Response to treatments for depression: The role of initial status on targeted cognitive and behavioral skills

https://doi.org/10.1016/0272-7358(91)90001-BGet rights and content

Abstract

Cognitive and behavioral treatments of depression target specific deficits for remediation. Depressives who show the targeted deficits are typically expected to benefit most from therapy. This article reviews therapy outcome studies in which measures of cognitive or behavioral deficits were employed as predictors of response to related therapy. Contrary to expectation, there was no relationship between deficit score and outcome in many studies and, in several, a finding opposite to prediction obtained: Ss with more functional scores on the cognitive or behavioral measures did better in therapy than those with less functional scores. It is unclear whether the advantage seen in these studies is a response to a particular type of treatment or whether it represents general prognosis. Methodological and conceptual implications of these results are discussed.

References (70)

  • A.T. Beck et al.

    Reliability of psychiatric diagnoses: 2. A study of consistency of clinical judgements and ratings

    American Journal of Psychiatry

    (1962)
  • R.A. Brown et al.

    A psychoeducational approach to the treatment of depression: Comparison of group, individual and minimal contact procedures

    Journal of Consulting and Clinical Psychology

    (1984)
  • S. Cohen et al.

    Locus of control and the generality of learned helplessness in humans

    Journal of Personality and Social Psychology

    (1976)
  • L.J. Cronbach et al.

    Aptitudes and instructional methods

    (1977)
  • K.S. Dobson

    A meta-analysis of the efficacy of cognitive therapy for depression

    Journal of Consulting and Clinical Psychology

    (1989)
  • I. Elkin et al.

    NIMH treatment of depression collaborative research program: Background and research plan

    Archives of General Psychiatry

    (1985)
  • H.J. Eysenck et al.

    Manual for the Eysenck Personality Inventory

    (1968)
  • C.Z. Fuchs et al.

    A self-control behavior therapy program for depression

    Journal of Consulting and Clinical Psychology

    (1977)
  • M.A. Graf

    A mood-related activities schedule for the treatment of depression

    Dissertation Abstracts International

    (1977)
  • M. Hamilton

    Development of a rating scale for primary depressive illness

    British Journal of Social and Clinical Psychology

    (1967)
  • M. Hersen et al.

    Treatment of unipolar depression with social skills training

    Behavior Modification

    (1980)
  • H.M. Hoberman et al.

    Group treatment of depression: Individual predictors of outcome

    Journal of Consulting and Clinical Psychology

    (1988)
  • S.D. Hollon

    Predicting outcome vs. differential response: Matching clients to treatment

    (1986)
  • S.D. Hollon et al.

    Cognitive self-statements in depression: Development of an automatic thoughts questionnaire

    Cognitive Therapy and Research

    (1980)
  • S.D. Imber et al.

    Mode-specific effects among three treatments for depression

    Journal of Consulting and Clinical Psychology

    (1990)
  • R.B. Jarrett et al.

    Predictors of response to cognitive therapy or tricyclic antidepressants in depressed outpatients

    (1988)
  • K.E. Keller

    Dysfunctional attitudes and cognitive therapy for depression

    Cognitive Therapy and Research

    (1983)
  • S.J. Kornblith et al.

    The contribution of self-reinforcement training and behavioral assignments to the efficacy of self-control therapy for depression

    Cognitive Therapy and Research

    (1983)
  • P.M. Lewinsohn

    The behavioral study and treatment of depression

  • P.M. Lewinsohn

    The use of activity schedules in the treatment of depressed individuals

  • P.M. Lewinsohn et al.

    The Coping with Depression Course: A psychoeducational intervention for unipolar depression

    (1984)
  • P.M. Lewinsohn et al.

    Pleasant activities and depression

    Journal of Consulting and Clinical Psychology

    (1973)
  • P.M. Lewinsohn et al.

    The measurement of expectancies and other cognitions in depressed individuals

    Cognitive Therapy and Research

    (1982)
  • P.M. Lewinsohn et al.

    Social competence and depression: The role of illusory self-perceptions

    Journal of Abnormal Psychology

    (1980)
  • B. Lubin

    Depression Adjective Checklists: Manual

    (1967)
  • Cited by (79)

    • Who Benefits From a Cognitive vs. Behavioral Approach to Treating Depression? A Pilot Study of Prescriptive Predictors

      2021, Behavior Therapy
      Citation Excerpt :

      Although we selected these vulnerabilities and CBT skills as potential prescriptive predictors, we were less certain about how these variables might predict differential outcome in cognitive versus behavioral treatments. Hypotheses for prescriptive predictors have often been framed as being based on the compensation or capitalization model (Rude & Rehm, 1991). The compensation model posits that treatments will be more successful when they help clients remedy deficits or compensate for their weaknesses.

    • Neural connectivity during affect labeling predicts treatment response to psychological therapies for social anxiety disorder

      2019, Journal of Affective Disorders
      Citation Excerpt :

      In previous work, we demonstrated that enhanced inverse connectivity within this circuitry was associated with symptom reduction following treatment, collapsing across CBT and ACT groups (Young et al., 2017). Together, this would suggest a ‘building on strengths’ model (Engebretson et al., 1989; Rude and Rehm, 1991), such that individuals with greater capacity to implicitly regulate their emotions may benefit more from psychological treatment. Given that CBT teaches reappraisal-based emotion regulation and ACT teaches acceptance-based regulation, the explicit emotion regulation task allowed direct assessment of treatment-relevant mechanisms.

    • Lateralization for speech predicts therapeutic response to cognitive behavioral therapy for depression

      2015, Psychiatry Research
      Citation Excerpt :

      Although there are encouraging findings for potential neuroimaging biomarkers (Siegle et al., 2012; McGrath et al., 2013), these tests are expensive and may be difficult to implement in clinical settings. Although studies have raised the possibility of developing inexpensive behavioral tests for predicting response to CBT, the findings of early studies using self-report measures of beliefs or attitudes were conflicting (Rude and Rehm, 1991; Sotsky et al., 1991). There has, however, been less research on whether performance on neuropsychological tests of cognitive abilities might predict CBT response.

    View all citing articles on Scopus
    View full text