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Cognitive Therapy of Depression
Abstract
This article reviews the cognitive therapy of depression. The psychotherapy based on this theory consists of behavioral and verbal techniques to change cognitions, beliefs, and errors in logic in the patient's thinking. A few of the various techniques are described and a case example is provided. Finally, the outcome studies testing the efficacy of this approach are reviewed.
... In accordance with previous studies (Cuijpers, van Straten, Andersson, & van Oppen, 2008), CBT was grouped into two categories: (1) CBT in which cognitive restructuring is the core element of the treatment, and (2) CBT in which cognitive restructuring is an important component, but in which other components (such as behavioral activation, social skills training, relaxation, or coping skills) also have a prominent place. Within the first subtype, two variants are distinguished: (Variant 1a) The CBT is based on the manual developed by Beck and Rush (1979, which includes a module on behavioral activation). (Variant 1b) Cognitive restructuring is used as a treatment (with or without a module on behavioral activation), but no explicit reference is made to Beck et al.'s manual (Beck & Rush, 1979). ...
... Within the first subtype, two variants are distinguished: (Variant 1a) The CBT is based on the manual developed by Beck and Rush (1979, which includes a module on behavioral activation). (Variant 1b) Cognitive restructuring is used as a treatment (with or without a module on behavioral activation), but no explicit reference is made to Beck et al.'s manual (Beck & Rush, 1979). Only studies with individual and face-to-face contacts by psychotherapists were included. ...
... Note. CBT Type 1a = CBT in which cognitive restructuring is the core element of the treatment and the manual developed by Beck and Rush (1979) is the most widely used manual for CBT (which includes a module on behavioral activation). CBT Type 1b = CBT in which cognitive restructuring is the core element of the treatment (with or without a module on behavioral activation), but no explicit reference is made to Beck et al.'s manual (Beck & Rush, 1979). ...
Objective: Evidence on the optimal “dose” of cognitive behavioral therapy (CBT) for treating major depressive disorder is sparse. This analysis aimed to evaluate the dose–response curve in CBT using a nonlinear approach, whereby “dose” was defined as number of treatment sessions. The dose–response curve of CBT was compared to other psychotherapies and pharmacological treatments for depression. Method: A systematic review and metaregression analysis of randomized controlled trials (RCTs) examining the efficacy of CBT in adults with acute depression was conducted. Treatment arms examining other psychosocial or pharmacological interventions were also analyzed. Cubic spline metaregression techniques were used to model nonlinear dose–response curves. Results: Seventy-two studies and 7,377 participants were included. Modeling the dose–response curve between change of depression symptom severity and the number of CBT sessions resulted in a nonlinear curve characterized by a strong improvement in symptom severity from baseline within the first eight sessions. Symptom reduction continues in the further course of the treatment, but at a slower pace. A similar pattern of symptom development was found for other therapies as well, although the prominence of early improvement and overall effect sizes vary across treatment arms. Conclusion: Results imply a general tendency for the strongest alleviation of depressive symptom severity in early stages of CBT treatment, thus, if aiming at symptom alleviation, speak for short CBT interventions. However, these findings have to be discussed in the light of the limited data regarding the sustainability of treatment effects in short-term therapies and effects beyond symptomatic changes.
... If we assume that certain beliefs are causally responsible for the emergence and persistence of psychopathology, it is natural to think that their revision should be a crucial component of treatment or therapy. This prima facie compelling inference is central to Cognitive Behavioral Therapy (CBT) (e.g., Ellis, 1962;Beck et al., 1979;Beck, 2011;Hofmann et al., 2013)-a therapeutic approach rooted in the cognitive model of psychopathology. 1 Thus, one of the core therapeutic processes of CBT is cognitive restructuring, i.e., the process of modification or revision of the dysfunctional beliefs responsible for our mental suffering. ...
... According to the cognitive model of psychopathology, the main factor responsible for the emergence and persistence of psychological suffering and many mental disorders is maladaptive 4 thoughts, beliefs, and information-processing patterns, often labeled jointly as "cognitions" (see, e.g., Beck et al., 1979;Padesky, 1994;Young, 1990;Brewin, 2006;Clark, 2013;A. T. Beck & Haigh, 2014;Newman, 2015;Arntz, 2018). ...
... At this point, Tom's therapist faces an important decision: which therapeutic methods and techniques should she apply to help her client? If she is trained in CBT, it is very likely that one of the main techniques in her therapeutic toolbox will be cognitive restructuring (e.g., Beck et al., 1979;Dobson & Dozois, 2010;A. T. Beck & Haigh, 2014;Newman, 2015;Arntz, 2018). ...
According to the cognitive model of psychopathology, maladaptive beliefs about oneself, others, and the world are the main factors contributing to the development and persistence of various forms of mental suffering. Therefore, the key therapeutic process of Cognitive Behavioral Therapy (CBT)—a therapeutic approach rooted in the cognitive model—is cognitive restructuring, i.e., a process of revision of such maladaptive beliefs. In this paper, I examine the philosophical assumptions underlying CBT and offer theoretical reasons to think that the effectiveness of belief revision in psychotherapy is very limited. This is the case, I argue, because the cognitive model wrongly assumes that our body of beliefs is unified, while it is in fact fragmented.
... Symptoms that exposure-focused treatments target include anxious avoidance of feared stimuli related to panic, agoraphobia, and PTSD and ritual behavior used to counter obsessions of people with obsessive-compulsive disorder (OCD). These cognitive (25) and behavioral (26) therapies often focus on cognitive responses to unruly emotional reactions and on theories derived from Pavlovian conditioning research or fightversus-flight paradigms (27). Examples include cognitive therapy (25), prolonged exposure (26), and acceptance and commitment therapy (ACT) (28). ...
... These cognitive (25) and behavioral (26) therapies often focus on cognitive responses to unruly emotional reactions and on theories derived from Pavlovian conditioning research or fightversus-flight paradigms (27). Examples include cognitive therapy (25), prolonged exposure (26), and acceptance and commitment therapy (ACT) (28). Exposure-based therapies differ from one another in their cognitive versus behavioral theoretical and technical emphases but are more structured and symptom focused than affect-focused therapies. ...
... For example, the mood-congruent negative thinking involved in depression steers patients to pessimism and inhibits activity (e.g., "Why bother?"). Thus, the patient needs to learn to assess such thinking objectively by considering objective evidence (25). Patients caught in cascades of irrational worst-case scenarios and struggling to think flexibly or realistically can find this structure very helpful and stabilizing. ...
