Self-initiated attempts to cope with depression (original) (raw)
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Staying well after depression: trial design and protocol
BMC …, 2010
Background: Depression is often a chronic relapsing condition, with relapse rates of 50-80% in those who have been depressed before. This is particularly problematic for those who become suicidal when depressed since habitual recurrence of suicidal thoughts increases likelihood of further acute suicidal episodes. Therefore the question how to prevent relapse is of particular urgency in this group.
Self-Psychological Interventions for Major Depression: Technique and Theory
American Journal of Psychotherapy, 1988
Cases of significantly depressed and regressed patients, where functional impairment necessitated psychiatric hospitalization, are presented to show the effects of a style of psychotherapeutic intervention whose goal is rapid mobilization of preexisting self-representations linked to positive affects. After defining the relevant self-psychological terms, we discuss the factors influencing emergence into consciousness of these positive affects and effects on the patient's vegetative symptoms of depression during self-psychologically oriented psychotherapy.
Cognitive therapy and research, 2017
Self-regulation models of psychopathology provide a theory-based, empirically supported framework for developing psychotherapeutic interventions that complement and extend current cognitive-behavioral models. However, many clinicians are only minimally familiar with the psychology of self-regulation. The aim of the present manuscript is twofold. First, we provide an overview of self-regulation as a motivational process essential to well-being and introduce two related theories of self-regulation which have been applied to depression. Second, we describe how self-regulatory concepts and processes from those two theories have been translated into psychosocial interventions, focusing specifically on self-system therapy (SST), a brief structured treatment for depression that targets personal goal pursuit. Two randomized controlled trials have shown that SST is superior to cognitive therapy for depressed clients with specific self-regulatory deficits, and both studies found evidence that...
Changes in symptoms of depression during the course of therapy
Cognitive Therapy and Research, 1984
Questions concerning the qualitative and quantitative nature of symptom change were investigated within the context of a large outcome study which compared three versions of a self-control therapy program for depression. Weekly short-form Beck Depression Inventory items were examined for patterns and rates of change for 13 symptoms of depression throughout the treatment program. Results indicated no differences due to the specific content of the therapy program. Most symptoms diminish in curvilinear fashion with the greatest change occurring in the first three to four weeks of therapy. Several symptoms, and particularly sadness and suicidal ideation, showed major decreases prior to the first therapy session. The sequential order of item changes are descriOed. The self-control therapy program for depression has been examined in a programmatic series of studies (
Self-help treatment for depression: Who succeeds?
Journal of Counseling Psychology, 1988
The growing popularity and use of bibliotherapy or "self-help" makes it important to find an empirical basis for determining who will profit from bibliotherapy treatments. Results from the career counseling field, using Holland's RIASEC model ) have characterized the self-help succeeder as Realistic, Investigative, and Conventional. Holland codes, selfpsychology variables, generalized self-efficacy, and locus of control were used to predict attrition from treatment, change in depression score, satisfaction with treatment, and preference for treatment. Fifty-two mildly depressed undergraduates (18 men and 34 women) contracted for a 7-week treatment for depression, using an empirically evaluated, cognitive-behavioral, self-help manual. Results suggest that Realistic types are most successful at self-help treatment in terms of reduction of depression scores, whereas Enterprising types are least successful in terms of rate of attrition. Low superiority, high generalized self-efficacy, and an internal locus of control were also related to success in the self-help depression treatment. Implications, limitations, and suggestions for future research are discussed.
