Differential cognitive response to a mood challenge following successful cognitive therapy or pharmacotherapy for unipolar depression.

Abstract

This study examined the nature of cognitive reactivity to mood changes in formerly depressed patients. Patients who recovered either through cognitive-behavior therapy (CBT; N = 25) or through pharmacotherapy (PT; N = 29) completed self-reported ratings of dysfunctional attitudes before and after a negative mood induction procedure. In response to similar levels of induced sad mood, PT patients showed a significant increase in dysfunctional cognitions compared with patients in the CBT group. To evaluate the effects of such cognitive reactivity on the subsequent course of depression, follow-up analyses reassessed 30 patients several years after initial testing. Results indicated that patients' reactions to the mood induction procedure were predictive of depressive relapse. These findings argue for differential effects of treatment on cognitive reactivity to mood induction and for the link between such reactivity and risk for later depressive relapse.

Mood reactivity rather than cognitive reactivity is predictive of depressive relapse: A randomized study with 5.5-year follow-up.

“…Several studies have found support for the prediction of relapse by cognitive reactivity after remission from MDD (233 patients; Kuyken et al, 2010;Segal, Gemar, & Williams, 1999;Segal et al, 2006). Though, one recent study found no evidence for cognitive reactivity in patients remitted from MDD (Jarrett et al, 2012), whereas Lethbridge and Allen (2008) were unable to corroborate the predictive validity of cognitive reactivity (52 patients).…”

“…Until now, only post-treatment cognitive reactivity had been examined (Kuyken et al, 2010;Segal et al, 1999Segal et al, , 2006. We therefore repeated previous analyses for post-treatment cognitive reactivity and cognitive extremity reactivity.…”

“…Patients completed a mood provocation procedure as described by Segal et al (1999Segal et al ( , 2006 following inclusion in the study. Patients listened to a piece of music by Prokofiev called "Russia under the Mongolian Yoke" from the movie Alexander Nevsky.…”

“…Only one of Segal's studies (Segal et al, 2006) randomized patients over treatment conditions. Moreover, interpretation of true mediation by change in cognitive reactivity is limited; both Segal et al (1999) and Segal et al (2006) were unable to examine pretreatment cognitive reactivity as they used currently depressed patient samples, and Kuyken et al (2010) only measured post-treatment cognitive reactivity as well in their sample of remitted patients.…”

Relationship of posttreatment decentering and cognitive reactivity to relapse in major depression.

“…This piece was remastered at half speed and runs for approximately 8 min. This piece, played at half speed, has been shown to be very effective in inducing a negative or depressed mood (e.g., Fresco, Heimberg, Abramowitz, & Bertram, 2006;Segal et al, 1999Segal et al, , 2006. A meta-analysis of musical mood induction procedures found a good effect size (Cohen's f ϭ .56) for sad mood inductions including, but not limited to, this Prokofiev piece played at half speed (Westermann, Spies, Stahl, & Hesse, 1996).…”