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Gepubliceerd in: Cognitive Therapy and Research 3/2009

01-06-2009 | Original Article

Metacognitive Therapy in Recurrent and Persistent Depression: A Multiple-Baseline Study of a New Treatment

Auteurs: Adrian Wells, Peter Fisher, Samuel Myers, Jon Wheatley, Trishna Patel, Chris R. Brewin

Gepubliceerd in: Cognitive Therapy and Research | Uitgave 3/2009

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Abstract

Metacognitive Therapy (MCT) for depression is a formulation-driven treatment grounded in the Wells and Matthews (Attention and emotion: A clinical perspective, 1994) self-regulatory model. Unlike traditional CBT it does not focus on challenging the content of depressive thoughts or on increasing mastery and pleasure. Instead it focuses on reducing unhelpful cognitive processes and facilitates metacognitive modes of processing. MCT enables patients to interrupt rumination, reduce unhelpful self-monitoring tendencies, and establish more adaptive styles of responding to thoughts and feelings. An important component of treatment is modification of positive and negative metacognitive beliefs about rumination. MCT was evaluated in 6–8 sessions of up to 1 h each across 4 patients with recurrent and/or chronic major depressive disorder. A non-concurrent multiple-baseline with follow-up at 3 and 6 months was used. Patients were randomly allocated to different length baselines and outcomes were assessed via self-report and assessor ratings. Treatment was associated with large and clinically significant improvements in depressive symptoms, rumination and metacognitive beliefs and gains were maintained over follow-up. The small number of cases limits generalisability but continued evaluation of this new brief treatment is clearly indicated.
Literatuur
go back to reference Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988). An inventory for measuring clinical anxiety: Psychometric properties. Journal of Consulting and Clinical Psychology, 56, 893–897. PubMedCrossRef Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988). An inventory for measuring clinical anxiety: Psychometric properties. Journal of Consulting and Clinical Psychology, 56, 893–897. PubMedCrossRef
go back to reference Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561–571. PubMed Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561–571. PubMed
go back to reference Butler, A. C., Chapman, J. E., Forman, E. M., & Beck, A. T. (2006). The empirical status of cognitive-behavioral therapy: A review of meta-analyses. Clinical Psychology Review, 26, 17–31. PubMedCrossRef Butler, A. C., Chapman, J. E., Forman, E. M., & Beck, A. T. (2006). The empirical status of cognitive-behavioral therapy: A review of meta-analyses. Clinical Psychology Review, 26, 17–31. PubMedCrossRef
go back to reference Cavanagh, M., & Franklin, J. (2001). Attention training and hypochondriasis: A randomised controlled trial. Paper presented at the World Congress of Cognitive Therapy, Vancouver, Canada. Cavanagh, M., & Franklin, J. (2001). Attention training and hypochondriasis: A randomised controlled trial. Paper presented at the World Congress of Cognitive Therapy, Vancouver, Canada.
