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Gepubliceerd in: Cognitive Therapy and Research 2/2021

09-10-2020 | Original Article

Early Life Adversity as a Moderator of Symptom Change following Selective Serotonin Reuptake Inhibitors and Cognitive Behavioral Therapy

Auteurs: Meredith A. Gruhn, K. Luan Phan, Heide Klumpp, Olusola Ajilore, Stephanie M. Gorka

Gepubliceerd in: Cognitive Therapy and Research | Uitgave 2/2021

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Abstract

Background

Early Life Adversity (ELA) is consistently linked to chronic, treatment-resistant depression and anxiety. Selective serotonin reuptake inhibitors (SSRIs) and cognitive-behavioral therapy (CBT) represent the two first-line treatments for internalizing disorders. However, little is known about the efficacy of these therapies for individuals with ELA, particularly within heterogeneous cohorts of patients with high levels of comorbidity.

Methods

Treatment seeking adults with depression and/or anxiety were randomized to twelve weeks of SSRI (n = 46) or CBT (n = 50), and internalizing disorder symptoms were assessed pre- and post-treatment. Individuals with and without ELA were included.

Results

Both SSRI and CBT resulted in reductions in internalizing symptoms, as expected. A significant ELA by treatment type interaction for depression, but not anxiety, also emerged. Individuals with a positive history of ELA had a greater reduction in depression symptoms following SSRIs compared with CBT. In contrast, individuals with a negative history of ELA had a greater reduction in depression symptoms following CBT compared with SSRIs.

Conclusions

Findings suggest that SSRIs may be particularly effective for individuals with ELA and CBT may be particularly effective for individuals without ELA in reducing depression, but not anxiety, symptoms. Clinical implications and future directions are discussed.
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1
Exploratory post-hoc analyses were conducted to assess whether effects are sustained when examining emotion-based ELA only (i.e., emotional abuse, emotional neglect). The same pattern of significance is retained in post-hoc analyses. Regression tables can be found in Supplementary Materials online at [link].
 
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Metagegevens
Titel
Early Life Adversity as a Moderator of Symptom Change following Selective Serotonin Reuptake Inhibitors and Cognitive Behavioral Therapy
Auteurs
Meredith A. Gruhn
K. Luan Phan
Heide Klumpp
Olusola Ajilore
Stephanie M. Gorka
Publicatiedatum
09-10-2020
Uitgeverij
Springer US
Gepubliceerd in
Cognitive Therapy and Research / Uitgave 2/2021
Print ISSN: 0147-5916
Elektronisch ISSN: 1573-2819
DOI
https://doi.org/10.1007/s10608-020-10158-5

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