and well-being, but this population may experience difficulties adopting healthy lifestyle practices. Personalised behaviour change programmes that are feasible, acceptable and cost-effective are needed. The aim of this trial is to pilot a manualised programme about healthy eating and physical activity. Methods/design: This is a phase II, individually randomized, parallel, controlled, two-site, pilot clinical trial. Adult endometrial cancer survivors (n = 64) who have been diagnosed with endometrial cancer within the previous 3 years and are not on active treatment will be invited to participate. Participants will be assigned in a 1:1 ratio through minimisation to either an 8-week, group-based, behaviour-change programme wit

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Au J, Katz B, Buschkuehl M, Bunarjo K, Senger T, Zabel C, Jaeggi SM, Jonides J (2016)randomised controlled trialMEDLINE-indexed journal, not yet read by usJournal of cognitive neuroscience110 citations

Enhancing Working Memory Training with Transcranial Direct Current Stimulation.

Working memory (WM) is a fundamental cognitive ability that supports complex thought but is limited in capacity. Thus, WM training interventions have become very popular as a means of potentially improving WM-related skills. Another promising intervention that has gained increasing traction in recent years is transcranial direct current stimulation (tDCS), a noninvasive form of brain stimulation that can modulate cortical excitability and temporarily increase brain plasticity. As such, it has the potential to boost learning and enhance performance on cognitive tasks. This study assessed the efficacy of tDCS to supplement WM training. Sixty-two participants were randomized to receive either right prefrontal, left prefrontal, or sham stimulation with concurrent visuospatial WM training over the course of seven training sessions. Results showed that tDCS enhanced training performance, which

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Shimoni E, Asbe M, Eyal T, Berger A (2016)randomised controlled trialMEDLINE-indexed journal, not yet read by usJournal of experimental child psychology12 citations

Too proud to regulate: The differential effect of pride versus joy on children's ability to delay gratification.

We examined the effect of the distinct positive emotions pride and joy on children's self-regulation, focusing on their ability to delay gratification (i.e., resist a temptation in favor of a long-term goal). We hypothesized that because pride corresponds to the attainment of long-term goals and joy corresponds to the attainment of immediate desires, the experience of pride may signal sufficient progress toward a long-term goal, resulting in less delay of gratification than the experience of joy. To test this hypothesis, we induced an experience of pride or joy in 8-year-old children. At this age, the ability to self-regulate--and to experience pride and joy distinctively--is relatively mature. We then measured performance in a delay discounting task. We found that, compared with the joy condition and a control condition, children who experienced pride performed worse on the delay discou

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Julion WA, Sumo J, Bounds DT, Breitenstein SM, Schoeny M, Gross D, Fogg L (2016)randomised controlled trialMEDLINE-indexed journal, not yet read by usContemporary clinical trials6 citations

Study protocol for a randomized clinical trial of a fatherhood intervention for African American non-resident fathers: Can we improve father and child outcomes?

Purpose: African American (AA) fathers who live apart from their children face multiple obstacles to consistent and positive involvement with their children. Consequently, significant numbers of children are bereft of their father's positive involvement. Intervention research that is explicitly focused on promoting the positive involvement of non-resident AA fathers with their young children is limited. The purpose of this article is to describe the study protocol of a randomized trial (RCT) designed to test the Building Bridges to Fatherhood program against a financial literacy comparison condition; and discuss early implementation challenges. Methods: Fathers (n=180) are recruited to attend 10 group meetings, reimbursed for transportation, given dinner and activity vouchers for spending time with their child, and incentivized with a $40 gift card at each data collection time point. Mot

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Bond DS, Vithiananthan S, Thomas JG, Trautvetter J, Unick JL, Jakicic JM, Pohl D, Ryder BA, Roye GD, Sax HC, Wing RR (2015)randomised controlled trialMEDLINE-indexed journal, not yet read by usSurgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery62 citations

Bari-Active: a randomized controlled trial of a preoperative intervention to increase physical activity in bariatric surgery patients.

Background: Habitual physical activity (PA) may help to optimize bariatric surgery outcomes; however, objective PA measures show that most patients have low PA preoperatively and make only modest PA changes postoperatively. Patients require additional support to adopt habitual PA. The objective of this study was to test the efficacy of a preoperative PA intervention (PAI) versus standard presurgical care (SC) for increasing daily moderate-to-vigorous PA (MVPA) in bariatric surgery patients. Methods: Outcomes analysis included 75 participants (86.7% women; 46.0±8.9 years; body mass index [BMI]=45.0±6.5 kg/m2) who were randomly assigned preoperatively to 6 weeks of PAI (n=40) or SC (n=35). PAI received weekly individual face-to-face sessions with tailored instruction in behavioral strategies (e.g., self-monitoring, goal-setting) to increase home-based walking exercise. The primary outcome,

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Chadwick AE (2015)randomised controlled trialMEDLINE-indexed journal, not yet read by usHealth communication47 citations

Toward a theory of persuasive hope: effects of cognitive appraisals, hope appeals, and hope in the context of climate change.