go back to reference Coffman, S. J., Martell, C. R., Dimidjian, S., Gallop, R., & Hollon, S. D. (2007). Extreme nonresponse in cognitive therapy: Can behavioral activation succeed where cognitive therapy fails? Journal of Consulting and Clinical Psychology, 75, 531–541. PubMedCrossRef Coffman, S. J., Martell, C. R., Dimidjian, S., Gallop, R., & Hollon, S. D. (2007). Extreme nonresponse in cognitive therapy: Can behavioral activation succeed where cognitive therapy fails? Journal of Consulting and Clinical Psychology, 75, 531–541. PubMedCrossRef
go back to reference DeRubeis, R. J., & Crits-Christoph, P. (1998). Empirically supported individual and group psychological treatments for adult mental disorders. Journal of Consulting and Clinical Psychology, 66, 37–52. PubMedCrossRef DeRubeis, R. J., & Crits-Christoph, P. (1998). Empirically supported individual and group psychological treatments for adult mental disorders. Journal of Consulting and Clinical Psychology, 66, 37–52. PubMedCrossRef
go back to reference Dimidjian, S., Hollon, S. D., Dobson, K. S., Schmaling, K. B., Kohlenberg, R. J., Addis, M. E., Gallop, R., McGlinchey, J. B., Markely, D. K., Gollan, J. K., Atkins, D. C., Dunner, D. L., & Jacobsen, N. S. (2006). Randomized trial of behavioural activation, cognitive therapy, and antidepressant medication in the acute treatment of adults with major depression. Journal of Consulting and Clinical Psychology, 74, 658–670. PubMedCrossRef Dimidjian, S., Hollon, S. D., Dobson, K. S., Schmaling, K. B., Kohlenberg, R. J., Addis, M. E., Gallop, R., McGlinchey, J. B., Markely, D. K., Gollan, J. K., Atkins, D. C., Dunner, D. L., & Jacobsen, N. S. (2006). Randomized trial of behavioural activation, cognitive therapy, and antidepressant medication in the acute treatment of adults with major depression. Journal of Consulting and Clinical Psychology, 74, 658–670. PubMedCrossRef
go back to reference Edwards, B. C., Lambert, M. J., Moran, P. W., McCully, T., Smith, K. C., & Ellingson, G. (1984). A meta-analytic comparison of the beck depression inventory and the Hamilton rating scale for depression as measures of treatment outcome. British Journal of Clinical Psychology, 23, 93–99. PubMed Edwards, B. C., Lambert, M. J., Moran, P. W., McCully, T., Smith, K. C., & Ellingson, G. (1984). A meta-analytic comparison of the beck depression inventory and the Hamilton rating scale for depression as measures of treatment outcome. British Journal of Clinical Psychology, 23, 93–99. PubMed
go back to reference First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. W. (1997). Structured Clinical Interview for DSM-IV Axis I Disorders––Patient Edition (SCID-IP. Version 2.0. 4. 97 revision): Biometrics Research Department, New York State Psychiatric Institute, New York. First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. W. (1997). Structured Clinical Interview for DSM-IV Axis I Disorders––Patient Edition (SCID-IP. Version 2.0. 4. 97 revision): Biometrics Research Department, New York State Psychiatric Institute, New York.
go back to reference Fisher, P. L., & Wells, A. (2007). Metacognitive therapy for obsessive-compulsive disorder: A case series. Journal of Behavior Therapy and Experimental Psychiatry, in press. Fisher, P. L., & Wells, A. (2007). Metacognitive therapy for obsessive-compulsive disorder: A case series. Journal of Behavior Therapy and Experimental Psychiatry, in press.
go back to reference Frank, E., Prien, R., Jarrett, R. B., Keller, M. B., Kupfer, D. J., Lavori, P. W., et al. (1991). Conceptualization and rationale for consensus definitions of terms in major depressive disorder: Remission, recovery, relapse, and recurrence. Archives of General Psychiatry, 48, 851–855. PubMed Frank, E., Prien, R., Jarrett, R. B., Keller, M. B., Kupfer, D. J., Lavori, P. W., et al. (1991). Conceptualization and rationale for consensus definitions of terms in major depressive disorder: Remission, recovery, relapse, and recurrence. Archives of General Psychiatry, 48, 851–855. PubMed
go back to reference Gortner, E. T., Gollan, J. K., Dobson, K. S., & Jacobsen, N. S. (1998). Cognitive-behavioral treatment for depression: Relapse prevention. Journal of Consulting and Clinical Psychology, 66, 377–384. PubMedCrossRef Gortner, E. T., Gollan, J. K., Dobson, K. S., & Jacobsen, N. S. (1998). Cognitive-behavioral treatment for depression: Relapse prevention. Journal of Consulting and Clinical Psychology, 66, 377–384. PubMedCrossRef
go back to reference Hamilton, M. (1960). A rating scale for depression. Journal of Neurology Neurosurgery and Psychiatry, 23, 56–62. CrossRef Hamilton, M. (1960). A rating scale for depression. Journal of Neurology Neurosurgery and Psychiatry, 23, 56–62. CrossRef
go back to reference Hamilton, M. (1967). Development of a rating scale for primary depressive illness. British Journal of Social and Clinical Psychology, 6, 278–296. PubMed Hamilton, M. (1967). Development of a rating scale for primary depressive illness. British Journal of Social and Clinical Psychology, 6, 278–296. PubMed
go back to reference Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and commitment therapy: An experiential approach to behaviour change. New York: Guilford Press. Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and commitment therapy: An experiential approach to behaviour change. New York: Guilford Press.
