An Examination of CT Skills as a Mediator of the Enduring Effect of Cognitive Therapy for Depression
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The Ohio State University / OhioLINK
2015
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| Online Access: | http://rave.ohiolink.edu/etdc/view?acc_num=osu1439986785 |
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ndltd-OhioLink-oai-etd.ohiolink.edu-osu14399867852021-08-03T06:33:01Z An Examination of CT Skills as a Mediator of the Enduring Effect of Cognitive Therapy for Depression Pfeifer, Benjamin J. Psychology Clinical Psychology Psychotherapy cognitive therapy CT skills depression relapse enduring effect ways of responding WOR Cognitive Therapy (CT) is an evidence-based treatment for depression with a substantial supporting literature. Numerous clinical trials support its efficacy in producing acute symptom reduction. Follow-up studies also suggest that CT produces an enduring effect of reduced risk for subsequent relapse or recurrence relative to discontinued antidepressant medication (ADM). However, the mechanism that produces this enduring effect remains unclear. Although some researchers have suggested that skills learned in CT to identify and reduce negative biases may be the mechanism of CT’s enduring effect, there has not yet been a test of whether post-treatment skills account for the reduced risk of relapse and recurrence observed in CT compared to ADM. In the current study, I test this hypothesis in a sample of 104 patients with moderate to severe depression who responded to one of three randomly assigned treatment conditions: CT, continued ADM, or ADM withdrawn to placebo (DeRubeis et al., 2005; Hollon et al., 2005). Results are mixed, with evidence supporting some elements of a mediation hypothesis but not all. Treatment condition predicted risk of relapse/recurrence in this trial, although there was a significant site by treatment interaction such that the magnitude of treatment effects differed between sites. There was also a significant treatment condition by site interaction predicting post-treatment CT skills, and one CT skill score significantly predicted reduced risk of relapse/recurrence. However, results also showed that post-treatment skills did not significantly mediate the effect of treatment condition on risk of relapse/recurrence. These findings do not support a straightforward mediation hypothesis for CT skills, with some indications that site differences in patient characteristics or treatment procedures may have played a role. I discuss the roles of both treatment condition and site in these analyses, explore the possibility of patient characteristics as a potential moderator, and note limitations and possible future directions for this research. 2015 English text The Ohio State University / OhioLINK http://rave.ohiolink.edu/etdc/view?acc_num=osu1439986785 http://rave.ohiolink.edu/etdc/view?acc_num=osu1439986785 unrestricted This thesis or dissertation is protected by copyright: all rights reserved. It may not be copied or redistributed beyond the terms of applicable copyright laws. |
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NDLTD |
| language |
English |
| sources |
NDLTD |
| topic |
Psychology Clinical Psychology Psychotherapy cognitive therapy CT skills depression relapse enduring effect ways of responding WOR |
| spellingShingle |
Psychology Clinical Psychology Psychotherapy cognitive therapy CT skills depression relapse enduring effect ways of responding WOR Pfeifer, Benjamin J. An Examination of CT Skills as a Mediator of the Enduring Effect of Cognitive Therapy for Depression |
| author |
Pfeifer, Benjamin J. |
| author_facet |
Pfeifer, Benjamin J. |
| author_sort |
Pfeifer, Benjamin J. |
| title |
An Examination of CT Skills as a Mediator of the Enduring Effect of Cognitive Therapy for Depression |
| title_short |
An Examination of CT Skills as a Mediator of the Enduring Effect of Cognitive Therapy for Depression |
| title_full |
An Examination of CT Skills as a Mediator of the Enduring Effect of Cognitive Therapy for Depression |
| title_fullStr |
An Examination of CT Skills as a Mediator of the Enduring Effect of Cognitive Therapy for Depression |
| title_full_unstemmed |
An Examination of CT Skills as a Mediator of the Enduring Effect of Cognitive Therapy for Depression |
| title_sort |
examination of ct skills as a mediator of the enduring effect of cognitive therapy for depression |
| publisher |
The Ohio State University / OhioLINK |
| publishDate |
2015 |
| url |
http://rave.ohiolink.edu/etdc/view?acc_num=osu1439986785 |
| work_keys_str_mv |
AT pfeiferbenjaminj anexaminationofctskillsasamediatoroftheenduringeffectofcognitivetherapyfordepression AT pfeiferbenjaminj examinationofctskillsasamediatoroftheenduringeffectofcognitivetherapyfordepression |
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1719438788309024768 |