Hope has the potential to be a powerful motivator for influencing behavior. However, hope and messages that evoke hope (hope appeals) have rarely been the focus of theoretical development or empirical research. As a step toward the effective development and use of hope appeals in persuasive communication, this study conceptualized and operationalized hope appeals in the context of climate change prevention. Then, the study manipulated components of the hope evocation part of a hope appeal. Specifically, the components were designed to address appraisals of the importance, goal congruence, future expectation, and possibility of climate protection, resulting in a 2 (strong/weak importance) × 2 (strong/weak goal congruence) × 2 (strong/weak future expectation) × 2 (strong/weak possibility) between-subjects pretest-posttest factorial design. Two hundred forty-five undergraduate students were

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Clarke JL, Griffin TL, Lancashire ER, Adab P, Parry JM, Pallan MJ, WAVES study trial investigators (2015)randomised controlled trialMEDLINE-indexed journal, not yet read by usBMC public health21 citations

Parent and child perceptions of school-based obesity prevention in England: a qualitative study.

Background: Schools are key settings for childhood obesity prevention, and the location for many intervention studies. This qualitative study aims to explore parent and child experiences of the WAVES study obesity prevention intervention, in order to gain understanding of the mechanisms by which the intervention results in behaviour change, and provide context to support interpretation of the main trial results. Methods: Focus groups were held with 30 parents and 62 children (aged 6-7 years) from primary schools in the West Midlands, UK. Data analysis (conducted using NVivo 10) was guided by the Framework Approach. Results: Three over-arching themes were identified: 'Impact', 'Sustainability' and 'Responsibilities', under which sub-themes were determined. Participants were supportive of the school-based intervention. Parental involvement and the influential role of the teacher were seen

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Carnes M, Devine PG, Baier Manwell L, Byars-Winston A, Fine E, Ford CE, Forscher P, Isaac C, Kaatz A, Magua W, Palta M, Sheridan J (2015)randomised controlled trialMEDLINE-indexed journal, not yet read by usAcademic medicine : journal of the Association of American Medical Colleges256 citations

The effect of an intervention to break the gender bias habit for faculty at one institution: a cluster randomized, controlled trial.

Purpose: Despite sincere commitment to egalitarian, meritocratic principles, subtle gender bias persists, constraining women's opportunities for academic advancement. The authors implemented a pair-matched, single-blind, cluster randomized, controlled study of a gender-bias-habit-changing intervention at a large public university. Method: Participants were faculty in 92 departments or divisions at the University of Wisconsin-Madison. Between September 2010 and March 2012, experimental departments were offered a gender-bias-habit-changing intervention as a 2.5-hour workshop. Surveys measured gender bias awareness; motivation, self-efficacy, and outcome expectations to reduce bias; and gender equity action. A timed word categorization task measured implicit gender/leadership bias. Faculty completed a work-life survey before and after all experimental departments received the intervention.

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Mathews C, Eggers SM, de Vries PJ, Mason-Jones AJ, Townsend L, Aarø LE, De Vries H (2015)randomised controlled trialMEDLINE-indexed journal, not yet read by usBMC public health21 citations

Reaching the hard to reach: longitudinal investigation of adolescents' attendance at an after-school sexual and reproductive health programme in Western Cape, South Africa.

Background: Adolescents need access to effective sexual and reproductive health (SRH) interventions, but face barriers accessing them through traditional health systems. School-based approaches might provide accessible, complementary strategies. We investigated whether a 21-session after-school SRH education programme and school health service attracted adolescents most at risk for adverse SRH outcomes and explored motivators for and barriers to attendance. Methods: Grade 8 adolescents (average age 13 years) from 20 schools in the intervention arm of an HIV prevention cluster randomised controlled trial in the Western Cape Province of South Africa, were invited to participate in an after-school SRH program and to attend school health services. Using a longitudinal design, we surveyed participants at baseline, measured their attendance at weekly after-school sessions for 6 months and surv

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Wilson DK, Kitzman-Ulrich H, Resnicow K, Van Horn ML, St George SM, Siceloff ER, Alia KA, McDaniel T, Heatley V, Huffman L, Coulon S, Prinz R (2015)randomised controlled trialMEDLINE-indexed journal, not yet read by usContemporary clinical trials46 citations

An overview of the Families Improving Together (FIT) for weight loss randomized controlled trial in African American families.