go back to reference Jacobson, N. S., Roberts, L. J., Berns, S. B., & McGlinchey, J. (1999). Methods for defining and determining the clinical significance of treatment effects in mental health research: Current status, new applications and future directions. Journal of Consulting and Clinical Psychology, 67, 300–307. PubMedCrossRef Jacobson, N. S., Roberts, L. J., Berns, S. B., & McGlinchey, J. (1999). Methods for defining and determining the clinical significance of treatment effects in mental health research: Current status, new applications and future directions. Journal of Consulting and Clinical Psychology, 67, 300–307. PubMedCrossRef
go back to reference Just, N., & Alloy, L. B. (1997). The response styles theory of depression: Tests and an extension of the theory. Journal of Abnormal Psychology, 106, 221–229. PubMedCrossRef Just, N., & Alloy, L. B. (1997). The response styles theory of depression: Tests and an extension of the theory. Journal of Abnormal Psychology, 106, 221–229. PubMedCrossRef
go back to reference Luminet, O. (2004). Measurement of depressive rumination and associated constructs. In C. Papageorgiou & A. Wells (Eds.), Depressive rumination: Nature, theory and treatment (pp. 187–215). Chichester, UK: Wiley. Luminet, O. (2004). Measurement of depressive rumination and associated constructs. In C. Papageorgiou & A. Wells (Eds.), Depressive rumination: Nature, theory and treatment (pp. 187–215). Chichester, UK: Wiley.
go back to reference National Institute for Clinical Excellence (NICE), (2004). Depression: Management of depression in primary and secondary care. National Clinical practice Guideline Number 23. National Institute for Clinical Excellence (NICE), (2004). Depression: Management of depression in primary and secondary care. National Clinical practice Guideline Number 23.
go back to reference Nolen-Hoeksema, S. (1991). Responses to depression and their effects on the duration of depressive episodes. Journal of Abnormal Psychology, 100, 569–582. PubMedCrossRef Nolen-Hoeksema, S. (1991). Responses to depression and their effects on the duration of depressive episodes. Journal of Abnormal Psychology, 100, 569–582. PubMedCrossRef
go back to reference Nolen-Hoeksema, S., Larson, J., & Grayson, C. (1999). Explaining the gender difference in depressive symptoms. Journal of Personality and Social Psychology, 77, 1061–1072. PubMedCrossRef Nolen-Hoeksema, S., Larson, J., & Grayson, C. (1999). Explaining the gender difference in depressive symptoms. Journal of Personality and Social Psychology, 77, 1061–1072. PubMedCrossRef
go back to reference Nolen-Hoeksema, S., & Morrow, J. (1991). A prospective study of depression and posttraumatic stress symptoms after a natural disaster: The 1989 Loma Prieta earthquake. Journal of Personality and Social Psychology, 61, 115–121. PubMedCrossRef Nolen-Hoeksema, S., & Morrow, J. (1991). A prospective study of depression and posttraumatic stress symptoms after a natural disaster: The 1989 Loma Prieta earthquake. Journal of Personality and Social Psychology, 61, 115–121. PubMedCrossRef
go back to reference Nolen-Hoeksema, S., Morrow, J., & Fredrickson, B. L. (1993). Response style and the duration of episodes of depressed mood. Journal of Abnormal Psychology, 102, 20–25. PubMedCrossRef Nolen-Hoeksema, S., Morrow, J., & Fredrickson, B. L. (1993). Response style and the duration of episodes of depressed mood. Journal of Abnormal Psychology, 102, 20–25. PubMedCrossRef
