Mode-specific effects among three treatments for depression.

Abstract

In the NIMH Treatment of Depression Collaborative Research Program (TDCRP), 250 depressed outpatients were randomly assigned to interpersonal psychotherapy, cognitive-behavioral therapy, imipramine plus clinical management, or pill placebo plus clinical management treatments. Although all treatments demonstrated significant symptom reduction with few differences in general outcomes, an important question concerned possible effects specific to each treatment. The therapies differ in rationale and procedures, suggesting that mode-specific effects may differ among treatments, each of which was precisely specified, applied appropriately, and shown to be discriminable. Outcome measures were selected for presumed sensitivity to the different treatments. Findings provided only scattered and relatively insubstantial support for mode-specific differences. None of the therapies produced consistent effects on measures related to its theoretical origins.

Extreme response style in recurrent and chronically depressed patients: Change with antidepressant administration and stability during continuation treatment.

“…The DAS consists of 40 statements to which patients respond on a 7-point scale ranging from 1 (totally agree) to 7 (totally disagree). For the current study, scores for the 11-item Need for Social Approval subscale (DAS-Approval; Imber et al, 1990; details provided by P. A. Pilkonis, personal communication, December 26, 2003) were used in analyses.…”

Relationship of posttreatment decentering and cognitive reactivity to relapse in major depression.

“…For instance, reductions in negative cognitive products (i.e., the surface-level thoughts or dysfunctional attitudes) do not appear to be the mechanism by which CBT produces its results, as reductions in these thoughts have tended to covary with reductions in depression symptoms, occur in response to noncognitive treatments such as ADM therapy and interpersonal psychotherapy, and show little association with the durability of the treatment gains (cf. Hollon et al, 1992;Hollon & Kriss, 1984;Imber et al, 1990;Safran, Vallis, Segal, & Shaw, 1986;Simons, Garfield, & Murphy, 1984). Rather, changes in cognitive structures, core schema, or core processes are regarded as representing critical change mechanisms in cognitive therapy (Beck, Rush, Shaw, & Emery, 1979;Safran et al, 1986).…”

CBT in Affective Disorders – New Frontiers

“…However, this was nothing unique to CBT but has also been found to occur during a Mindfulness-Based Cognitive Therapy (MBCT) [66]. Moreover, it has been shown that during CBT as well as during ADM automatic negative thoughts decrease and this reduction in turn has been associated with overall clinical improvement, so as to patients who did not benefit from either intervention showed significantly less change on cognitive measures [67][68]. Further studies have confirmed that reductions in negative cognitions are not only present in CBT but that different CBT treatment components are comparably effective in reducing negative cognitions.…”