Social and Behavioral Sciences Commons^™

Cognitive Change In Cognitive-Behavioural Therapy, Leanne Quigley, David J A Dozois, R Michael Bagby, Daniela S S Lobo, Lakshmi Ravindran, Lena C Quilty

Psychology Publications

BACKGROUND: Although cognitive-behavioural therapy (CBT) is a well-established treatment for adult depression, its efficacy and efficiency may be enhanced by better understanding its mechanism(s) of action. According to the theoretical model of CBT, symptom improvement occurs via reductions in maladaptive cognition. However, previous research has not established clear evidence for this cognitive mediation model.

METHODS: The present study investigated the cognitive mediation model of CBT in the context of a randomized controlled trial of CBT v. antidepressant medication (ADM) for adult depression. Participants with major depressive disorder were randomized to receive 16 weeks of CBT (n = 54) or ADM …

The Role Of Outcome Expectancy In Therapeutic Change Across Psychotherapy Versus Pharmacotherapy For Depression., Thulasi Thiruchselvam, David J A Dozois, R Michael Bagby, Daniela S S Lobo, Lakshmi N Ravindran, Lena C Quilty

Psychology Publications

BACKGROUND: Patient outcome expectancy - the belief that treatment will lead to an improvement in symptoms - is linked to favourable therapeutic outcomes in major depressive disorder (MDD). The present study extends this literature by investigating the temporal dynamics of expectancy, and by exploring whether expectancy during treatment is linked to differential outcomes across treatment modalities, for both optimistic versus pessimistic expectancy.

METHODS: A total of 104 patients with MDD were randomized to receive either cognitive behavioral therapy (CBT) or pharmacotherapy for 16 weeks. Outcome expectancy was measured throughout treatment using the Depression Change Expectancy Scale (DCES). Depression severity was …

Translating The Bdi And Bdi-Ii Into The Hamd And Vice Versa With Equipercentile Linking., Toshi A Furukawa, Mirjam Reijnders, Sanae Kishimoto, Masatsugu Sakata, Robert J Derubeis, Sona Dimidjian, David J. A. Dozois, Ulrich Hegerl, Steven D Hollon, Robin B Jarrett, François Lespérance, Zindel V Segal, David C Mohr, Anne D Simons, Lena C Quilty, Charles F Reynolds, Claudio Gentili, Stefan Leucht, Rolf R Engel, Pim Cuijpers

Psychology Publications

AIMS: The Hamilton Depression Rating Scale (HAMD) and the Beck Depression Inventory (BDI) are the most frequently used observer-rated and self-report scales of depression, respectively. It is important to know what a given total score or a change score from baseline on one scale means in relation to the other scale.

METHODS: We obtained individual participant data from the randomised controlled trials of psychological and pharmacological treatments for major depressive disorders. We then identified corresponding scores of the HAMD and the BDI (369 patients from seven trials) or the BDI-II (683 patients from another seven trials) using the equipercentile linking …

Cognition And The Brain Of Brood Parasitic Cowbirds., David F Sherry, Mélanie F Guigueno

Psychology Publications

Cowbirds are brood parasites. Females lay their eggs in the nests of other species, which then incubate the cowbird eggs and raise the young cowbirds. Finding and returning to heterospecific nests presents cowbirds with several cognitive challenges. In some species, such as brown-headed cowbirds (Molothrus ater), females but not males search for and remember the locations of potential host nests. We describe recent research on sex differences in cognition and the hippocampus associated with this sex difference in search for host nests. Female brown-headed cowbirds perform better than males on some, but not all, tests of spatial memory and females …

Prospective Evaluation Of A Cognitive Vulnerability-Stress Model For Depression: The Interaction Of Schema Self-Structures And Negative Life Events., Pamela M Seeds, David J A Dozois

Psychology Publications

This study tested the diathesis-stress component of Beck's (1967) cognitive theory of depression. Initially, participants completed measures assessing cognitive organization of the self-schema and depressive symptoms. One year later, participants completed measures assessing cognitive organization of the self-schema, depressive symptoms, and negative life events. Hierarchical multiple regression analyses, controlling for initial depression, indicated that more tightly interconnected negative content was associated with greater elevations in depressive symptoms following the occurrence of life events. More diffusely interconnected positive content for interpersonal self-referent information also interacted with life events to predict depressive symptoms. Cognitive organization dimensions showed moderate to high stability across …

Somatic Symptom Overlap In Beck Depression Inventory-Ii Scores Following Myocardial Infarction., Brett D Thombs, Roy C Ziegelstein, Louise Pilote, David J A Dozois, Aaron T Beck, Keith S Dobson, Samantha Fuss, Peter De Jonge, Sherry L Grace, Donne E Stewart, Johan Ormel, Susan E Abbey

Psychology Publications

BACKGROUND: Depression measures that include somatic symptoms may inflate severity estimates among medically ill patients, including those with cardiovascular disease.