The authors discuss the two broad domains of affect-focused and exposure-focused psychotherapies, defining the characteristics and potential advantages and disadvantages of each. The two domains differ in their theoretical approaches, structures, and techniques. Exposure-focused therapies have come to dominate research and practice, leading to the relative neglect of affect-focused therapies. When the two approaches have been examined in well-conducted clinical trials, they generally appear to be equally beneficial for treating common mood, anxiety, and trauma disorders, although further research may better define differential therapeutics. The authors argue for better training in affect awareness and tolerance across psychotherapies and use a brief case vignette to illustrate several aspects of these different approaches.
... Symptoms that exposure-focused treatments target include anxious avoidance of feared stimuli related to panic, agoraphobia, and PTSD and ritual behavior used to counter obsessions of people with obsessive-compulsive disorder (OCD). These cognitive (25) and behavioral (26) therapies often focus on cognitive responses to unruly emotional reactions and on theories derived from Pavlovian conditioning research or fightversus-flight paradigms (27). Examples include cognitive therapy (25), prolonged exposure (26), and acceptance and commitment therapy (ACT) (28). ...
... These cognitive (25) and behavioral (26) therapies often focus on cognitive responses to unruly emotional reactions and on theories derived from Pavlovian conditioning research or fightversus-flight paradigms (27). Examples include cognitive therapy (25), prolonged exposure (26), and acceptance and commitment therapy (ACT) (28). Exposure-based therapies differ from one another in their cognitive versus behavioral theoretical and technical emphases but are more structured and symptom focused than affect-focused therapies. ...
... For example, the mood-congruent negative thinking involved in depression steers patients to pessimism and inhibits activity (e.g., "Why bother?"). Thus, the patient needs to learn to assess such thinking objectively by considering objective evidence (25). Patients caught in cascades of irrational worst-case scenarios and struggling to think flexibly or realistically can find this structure very helpful and stabilizing. ...
We divide psychotherapies into two broad categories, affect-focused and exposure-focused, and detail the advantages and disadvantages of each.
... Transference has been documented by such authors as Carl Rogers (16), within the clientcentered therapy, Fritz Perls (17), within gestalt therapy, and Rollo May (18) within existential therapy. In the CBT model, Beck (14,19) talked explicitly of transference, Goldfried and Davison (20) described it in terms of 'parataxic distortion.' Other CBT therapists define it as overgeneralization (21). ...
... The two-factor model showed good fit to the data: c² [19] ...
Background
Psychotherapists need effective tools to monitor changes in the patient’s affective perception of the therapist and the therapeutic relationship during sessions to tailor therapeutic interventions and improve treatment outcomes. This study aims to evaluate the factor structure, reliability, and validity of the in-Session Patient Affective Reactions Questionnaire (SPARQ), a concise self-report measure designed for practical application in real-world psychotherapy settings.
Methods
Validation data was gathered from (N = 700) adult patients in individual psychotherapy. These patients completed the SPARQ in conjunction with additional measures capturing sociodemographic details, characteristics of therapeutic interventions, individual personality traits, mental health symptom severity, elements of the therapeutic relationship, and session outcomes. This comprehensive approach was employed to assess the construct and criterion-related validity of the SPARQ.
Results
The SPARQ has a two-factor structure: Positive Affect (k = 4, ω total = .87) and Negative Affect (k = 4, ω total = .75). Bifactor confirmatory factor analysis (CFA) yielded the following fit indices: X²[df] = 2.53, CFI = .99; TLI = .98; RMSEA = .05; and SRMR = .02. Multi-group CFAs demonstrated measurement invariance (i) across patients who attended psychotherapy sessions in person versus in remote mode, and (ii) across patients with and without psychiatric diagnoses confirmed metric invariance. Furthermore, the SPARQ showed meaningful correlations with concurrently administered measures.
Discussion
The SPARQ proves to be a valuable instrument in clinical, training, and research contexts, adept at capturing patients’ session-level affective responses towards their therapist and perceptions of the therapeutic alliance. Comprehensive descriptive statistics and a range of score precision indices have been reported, intended to serve as benchmarks for future research.
... The CBT protocol was based on the manual by Beck and colleagues. [20] ...
... There are findings on the contrary that the efficacy of either therapy is noted to be comparable. [20] CBT and IPT also share several common features: both are time-limited, symptom-targeted, and present-focused and encourage the patient to regain control of mood and functioning. Furthermore, both try to increase the patient's activity level and pay special attention to the identification of expectations and assumptions using interventions such as exploration and clarification. ...
Background
Depressive disorders are one of the most common psychiatric disorders that occur in people of all ages.
Aim
To assess the efficacy of cognitive behavior therapy (CBT) and interpersonal therapy (IPT) in cases of depression.
Materials and Methods
The sample for the study comprised 52 diagnosed cases of major depressive disorder (MDD) based on the 10 th revision of the International Classification of Diseases (ICD-10) criteria in the age range of 21 to 50 years. They were randomized with the help of the app and assigned to CBT and IPT groups. Two patients had dropped out of the CBT group. Hence, finally, 50 cases were taken for study. A total of 12 therapy sessions were given. All patients were given standard treatment as prescribed.
Results
Findings of paired samples t -test to assess the within-group differences in both the groups (CBT and IPT) as well as gains score statistics or difference score statistics (pre-test minus post-test) were applied to compare group differences. Results of paired samples ‘ t ’ test suggest that there was a statistically significant difference in the scores of both the groups from pre-test to post-test. IPT group had shown significantly better outcomes as quantified by the percentage of patients scoring less on the outcome variable of the Beck Depression Inventory (BDI), Montgomery–Asberg Depression Rating Scale (MADRS), Hopelessness Scale, and General Health Questionnaire (GHQ).
Conclusion
Both CBT and IPT are efficacious in the treatment of MDD. IPT yielded better results on MADRS as compared to CBT on parameters of outcome in the present study. The findings indicate that interventions were effective in reducing the symptoms of depression.
... Careful assessment of depression, anxiety, and trauma should be made before undertaking life review approaches because it may not be the most useful strategy (Laidlaw, 2010). Under these circumstances, cognitive-behavioral therapy (CBT; Beck, 1979; A. C. Butler, Chapman, Forman, & Beck, 2006) may be more appropriate and has been found in RCTs to work well with symptom reduction of depression and anxiety in late life (Laidlaw et al., 2008; Chapter 5, this volume; see also Volume II, Chapters 1 and 2, this handbook). ...
... 531). In cases in which depression contributes to unproductive recall and rumination about perceived failures (Papageorgiou & Wells, 2003), CBT's cognitive restructuring (Beck, 1979) is recommended to challenge unhelpful appraisals and substitute them with more useful and realistic appraisals. Rumination is consistent with Wong and Watt's (1991) description of unproductive obsessive reminiscence. ...
