Browsing by Subject "Cognitive Therapy"
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Item Change in Psychosocial Functioning during Cognitive therapy for Depression(2009-01-09) Dunn, Todd Wilson; Jarrett, Robin B.Major Depressive Disorder (MDD) is a highly prevalent and recurrent disorder that impairs peoples' work, relationships, and leisure activities. Cognitive Therapy (CT) improves this impairment in psychosocial functioning in adults with MDD, but questions remain as to how improvements occur both independently and in relation to depressive symptoms. To address this issue, the current study developed a theoretical framework based on social cognitive theory to conceptualize change in psychosocial functioning during CT and tested it with structural equation modeling. Using data from 470 patients undergoing acute-phase CT (A-CT) for MDD, results showed that: a) change in psychosocial functioning and depressive symptom severity occurred independently of each other, b) change in psychosocial functioning during the first month of A-CT partially mediated change in depressive symptom severity from treatment baseline to week seven of A-CT, and c) psychosocial functioning at week seven of A-CT significantly predicted subsequent depressive symptom severity. In terms of the theoretical framework, results suggested that when people with MDD were exposed to an environmental stimuli (i.e., acute-phase CT), change in their behavior (i.e., psychosocial functioning) partially mediated change in personal factors (i.e., depressive symptom severity) and not vice versa. By disentangling the sequence of change in psychosocial functioning and depressive symptom severity, this study pushed the field one step closer to understanding how A-CT treats the impairment in psychosocial functioning associated with MDD.Item Does Depressive Severity Have an Immediate Effect on Therapeutic Distance at Mid-Acute Phase in Cognitive Therapy for Recurrent Major Depressive Disorder?(2011-02-01T19:33:39Z) Bowers, Alycia D.; Minhajuddin, AbuThe degree to which severity of depression predicted Therapeutic Distance (TD) was researched with 375 patients with recurrent Major Depressive Disorder who received Cognitive Therapy. Therapeutic Distance was calculated by subtracting Working Alliance Inventory-Form C (WAI-C) from Working Alliance Inventory-Form T (WAI-T). Therapeutic Distance of each of the three subscales of the WAI was also calculated in order to determine whether the severity of depression predicted TD in the Bond, Task, or Goal subscales. The extent to which the severity of depression had an effect on the TD from midpoint to endpoint of the study was determined. Furthermore, the severity of depression and response to treatment at the first blind evaluation was analyzed. Results suggested that depressive severity was not predictive of TD overall or of the three subscales. However, when looking at TD over time, it seems that TD task is significantly different from midpoint to endpoint of the acute phase CT. Additionally, it appears that regardless of the severity of depression, the working alliance was established rather quickly and remained fairly stable throughout the acute phase of the study.Item Efficacy of an Early Biopsychosocial Intervention for Patients with Acute Temporomandibular Disorder-Related Pain: A Long-Term Follow-Up Study(2007-08-08) Robinson, Kelly; Stowell, Anna WrightA long-term follow-up (LTF) study was conducted to further evaluate the efficacy of a biopsychosocial intervention for acute high risk (HR) temporomandibular disorder (TMD) patients. Subjects from Gatchel and colleagues' one-year outcome study (Gatchel, Stowell, Wildenstein, Riggs,&Ellis, 2006) were contacted to assess pain and psychosocial measures at LTF (two to six years post intake). An early-intervention (EI) group had received cognitive behavioral skills training and biofeedback, while a nonintervention group (NI) had received no intervention. Similar to one-year follow-up findings, EI group subjects had significantly lower levels of self-reported pain and depression at LTF as compared to intake. The EI group was also associated with significantly lower pain and depression scores, relative to the NI group. EI group subjects continued to show a decreasing trend on jaw pain-related health care visits relative to NI group subjects, providing further evidence for reduced costs associated with early interventions. The present study supports and extends the findings of the earlier one-year outcome study, indicating that an early biopsychosocial intervention is beneficial for patients with acute TMD. By receiving treatment during the acute stage of TMD, patients are less likely to develop chronic TMD, and to be impacted long-term by the physical, emotional and financial aspects of TMD.Item The Impact of Trauma History on Acute Treatment Outcomes in Pediatric Major Depressive Disorder(2011-12-14) Mahoney, Jodi Rae; Kennard, Betsy D.The impact of childhood trauma on depression in youth was examined through a secondary analysis of pooled data from three studies of Major Depressive Disorder (MDD) in youth. A total of 292 children and adolescents ages 7 to 18 (53% male, 70% Caucasian, mean age = 12.83), received open treatment with fluoxetine for a period of 6 to 12 weeks. Youth were separated into three trauma history groups: no trauma, trauma—no abuse, and abuse. Associations between trauma history and demographic and clinical characteristics of depression were examined. The effects of trauma and abuse history on depression severity and remission rates following acute treatment with fluoxetine were explored using depression severity scores from the Children’s Depressive Rating Scale-Revised (CDRS-R) and remission status, defined as a score of ≤ 28 on CDRS-R and a Clinical Global Impressions (CGI) Improvement score of 1 or 2. Abuse history was associated with older age, older age of depression onset, longer length of illness, and suicidal ideation and behavior at baseline. Abuse history was also associated with some differences in initial depressive symptom profiles among children. The hypothesis that youth with a history of abuse would demonstrate lower remission rates at the end of acute treatment was partially supported. Odds ratios indicated that youth without a history of abuse were twice as likely to have remitted at the end of acute treatment when compared to those with no abuse history. This finding did not remain significant after controlling for the effects of age and family history of depression. No differences were found in depression severity across the acute phase of treatment based on trauma history. Additionally, trauma history was not associated with a difference in youth’s time to achieve remission. Results should be considered in context of small sample sizes and limited assessment of trauma in the current study. These results suggest the importance of thoroughly assessing for trauma history, especially abuse, and considering the impact of these events on youth’s depressive presentation and treatment needs.