Applying the unified protocol to a single case of major depression with schizoid and depressive personality traits (original) (raw)
Related papers
Iranian Evolutionary Educational Psychology Journal, 2023
This study was undertaken with the primary objective of assessing the efficacy of schema therapy in addressing dysfunctional attitudes and emotional dysregulation among patients diagnosed with persistent depressive disorder. The research methodology employed in this investigation followed a semi-experimental approach, incorporating a pre-test and post-test design encompassing both experimental and control groups. The study's target population consisted of all individuals diagnosed with persistent depressive disorder who sought treatment at psychology and psychiatry clinics in Tehran in 2022. From this population, a sample of 30 participants was selected using an accessible sampling method and Structured Clinical Interview for DSM Disorders (SCID) was taken from the participants. To gather data and evaluate relevant attributes and conditions, a semi-structured clinical interview demographic form and the second version of the Beck Depression Inventory were administered. Moreover, for the analysis of research hypotheses, statistical methods including the ANCOVA analysis test and paired t-tests were applied through the SPSS-16 statistical software. The findings of this study indicated that schema therapy significantly influenced the levels of dysfunctional attitudes and emotional dysregulation in patients with persistent depressive disorder.
The Impact of the Unified Protocol for Emotional Disorders on Quality of Life
International Journal of Cognitive Therapy, 2013
It has become increasingly clear that mental health is more than just the absence of psychopathology and that there is clinical utility in examining positive aspects of mental health. The present study examined the effects of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders on quality of life in a randomized controlled trial that included individuals with a diverse range of emotional disorders. Results indicated that the Unified Protocol produced significant increases in quality of life when examining both within-individual effect sizes and between-conditions effect sizes compared to a waitlist condition. Furthermore, results indicated that post-treatment levels of quality of life predicted levels of functional impairment independently of diagnostic severity. These results provide further evidence of the importance of examining indicators of mental health in conjunction with markers of psychopathology and provide promising evidence that the Unified Protocol may promote improved mental health in addition to treating psychopathology.
A systematic review of cognitive remediation for schizo-affective and affective disorders
Journal of Affective Disorders, 2012
Background: Cognitive remediation is accepted as an important therapeutic intervention in schizophrenia, but few studies provide data on whether the benefits extend to affective disorders. Objectives: To review quantitatively studies of cognitive remediation with samples that included cases of schizoaffective disorder, affective psychosis, unipolar and/or bipolar disorders. Methods: Twenty one studies met preliminary inclusion criteria, comprising a total of 940 participants of which 35% had an affective or schizoaffective disorder. Effect sizes (ES) for pre-to post-intervention change in cognitive performance were estimated. Results: A meta-analysis of 16 studies gave a pooled ES for change in cognitive function of 0.32 (95% Confidence Intervals 0.20 to 0.43) and produced statistical homogeneity. Overall, ES were significantly positively correlated with higher proportion of schizo-affective and affective cases (r¼ 0.61; p¼ 0.007), even when age, gender and duration of therapy were included as covariates in the analysis (r¼ .59, p¼ 0.017).
Trials
Background: Major depressive disorder is a leading cause of disease burden worldwide, indicating the importance of effective therapies. Outcome studies have shown overall efficacy of different types of psychotherapy across groups, yet large variability within groups. Although patient characteristics are considered crucial in understanding outcome, they have received limited research attention. This trial aims at investigating the interaction between therapeutic approach (pre-structured versus explorative) and the personality style of patients (dependent versus self-critical), which is considered a core underlying dimension of depressive pathology. Methods/design: This study is a pragmatic stratified (dependent and self-critical patients) parallel trial with equal randomization (allocation 1:1) conducted in Flanders, Belgium. One hundred and four patients will be recruited and randomized to either 16-20 sessions of cognitive behavioral therapy for depression (pre-structured approach) or 16-20 sessions of short-term psychodynamic psychotherapy for depression (explorative approach) conducted by trained psychotherapists in private practices. The primary outcome is the severity of depression as measured by the Hamilton Rating Scale for Depression at completion of therapy. Secondary outcome measures include self-reported depressive and other symptoms, interpersonal functioning, idiosyncratic complaints, and the presence of the diagnosis of depression. Additional measures include biological measures, narrative material (sessions, interviews), and health care costs. Discussion: This trial presents the test of an often-described, yet hardly investigated interaction between important personality dimensions and therapeutic approach in the treatment of depression. Results could inform therapists on how to match psychotherapeutic treatments to specific personality characteristics of their patients.
Effect of Positive Emotional Treatment Program on Anhedonia and Apathy among Schizophrenic Patients
2017
The purpose of this study was to investigate the effectiveness of positive emotional treatment program on anhedonia and apathy among schizophrenic patients. Setting: The present study was conducted at the Al-Abbassia Mental Health Hospital. Sample: A purposive sample consisted of thirty schizophrenic patients was recruited in the current study. The sample of the current study was divided into experimental and control groups. Methods: A quazi-experimental design was used in this study. Three tools were used to collect the data for the current study, Personal data sheet, Scale for the Assessment of Negative Symptoms and The Savoring Beliefs Inventory. A constructed positive emotional program was designed to help patients to develop necessary skills for modifying defeatist thinking, to learn and practice a new skill to improve their anticipation or maintenance of pleasure. This program was implemented over thirteen sessions, two sessions per week and each session lasted about 60-90 min...