Background: The Families Improving Together (FIT) randomized controlled trial tests the efficacy of integrating cultural tailoring, positive parenting, and motivational strategies into a comprehensive curriculum for weight loss in African American adolescents. The overall goal of the FIT trial is to test the effects of an integrated intervention curriculum and the added effects of a tailored web-based intervention on reducing z-BMI in overweight African American adolescents. Design and setting: The FIT trial is a randomized group cohort design the will involve 520 African American families with an overweight adolescent between the ages of 11-16 years. The trial tests the efficacy of an 8-week face-to-face group randomized program comparing M + FWL (Motivational Plus Family Weight Loss) to a comprehensive health education program (CHE) and re-randomizes participants to either an 8-week on

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Heffner JL, Vilardaga R, Mercer LD, Kientz JA, Bricker JB (2015)randomised controlled trialMEDLINE-indexed journal, not yet read by usThe American journal of drug and alcohol abuse73 citations

Feature-level analysis of a novel smartphone application for smoking cessation.

Background: Currently, there are over 400 smoking cessation smartphone apps available, downloaded an estimated 780,000 times per month. No prior studies have examined how individuals engage with specific features of cessation apps and whether use of these features is associated with quitting. Objectives: Using data from a pilot trial of a novel smoking cessation app, we examined: (i) the 10 most-used app features, and (ii) prospective associations between feature usage and quitting. Methods: Participants (n = 76) were from the experimental arm of a randomized, controlled pilot trial of an app for smoking cessation called "SmartQuit," which includes elements of both Acceptance and Commitment Therapy (ACT) and traditional cognitive behavioral therapy (CBT). Utilization data were automatically tracked during the 8-week treatment phase. Thirty-day point prevalence smoking abstinence was asse

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Cranwell J, Benford S, Houghton RJ, Golembewski M, Fischer JE, Hagger MS (2014)randomised controlled trialMEDLINE-indexed journal, not yet read by usCyberpsychology, behavior and social networking15 citations

Increasing self-regulatory energy using an Internet-based training application delivered by smartphone technology.

Self-control resources can be defined in terms of "energy." Repeated attempts to override desires and impulses can result in a state of reduced self-control energy termed "ego depletion" leading to a reduced capacity to regulate future self-control behaviors effectively. Regular practice or "training" on self-control tasks may improve an individual's capacity to overcome ego depletion effectively. The current research tested the effectiveness of training using a novel Internet-based smartphone application to improve self-control and reduce ego depletion. In two experiments, participants were randomly assigned to either an experimental group, which received a daily program of self-control training using a modified Stroop-task Internet-based application delivered via smartphone to participants over a 4-week period, or a no-training control group. Participants assigned to the experimental g

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Littlecott HJ, Moore GF, Moore L, Murphy S (2014)randomised controlled trialMEDLINE-indexed journal, not yet read by usThe international journal of behavioral nutrition and physical activity25 citations

Psychosocial mediators of change in physical activity in the Welsh national exercise referral scheme: secondary analysis of a randomised controlled trial.

Objective: While an increasing number of randomised controlled trials report impacts of exercise referral schemes (ERS) on physical activity, few have investigated the mechanisms through which increases in physical activity are produced. This study examines whether a National Exercise Referral Scheme (NERS) in Wales is associated with improvements in autonomous motivation, self-efficacy and social support, and whether change in physical activity is mediated by change in these psychosocial processes. Methods: A pragmatic randomised controlled trial of NERS across 12 LHBs in Wales. Questionnaires measured demographic data and physical activity at baseline. Participants (N = 2160) with depression, anxiety or CHD risk factors were referred by health professionals and randomly assigned to control or intervention. At six months psychological process measures were collected by questionnaire. At

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Leuchter AF, Hunter AM, Tartter M, Cook IA (2014)randomised controlled trialMEDLINE-indexed journal, not yet read by usThe British journal of psychiatry : the journal of mental science62 citations

Role of pill-taking, expectation and therapeutic alliance in the placebo response in clinical trials for major depression.

Background: Pill-taking, expectations and therapeutic alliance may account for much of the benefit of medication and placebo treatment for major depressive disorder (MDD). Aims To examine the effects of medication, placebo and supportive care on treatment outcome, and the relationships of expectations and therapeutic alliance to improvement. Method: A total of 88 participants were randomised to 8 weeks of treatment with supportive care alone or combined with double-blind treatment with placebo or antidepressant medication. Expectations of medication effectiveness, general treatment effectiveness and therapeutic alliance were measured (trial registration at ClinicalTrials.gov: NCT00200902). Results: Medication or placebo plus supportive care were not significantly different but had significantly better outcome than supportive care alone. Therapeutic alliance predicted response to medicati

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