... A number of researches indicate that fantasy prone individuals show a greater range and level of psychopathology compared to people who are not prone to fantasizing (Tan et al., 2019;Lynn et al., 2018;Waldo & Meritt, 2000;Irwin, 1991;Rhue & Lynn, 1989;Lynn & Rhue, 1988). Increased prevalence of symptoms, in fantasy prone personalities, is most evident in the following disorders: depression (Lynn et al., 2018;Golding & Singer, 1983;Beck, 1979); person with OCD spectrum disorder (van Heugtenvan der Kloet et al., 2014;Klinger et al., 2009;Rauschenberger & Lynn, 1995); dissociative disorders (Merckelbarch et al., 2005;Pekala et al., 2001;Merckelbach et al., 2000b) and posttraumatic stress disorder (PTSD) (Dalenberg et al., 2012;Thomson et al., 2009;Muris et al., 2003). Also, fantasizing has been associated with schizotyping in both adults (Merckelbach & Giesbrecht, 2006) and adolescents (Sánchez -Bernardos & Avia, 2004). ...
... Fanaticizing has proven to be a very adaptive overcoming mechanism. The features of fantasies that are disruptive to mental health are their disturbing content, repetitive character, and being accompanied by negative emotions (Beck, 1979). Therefore, such fantasies can be understood as a reflection of a person's current mental state, as a channel through which negative influences, obtained from elsewhere and in some other way, are expressed. ...
Fantasy proneness has so far been treated as a trait associated with both pathological and adaptive mechanisms. What also seems to be the case is that both claims are evident and experimentally verified. This is an indicator of the much greater sensitivity with which these traits should be treated. This paper examines the relationship between fantasy proneness with selected indicators of mental health and sociodemographic characteristics with special consideration of the corresponding role of positive and negative affect. Obtained results contribute to detecting the sensitivity traits that seem to categorize fantasy prone individuals into the groups of those under risk for the development of mental health problems and those who are well adapted. This has been done by performing statistical analysis on impact detection methods to achieve significant correlation and determination of fantasy proneness via sociodemographic variables and mental health indicator variables. The results indicate that only marital status is a significant socio-demographic predictor, while all of the mental health indicators have significant direct or indirect impact on fantasy proneness.
... Specifically, EFMT targets the activation of cognitive control and emotion-processing networks, including the dorsolateral prefrontal cortex (DLPFC) and the amygdala (1). CBT targets maladaptive cognitions and behaviors that contribute to depression (2). ...
... Cognitivebehavioral therapy is a common-sense-based approach grounded on two fundamental principles: first, cognitive schemas have a controlling effect on emotions and behaviors; and second, the manner of functioning or behavior strongly influences an individual's patterns of thought and emotional states. Cognitive elements of this approach were identified centuries ago by sophists like Epictetus and also by Cicero, Seneca, and others, long before cognitive-behavioral therapy was introduced (Beck, 1979(Beck, , 1996. ...
Objective: This study aimed to compare the effectiveness of cognitive-behavioral therapy, brief intervention, and combined intervention on social alienation among COVID-19 recovery patients in Andimeshk. Research Methods and Materials: The method used in this study was a quasi-experimental pre-test post-test design with a control group. The sample consisted of 80 COVID-19 recovery patients covered by comprehensive health centers in Andimeshk, who were randomly assigned to experimental and control groups (each group containing 20 individuals). The experimental group underwent cognitive-behavioral therapy interventions in eight 90-minute sessions held weekly, while the control group received no intervention. Data were collected using the Melvin Seeman Social Alienation questionnaire, and hypotheses were tested using analysis of covariance. Findings: The results showed a significant difference between the effectiveness of cognitive-behavioral therapy and brief intervention on social alienation among COVID-19 recovery patients in Andimeshk; however, no significant difference was found between the effectiveness of cognitive-behavioral therapy and the combined intervention on social alienation among these patients. Conclusion: Based on the findings, it can be concluded that cognitive-behavioral therapy is effective in reducing social alienation, and there is no difference in effectiveness between cognitive-behavioral therapy and the combined intervention (cognitive-behavioral therapy and brief intervention).
... Classic Freudian theory which explains depression as aggression displaced from an external hostile object and turned inwards against the self, provides a psychodynamic framework for understanding this association. However, there is more evidence in the research base to support the cognitive formulation, which proposes that early adverse experiences could result in an enduring triad of negative cognitions about the self, the world, and the future, which then become embedded as a latent negative schema and is activated by subsequent events [59,60]. The significant association between depression and the reported experience of being bullied may be explained by Seligman's learned helplessness theory, which proposes that frequent exposure to uncontrollable and unpredictable events leads to an enduring loss of adaptive behaviors, eventually resulting in permanent deficits in cognitive and emotional processes [61]. ...
Background
Depressive disorders, with a prevalence of 15–21%, are among the most common disorders in children and adolescents, and increases the risk of suicide, the second leading cause of death in children aged 10 to 19.
Aim
To determine the prevalence and correlates of depressive disorders among senior students attending secondary schools in Abeokuta.
Method
The study was conducted in five schools randomly selected from a representative sample and was carried out in 2 phases. In the first phase, students were selected via systematic random sampling and given consent forms and GHQ-12 to administer to the parents. In the second phase, students who returned a signed informed consent form and filled out GHQ-12 were interviewed using MINI-KID, Rosenberg’s Self-Esteem Scale, Family-APGAR, and sociodemographic questionnaire. Multivariate regression analyses were conducted with p-value <0.05 as level of significance.
Results
The mean age was 15.3 years (SD = 1.27); 48.8% were male. The twelve-month prevalence of major depression was 11.3% and dysthymia was 1.4%. In the final regression analysis, female gender [OR = 4.3, p = 0.046], the experience of bullying [OR = 7.96, p = 0.004], difficulty getting along with friends, [OR = 7.5, p = 0.004], history of sexual abuse [OR = 8.1, p = 0.01], and perceived family dysfunction [OR = 4.9, p = 0,023] were found to be independent predictors of depressive disorders.
Conclusion
Depressive syndromes are a significant health burden in adolescents. Being female, being bullied, having a history of sexual abuse, and family dysfunctionality are risk factors associated with depression among these population.
... The average score of the SDS was 34.77 with a range from 20 to 55, indicating that they had no serious depressive symptoms according to the Chinese norms for this scale (Wang, 1999). We also found a positive correlation between the neuroticism score and the depression score (r ¼0.59, p o0.001), the ATQ score and the depression score (r ¼ 0.63, p o0.001), the neuroticism score and the ATQ (r ¼0.56, p o0.001), which was in accord with previous studies (Beck, 1979;Harrell and Ryon, 1983;Fergusson et al., 1989;McWilliams et al., 2003). Table 1 presents the demographic characteristics of the total sample. ...
