ORIGINAL RESEARCH article
Front. Psychol.
Sec. Psychology for Clinical Settings
Volume 16 - 2025 | doi: 10.3389/fpsyg.2025.1444419
This article is part of the Research TopicAdapting and Implementing Behavioral Activation Across Diverse ContextsView all 3 articles
Differential benefits of internet-based behavioral activation (iBA) for adolescents with high vs. low reward probability: a secondary analysis
Provisionally accepted
- 1School of Psychology, College of Liberal Arts, Korea University, Seoul, Republic of Korea
- 2KU Mind Health Institute, Korea University, Seoul, Republic of Korea
- 3MINDEEP CBT Center, Seoul, Republic of Korea
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Behavioral activation (BA) therapy is effective in treating depression in both adults and adolescents, and internet-based BA (iBA) therapy showed promise during the COVID-19 pandemic. Adolescents with depression often exhibit motivational impairment, which is associated with reduced motivation and engagement in rewarding activities as well as a heightened risk of problematic internet use. This study examined the differential benefits of iBA in alleviating depressive symptoms in adolescents with relatively high and low Reward Probability Index (RPI) levels. Using a randomized controlled trial design, this secondary analysis included 38 adolescents diagnosed with major depressive disorder, who were randomly assigned to either the iBA or internet-based psychoeducation and supportive therapy (iST) groups. Depressive symptoms, BA levels, and RPI were assessed at pre-treatment, post-treatment, and the 3-month follow-up. The findings revealed that adolescents with low baseline RPI who received iBA showed a significantly greater reduction in depressive symptoms than those with high baseline RPI. Additionally, adolescents with low baseline RPI in the iBA group showed a significantly greater reduction in depressive symptoms than those in the iST group. These results suggest that iBA is particularly beneficial for adolescents with low RPI, especially those experiencing anhedonia, and provides a promising approach to enhance treatment outcomes in this population. High accessibility of iBA may promote engagement in rewarding real-life activities.
Keywords: Internet-based behavioral activation, Depression, adolescents, reward probability, randomized controlled trial
Received: 05 Jun 2024; Accepted: 09 Sep 2025.
Copyright: © 2025 Kim, Lee and Choi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Kee-Hong Choi, School of Psychology, College of Liberal Arts, Korea University, Seoul, Republic of Korea
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