A Systematic Review of Comparative Efficacy of Treatments and Controls for Depression
PLoS ONE, 2012
Background: Although previous meta-analyses have examined effects of antidepressants, psychotherapy, and alternative therapies for depression, the efficacy of these treatments alone and in combination has not been systematically compared. We hypothesized that the differences between approved depression treatments and controls would be small. Methods and Findings: The authors first reviewed data from Food and Drug Administration Summary Basis of Approval reports of 62 pivotal antidepressant trials consisting of data from 13,802 depressed patients. This was followed by a systematic review of data from 115 published trials evaluating efficacy of psychotherapies and alternative therapies for depression. The published depression trials consisted of 10,310 depressed patients. We assessed the percentage symptom reduction experienced by the patients based on treatment assignment. Overall, antidepressants led to greater symptom reduction compared to placebo among both unpublished FDA data and published trials (F = 38.5, df = 239, p,0.001). In the published trials we noted that the magnitude of symptom reduction with active depression treatments compared to controls was significantly larger when raters evaluating treatment effects were un-blinded compared to the trials with blinded raters (F = 2.17, df = 313, p,0.05). In the blinded trials, the combination of antidepressants and psychotherapy provided a slight advantage over antidepressants (p = 0.027) and psychotherapy (p = 0.022) alone. The magnitude of symptom reduction was greater with psychotherapies compared to placebo (p = 0.019), treatment-as-usual (p = 0.012) and waiting-list (p,0.001). Differences were not seen with psychotherapy compared to antidepressants, alternative therapies or active intervention controls. Conclusions: In conclusion, the combination of psychotherapy and antidepressants for depression may provide a slight advantage whereas antidepressants alone and psychotherapy alone are not significantly different from alternative therapies or active intervention controls. These data suggest that type of treatment offered is less important than getting depressed patients involved in an active therapeutic program. Future research should consider whether certain patient profiles might justify a specific treatment modality.
The effects of treatments for depression on perceived failure in self-regulation
Cognitive therapy and …, 2001
Two studies examined the effect of treatments for depression on perceived failure in self-regulation, operationalized as within-self discrepancy. In Study 1, patients received group cognitive-behavioral therapy (CBT); in Study 2, patients received either individual CBT, interpersonal psychotherapy (IPT), or medication. Treatments showed equivalent efficacy, but only psychotherapy was associated with decreased self-discrepancy and priming reactivity. Highly self-discrepant patients showed less improvement than other patients in all treatments, even after controlling for initial severity. The findings suggest that treatments differ in their impact on self-regulatory cognition, and that highly self-discrepant patients may require longer or alternative treatment.
Clinical Psychology Review, 2009
This meta-analysis found that the Coping with Depression course was effective for preventing new cases of major depressive disorders in people without a disorder at baseline and was also effective for treating existing depression. These conclusions were supported by the analysis results, but their reliability is unclear due to the lack of reporting of the review methods. Authors' objectives To review the effectiveness of the Coping with Depression course. Searching Studies were identified in the following ways: from those conducted by the review authors and their colleagues; from a database of studies on the psychological treatment of depression, which was developed from a comprehensive literature search for articles from 1966 to December 2007 in PsycINFO, PubMed, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), and DAI; and from those identified in earlier meta-analyses. The search terms were partially reported and the reference lists of identified articles were searched. Study selection Randomised controlled trials of the Coping with Depression course used for the prevention or treatment of depression were eligible for inclusion if they compared the intervention with a control or another treatment for adult depression, which could be psychotherapy or pharmacotherapy. In trials of prevention, Coping with Depression was used for participants with subthreshold depression (symptoms that did not meet the criteria for a depressive disorder) that was established by a diagnostic interview. The control groups received care as usual and the outcome was the incidence of new depressive disorders. In treatment trials, most of the participants met the criteria for a depressive disorder, based on a diagnostic interview, while the other participants were classified using a self-rated depression score. The outcome was the reduction in depressive symptoms. Interventions were delivered to groups, individuals, or both and were compared with care as usual, waiting list, relaxation, or life skills. The participants in prevention and treatment trials were adolescents, adults, minority adults, older adults (aged over 50 years), alcoholics, or women with post-natal depression. Where reported, the number of sessions ranged from five to 16, with sessions lasting from five minutes to two hours. For prevention trials, the incidence rate ratio was calculated by the incidence rate of new depressive disorders with Coping with Depression, relative to the control group, divided by the number of person-years at risk (to account for different lengths of follow-up across trials). For treatment trials, the means and standard deviations for post-test outcomes were extracted for Coping with Depression and control groups and these were used to calculate Cohen's d effect sizes. If a study reported more than one depression measure, the mean of all effect sizes was calculated. The authors did not state how many reviewers extracted the data.