Change in Interpersonal and Metacognitive Skills During Treatment With Cognitive Behavioral Analysis System of Psychotherapy and Metacognitive Therapy: Results From an Observational Study

Abstract

Background: Interpersonal skills deficits and dysfunctional metacognitive beliefs have been implicated in the etiology and maintenance of depression. This study aimed to investigate the association between changes in these skills deficits and change in depressive symptoms over the course of treatment with Cognitive Behavioral Analysis System of Psychotherapy (CBASP) and Metacognitive Therapy (MCT).Methods: In this prospective, parallel group observational study, data was collected at baseline and after 8 weeks of an intensive day clinic psychotherapy program. Based on a shared decision between patients and clinicians, patients received either CBASP or MCT. Ninety patients were included in the analyses (CBASP: age M = 38.7, 40.5% female, MCT: age M = 44.7, 43.3% female). Interpersonal deficits were assessed with the short-form of the Luebeck Questionnaire for Recording Preoperational Thinking (LQPT-SF) and the Impact Message Inventory (IMI-R). Metacognitive beliefs were assessed with the Metacognition Questionnaire-30 (MCQ-30). The Quick Inventory of Depressive Symptomatology (QIDS-SR16) was utilized to assess depressive symptoms. A regression analysis was conducted to assess variables associated with outcome. ANCOVAs were utilized to investigate whether improvement in skills deficits is dependent on type of treatment received.Results: Improvements in preoperational thinking and increases in friendly-dominant behavior were associated with change in depressive symptoms. There was no association between reductions in dysfunctional metacognitive beliefs and a decrease in depressive symptoms. While both treatment groups showed significant improvements in interpersonal and metacognitive skills, there was no significant between-group difference in the change scores for either of these skills.Conclusion: Our findings suggest that changes in interpersonal skills seem to be of particular relevance in the treatment of depression. These results have to be replicated in a randomized-controlled design before firm conclusions can be drawn.

The Effectiveness of Metacognitive Therapy Compared to Behavioral Activation for Severely Depressed Outpatients: A Single-Center Randomized Trial

“…Within-group effect sizes and remission and response rates in our sample were smaller than in previous studies on BA and MCT ([47-50], for a more detailed comparison with previous studies, see online suppl. material).…”

Identifying active ingredients in cognitive-behavioral therapies: What if we didn't?

“…Webb et al, 2011), andagain (Lorenzo-Luaces et al, 2015), and again (Lemmens et al, 2016;Lorenzo-Luaces et al, 2016). Despite how often this issue has been pointed out in the literature, and it being a general issue of causal inference in research, to this day researchers publish psychotherapy process studies in which they correlate alleged processes of change with symptoms without establishing temporal precedence (e.g., Sürig et al, 2021). While most of these studies acknowledge that they cannot claim Active ingredients of CBTs 6 causality, usually with a handful of sentences in the "limitations" section, this is largely a euphemistic replacement for a causal understanding of the relationships between the variables (Hernán, 2018).…”

CBASP – eine evidenzbasierte und praxisorientierte Einführung

“…Etwa 20-30% aller Depressionen nehmen einen chronischen Verlauf [2]. In spezialisierten Behandlungssettings für depressive Störungen ist der Anteil mehr als zwei Drittel [3]. Lange Zeit ist man davon ausgegangen, dass es sich bei chronischen Depressionen um eine leichte psychische Störung handelt, die sog.…”

“…Misst man die Wirksamkeit von CBASP nicht an der Reduktion der depressiven Kernsymptome, sondern an der Reduktion der mit der Diagnose einhergehenden Funktionseinschränkungen, so lassen sich zum derzeitigen Stand der Forschung folgende Ergebnisse resümieren: ▪ Prälogisches Denken: Eine Verbesserung des präoperatorischen Denkens erwies sich in einer 8-wöchigen Beobachtungsstudie als der wichtigste Prädiktor für einen Erfolg von CBASP [3] Verhaltensweisen und eine Abnahme feindseligsubmissiver Verhaltensweisen im Therapieverlauf [37], die ebenfalls mit einer Reduktion der Kernsymptomatik in Verbindung gebracht werden konnte [38,39]. Darüber hinaus berichten Personen nach einer Behandlung mit CBASP über eine größere Zunahme sozialer Problemlösefertigkeiten als nach Supportiver Therapie [40] und nach Behavioral Activation [41].…”

“…Diese Analysen beantworten die Frage, ob sich in einer Subgruppe ein besonderer Vorteil zugunsten einer bestimmten Therapie ergibt. [22,42], einer Beobachtungsstudie [3] und einer experimentellen unkontrollierten Studie [28].…”