Cognitive Change as a Predictor of Session-to-Session Symptom Change in Cognitive Therapy for Depression
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Date
2017-05
Authors
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Publisher
The Ohio State University
Abstract
Studies of cognitive therapy for depression (CT) suggest that decreases in negative cognitions coincide with reductions in depressive symptoms over the course of treatment. Although these results are consistent with the theory that cognitive change is responsible for therapeutic gains, the timing of such assessments has precluded establishing cognitive change as a predictor of subsequent symptom reduction. To test cognitive change as a predictor of symptom change, we examined patient-reported cognitive change observed during (immediate cognitive change; CC-I) and between (delayed cognitive change; CC-D) therapy sessions as predictors of symptom reduction across sessions 1 through 5 in CT. Additionally, we explored if these potential predictive relations vary according to patients’ pretreatment maladaptive personality traits and interpersonal problems and functioning. To further understand the function of cognitive change in CT, we also assessed CC-I as a predictor of session-to-session CC-D across these sessions of interest. A total of 126 adults with major depressive disorder participated in 16 weeks of CT. CC-I was evaluated immediately after each session, and CC-D and depressive symptoms were assessed before each session. To rule out stable patient characteristics as potential confounds, we disaggregated the within- and between-patient effects of cognitive change scores and focused on the within-patient effects as predictors. Within-patient CC-I significantly predicted subsequent CC-D, and within-patient CC-D significantly predicted subsequent symptom change. Within-patient CC-I did not significantly predict session-to-session symptom change. Interestingly, the relation of within-patient CC-I and symptom change was significantly moderated by patient maladaptive personality traits and interpersonal problems, whereas interpersonal functioning significantly moderated the relation of within-patient CC-D and symptom change. These results suggest that cognitive changes observed during therapy sessions predict additional cognitive change between sessions, which ultimately produce subsequent depressive symptom reduction.
Description
The Ohio State University Denman Research Forum, Award Winner
The Three Minute Undergraduate Thesis Competition, Awardee
The Three Minute Undergraduate Thesis Competition, Awardee
Keywords
Depression, Cognitive therapy, Therapeutic mechanism, Cognitive change