AIMS: To evaluate whether people receiving in-patient treatment following acute myocardial infarction (AMI) had higher somatic symptom scores on the Beck Depression Inventory-II (BDI-II) than a non-medically ill control group matched on cognitive/affective scores.

METHOD: Somatic scores on the BDI-II were compared between 209 patients admitted to hospital following an AMI and 209 psychiatry out-patients matched on gender, age and cognitive/affective scores, and between 366 post-AMI patients and 366 undergraduate students matched on gender and cognitive/affective scores.

RESULTS: Somatic symptoms …

Adding A Motivational Interviewing Pretreatment To Cognitive Behavioral Therapy For Generalized Anxiety Disorder: A Preliminary Randomized Controlled Trial., Henny A Westra, Hal Arkowitz, David J A Dozois

Psychology Publications

Seventy-six individuals with a principal diagnosis of generalized anxiety disorder (GAD) were randomly assigned to receive either an MI pretreatment or no pretreatment (NPT), prior to receiving CBT. Significant group differences favoring the MI-CBT group were observed on the hallmark GAD symptom of worry and on therapist-rated homework compliance, which mediated the impact of treatment group on worry reduction. Adding MI pretreatment to CBT was specifically and substantively beneficial for individuals with high worry severity at baseline. There was evidence of relapse at 6-month follow-up for high severity individuals who received MI-CBT, but significant moderator effects favoring the high severity …

Changes In Self-Schema Structure In Cognitive Therapy For Major Depressive Disorder: A Randomized Clinical Trial., David J A Dozois, Peter J Bieling, Irene Patelis-Siotis, Lori Hoar, Susan Chudzik, Katie Mccabe, Henny A Westra

Psychology Publications

Negative cognitive structure (particularly for interpersonal content) has been shown in some research to persist past a current episode of depression and potentially to be a stable marker of vulnerability for depression (D. J. A. Dozois, 2007; D. J. A. Dozois & K. S. Dobson, 2001a). Given that cognitive therapy (CT) is highly effective for treating the acute phase of a depressive episode and that this treatment also reduces the risk of relapse and recurrence, it is possible that CT may alter these stable cognitive structures. In the current study, patients were randomly assigned to CT+ pharmacotherapy (n = 21) …

Ruminative Thought Style And Depressed Mood., Jay K Brinker, David J A Dozois

Psychology Publications

Recent research has suggested that the measure most commonly used to assess rumination, the Response Style Questionnaire (RSQ; L. D. Butler & S. Nolen-Hoeksema, 1994), may be heavily biased by depressive symptoms, thereby restricting the scope of research exploring this construct. This article offers a broader conceptualization of rumination, which includes positive, negative, and neutral thoughts as well as past and future-oriented thoughts. The first two studies describe the development and evaluation of the Ruminative Thought Style Questionnaire (RTS), a psychometrically sound measure of the general tendency to ruminate. Further, the scale is comprised of a single factor and shows …

Meta-Analysis Of Alexithymia In Posttraumatic Stress Disorder., Paul A Frewen, David J A Dozois, Richard W J Neufeld, Ruth A Lanius

Psychology Publications

The authors present a meta-analysis investigating the prevalence of alexithymia in 12 studies encompassing 1,095 individuals with posttraumatic stress disorder (PTSD). A large effect size was found associating PTSD with alexithymia. Effect sizes were higher in studies of male combat PTSD samples in comparison with studies of other PTSD samples. Clinical and research directions are discussed.

