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Cognitive Therapy and Research
Gepubliceerd in:

01-04-2011 | Original Article

Preliminary Evidence that Anxiety is Associated with Accelerated Response in Cognitive Therapy for Depression

Auteurs: Nicholas R. Forand, Kathleen C. Gunthert, Lawrence H. Cohen, Andrew C. Butler, Judith S. Beck

Gepubliceerd in: Cognitive Therapy and Research | Uitgave 2/2011

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Abstract

We conducted two studies that assessed the role of initial anxiety in rate of change (depression reduction) in cognitive therapy for major depression. In both studies, depression and anxiety were assessed at intake, and depression was assessed at every treatment session. Longitudinal growth modeling was used to predict rate of change in treatment from sessions 1–12 controlling for intake depression, with intake anxiety as a moderator of change. In Study 1, high initial anxiety was associated with a faster rate of depression reduction across the course of cognitive therapy, whereas in Study 2, high initial anxiety was associated with a faster rate of depression reduction in the early sessions of treatment. The influence of intake depression on rate of change was controlled, and therefore the results are likely not due to greater symptom severity or distress among those high in anxiety. BAI subscale analyses suggest that the results are likely due to the physiological arousal characteristic of anxiety. These results suggest a potentially beneficial role for initial anxiety in cognitive therapy for depression.
vorige artikel Negative Repetitive Thought and College Drinking: Angry Rumination, Depressive Rumination, Co-Rumination, and Worry
volgende artikel Pre-Stressor Interference Control and Intrusive Memories
Voetnoten
1
The level-1 equation is Y ti  = π 0i  + π 1i (Session) + e ti, where BDI-II scores (Y ti ) are predicted as a function of an intercept (π 0i ), session number (π 1i ), and random error (e ti). To compare rates of growth across a standardized time frame we limited our analyses to the first 12 sessions (Cohen et al. 2008).
 
2
In order to reduce collinearity between the predictor and its quadratic term, we introduced a centering constant. In this case, the “center” time point for each person would be quite different (individuals are in treatment for different lengths of time), and so we introduced an a priori centering constant that would be the theoretical “center” of treatment. The average number of sessions in Study 1 was 11, and in Study 2 the average was 13. To compare across studies, we set the theoretical midpoint of treatment at Session 6. The linear component, π 1 , represents the instantaneous rate of change for person i midway through therapy (at Session 6), and π 2 signifies the acceleration in each growth trajectory (Raudenbush and Bryk 2002). Although group-mean centering techniques are generally preferred when attempting to obtain an estimate of the level-1 relationship independent of any group membership effects, group mean centering would render the estimates difficult to interpret in this instance due to the varying number of sessions attended. Thus, we chose to center around the theoretical “center” of treatment (session 6), which results in centering around the same point for each patient.
 
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Metagegevens
Titel
Preliminary Evidence that Anxiety is Associated with Accelerated Response in Cognitive Therapy for Depression
Auteurs
Nicholas R. Forand
Kathleen C. Gunthert
Lawrence H. Cohen
Andrew C. Butler
Judith S. Beck
Publicatiedatum
01-04-2011
Uitgeverij
Springer US
Gepubliceerd in
Cognitive Therapy and Research / Uitgave 2/2011
Print ISSN: 0147-5916
Elektronisch ISSN: 1573-2819
DOI
https://doi.org/10.1007/s10608-010-9348-5

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