Previous behavioral studies have examined the correlation between personality and depression, and between negative automatic thoughts and depression. Little is known, however, about the relationships among these three factors. Even less is known about how variations in brain structure are related to negative automatic thoughts, which are thought to mediate the association between personality traits and depressive symptoms. A total of 298 healthy participants underwent magnetic resonance imaging and completed the following questionnaires: a Neuroticism scale, the Automatic Thoughts Questionnaire (ATQ), and the Self-Rating Depression Scale (SDS). We first investigated the relationships among the three questionnaires and found that the ATQ was a mediator between the Neuroticism scale and the SDS. Then, we investigated the neuroanatomical correlates of the ATQ in the participants using voxel-based morphometry. We found that the ATQ was significantly positively correlated with the gray matter volume of the parahippocampal gyrus (PHG). Structural Equation Modeling revealed that negative automatic thoughts mediated the relationship between the GMV of the parahippocampal gyrus and depression. Moreover, the interaction between parahippocampal gyrus volume and neuroticism predicted automatic thoughts. These findings highlight that negative automatic thoughts might be a good predictor of depression outcome.
... Some cognitive coping strategies (e.g., rumination, catastrophizing) are associated with worse depressive symptoms, while others (e.g., positive reappraisal) are associated with less severe symptoms (Garnefski & Kraaij, 2006. Cognitive emotion regulation strategies are a primary target of cognitive and cognitive-behavioral therapies for depression (Beck, 1979). ...
... Punishment sensitivity, on the other hand, is associated with social anhedonia (lack of interest and pleasure) and emotional distress (Slessareva & Muraven, 2004). Beck's (1979) depression theory suggests that depressed individuals often magnify failures and predict more future failures than non-depressed counterparts; thus, show a higher sensitivity toward punishment (Dong et al., 2022). Existing literature has been consistent in showing elevated BIS activation among individuals with depression (Bowins, 2014;Kasch et al., 2002;Li et al., 2015;Mellick et al., 2014). ...
Human temperament, in terms of sensitivity to punishment and rewards, immensely impacts emotions, behaviours, and psychological well-being. Punishment sensitivity is a significant predictor of depression, but, only a few studies have explored the mediating mechanisms between them. The current study attempts to test the causal effect between punishment sensitivity and depression among students, and the chain mediating effects of procrastination (active and traditional) and academic satisfaction. For this purpose, self-report surveys were conducted on a sample of 295 engineering undergraduates in India. The data has been analyzed using structural equation modelling, where hypothesized models that connect punishment sensitivity, procrastination (active procrastination and traditional procrastination), academic satisfaction, and depression, were tested. The result revealed that punishment sensitivity positively predicts depression, and this relationship is serially mediated by procrastination (active and traditional) and academic satisfaction, respectively. Active procrastination negatively and traditional procrastination positively predict depression. Based on the study findings, future interventions against procrastination must consider punishment sensitivity as an important variable. The implications of the research are discussed.
... It supported the hypotheses that fear of COVID-19 was both associated with COVID-19 perceived risk and depression/ anxiety, which was partially in line with the Common Sense Model (CSM), i.e. an illness determines emotional responses that further affects mental health [34,35]. Also, Beck's cognitive theory proposed that cognitive content (including individuals' belief systems, expectations, assumptions, and evaluations) is activated by events and driven by subjective meaning that interacts with their affective systems [68]. Therefore, exaggerated interpretations of threats, including fear of COVID-19 [69], may lead to inappropriate or excessive anxiety and depression [70]. ...
Background
Depression and anxiety have been found prevalent during all phases of the COVID-19 pandemic. In late December 2022, almost all COVID-19 control measures were lifted in China, leading to a surge in COVID-19 infections. The public’s perceived risk and fear of COVID-19 would be increased. This study aims to examine the prevalence of depression and anxiety in the Chinese general population and explores the mediating role of fear of COVID-19 between COVID-19 perceived risk and depression/anxiety and the moderating role of resilience between fear of COVID-19 and depression/anxiety.
Methods
A cross-sectional online survey was conducted in Wenzhou, China, immediately following almost all COVID-19 control measures lifted. The 9-item Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), the COVID-19 Risk Perception Scale, the Fear of COVID-19 Scale, and the Connor-Davidson Resilience Scale (CD-RISC) were used to evaluate depression, anxiety, COVID-19 perceived risk, fear of COVID-19, and resilience, respectively. Structural Equation Modeling (SEM) with Maximum Likelihood (ML) estimator and adjusted for significant background factors was performed to test the moderated mediation. Data obtained from 935 participants were analyzed.
Results
The prevalence of moderate to severe depression and anxiety was 23.7% and 9.5%, respectively. The present study revealed positive associations among COVID-19 perceived risk, fear of COVID-19 and depression/anxiety, and negative associations between resilience and fear of COVID-19/depression/anxiety. Fear of COVID-19 partially mediated the association between COVID-19 perceived risk and depression/anxiety. Furthermore, resilience significantly moderated the association between fear of COVID-19 and depression/anxiety. Two moderated mediation models were constructed.
Conclusion
Depression and anxiety were prevalent among Chinese adults during the final phase of the pandemic in China. The significant mediation role of fear of COVID-19 implies that reducing fear of COVID-19 may effectively alleviate depression and anxiety symptoms. Moreover, enhancing public resilience during an epidemic crisis is crucial for promoting mental health.
... It is a measure of the severity of symptoms of depression and was developed by Beck (8). It is a 4-point self-rating scale of the Likert type. ...
... In addition, "Personal devaluation" also exhibits a robust edge with "Hopelessness" and "Emptiness" in both the MDD and BD groups. The relationships between "Hopelessness" and "Personal devaluation" are in line with Beck's cognitive triad concept [72]. Consequently, "Emptiness", despite being categorized as the first criterion of the DSM-5 MDE symptoms, presents distinct dimensions compared with the affective valence of "Depressed affect" and "Crying spell". ...
Background and Objectives: Depressive symptoms are prominent in both major depressive disorder (MDD) and bipolar disorder (BD). However, comparative research on the network structure of depressive symptoms in these two diagnostic groups has been limited. This study aims to compare the network structure of depressive symptoms in MDD and BD, providing a deeper understanding of the depressive symptomatology of each disorder. Materials and Methods: The Zung Self-Rating Depressive Scale, a 20-item questionnaire, was administered to assess the depressive symptoms in individuals with MDD (n = 322) and BD (n = 516). A network analysis was conducted using exploratory graph analysis (EGA), and the network structure was analyzed using regularized partial correlation models. To validate the dimensionality of the Zung SDS, principal component analysis (PCA) was adopted. Centrality measures of the depressive symptoms within each group were assessed, followed by a network comparison test between the two groups. Results: In both diagnostic groups, the network analysis revealed four distinct categories, aligning closely with the PCA results. “Depressed affect” emerged as the most central symptom in both MDD and BD. Furthermore, non-core symptoms, “Personal devaluation” in MDD and “Confusion” in BD, displayed strong centrality. The network comparison test did not reveal significant differences in the network structure between MDD and BD. Conclusions: The absence of significant differences in the network structures between MDD and BD suggests that the underlying mechanisms of depressive symptoms may be similar across these disorders. The identified central symptoms, including “Depressed affect”, in both disorders and the distinct non-core symptoms in each highlight the complexity of the depressive symptomatology. Future research should focus on validating these symptoms as therapeutic targets and incorporate various methodologies, including non-metric dimension reduction techniques or canonical analysis.