go back to reference Nolen-Hoeksema, S., Parker, L. E., & Larson, J. (1994). Ruminative coping with depressed mood following loss. Journal of Personality and Social Psychology, 67, 92–104. PubMedCrossRef Nolen-Hoeksema, S., Parker, L. E., & Larson, J. (1994). Ruminative coping with depressed mood following loss. Journal of Personality and Social Psychology, 67, 92–104. PubMedCrossRef
go back to reference Papageorgiou, C., & Wells, A. (1998). Effects of attention training on hypochondriasis: A brief case series. Psychological Medicine, 28, 193–200. PubMedCrossRef Papageorgiou, C., & Wells, A. (1998). Effects of attention training on hypochondriasis: A brief case series. Psychological Medicine, 28, 193–200. PubMedCrossRef
go back to reference Papageorgiou, C., & Wells, A. (2000). Treatment of recurrent major depression with attention training. Cognitive and Behavioral Practice, 7, 407–413. CrossRef Papageorgiou, C., & Wells, A. (2000). Treatment of recurrent major depression with attention training. Cognitive and Behavioral Practice, 7, 407–413. CrossRef
go back to reference Papageorgiou, C., & Wells, A. (2001a). Metacognitive beliefs about rumination in recurrent major depression. Cognitive and Behavioral Practice, 8, 160–164. CrossRef Papageorgiou, C., & Wells, A. (2001a). Metacognitive beliefs about rumination in recurrent major depression. Cognitive and Behavioral Practice, 8, 160–164. CrossRef
go back to reference Papageorgiou, C., & Wells, A. (2001b). Positive beliefs about depressive rumination: Development and preliminary validation of a self-report scale. Behavior Therapy, 32, 13–26. CrossRef Papageorgiou, C., & Wells, A. (2001b). Positive beliefs about depressive rumination: Development and preliminary validation of a self-report scale. Behavior Therapy, 32, 13–26. CrossRef
go back to reference Papageorgiou, C., & Wells, A. (2003). An empirical test of a clinical metacognitive model of rumination and depression. Cognitive Therapy and Research, 27, 261–273. CrossRef Papageorgiou, C., & Wells, A. (2003). An empirical test of a clinical metacognitive model of rumination and depression. Cognitive Therapy and Research, 27, 261–273. CrossRef
go back to reference Papageorgiou, C., Wells, A., & Meina, L. J. (in prep). Development and preliminary evaluation of the negative beliefs about rumination scale. Papageorgiou, C., Wells, A., & Meina, L. J. (in prep). Development and preliminary evaluation of the negative beliefs about rumination scale.
go back to reference Parsonson, B. S., & Baer, D. M. (1992). The visual analysis of data and current research into the stimuli controlling it. In T. R. Kratochwill & J. R. Levin (Eds.), Single-case research design and analysis: New directions for psychology and education (pp. 15–40). Hillsdale, NJ: Lawrence Erlbaum. Parsonson, B. S., & Baer, D. M. (1992). The visual analysis of data and current research into the stimuli controlling it. In T. R. Kratochwill & J. R. Levin (Eds.), Single-case research design and analysis: New directions for psychology and education (pp. 15–40). Hillsdale, NJ: Lawrence Erlbaum.
go back to reference Roth, A., & Fonagy, P. (1996). What works for whom? A critical review of psychotherapy research. New York: Guilford Press. Roth, A., & Fonagy, P. (1996). What works for whom? A critical review of psychotherapy research. New York: Guilford Press.
