Rumination-focused cognitive behaviour therapy for residual depression: A case series

Watkins, Ed; Scott, Jan; Wingrove, Janet; Rimes, Katharine A.; Bathurst, Neil; Steiner, Herbert; Kennell-Webb, Sandra; Moulds, Michelle L.; Malliaris, Yanni

doi:10.1016/j.brat.2006.09.018

Cited by 295 publications

(208 citation statements)

References 42 publications

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“…Therefore, reducing RTm during the treatment of depressive symptoms might be beneficial for a substantial number of children. Interventions that have been successful in reducing other types of repetitive thinking, like rumination-focused cognitive behavior therapy (RFCBT; Watkins et al, 2007) and Mindfulness Based Cognitive Therapy (MBCT; Teasdale et al, 2000), might be useful and could be easily adapted to reduce RTm. Moreover, children with a more narrow attentional field around their mother who initially experience less trust in maternal support or more RTm during distress seem more vulnerable to depressive symptoms.…”

Section: Discussionmentioning

confidence: 99%

Repetitive thinking about the mother during distress moderates the link between children's attentional breadth around the mother and depressive symptoms in middle childhood

Walle

Bijttebier

Raedt

et al. 2017

Behaviour Research and Therapy

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Section: Discussionmentioning

confidence: 99%

Repetitive thinking about the mother during distress moderates the link between children's attentional breadth around the mother and depressive symptoms in middle childhood

Walle

Bijttebier

Raedt

et al. 2017

Behaviour Research and Therapy

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“…The view taken by contextual-functional approaches to depression such as BA (Martell, Addis & Jacobson, 2001;Watkins et al, 2007) is that rumination may be more frequent and extensive if it has been learned in the course of someone's life in response to particular environments with perceived positive consequences. This module describes how the BA approach, and in particular functional analysis, is used to treat rumination (see Watkins et al, 2007Watkins et al, , 2011.…”

Section: Appendix 4 Baseline Case Report Formmentioning

confidence: 99%

“…It includes material directly adapted from existing manuals (copyright retained, © Watkins, 2004© Watkins, , 2008© Watkins, , 2009© Watkins, , 2011. For further details please see Watkins et al, 2007;Watkins, 2007Watkins, , 2009Watkins et al, 2009;Watkins et al, 2011;Watkins et al, 2012. Rumination is repetitive negative thought, a covert mental process common in depression. It tends to focus on self, negative mood, problems and difficulties.…”

Section: Appendix 4 Baseline Case Report Formmentioning

confidence: 99%

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Cost and Outcome of BehaviouRal Activation (COBRA): a randomised controlled trial of behavioural activation versus cognitive–behavioural therapy for depression

Richards

Rhodes

Ekers

et al. 2017

Health Technol Assess

Self Cite

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BackgroundDepression is a common, debilitating and costly disorder. The best-evidenced psychological therapy – cognitive–behavioural therapy (CBT) – is complex and costly. A simpler therapy, behavioural activation (BA), may be an effective alternative.ObjectivesTo determine the clinical effectiveness and cost-effectiveness of BA compared with CBT for depressed adults at 12 and 18 months’ follow-up, and to investigate the processes of treatments.DesignRandomised controlled, non-inferiority trial stratified by depression severity, antidepressant use and recruitment site, with embedded process evaluation; and randomisation by remote computer-generated allocation.SettingThree community mental health services in England.ParticipantsAdults aged ≥ 18 years with major depressive disorder (MDD) recruited from primary care and psychological therapy services.InterventionsBA delivered by NHS junior mental health workers (MHWs); CBT by NHS psychological therapists.OutcomesPrimary: depression severity (as measured via the Patient Health Questionnaire-9; PHQ-9) at 12 months. Secondary: MDD status; number of depression-free days; anxiety (as measured via the Generalised Anxiety Disorder-7); health-related quality of life (as measured via the Short Form questionnaire-36 items) at 6, 12 and 18 months; and PHQ-9 at 6 and 18 months, all collected by assessors blinded to treatment allocation. Non-inferiority margin was 1.9 PHQ-9 points. We undertook intention-to-treat (ITT) and per protocol (PP) analyses. We explored cost-effectiveness by collecting direct treatment and other health- and social-care costs and calculating quality-adjusted life-years (QALYs) using the EuroQol-5 Dimensions, three-level version, at 18 months.ResultsWe recruited 440 participants (BA,n = 221; CBT,n = 219); 175 (79%) BA and 189 (86%) CBT participants provided ITT data and 135 (61%) BA and 151 (69%) CBT participants provided PP data. At 12 months we found that BA was non-inferior to CBT {ITT: CBT 8.4 PHQ-9 points [standard deviation (SD) 7.5 PHQ-9 points], BA 8.4 PHQ-9 points (SD 7.0 PHQ-9 points), mean difference 0.1 PHQ-9 points, 95% confidence interval (CI) –1.3 to 1.5 PHQ-9 points,p = 0.89; PP: CBT 7.9 PHQ-9 points (SD 7.3 PHQ-9 points), BA 7.8 PHQ-9 points (SD 6.5 PHQ-9 points), mean difference 0.0 PHQ-9 points, 95% CI –1.5 to 1.6 PHQ-9 points,p = 0.99}. We found no differences in secondary outcomes. We found a significant difference in mean intervention costs (BA, £975; CBT, £1235;p < 0.001), but no differences in non-intervention (hospital, community health, social care and medication costs) or total (non-intervention plus intervention) costs. Costs were lower and QALY outcomes better in the BA group, generating an incremental cost-effectiveness ratio of –£6865. The probability of BA being cost-effective compared with CBT was almost 80% at the National Institute for Health and Care Excellence’s preferred willingness-to-pay threshold of £20,000–30,000 per QALY. There were no trial-related adverse events.LimitationsIn this pragmatic trial many depressed participants in both groups were also taking antidepressant medication, although most had been doing so for a considerable time before entering the trial. Around one-third of participants chose not to complete a PP dose of treatment, a finding common in both psychotherapy trials and routine practice.ConclusionsWe found that BA is as effective as CBT, more cost-effective and can be delivered by MHWs with no professional training in psychological therapies.Future workSettings and countries with a paucity of professionally qualified psychological therapists, might choose to investigate the delivery of effective psychological therapy for depression without the need to develop an extensive and costly professional infrastructure.Trial registrationCurrent Controlled Trials ISRCTN27473954.FundingThis project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 21, No. 46. See the NIHR Journals Library website for further project information.

