Discontinuities and Cognitive Changes in an Exposure-Based Cognitive Therapy for Depression

Significant shifts or discontinuities in symptom course can mark points of transition and reveal important change processes. The authors investigated 2 patterns of change in depression--the rapid early response and a transient period of apparent worsening that the authors call a depression spike. Pa...

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Published inJournal of consulting and clinical psychology Vol. 75; no. 3; pp. 409 - 421
Main Authors Hayes, Adele M, Feldman, Greg C, Beevers, Christopher G, Laurenceau, Jean-Philippe, Cardaciotto, Leeann, Lewis-Smith, Jamie
Format Journal Article
LanguageEnglish
Published United States American Psychological Association 01.06.2007
Subjects
Adolescent
Adult
Affect
Anxiety
Behavior Change
Behavior Modification
Clinical Diagnosis
Cognition Disorders - diagnosis
Cognition Disorders - epidemiology
Cognitive Behavioral Therapy - methods
Cognitive Restructuring
Depression (Psychology)
Depressive Disorder, Major - diagnosis
Depressive Disorder, Major - epidemiology
Depressive Disorder, Major - therapy
Female
Humans
Male
Middle Aged
Neuropsychological Tests
Outcomes of Treatment
Patients
Severity of Illness Index
Symptoms (Individual Disorders)
Therapy
Treatment Outcome
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Summary:Significant shifts or discontinuities in symptom course can mark points of transition and reveal important change processes. The authors investigated 2 patterns of change in depression--the rapid early response and a transient period of apparent worsening that the authors call a depression spike. Participants were 29 patients diagnosed with major depressive disorder who enrolled in an open trial of an exposure-based cognitive therapy. Hierarchical linear modeling revealed an overall cubic shape of symptom change and that both the rapid response and spike patterns predicted lower posttreatment depression. Patients wrote weekly narratives about their depression. Early narratives of rapid responders were coded as having more hope than those of nonrapid responders. The narratives of patients with a depression spike had more cognitive-emotional processing during this period of arousal than those without a spike. Findings are discussed in the context of cognitive-emotional processing theories in depression and anxiety disorders.
ISSN:0022-006X
DOI:10.1037/0022-006X.75.3.409