Browsing by Subject "CBT"
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Item A computerized intervention for depression : a randomized clinical trial(2014-12) Sandoval, Luis Roberto; Ainslie, Ricardo C.One in ten adults in the U.S. report depression, and thirty-eight percent of those receiving treatment are receiving minimally adequate treatment. Studies show that evidence-based Internet interventions are highly effective in treating depression at a low cost. The aim of this study was to reduce symptoms of depression in subjects through the use of a new, electronic Problem Solving Treatment (ePST). Adult participants with moderate to severe depression symptoms were randomly assigned to either treatment or a wait-list condition. The Beck Depression Inventory-II was used as the primary outcome measure. A Repeated Measure Design with one factor in the between (treatment vs control) and one factor in the within (pre, mid-point, and post-treatment) was used in the analysis. Study results showed that participants in the ePST group improved their depression symptoms (from Moderate to Mild levels of depression) after receiving 3 session of ePST, as well as after receiving six session of ePST (from moderate to minimal levels of depression). On the other hand, participants assigned to the control group remained with Moderate levels of depression.Item Examining sudden gains during cognitive-behavioral therapy for depressed 9 to 13 year old girls(2010-08) Fisher, Melissa Elizabeth, 1980-; Stark, Kevin Douglas; Tharinger, Deborah J.; Keith, Timothy Z.; Loukas, Alexandra; Weersing, RobinCognitive-behavioral therapy (CBT) is used to treat children and adolescents with depression. Researchers determined that many individuals undergoing CBT and other therapies experienced sudden gains, meaning that they experienced a rapid and large improvement in their symptoms between sessions. The studies demonstrated that by the end of treatment, individuals who experienced sudden gains were significantly less depressed and had better long-term outcomes than individuals who did not experience sudden gains. Previous studies investigated sudden gains in individual therapy while the present study examined sudden gains in group treatment. In addition to replicating results of previous studies, the present study sought to examine the effect of sudden gains on depressive symptoms, family environment, cognitive triad, and negative life events at pre-treatment and at a one year follow-up using multivariate analysis of variance. Participants included 136 girls, aged 9 to 13, in two treatment conditions (CBT, CBT+ parent training (CBT+PT), and a Minimal Contact Control (MCC)). At pre-treatment, post-treatment, and at a one year follow-up, participants completed self-report measures of the family environment, cognitive triad, and negative life events. They also completed a semi-structured diagnostic interview designed to symptoms of depression. After beginning the study, participants’ depressive symptoms were monitored with a brief symptom interview and/or a self-report measure of depressive symptoms. Findings from the study provided further evidence that sudden gains occur during group CBT, and that the majority of sudden gains occur early in CBT. The number of sudden gains did not vary significantly by treatment condition, and similar to previous research, the presence of a parent intervention component did not appear to significantly change the relation between sudden gains and treatment outcome. One important finding was participants in the Minimal Contact Control group experienced sudden gains despite not being in treatment. Another important finding was that the participants who experienced sudden gains differed significantly from the participants who did not experience sudden gains on pre-treatment measures of family environment and the cognitive triad but no differences were found at post-treatment or at a one year follow-up. Implications of these results, limitations, and recommendations for future research are provided.Item Maintenance of treatment effects from cognitive-behavioral therapy and parent training on family functioning and girls' depressive symptoms(2011-08) Krumholz, Lauren Sarah; Tharinger, Deborah J.; Stark, Kevin Douglas; Carlson, Cindy; Pituch, Keenan; Hargrave, JenniferImproving treatment for early adolescent girls with depression by understanding factors that promote the maintenance of treatment effects is an important area of research given the association of depression with functional impairment and negative future outcomes. The effectiveness of CBT for treating depressed youth in the short-term has been well-established. However, limited research exists on the impact of CBT beyond one year post-treatment and on factors that enhance treatment maintenance for children and adolescents with depression. An intervention strategy that may yield the maintenance of treatment effects is the inclusion of primary caregivers. However, there is presently insufficient evidence to ascertain whether including primary caregivers in girls’ depression treatment produces additional benefits because they have rarely been incorporated into clinical trials of depression treatment for youth. This approach warrants study since families of depressed youngsters are often characterized by disturbances in family functioning and because aspects of the family environment are related to the development and maintenance of depressive disorders in youth. The current study addressed gaps in the existing literature about the maintenance of treatment effects for girls with depression by examining the impact of a parent training (PT) component added to a school-based, group-administered CBT intervention on girls’ depressive symptoms and key areas of family functioning (i.e., conflict, cohesion, communication, and family sociability). Participants included 9- to 14-year-old girls with a depressive disorder, one primary caregiver for each girl who completed measures, and caregivers in the parental treatment component. Girls were randomly assigned to a CBT, CBT+PT, or minimal contact control condition. Ratings of girls’ depressive symptoms and the family functioning variables were obtained from girls and primary caregivers at pre-treatment, post-treatment, and annually for up to four years following treatment. Results from growth curve modeling using hierarchical linear models indicated no significant differences in rate of change of girls’ depressive symptoms over time depending on whether they were in the CBT or CBT+PT condition. However, subsequent analyses revealed two significant factors associated with treatment maintenance: child attendance at CBT meetings and parental attendance at PT meetings. Specifically, higher rates of child and parental attendance were generally predictive of a sustained decline in girls’ depressive symptoms over time. In addition, findings supported the positive impact of CBT with PT on aspects of the family environment from pre- to post-treatment, but not from post-treatment through the four years of follow-up assessment. Implications, limitations, and recommendations for further areas of research are discussed.Item Mechanisms of change in CBT for depressed early adolescent girls : mediating effects of the cognitive triad on cognitive interventions for depressive symptoms(2009-12) Monnat, Lynn Mie 1970-; Stark, Kevin DouglasDepression is an increasingly common health problem among youth. There is growing empirical evidence that CBT is a promising treatment for childhood depression. It remains unclear what treatment-specific effects of CBT contribute to therapeutic gains. Cognitive theories propose that a primary mechanism of change in CBT are cognitive interventions that target depressogenic cognitions regarding the self, world, and future (cognitive triad), which are thought to mediate depression. The effects of cognitive interventions on depressive symptoms are thus hypothesized to be mediated by changes in the cognitive triad. No studies have investigated whether CBT for depressed youth works by treating the cognitive triad through the implementation of cognitive techniques. As part of a larger study analyzing the mechanisms of change in CBT for depressed youth, the purpose of this study was to investigate: (1) whether specific cognitive techniques are related to depressive symptom reduction in youth, and (2) if improvements in depressive symptoms are mediated through the cognitive triad of depressed youth. Participants were 42 girls, aged 8 to 14, who completed a manualized CBT protocol for depression in group format. Girls completed a diagnostic interview for depression and self-report measures assessing the cognitive triad. Group therapy sessions were coded for cognitive interventions. Results indicated a non-significant relation between levels of cognitive interventions and post-treatment depression scores, after controlling for pre-treatment depression. Therefore, tests of mediation were discontinued. Relevant control variables were added to the model to reduce error variance. After controlling for pre-treatment depression, age, presence of learning disorder, mastery of therapeutic skills, and behavioral interventions, cognitive interventions were significantly and positively associated with post-treatment depression. The relation between cognitive interventions and the cognitive triad was non-significant and meditational analyses were discontinued. Exploratory factor analysis revealed four cognitive interventions factors that were consistent with CBT theory. Further analyses revealed that all factors were not significantly related to post-treatment depression. Tests of interactions between cognitive interventions and behavioral interventions, age, and mastery level of therapeutic skills were also non-significant. Implications, limitations, and recommendations for further areas of research are presented.Item The utility of Cogntive Behavioral Therapy in the treatment of the schizophrenic patient(2010-05) Borkowski, Jennifer Nickole; McCarthy, Christopher J.; Rude, StephanieSchizophrenia is a complex and pervasive brain disorder that effects millions of people in the United States. There are three tiers of symptoms associated with the disorder, they include: positive symptoms, negative symptoms and thought disorders. The most common method of treatment for this disorder involves the use of antipsychotic medications, and while these medications have been shown to be effective in treating certain positive symptoms of the disorder, they have a tendency to be less effective in treating the negative cluster of symptoms and the thought disorders that can be highly debilitating for patients. The aim of this review was to determine the level of effectiveness of psychosocial treatments for the disorder, and in particular to look in to Cognitive- Behavioral Therapy (CBT) as an adjunctive method of treatment to be used in conjunction with medication. By performing searches using the PsycInfo, ERIC, EBSCO and Medline databases, the researcher was able to draw the conclusion that while there are some complications and areas of improvement in study construction, CBT can indeed be a helpful method of treatment for many patients. Importantly, CBT tends to be a very flexible treatment that can accommodate many different combinations of symptoms at varying levels or severity and stages of the illness. A discussion of a possible model of treatment that uses CBT was also undertaken to provide readers with a practical example of how this form of treatment can be used.