... Počeci kognitivne psihoterapije su povezani sa terapijom depresije, o čemu svedoči i kapitalno delo Arona Beka, "Kognitivna terapija depresije" iz 1979. godine [27] . Jedan od osnovnih Bekovih uvida jeste da održavanju simptoma depresije doprinosi negativni kognitivni trijas (tzv. ...
Hronična depresija predstavlja psihoterapijski izazov koji zahteva poseban pristup u poređenju sa akutnom depresijom. Psihoterapijski proces koji se zasniva na kognitivno-bihejvioralnoj terapiji mora da uzme u obzir niz specifičnosti ovog stanja, uključujući: (1) izazove u izgradnji terapijskog saveza; (2) izbegavanje kao dominantni mehanizam održavanja; (3) sržna uverenja o samoj depresiji. Izgradnja terapijskog saveza je često komplikovana dugogodišnjom demoralizacijom pacijenta, koja zahteva poseban senzibilitet i strpljenje terapeuta. Vodeći kognitivni model hronične depresije označava izbegavanje kao jedan od ključnih mehanizama održavanja poremećaja. Izbegavanje se može konceptualizovati u vidu bihejvioralnog, kognitivnog i emocionalnog. Bihejvioralno izbegavanje se manifestuje kao sklonost ka izbegavanju, ili uzdržavanje od suočavanja sa situacijama ili stimulusima iz sredine koji izazivaju nelagodnost. Kognitivno izbegavanje podrazumeva strategije za izbegavanje uznemirujućih misli ili sećanja i može se manifestovati kroz poricanje, preterano uopštavanje, minimiziranje i rumniacije. Emocionalno izbegavanje čini supresija neprijatnih emocionalnih stanja, što često dovodi do sveopšte emocionalne utrnulosti. Mehanizmi izbegavanja su usko isprepletani sa verovanjem osobe o sopstvenoj depresiji. Percepcija postojanja depresije kao znaka lične slabosti ili "biološkog" problema onemogućava povezivanje situacionog konteksta sa simptomima, pojačavajući doživljaj bespomoćnosti. Sveobuhvatni pristup terapiji hronične depresije podrazumeva neophodnost prepoznavanja i adresiranja ovih izazova.
Exposure therapy is a central component to successful cognitive-behavioral therapy (CBT) for anxiety disorders and can be effectively used to treat a wide range of anxiety disorders. As CBT interventions become more intensive and condensed, mental health professionals must consider the ethics of providing such treatment to youth, adolescents, and young adults. This chapter highlights the ethical considerations likely to arise with brief, intensive CBT interventions that often incorporate exposure. We review the six distinctive features of CBT that contribute to its efficacy, how such features apply to exposure therapy, and the ethical considerations associated with each feature. These CBT features (e.g., outside-of-session activities, emphasis on current experiences, providing patients with information about their treatment) have important implications for informed consent, avoiding harm, and maintaining confidentiality, boundaries, and treatment fidelity. Given that clinicians’ negative beliefs often stand in the way of providing effective treatment, the importance of assessing one’s own biases and competencies are also discussed. It is concluded that careful consideration and adherence to core ethical principles allows for the safe and effective delivery of brief, intensive CBT interventions.
Objectives This study aims to assess the effect of dialectical behavior therapy (DBT) on cognitive emotion regulation, cognitive flexibility and worry in women with depression. Methods This is a randomized controlled clinical trial with a pre-test/post-test design. The study population consists of all women with depression referred to psychology clinics in Jahrom, Iran, in 2022. From three clinics of Hami, Rahgosha, and Fardaye Behtar, 30 women with a Beck depression inventory (BDI) score of 20-28 (moderate depression) were selected using a purposeful sampling method, and were randomly divided into intervention (n=15) and control (n=15) groups. Garnefski et al.'s cognitive emotion regulation questionnaire, Dennis and Vander Wal's cognitive flexibility questionnaire, Meir et al.'s Penn State worry questionnaire, and BDI were used to collect data. Data analysis was done using the analysis of covariance. Results The DBT had a significant effect on the study variables. It has caused an increase in adaptive CER strategies and cognitive flexibility and a decrease in maladaptive CER strategies and worry. Conclusion The DBT can be used to reduce worry and improve cognitive flexibility and adaptive CER strategies in depressed women.
Objective: Despite the importance for understanding mechanisms of change, little is known about the order of change in daily life emotions, cognitions, and behaviors during treatment of depression. This study examined the within-person temporal order of emotional, cognitive, and behavioral improvements using ecological momentary assessment data. Method: Thirty-two individuals with diagnosed depression completed ecological momentary assessment questions on emotions (sad mood, happy mood), behaviors (social interaction, number of activities), and cognitive variables (worrying, negative self-thoughts) 5 times a day during a 4-month period in which they underwent psychotherapy for depression. Nonparametric change-point analyses were used to determine the timing of gains (i.e., improvements in the mean of each variable) for each individual. We then established whether the first (i.e., earliest) gains in emotions preceded, followed, or occurred in the same week as cognitive and behavioral gains for each individual. Results: Contrary to our hypotheses, first gains in behaviors did not precede first emotional gains (3 times, 8%) more often than they followed them (26 times, 70%). Cognitive gains often occurred in the same week as first emotional gains (43 times, 58%) and less often preceded (13 times, 18%) or followed emotional gains (18 times, 24%). Conclusion: The first improvements in behaviors did not tend to precede the first improvements in emotions likely because fewer behavioral gains were found. The finding that cognitive variables tend to improve around the same time as sad mood may explain why many studies failed to find that cognitive change predicts later change in depressive symptoms.
Changing behavior has been a challenge for thousands of years. This issue has been exacerbated in modern times as substances (e.g., drugs and food) are becoming increasingly refined and tweaked to increase their addictive potential. Behavioral addictions have also come to the fore as advances in neuroscience have made it possible for companies to pinpoint and advertise “pain points” in society (e.g., physical and emotional pain, boredom, social comparison), offering distraction and escape as relief in various forms ranging from video games to social media. And in an age of relative abundance and availability, even food is engineered and designed for overconsumption, leading to overeating, overweight/obesity, and poor mental and physical health. Modern solutions (e.g., Cognitive Behavioral Therapy) have failed to adequately address our collective “bad” habits and addictions as overeating, anxiety, and addiction continue to increase. Over the past several decades, ancient Buddhist theories that directly target reinforcement learning have begun to be tested in research and clinical settings. In this commentary, I give a brief first-person historical account of the merging of Buddhist theory, clinical practice, and research that suggests that such approaches could offer more effective strategies for improving health outcomes compared to current treatment paradigms that focus on cognitive restructuring and willpower.
