Abstract
Research suggests that depressed patients’ beliefs about the causes of their depression affect the course and outcomes of treatment. However, changes in such beliefs during treatment have not been investigated. Before and after treatment, participants in a randomized control trial comparing cognitive therapy (CT) with antidepressant medication (ADM) in the treatment of depression were asked about their beliefs concerning the reasons for their depression. The reason clusters of interest were: Characterological, conceptually related to CT; and Biological, conceptually related to ADM. Contrary to predictions, endorsement of treatment-relevant reasons did not increase after a successful treatment. Rather, endorsement of treatment-irrelevant reasons decreased significantly. Thus, successful treatment may preserve people’s beliefs in causes of depression most closely related to the treatment, and diminish beliefs in unrelated causes.
Similar content being viewed by others
References
Addis, M. E., & Carpenter, K. M. (1999). Why, why, why?: Reason-giving and rumination as predictor of response to activation- and insight-oriented Treatment Rationales. Journal of Clinical Psychology, 55, 881–894.
Addis, M. E., & Jacobson, N. S. (1996). Reasons for depression and the process and outcome of cognitive-behavioral psychotherapies. Journal of Consulting and Clinical Psychology, 64, 1417–1424.
Addis, M. E., Truax, P., & Jacobson, N. S. (1995). Why do people think they are depressed?: The Reasons for Depression Questionnaire. Psychotherapy, 32, 476–483.
American Psychological Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington DC: Author.
Barber, J. P., & DeRubeis, R. J. (2001). Change in compensatory skills in cognitive therapy for depression. Journal of Psychotherapy Practice and Research, 10, 8–13.
Beck, J. S. (1995). Cognitive therapy: Basics and beyond. New York: Guilford Press.
Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression. New York: Guilford Press.
Beevers, C. G., Keitner, G. I., & Ryan, C. E. (2003). Cognitive predictors of symptom return following depression treatment. Journal of Abnormal Psychology, 112, 488–496.
Beutler, L. E., Engle, D., Mohr, D., Daldrup, R. J., Bergan, J., Meredith, K., & Merry, W. (1991). Predictors of differential response to cognitive, experiential, and self-directed psychotherapeutic procedures. Journal of Consulting and Clinical Psychology, 59, 333–340.
Borup, C., Meidahl, B., Petersen, I., Vangtorp, A., & le Fevre Honore, P. (1982). An early clinical phase II evaluation of paroxetine, a new potent and selective 5HT-uptake inhibitor in patients with depressive illness. Pharmacopsychiatria, 15, 183–186.
Burns, D. D., & Spangler, D. L. (2000). Does psychotherapy homework lead to improvements in depression in cognitive-behavioral therapy or does improvement lead to increased homework compliance? Journal of Consulting & Clinical Psychology, 68, 46–56.
Burns, D. D., & Spangler, D. L. (2001a). Can we confirm our theories? Can we measure causal effects?: Reply to Kazantzis et al. (2001). Journal of Consulting & Clinical Psychology, 69, 1084–1086.
Burns, D. D., & Spangler, D. L. (2001b). Do changes in dysfunctional attitudes mediate changes in depression and anxiety in cognitive behavioral therapy? Behavior Therapy, 32, 337–369.
Calvert, S. J., Beutler, L. E., & Crago, M. (1988). Psychotherapy outcome as a function of therapist-patient matching on selected variables. Journal of Social & Clinical Psychology, 6, 104–117.
DeRubeis, R. J., Hollon, S. D., Amsterdam, J. D., Shelton, R. C., Young, P. R., Salomon, R. M., O’Reardon, J. P., Lovett, M. L., Gladis, M. M., Brown, L. L., & Gallop, R. (2005). Cognitive therapy vs medications in the treatment of moderate to severe depression. Archives of General Psychiatry, 62, 409–416.
Fawcett, J., Epstein, P., Fiester, S. J., Elkin, I., Autry, J. H. (1987). Clinical management – imipramine/placebo administration manual: NIMH Treatment of Depression Collaborative Research Program. Psychopharmacology Bulletin, 23, 309–324.
First, M. B., Spitzer, R. L., Miriam, G., & Williams, J. B. W. (2001). Structured Clinical Interview for DSM-IV-TR Axis I Disorders, research version, patient edition. (SCID-I/P). New York: Biometrics Research, New York State Psychiatric Institute.
Fitzgerald, J. M., & Richardson, H. (2002). Use of the Reasons for Depression Questionnaire with adolescents. Journal of Clinical Psychology, 58, 1045–1056.
Hamilton, M. (1960). A rating scale for depression. Journal of Neurology Neurosurgery and Psychiatry, 23, 56–62.
Karno, M. P., Beutler, L. E., & Harwood, T. M. (2002). Interactions between psychotherapy procedures and patient attributes that predict alcohol treatment effectiveness: A preliminary report. Addiction Behavior, 27, 779–797.
Kazantzis, N., Ronan, K., & Deane, F. (2000). Concluding causation from correlation: Comment on Burns and Spangler (2000). Journal of Consulting & Clinical Psychology, 69, 1084–1086.
Lievens, F., & Anseel, F. (2004). Confirmatory factor analysis and invariance of an organizational citizenship behaviour measure across samples in a Dutch-speaking context. Journal of Occupational and Organizational Psychology, 77, 299–306.
Mann, J. J. (1999). Role of the serotonergic system in the pathogenesis of major depression and suicidal behavior. Neuropsychopharmacology, 21(2 Suppl), 99S–105S.
Reimherr, F. W., Amsterdam, J. D., Quitkin, F. M., Rosenbaum, J. F., Fava, M., Zajecka, J., Beasley, C. M., Michelson, D., Roback, P., & Sundell, K. (1998). Optimal length of continuation therapy in depression: A prospective assessment during long-term fluoxetine treatment. American Journal of Psychiatry, 155, 1247–1253.
Rossi, A., Barraco, A., & Donda, P. (2004). Fluoxetine: a review on evidence based medicine. Annals of General Psychiatry, 3, 2.
Shaik, N., Lowe, S., & Pinegar, K. (2006). DL-sQUAL: A Multiple-Item Scale for Measuring Service Quality of Online Distance Learning Programs. Online Journal of Distance Learning Administration, 9.
Swisher, L. L., Beckstead, J. W., & Bebeau, M. J. (2004). Factor analysis as a tool for survey analysis using a professional role orientation inventory as an example. Physical Therapy, 84, 784–799.
Thase, M. E. (2003). Achieving remission and managing relapse in depression. Clinical Psychiatry, 64(Suppl 18) 3–7.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Leykin, Y., DeRubeis, R.J., Shelton, R.C. et al. Changes in Patients’ Beliefs About the Causes of their Depression Following Successful Treatment. Cogn Ther Res 31, 437–449 (2007). https://doi.org/10.1007/s10608-007-9130-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10608-007-9130-5