go back to reference Rush, A. J., Kraemer, H. C., Sackeim, H. A., Fava, M., Trivedi, M. H., Frank, E., Ninan, P. T., Thase, M. E., Gelenberg, A. J., Kupfer, D. J., Regier, D. A., Rosenbaum, J. F., Ray, O., & Schatzberg, A. F. (2006). Report by the ANCP task force on response and remission in major depressive disorder. Neuropsychopharmacology, 31, 1841–1853. PubMedCrossRef Rush, A. J., Kraemer, H. C., Sackeim, H. A., Fava, M., Trivedi, M. H., Frank, E., Ninan, P. T., Thase, M. E., Gelenberg, A. J., Kupfer, D. J., Regier, D. A., Rosenbaum, J. F., Ray, O., & Schatzberg, A. F. (2006). Report by the ANCP task force on response and remission in major depressive disorder. Neuropsychopharmacology, 31, 1841–1853. PubMedCrossRef
go back to reference Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2002). Mindfulness-based cognitive therapy for depression: A new approach to preventing relapse. New York: Guilford Press. Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2002). Mindfulness-based cognitive therapy for depression: A new approach to preventing relapse. New York: Guilford Press.
go back to reference Seggar, L. B., Lambert, M. J., & Hansen, N. B. (2002). Assessing clinical significance: Application to the Beck depression inventory. Behavior Therapy, 33, 253–269. CrossRef Seggar, L. B., Lambert, M. J., & Hansen, N. B. (2002). Assessing clinical significance: Application to the Beck depression inventory. Behavior Therapy, 33, 253–269. CrossRef
go back to reference Teasdale, J., Segal, Z., Williams, J. M. G., Ridgeway, V. A., Soulsby, J. M., & Lau, M. A. (2000). Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Journal of Consulting and Clinical Psychology, 68, 615–623. PubMedCrossRef Teasdale, J., Segal, Z., Williams, J. M. G., Ridgeway, V. A., Soulsby, J. M., & Lau, M. A. (2000). Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Journal of Consulting and Clinical Psychology, 68, 615–623. PubMedCrossRef
go back to reference Watson, P. J., & Workman, E. A. (1981). The nonconcurrent multiple baseline across individuals design: An extension of the traditional multiple baseline design. Journal of Behavior Therapy and Experimental Psychiatry, 12, 257–259. PubMedCrossRef Watson, P. J., & Workman, E. A. (1981). The nonconcurrent multiple baseline across individuals design: An extension of the traditional multiple baseline design. Journal of Behavior Therapy and Experimental Psychiatry, 12, 257–259. PubMedCrossRef
go back to reference Wells, A. (1990). Panic disorder in association with relaxation-induced anxiety: An attentional training approach to treatment. Behavior Therapy, 21, 273–280. CrossRef Wells, A. (1990). Panic disorder in association with relaxation-induced anxiety: An attentional training approach to treatment. Behavior Therapy, 21, 273–280. CrossRef
go back to reference Wells, A. (1995). Meta-cognition and worry: A cognitive model of generalized anxiety disorder. Behavioural and Cognitive Psychotherapy, 23, 310–320. Wells, A. (1995). Meta-cognition and worry: A cognitive model of generalized anxiety disorder. Behavioural and Cognitive Psychotherapy, 23, 310–320.
go back to reference Wells, A. (2000). Emotional disorders and metacognition: Innovative cognitive therapy. Chichester, UK: Wiley. Wells, A. (2000). Emotional disorders and metacognition: Innovative cognitive therapy. Chichester, UK: Wiley.
go back to reference Wells, A. (2005). Detached mindfulness in cognitive therapy: A metacognitive analysis and ten techniques. Journal of Rational-Emotive of Cognitive-Behavior Therapy, 23, 337–355. CrossRef Wells, A. (2005). Detached mindfulness in cognitive therapy: A metacognitive analysis and ten techniques. Journal of Rational-Emotive of Cognitive-Behavior Therapy, 23, 337–355. CrossRef
go back to reference Wells, A. (2008). Metacognitive therapy: A practical guide. (Ch.9: Major depressive disorder). New York: Guilford Press. Wells, A. (2008). Metacognitive therapy: A practical guide. (Ch.9: Major depressive disorder). New York: Guilford Press.