Depression is one of the most common symptom seen in Schizophrenic patients. Cognitive Behavioural Therapy is one of the effective psychotherapy treatment modality for treating depression, which includes both cognitive and Behavioural strategies. It refers to the use of both cognitive restructuring and Behavioural plan of activity scheduling. Aim: To assess the efficacy of Cognitive Behavioural Therapy on the depressive symptoms for Schizophrenic patients in selected rehabilitation centres of Pune city. Methods:- True Experimental approach was adopted for the study. 50 samples (25 experimental and 25 control group) which met the inclusion criteria, was selected by simple random sampling technique. The Structured questionnaire was used to assess the level of depressive symptoms in Schizophrenic patients .A pilot study was conducted and the reliability of the tool was established by the split-half method and Cronbach’s alpha (r=0.87). The experimental group was administered with three sessions of Cognitive Behavioural Therapy in a gap of 2 days. Data analysis was done by descriptive and inferential statistics. Results:- Findings revealed that the average depression score in pre-test was 39.2 which reduced to 32.4 in posttest by applying paired t-test. Two sample t-test for the comparison of average reduction in depression scores of experimental and control groups was done. The Average change in depression score in the experimental group was 6.9 and control group had a score of 4. Age was found to have a significant association with the depressive symptoms among Schizophrenia patients. Conclusion:- Cognitive Behavioural Therapy is proved to be significantly effective in reducing the depressive symptoms among the Schizophrenic patients.
Affect Regulation and Depressive Personality Disorder
Journal of Personality Disorders, 2011
Disorder (DPD) has been under consideration for inclusion in the Diagnostic and Statistical Manual of Mental Disorders since 1994; yet, few studies have been published that test whether those with DPD have affective experiences that are characterized exclusively by depression and negative affect. One hundred ninety-seven undergraduate students were interviewed for DPD and Borderline Personality Disorder with the Personality Disorder Interview for DSM-IV (Widiger, Mangine, Corbitt, Ellis, & Thomas, 1995), in order to control for frequently co-occurring BPD which is characterized by affective lability. Participants also were administered measures of affective lability, affective intensity, anxious and depressive states, and more traitlike manifestations of depression, anxiety, and anger. Results indicate that those with DPD may be described as having a mood state characterized by transitions from a baseline neutral mood to one of anxiety, with their experiences being more prominently depressed and dysphoric. They also have tendencies toward angry hostility, though they may not report frequent shifts from a baseline neutral mood to anger. Those with DPD also report intense, frequent experiences of depression and dysphoria, with many shifts between depression and anxiety. Depressive Personality Disorder (DPD) has been of interest for some time (Huprich, 1998), with some even noting a related phenomenon being described in Hippocrates' melancholic character (Phillips et al., 1998). Since its introduction in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition [DSM-IV; American Psychiatric Association (APA), 1994], an impressive body of research has developed on DPD's reliability, validity, and clinical utility (see Huprich, 2009, for a review of this literature). According to DSM-IV-TR (APA, 2000), the diagnostic criteria of DPD are defined as following: A pervasive pattern of depressive cognitions and behaviors beginning by early adulthood and present in a variety of contexts, as indicated as five (or more) of the following: (a) usual mood is dominated by dejection, gloominess, cheerlessness, joylessness, unhappi
BMC Psychiatry
Background: Patients with comorbid depression and personality disorders suffer from a heavy disease burden while tailored treatment options are limited, accounting for a high psychological and economic burden. Little is known about the effect of treatment dosage and type of psychotherapy for this specific co-morbid patient population, in terms of treatment-effect and cost-effectiveness. This study aims to compare treatment outcome of 25 versus 50 individual therapy sessions in a year. We expect the 50-session condition to be more effective in treating depression and maintaining the effect. Secondary objectives will be addressed in order to find therapyspecific and non-specific mechanisms of change. Methods: In a mono-center pragmatic randomized controlled trial with a 2 × 2 factorial design, 200 patients with a depressive disorder and personality disorder(s) will be included. Patients will be recruited from a Dutch mental health care institute for personality disorders. They will be randomized over therapy dosage (25 vs 50 sessions in a year) and type of therapy (schema therapy vs short-term psychodynamic supportive psychotherapy). The primary clinical outcome measure will be depression severity and remission. Changes in personality functioning and quality of life will be investigated as secondary outcomes. A priori postulated effect moderators and mediators will be collected as well. All patients are assessed at baseline and at 1, 2, 3, 6, 9-12 months (end of therapy) and at follow up (6 and 12 months after end of treatment). Alongside the trial, an economic evaluation will be conducted. Costs will be collected from a societal perspective. Discussion: This trial will be the first to compare two psychotherapy dosages in patients with both depression and personality disorders. Insight in the effect of treatment dosage for this patient group will contribute to both higher treatment effectiveness and lower costs. In addition, this study will contribute to the limited evidence base on treating patients with both depression and personality disorders. Understanding the processes that account for the therapeutic changes could help to gain insight in what works for whom.
Iranian Journal of Psychiatry and Behavioral Sciences
Background: The literature suggests the increasing application of acceptance and commitment therapy (ACT) for people with schizophrenia spectrum disorders (SSD). Objectives: This study aimed to determine the effectiveness of ACT on the positive and negative symptoms and emotion regulation of patients with SSD. Methods: The experimental design of the current study was an AB (baseline and intervention phases) along with the follow-up phase, in addition to Treatment-As-Usual (TAU), ACT sessions were held for the participants. Among the 20 participants who had inclusion criteria to the study, five participant (three men and two women in the age range of 32 - 43 years) were randomly allocated to participate in the intervention through drawing and evaluated using the Positive and Negative Syndrome Scale (PANSS) and Difficulties in Emotion Regulation Scale (DERS) in three phases of baseline, intervention, and follow-up. For data analysis, non-overlapping indices and Cohen's d effect si...