Ethical treatment for clients exhibiting trauma-related distress due to crisis events requires counselors to be familiar with various cognitive, emotional, interpersonal, and spiritual shifts that may occur in the wake of these life-altering experiences. This current work explores differentiations between thoughts, feelings, and beliefs in relation to unique ways clients respond to trauma, followed by a comprehensive overview of cognitive schema construction and commonly overlooked trauma wounds of guilt, shame, and moral injury. Readers will review an intrapersonal-environmental feedback loop model, which can serve as a psychoeducational and conceptual foundation for examining sources of distorted cognitions, emotional and physiological responses, behavior changes, and adapted belief systems as clients attempt to make new meaning following traumatic exposure. Finally, the authors introduce three evidence-based treatment approaches which intentionally and ethically match the greatest sources of distress in overall functioning for individual trauma survivors. These modalities include (1) schema, (2) Trauma Informed Guilt Reduction (TriGR), and narrative therapies.
This chapter examines the connection between negative cognitive schemas and the maintenance of trauma triggers in post-traumatic experiences. A case scenario is introduced and serves as the foundation for the conceptualization of how trauma impacts and supports schema development and avoidance behaviors. An overview of treatment considerations is given to provide a potential starting point for trauma processing. An ethical decision-making process is highlighted using the case scenario.
Purpose
To evaluate the long-term effect of a tablet-based, cognitive-behavioral group intervention (Tab-G) to improve daily walking for older adults with arthritis.
Method
Using an experimental pretest/posttest repeated measure design, long-term effects on step count, fatigue, self-efficacy, and quality of life (QOL) were investigated.
Results
Results of repeated measures analysis of variance showed significant improvement in step counts (F[1, 37] = 4.18, p = 0.048), fatigue (F[1, 36] = 9.971, p = 0.003), self-efficacy (F[1,28] = 4.645, p = 0.04), and QOL (F[1, 29] = 6.147, p = 0.019) in the Tab-G group compared to the control group. There were significant time effects across four time points (baseline and Weeks 4, 8, and 10) in fatigue (F[3, 108] = 5.43, p = 0.002), self-efficacy (F[3, 84] = 5.433, p = 0.002), and QOL (F[3, 87] = 3.673, p = 0.015), but not in step counts (F[3, 111] = 0.611, p = 0.609).
Conclusion
Findings demonstrate positive long-term effects on fatigue in older adults with arthritis. [ Journal of Gerontological Nursing, 50 (5), 35–42.]
Pain is a crucial factor in rheumatic disorders, and reducing it is a primary goal of successful treatment. Adaptive pain-coping strategies can enhance this improvement, but maladaptive approaches such as pain catastrophizing may worsen overall patient well-being. This narrative review aims to provide a concise overview of the existing knowledge on pain catastrophizing in the most prevalent specific rheumatic disorders. The objective of this study was to improve understanding of this phenomenon and its implications, as well as to pinpoint potential directions for future research. We conducted searches in the MEDLINE/PubMed, SCOPUS, and DOAJ bibliography databases to identify articles related to pain catastrophizing in rheumatoid arthritis, psoriatic arthritis, axial spondylarthritis, systemic sclerosis, systemic lupus erythematosus, Sjögren’s syndrome, juvenile idiopathic arthritis, and osteoarthritis (non-surgical treatment). Data extraction was performed on November 1, 2023. The investigators screened the identified articles to determine their relevance and whether they met the inclusion criteria. Following a bibliography search, which was further expanded by screening of citations and references, we included 156 records in the current review. The full-text analysis centred on pain catastrophizing, encompassing its prevalence, pathogenesis, and impact. The review established the role of catastrophizing in amplifying pain and diminishing various aspects of general well-being. Also, potential treatment approaches were discussed and summarised across the examined disorders. Pain catastrophizing is as a significant factor in rheumatic disorders. Its impact warrants further exploration through prospective controlled trials to enhance global patient outcomes.
Case conceptualization is an important stage in the sport and performance psychology (SPP) consulting process. The conceptualization of a case can influence a consultant's understanding of the underpinning mechanisms contributing to a presenting concern, interventions selected to help a client, and the effectiveness of provided services. Guidelines for case conceptualization have been developed for SPP professionals, but little is known about how this activity is undertaken in practice. The purpose of this study was to investigate the case-conceptualization methods and approaches of certified SPP professionals. Fifty-two certified mental performance consultants completed an online qualitative survey exploring how they conceptualized cases. Our findings suggested that SPP consultants viewed case conceptualization as an ongoing process, something that helps a consultant understand a client's presenting concerns and guide any intervention plans, a collaboration between client and consultant, and a way to evaluate the effectiveness of their practice.
Therapeutic alliance is relevant across diverse therapies and has a long history in psychotherapy. Theoretical definitions of the alliance have three common components across the therapy approaches including the collaborative nature of the relationship, the affective bond between client and therapist, and the client’s and therapist’s ability to mutually agree on treatment goals and tasks. Therapeutic alliance scales have the patient’s/ client’s version, the therapist’s version as well as the independent rater versions. The moderating effect of the therapeutic alliance is dependent on the kind of the assessment instrument used. Higher level of therapeutic alliance has been associated with better outcomes across the brief psychotherapies and the relationship between the outcome and alliance was modest. The current chapter covers the concept of therapeutic relationship and its various dimensions, the general principles and role of the therapist. It also covers the desirable personal attributes of the therapist such as being flexible, honest, respectful, trustworthy, confident, warm, interested, genuine and open that contribute positively to the alliance. The chapter also focuses on the methods of training to improve the therapeutic alliance building skills of the therapist.
BACKGROUND
Cataclysm refers to a large-scale and violent event involving disaster, catastrophe, calamity, and tragedy. The recent surge of a pandemic (coronavirus disease 2019 (COVID-19)), humanitarian crisis in Sudan, civil unrest, and war, such as the attacks in Syria and Ukraine, reiterate the need to address the trauma attached to such catastrophes. This study focuses on adapting positive psychology, one of the newest branches of psychology to emerge, to help human beings prosper and lead healthy, happy lives. It also explores post-traumatic stress disorder (PTSD) and means to overcome traumatizing psychological dejection caused by such mishaps.
MATERIALS AND METHODS
Demoralization is the immediate effect caused on victims and survivors of such devastations. A comprehensive study of cataclysm and demoralization is concomitant with the suffering produced by various factors pertaining to mass annihilation. A deductive methodology is incorporated into the qualitative data to analyze the oral testimonies of war and disaster survivors in Svetlana Alexievich’s works titled Zinky Boys: Soviet Voices from the Afghanistan War , Second Hand Time , The Unwomanly Face of War and Chernobyl Prayer .