go back to reference Wells, A., & Cartwright-Hatton, S. (2004). A short form of the metacognitions questionnaire: Properties of the MCQ-30. Behaviour Research and Therapy, 42, 385–396. PubMedCrossRef Wells, A., & Cartwright-Hatton, S. (2004). A short form of the metacognitions questionnaire: Properties of the MCQ-30. Behaviour Research and Therapy, 42, 385–396. PubMedCrossRef
go back to reference Wells, A., & King, P. (2006). Metacognitive therapy for generalized anxiety disorder: An open trial. Journal of Behavior Therapy and Experimental Psychiatry, 37, 206–212. PubMedCrossRef Wells, A., & King, P. (2006). Metacognitive therapy for generalized anxiety disorder: An open trial. Journal of Behavior Therapy and Experimental Psychiatry, 37, 206–212. PubMedCrossRef
go back to reference Wells, A., & Matthews, G. (1994). Attention and emotion: A clinical perspective. Hove, UK: Erlbaum. Wells, A., & Matthews, G. (1994). Attention and emotion: A clinical perspective. Hove, UK: Erlbaum.
go back to reference Wells, A., & Matthews, G. (1996). Modelling cognition in emotional disorder: The S-REF model. Behaviour Research and Therapy, 34, 881–888. PubMedCrossRef Wells, A., & Matthews, G. (1996). Modelling cognition in emotional disorder: The S-REF model. Behaviour Research and Therapy, 34, 881–888. PubMedCrossRef
go back to reference Wells, A., & Papageorgiou, C. (2001). Brief cognitive therapy for social phobia: A case series. Behaviour Research and Therapy, 39, 713–720. PubMedCrossRef Wells, A., & Papageorgiou, C. (2001). Brief cognitive therapy for social phobia: A case series. Behaviour Research and Therapy, 39, 713–720. PubMedCrossRef
go back to reference Wells, A., & Papageorgiou, C. (2004). Metacognitive therapy for depressive rumination. In C. Papageorgiou & A. Wells (Eds.), Depressive rumination: Nature, theory, and treatment (pp. 259–273). Chichester, UK: Wiley. Wells, A., & Papageorgiou, C. (2004). Metacognitive therapy for depressive rumination. In C. Papageorgiou & A. Wells (Eds.), Depressive rumination: Nature, theory, and treatment (pp. 259–273). Chichester, UK: Wiley.
go back to reference Wells, A., & Sembi, S. (2004). Metacognitive therapy for PTSD: A preliminary investigation of a new brief treatment. Journal of Behavior Therapy and Experimental Psychiatry, 35, 307–318. PubMedCrossRef Wells, A., & Sembi, S. (2004). Metacognitive therapy for PTSD: A preliminary investigation of a new brief treatment. Journal of Behavior Therapy and Experimental Psychiatry, 35, 307–318. PubMedCrossRef
go back to reference Wells, A., White, J., & Carter, K. (1997). Attention training: Effects on anxiety and beliefs in panic and social phobia. Clinical Psychology and Psychotherapy, 4, 226–232. CrossRef Wells, A., White, J., & Carter, K. (1997). Attention training: Effects on anxiety and beliefs in panic and social phobia. Clinical Psychology and Psychotherapy, 4, 226–232. CrossRef
Metagegevens
Titel
Metacognitive Therapy in Recurrent and Persistent Depression: A Multiple-Baseline Study of a New Treatment
Auteurs
Adrian Wells
Peter Fisher
Samuel Myers
Jon Wheatley
Trishna Patel
Chris R. Brewin
Publicatiedatum
01-06-2009
Uitgeverij
Springer US
Gepubliceerd in
Cognitive Therapy and Research / Uitgave 3/2009
Print ISSN: 0147-5916
Elektronisch ISSN: 1573-2819
DOI
https://doi.org/10.1007/s10608-007-9178-2