Abstract
Both patients’ competence in the coping skills taught in cognitive therapy (CT) and patients’ endorsement of dysfunctional cognitions following a sad mood induction [i.e., their cognitive reactivity (CR)] have been found to predict risk of relapse following a successful course of CT for depression. We examined the relationship between these constructs, specifically whether CT skills would be related to less CR following a mood induction among patients who responded to a course of CT. In a sample of 28 depressed patients, post-treatment CT skills were significantly related to less CR in response to a sad mood induction procedure (β = −.29). This relation was not accounted for by individual differences in mood reactivity. We discuss these findings as a key step in developing a more complete understanding of the role of CT coping skills and CR as markers of patients’ vulnerability to relapse.
Notes
The musical selection used was “Russia under the Mongolian Yoke” recorded at half speed as performed by Prokofiev from the film Alexander Nevsky (for a review of mood induction procedures including the use of this musical selection, see Martin 1990).
References
Adler, A. D., Conklin, L. R., & Strunk, D. R. (2013a). Quality of coping skills predicts depressive symptom reactivity over repeated stressors. Journal of Clinical Psychology. doi:10.1002/jclp.21993.
Adler, A. D., Strunk, D. R., & Fazio, R. H. (2013b). What changes in cognitive therapy for depression? An examination of compensatory skills and maladaptive beliefs (under review).
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Association.
Barber, J. P., & DeRubeis, R. J. (1989). On second thought: Where the action is in cognitive therapy for depression. Cognitive Therapy and Research, 13, 441–457.
Barber, J. P., & DeRubeis, R. J. (1992). The ways of responding: A scale to assess compensatory skills taught in cognitive therapy. Behavioral Assessment, 14, 93–115.
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.
Connolly Gibbons, M. B., Crits-Christoph, P., Barber, J. P., Stirman, S. W., Gallop, R., Goldstein, L. A., et al. (2009). Unique and common mechanisms of change across cognitive and dynamic psychotherapies. Journal of Consulting and Clinical Psychology, 77, 801–813.
De Graaf, L. E., Roelofs, J., & Huibers, M. J. H. (2009). Measuring dysfunctional attitudes in the general population: The dysfunctional attitude scale (form A) revised. Cognitive Therapy and Research, 33, 345–355.
DeRubeis, R. J., Webb, C. A., Tang, T. Z., & Beck, A. T. (2010). Cognitive therapy. In K. S. Dobson (Ed.), Handbook of cognitive-behavioral therapies (3rd ed., pp. 277–316). New York, NY: Guilford.
First, M. B., Spitzer, R. L., Miriam, G., & Williams, J. B. W. (2002). 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.
Garratt, G., Ingram, R. E., Rand, K. L., & Sawalani, G. (2007). Cognitive processes in cognitive therapy: Evaluation of the mechanisms of change in the treatment of depression. Clinical Psychology: Science and Practice, 14, 224–239.
Hamilton, M. (1960). A rating scale for depression. Journal of Neurological Neurosurgical Psychiatry, 23, 56–62.
Hollon, S. D., Thase, M. E., & Markowitz, J. C. (2002). Treatment and prevention of depression. American Psychological Society, 3, 39–77.
Hollon, S. D., DeRubeis, R. J., Shelton, R. C., Amsterdam, J. D., Salomon, R. M., O’Reardon, J. P., et al. (2005). Prevention of relapse following cognitive therapy vs medications in moderate to severe depression. Archives of General Psychiatry, 62, 417–422.
Hollon, S. D., Stewart, M. O., & Strunk, D. R. (2006). Enduring effects for cognitive behavior therapy in the treatment of depression and anxiety. Annual Review of Psychology, 57, 285–315.
Jarrett, R. B., Vittengl, J. R., Clark, L. A., & Thase, M. E. (2011). Skills of cognitive therapy (SoCT): A new measure of patients’ comprehension and use. Psychological Assessment, 23, 578–586.
Martin, M. (1990). On the induction of mood. Clinical Psychology Review, 10, 669–697.
Miranda, J., & Persons, J. B. (1988). Dysfunctional attitudes are mood-state dependent. Journal of Abnormal Psychology, 97, 96–99.
Oliver, J. M., & Baumgart, E. P. (1985). The dysfunctional attitude scale: Psychometric properties and relation to depression in an unselected adult population. Cognitive Therapy and Research, 9, 161–167.
Reimherr, F. W., Amsterdam, J. D., Quitkin, F. M., Rosenbaum, J. F., Fava, M., Zajecka, J., et al. (1998). Optimal length of continuation therapy in depression: a prospective assessment during long-term fluoxetine treatment. American Journal of Psychiatry, 155, 1247–1253.
Scher, C. D., Ingram, R. E., & Segal, Z. V. (2005). CR and vulnerability: Empirical evaluation of construct activation and cognitive diatheses in unipolar depression. Clinical Psychology Review, 25(4), 487–510.
Segal, Z. V., Gemar, M., & Williams, S. (1999). Differential cognitive response to a mood challenge following successful cognitive therapy or pharmacotherapy for unipolar depression. Journal of Abnormal Psychology, 108(1), 3–10.
Segal, Z. V., Kennedy, S., Gemar, M., Hood, K., Pedersen, R., & Buis, T. (2006). CR to sad mood provocation and the prediction of depression relapse. Archives of General Psychiatry, 63, 749–755.
Strunk, D. R., DeRubeis, R. J., Chiu, A. W., & Alvarez, J. (2007). Patients’ competence in and performance of cognitive therapy skills: Relation to the reduction of relapse risk following treatment for depression. Journal of Consulting and Clinical Psychology, 75, 523–530.
Weissman, A. N. (1979). The dysfunctional attitude scale: A validation study. Dissertation Abstracts International, 40, 1389B–1390B.
Acknowledgments
The project described was supported by the National Center for Research Resources (Award number TL1RR025753). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Center for Research Resources or the National Institutes of Health. We thank those who helped make this research possible. Abby D. Adler, Andrew A. Cooper, Laren R. Conklin, Lizabeth A. Goldstein, and Elizabeth T. Ryan served as cognitive therapists and clinical interviewers. Abby D. Adler served as study coordinator. Daniel R. Strunk provided training in and supervision of clinical assessments and cognitive therapy.
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Strunk, D.R., Adler, A.D. & Hollars, S.N. Cognitive Therapy Skills Predict Cognitive Reactivity to Sad Mood Following Cognitive Therapy for Depression. Cogn Ther Res 37, 1214–1219 (2013). https://doi.org/10.1007/s10608-013-9570-z
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DOI: https://doi.org/10.1007/s10608-013-9570-z