RESULTS
Interpretation of the polyphonic voices in the oral sagas of interviewees in Alexievich’s works reveals an increased level of anxiety, stress, and trauma post-catastrophic events.
CONCLUSION
The implementation of positive psychology has been identified as an appropriate psychological intervention to address the issues related to psychological devastation.
Broad deficits in emotion regulation skills have been observed in children with anxiety-related disorders. These deficits typically improve during cognitive-behavioral therapy (CBT), but few studies have examined changes in expressive suppression and cognitive reappraisal in youth with anxiety disorders and/or obsessive–compulsive disorder (OCD) during CBT, especially in real-world settings. In a naturalistic treatment-seeking sample, 123 youth completed measures of anxiety, depression, and emotion regulation strategy use before and after 15 sessions of CBT. For anxious youth, anxiety and expressive suppression decreased over treatment, while cognitive reappraisal increased. Reductions in expressive suppression and increases in cognitive reappraisal were significantly associated with improvements in anxiety and remained significantly associated with post-treatment anxiety after accounting for baseline anxiety and depression. Changes in expressive suppression and cognitive reappraisal over the course of treatment were not found for youth with primary OCD. Thus, CBT improves emotion regulation abilities in anxious youth, and these improvements are associated with anxiety reduction; improvements in emotion regulation do not appear to drive changes in OCD symptoms. Further research is needed to determine whether changes in emotion regulation strategies mediate changes in anxiety among youth receiving CBT.
Background
This paper examines cognitive and body-based therapies through the lens of embodiment, framing treatments as constructed experiences shaped by individuals' subjective and intersubjective lived experiences. Embodiment is considered to have restorative qualities that have the potential to improve psychotherapy’s success. We address some of the limitations associated with traditional brain-based reductionist approaches and treatments in clinical psychotherapy. An argument is made for the integration of an embodied approach, empowering clinicians and researchers to evaluate and integrate embodied therapeutic processes leading to successful treatment outcomes.
Methods
This integrative review provides evidence-based practice initiatives and findings from a range of embodied research as it applies to body-based techniques in psychotherapy. It gathers and synthesizes both empirical and theoretical evidence relevant to impact the overall success of psychotherapeutic interventions. Data collection involved keyword searches of electronic databases, including PsycINFO, NCBI, PubMED, Frontiers, MEDLINE, EBM Reviews, and Google Scholar.
Results
We present an array of cognitive and body-based methodologies that can be employed to enhance embodied and enactive therapeutic practices, offering a fresh and promising perspective on psychotherapy. Analyses provide insights into current body-based therapeutic applications, highlighting how a deeper understanding of recent advances in neuroscience can enrich both therapists’ and clients’ meta-awareness of mind–body-environment connections on mental health.
Conclusions
We conclude that psychotherapy can benefit from the transformative process that occurs when individuals gain insights, skills, and self-awareness through embodied therapeutic experiences. In the context of embodied psychotherapy, learning to self-heal extends beyond the acquisition of information; it involves a deeper understanding of the connection between one’s body, thoughts, emotions, behaviors, and the interconnectedness of these elements within the environment/context. Through this process, along with the therapist, clients acquire valuable insights into the root causes of challenges, develop coping strategies, and enhance emotional regulation. The learning extends to practical skills for managing stress, improving communication, and fostering healthier relationships. Embodiment in psychotherapy encourages a form of experiential learning, where individuals actively engage with and reflect upon their internal and external world.
Background/Aim. Obesity is a chronic and relapsing condition, and since recently, it has been considered a global epidemic. Current guidelines for tripartite treatment of obesity emphasize a program of lifestyle modifications such as medical nutrition therapy, aerobic exercise, and behavioral intervention. The aim of the study was to evaluate whether specific psychological factors (general attitudes and beliefs and frustration tolerance) could be predictors of successful weight loss, i.e., factors that can be further addressed as part of the integrated therapy approach. Methods. A total of 84 consecutive overweight and obese female participants who were apparently healthy and homogeneous in age, level of education, and marital or employment status were prescribed the same medical nutrition therapy protocol as a single six-month therapeutic intervention. Prior to starting the therapy, the General Attitude and Belief Scale (GABS) and the Frustration Discomfort Scale (FDS) were administered. The participants were divided into two groups: successful (group A) and unsuccessful (group B). Group A, or the successful group [with the mean body mass index (BMI) ? standard deviation (SD) of 24.1 ? 5.81 kg/m2], consisted of 40 participants who have reached the corresponding loss, i.e., they lost ? 10% of the starting body weight (BW). Group B, or the unsuccessful group (with the mean BMI ? SD of 28.51 ? 2.74 kg/m2), consisted of 44 participants who have not reached the corresponding loss, i.e., they lost < 10% of the starting BW. Results. Participants in group B had significantly higher scores (p < 0.05) on the GABS subscales for the Need for Approval, Need for Comfort, and Other Downing. A statistically significant difference between groups (p < 0.05) was shown for FDS subscales of Emotional Intolerance, Entitlement, and Achievement Frustration. Conclusion. Results of our study showed that participants who were unsuccessful in medical nutrition therapy had a higher degree of dysfunctional attitudes and beliefs and higher scores of frustration intolerance when compared to successful participants. The recommendation, based on our results, would be to include psychotherapeutic techniques in the integrative obesity treatment, aimed at cognitive changes and increasing frustration tolerance.
The principles of CBT emphasize the interactions among cognition, emotion, and behavior. CBT’s origins lie in Stoicism philosophy and share similarities with the ideas of Confucianism, Taoism, and Traditional Chinese Medicine (TCM) in China. The idea of mind–body regulation in traditional Chinese culture has laid a cultural foundation for the promotion of CBT in China. This paper analyzes the applicability and challenges of CBT in China based on the current development of CBT in mainland China and the learning and practice of CBT therapists. It also explores the potential further development of CBT in China and the integration of CBT with the Chinese culture.
Case conceptualization is a widely used tool to describe and organize patient infor- mation and plan interventions in psychotherapy. Life themes and semi-adaptive plans: Implications of biased beliefs, elicitation, and treatment (LIBET) is a new method for case conceptualization that validates the diathesis-stress model and incorporates elements from the most important theories in the CBT field. LIBET also includes process-based components as maintaining factors of psychological distress, and it is not anchored to a specific kind of psychotherapeutic approach. The LIBET-Questionnaire (LIBET-Q) is a structured interview which helps clini- cians achieve a LIBET case conceptualization, co-constructed with patients. The aim of the present study was to validate the process-based section of the LIBET- Q by analyzing its factorial structure, internal consistency, convergent validity, and clinical relevance. A sample of 396 outpatients was recruited to validate the LIBET-Q, which was administered along with interviews and self-report question- naires to investigate the presence of diagnoses, anxiety, and depression levels and global functioning and wellbeing. Results from both exploratory and confirmatory factor analyses showed a four-factor structure, with adequate consistency and good convergent validity. Process-based elements investigated with the LIBET-Q resulted in identifying different clinical populations. With satisfactory psychometric prop- erties, the LIBET-Q turned out to be a suitable support for case conceptualization and treatment formulation. The independence of the LIBET method from a specific intervention can improve its sharing between clinicians by offering a common frame in which the rationale of every specific technique can be explained.
