Cognitive change has been proposed as a mechanism of symptom change in Cognitive Therapy for depression (CT; Beck, Rush, Shaw, & Emery, 1979), but the exact nature of this cognitive change remains unclear. This change could take different forms, ranging from changes in deliberate cognitive skills requiring ongoing efforts to cope with negative thoughts to more fundamental change in one's beliefs (requiring little to no subsequent coping efforts). The current study sought to capture the range of strategic to automatic cognitive change achieved in CT through the use of four assessment methods: a thought-listing measure of compensatory skills (Ways of Responding Scale, WOR; Barber & DeRubeis, 1992), a self-report questionnaire of dysfunctional attitudes (Dysfunctional Attitude Scale, DAS; Weissman, 1979), an implicit measure of dysfunctional attitudes (Implicit Association Test, IAT; Greenwald, McGhee, & Schwartz, 1998), and mood induction procedures combined with self-report questionnaire or implicit measure. Individuals with current Major Depressive Disorder ( n = 44) completed the WOR, DAS, and IAT before and after going through 16 weeks of CT. Measures of depressive symptoms were completed over the course of treatment to capture the trajectory of symptom change. Treatment responders (n = 29) also completed the DAS and IAT after undergoing a negative mood induction. A matched sample of never-depressed controls ( n = 44) completed study measures to determine normative responses. Results showed (a) no change on the IAT over the course of treatment, (b) significant changes on the WOR and DAS over the course of treatment, with each of these measures also being associated with a faster rate of depressive symptom change, (c) significant differences between depressed patients prior to treatment and never-depressed controls on the WOR, DAS, and IAT, (d) no significant differences between depressed patients after treatment and never-depressed controls on the WOR, (e) differences at a trend-level between depressed patients after treatment and never-depressed controls on the IAT, (f) significant differences between depressed patients after treatment and never-depressed controls on the DAS, and (g) no differences in cognitive reactivity following a negative mood induction between treatment responders and never-depressed controls. These findings support the compensatory skills model of change in CT: the development of deliberate cognitive skills to cope with negative thoughts best accounts for depressive symptom change during acute CT.
|Commitee:||Cheavens, Jennifer, Fazio, Russell, Strunk, Daniel, Vasey, Michael|
|School:||The Ohio State University|
|School Location:||United States -- Ohio|
|Source:||DAI-B 78/11(E), Dissertation Abstracts International|
|Subjects:||Psychology, Clinical psychology, Cognitive psychology|
|Keywords:||Cognitive therapy, Compensatory skills, Depression, Dysfunctional attitudes, Implicit Association Test|
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