Clinical And Neural Correlates Of Alexithymia In Posttraumatic Stress Disorder., Paul A Frewen, Ruth A Lanius, David J A Dozois, Richard W J Neufeld, Clare Pain, James W Hopper, Maria Densmore, Todd K Stevens

Psychology Publications

Individuals with posttraumatic stress disorder (PTSD) often exhibit deficits in emotional experience and expression, which suggests that certain individuals with PTSD may be alexithymic. In this study, in a sample of 105 individuals with PTSD, clinical correlates of alexithymia included reexperiencing, hyperarousal, numbing, dissociative symptoms, and retrospectively reported experiences of childhood emotional neglect. In a subsample of 26 individuals with PTSD related to a motor vehicle accident, functional neural responses to trauma-script imagery were associated with severity of alexithymia, including increased right posterior-insula and ventral posterior-cingulate activation and decreased bilateral ventral anterior-cingulate, ventromedial prefrontal, anterior-insula, and right inferior frontal cortex …

A Meta-Analysis Of Cbt For Pathological Worry Among Clients With Gad., Roger Covin, Allison J Ouimet, Pamela M Seeds, David J A Dozois

Psychology Publications

Previous meta-analyses assessing the effectiveness of Cognitive Behavioural Therapy (CBT) for Generalized Anxiety Disorder (GAD) used general measures of anxiety to assess symptom severity and improvement (e.g., Hamilton Anxiety Ratings Scale or a composite measure of anxiety). While informative, these studies do not provide sufficient evidence as to whether CBT significantly reduces the cardinal symptom of GAD: pathological worry. The current meta-analysis employed stringent inclusion criteria to evaluate relevant outcome studies, including the use of the Penn State Worry Questionnaire as the main outcome variable. Results showed a large overall effect size (ES) that was moderated by age and modality …

Development Of The Anxiety Change Expectancy Scale (Aces) And Validation In College, Community, And Clinical Samples., David J A Dozois, Henny A Westra

Psychology Publications

This study investigated the psychometric properties of a newly developed 20-item instrument that assesses one's anticipation of being able to change anxiety: the Anxiety Change Expectancy Scale (ACES). Study 1 evaluated the ACES in undergraduate university students, self-identified as experiencing difficulties with anxiety. Study 2 examined the ACES in a community sample of persons with anxiety difficulties. Study 3 tested the utility of the ACES in predicting treatment change in a group of individuals with generalized anxiety disorder participating in group cognitive behavioral therapy for anxiety. Across these samples, the ACES demonstrated excellent internal reliability (coefficient alphas=.89-.92) as well as …

The Validity Of The Brief Version Of The Fear Of Negative Evaluation Scale., Kerry A Collins, Henny A Westra, David J A Dozois, Sherry H Stewart

Psychology Publications

The Fear of Negative Evaluation Scale [FNE; J. Consult. Clin. Psychol. 33 (1969) 448] is a commonly used measure of social anxiety. A brief version of the scale (FNEB) is available for convenient administration. Despite being widely advocated for use, the psychometric properties of the FNEB have not been evaluated with clinically anxious samples. The present study addressed the reliability and validity of the FNEB in a clinical sample of individuals with either social phobia (n = 82) or panic disorder (n = 99) presenting for treatment. Factor analysis supported the construct validity of the FNEB. The validity of the …

Normative Data On Cognitive Measures Of Depression., David J A Dozois, Roger Covin, Jay K Brinker

Psychology Publications

The assessment of cognition and cognitive change is important for case conceptualization, monitoring the efficacy of specific interventions, and evaluating treatment outcome in cognitive-behavioral therapy. Unfortunately, a paucity of normative data exists on cognitive measures used for psychotherapy outcome research in depression, and little information is available to guide a practitioner's understanding of the magnitude and clinical significance of a patient's cognitive change. This article presents normative data on 6 self-report instruments that assess negative and positive automatic thoughts, hopelessness, cognitive biases and errors, and dysfunctional attitudes. Normative data were derived from studies published from the date of inception of …

A Longitudinal Investigation Of Information Processing And Cognitive Organization In Clinical Depression: Stability Of Schematic Interconnectedness., D J Dozois, K S Dobson

Psychology Publications

This study longitudinally investigated information processing and cognitive organization in clinical depression. The main hypothesis was that individuals whose depression had remitted would show a significant cognitive shift on information processing (e.g., deactivation of negative processing) but not on cognitive organizational tasks, Forty-five individuals with clinical depression completed 2 information processing and 2 cognitive organizational tasks at initial assessment. At 6-month follow-up, the sample (23 remitted, 22 stable depressed) was readministered the tasks. As expected, information processing shifted significantly in individuals who had improved symptomatically, whereas negative cognitive organizational indices remained stable. The implications of these results are discussed as …