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“…Trait (Deyo, Wilson, Ong, & Koopman, 2009;Watkins et al, 2007). Although these treatments specifically targeted depressive rumination, they may be effectively adapted for individuals prone to anger rumination.…”

Section: Discussionmentioning

confidence: 99%

The Effects of Alcohol Intoxication and Cognitive Emotion Regulation Strategies on Lab-Based Partner Aggression

Watkins¹

2014

PsycEXTRA Dataset

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Intimate partner aggression (IPA) is a serious national health concern that affects an alarming number of individuals and can lead to substantial psychological and physical suffering. Situational risk factors that arise in the immediate context of IPA reflect statelike influences that trigger aggression. Because these factors are more variable and fluctuate according to the situation, they are potentially promising targets for prevention and intervention efforts (e.g., through cognitive and behavioral interventions). Within this realm, two factors in particular appear to play a prominent role in the etiology of IPA: alcohol intoxication and cognitive emotion regulation strategies. In contrast to prior correlational work, the present study experimentally manipulated alcohol consumption and emotion regulatory strategies to assess their individual and combined effects on IPA, which was measured both observationally and through self-report. It was expected that both alcohol intoxication and anger rumination would increase IPA perpetration, whereas reappraisal would result in decreased IPA perpetration. Further, intoxication and emotion regulation strategies were expected to have interactive effects on IPA perpetration such that rumination would enhance associations between alcohol intoxication and aggression, whereas reappraisal would attenuate the relationship between alcohol and IPA perpetration. Hypotheses for the study were partially supported. Findings show that participants in the alcohol condition generally displayed greater IPA than participants in the placebo condition. Emotion regulation strategy condition was not found to affect IPA. When examining only the effects of alcohol and emotion regulation strategy condition, emotion strategy use did not moderate the relationship between alcohol intoxication and IPA. However, alcohol and emotion regulation strategy conditions were found to interact with trait levels of rumination and reappraisal to predict IPA. The implications of these results, future directions for research, and implications for IPA intervention and prevention strategies are discussed. (Harned, 2002;Straus, 2004).Although most research examining IPA has focused on heterosexual couples, IPA also occurs among heterosexual and same sex couples at similar rates (McClennen, 2005).Further, researchers agree that it is important to systematically examine IPA perpetration among both genders (Holtzworth-Munroe, 2005;Johnson, 2006;Straus, 2006) and among both heterosexual and same-sex couples (Fahmy & Fradella, 2014;McCLennen, 2005). 3University students are particularly at risk for IPA, with past-year prevalence rates ranging from approximately 20% to 50% (Cogan & Fennell, 2007; Forke, Myers, Catallozzi, & Schwartz, 2008;Riggs & O'Leary, 1996;Straus, 2004 Identifying demographic and dispositional risk factors provides invaluable information on which individuals are more likely to be aggressive towards their partners.However, these risk factors do not provide information about the specific circumsta...

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Rumination-focused cognitive behaviour therapy for residual depression: A case series

Cited by 295 publications

References 42 publications

Repetitive thinking about the mother during distress moderates the link between children's attentional breadth around the mother and depressive symptoms in middle childhood

Repetitive thinking about the mother during distress moderates the link between children's attentional breadth around the mother and depressive symptoms in middle childhood

Cost and Outcome of BehaviouRal Activation (COBRA): a randomised controlled trial of behavioural activation versus cognitive–behavioural therapy for depression

The Effects of Alcohol Intoxication and Cognitive Emotion Regulation Strategies on Lab-Based Partner Aggression

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