The self-help movement has evolved into a multi-billion dollar industry in the 21st Century, as bookstores are continually replenished with manuals advertising previously undiscovered secrets of achieving happiness. These publications, however, along with newly refined versions of psychotherapeutic methodologies promising groundbreaking clinical impact, are often simply repackaging wisdom found in the ancient philosophical school of Stoicism; sometimes acknowledged, but more often not. Stoics were the first psychotherapists, and advocated for the reduction of suffering (today successfully done with Cognitive Behavioral Therapy and Rational Emotive Behavior Therapy) and the promotion of Eudaimonia (a rare point of emphasis in modern treatment plans, though Positive Psychology has begun to successfully change this). Psychotherapeutic practice is caught in a loop of rediscovering truths that have been known for millennia, perpetuating a cycle of stagnation in the field of mental health that masquerades as innovation. The present article is a call to disrupt this cycle, and instead reconnect with Stoicism’s ancient guidance on how to flourish and live excellently, rather than continue to resell its wisdom using other names.
Background
Interventions teaching cognitive-behavioral skills feature prominently among evidence-based treatments for emotional disorders. However, the relative impact of interventions that teach one cognitive-behavioral skill in-depth (i.e., an entrée intervention) versus those that provide limited coverage of multiple skills (i.e., a sampler intervention) remains unclear. In this study, we compared these two approaches using unguided single-session internet-based cognitive-behavioral interventions.
Methods
A total of 657 participants living in the U.S. with elevated depressive symptoms were randomly assigned to the entrée, sampler, or no-intervention control conditions. The entrée approach focused in-depth on developing one skill and the sampler condition introduced three skills. Both interventions lasted approximately 30 min. All participants completed measures of depressive symptoms, loneliness, and coping skill use and quality before the intervention and a week after the intervention.
Results
There were no condition differences in change in depressive symptoms, coping skill usage, coping skill quality, or loneliness. Those in the sampler condition were less likely to drop out than those in the entrée condition. In addition, condition differences were moderated by initial depressive symptom severity, such that among the more severely depressed the sampler condition led to greater symptom reduction than the entrée and control conditions.
Conclusions
We did not find overall differences between the entrée, sampler, and control conditions on primary outcomes. Nonetheless, the differences that did emerge suggest offering a variety of skills improves retention and provides greater relief for those with high initial depressive symptom severity in single-session internet-based interventions.
Clinicaltrials.gov ID NCT04643964, registered on 11/12/2020.
Multiple studies prove that poor mental health is usually correlated to other health and behavioural shortcomings. Mental health issues are more and more common, especially among young people. One of the main problems in investigating mental health in general, apart from a limited number of mental health professionals and their sometimes-limited qualifications, is the considerable patient stigma that comes with this subject. This study aims to breach the issue of depression and mental health issues among teenagers and young adults (15–35 years old) in urban Romania. The objectives of the study included obtaining an image of what depression means for this target group and how the target group usually acted when faced with one symptom that is mostly associated with depression: sadness. The authors also measured how the target group would deal with their own or someone else’s depression. The methodology had several steps: constructing a radiography of the Romanian health system and emphasizing its shortcomings, organizing focus groups with mental health professionals as well as with members of the target group, creating and disseminating a questionnaire to more than 1.000 respondents. The results show that the target group's members have a solid understanding of the importance of the issue, many times due to their own experiences or because this phenomenon affected someone from their family or circle of friends. However, the study shows that the target group mostly lacks the mechanisms to address depression, be it in themselves or others.
Interpersonal psychotherapy (IPT), is a short term, evidence-based treatment, has shown efficacy in treating individuals with affect dysregulation and other psychiatric condition. Interpersonal psychotherapy target helping patients to improve their interpersonal relationships or change their expectations about them. It also aims to assist patients to improve their social support network so that they can better manage their current interpersonal distress. This case study, therapeutic program consisting of 15-20 sessions based on the clinical interview and psychological evaluation. It mainly focused on interpersonal relationships as a means of bringing about interpersonal change and symptomatic recovery, with the goal of helping the individual to resolve the acute interpersonal crisis and to improve her social support system. This intervention included detailed assessment in the initial phase, interpersonal inventory, the interpersonal formulation, treatment agreement, IPT techniques (clarification, communication analysis, problem solving, use of affect, role playing, homework and other directives), conclusion of acute treatment and maintenance of treatment. The future directions of IPT involve assisting patients to improve their social support network with a view to ensure better management of their current interpersonal distress.
There are many studies showing that social anxiety disorder is associated with negative parental attitudes. It is known that exposure to negative parental attitudes and related negative experiences during childhood affect the cognitive process and cause the development of cognitive distortions. The aim of this study was to evaluate the relationship between perceived parental acceptance-rejection and control levels and social anxiety levels in adolescents, and the mediating role of interpersonal cognitive distortions in the relationship between both variables. The sample of the study consists of 142 adolescents with a mean age of 15.9 ± 1.36 years. Participants were evaluated with the “Social Anxiety Scale for Children-Revised Form”, “Child Versions the Parental Acceptance-Rejection/Control Questionnaire for Mothers and Fathers” and “Interpersonal Cognitive Distortions Scale”. The results showed that perceived levels of parental rejection and maternal control positively predicted adolescents’ social anxiety levels and interpersonal cognitive distortion levels. In the regression model established to evaluate the mediating role of the sub-dimensions of interpersonal cognitive distortions; it was found that “unrealistic relationship expectations” played a partial mediator role between mothers’ rejecting and overly controlling attitudes and adolescents’ social anxiety levels. “Interpersonal rejection”, which is the other sub-dimension of interpersonal cognitive distortions, was found to play a full mediator role between both the rejecting attitudes of mothers and fathers, the controlling attitudes of mothers, and the social anxiety levels of adolescents. The results showed that interpersonal cognitive distortions played a mediating role in the relationship between perceived negative parental attitudes and adolescents’ social anxiety levels. This study is one of the few studies that examines the relationship between parental attitudes and social anxiety levels in the adolescent age group in terms of the mediating effects of cognitive distortions. It is thought that our results are important for understanding the nature of social anxiety disorder and its treatment approach.
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