Dysfunctional attitudes and perceived stress predict depressive symptoms severity following antidepressant treatment in patients with chronic depression

Pedrelli, Paola; Feldman, Greg; Vorono, Sienna; Fava, Maurizio; Petersen, Timothy

doi:10.1016/j.psychres.2007.08.004

Cited by 30 publications

(32 citation statements)

References 34 publications

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“…Based on the literature, a 6-point difference on PSS-14 was expected between the experimental and control groups at 3 months [21]. With an assumed SD of 9, 40 participants per group needed to be included to detect this difference with an 80% power (Cronbach alpha=.05; 2-tailed).…”

Section: Methodsmentioning

confidence: 99%

A Web-Based Psychoeducational Program for Informal Caregivers of Patients With Alzheimer’s Disease: A Pilot Randomized Controlled Trial

Wrobel²,

et al. 2015

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BackgroundAlthough several face-to-face programs are dedicated to informal caregivers of persons with dementia, they are not always accessible to overburdened or isolated caregivers. Based on a face-to-face intervention program, we adapted and designed a Web-based fully automated psychoeducational program (called Diapason) inspired by a cognitive approach.ObjectiveThis study aimed to evaluate through a pilot unblinded randomized controlled trial the efficacy and acceptability of a Web-based psychoeducational program for informal caregivers of persons with Alzheimer’s disease (PWAD) based on a mixed methods research design.MethodsWe recruited and randomized offline 49 informal caregivers of a PWAD in a day care center in Paris, France. They either received the Web-based intervention and usual care for 3 months (experimental group, n=25) or only usual care (control group, n=24). Caregivers’ perceived stress (PSS-14, primary outcome), self-efficacy, burden, perceived health status, and depression (secondary outcomes) were measured during 3 face-to-face on-site visits: at baseline, at the end of the program (month 3), and after follow-up (month 6). Additionally, semistructured interviews were conducted with experimental group caregivers at month 6 and examined with thematic analysis.ResultsIntention-to-treat analysis did not show significant differences in self-perceived stress between the experimental and control groups (P=.98). The experimental group significantly improved their knowledge of the illness (d=.79, P=.008) from baseline to month 3. Of the 25 participants allocated to the experimental group, 17 (71%) finished the protocol and entirely viewed at least 10 of 12 online sessions. On average, participants used the website 19.72 times (SD 12.88) and were connected for 262.20 minutes (SD 270.74). The results of the satisfaction questionnaire showed that most participants considered the program to be useful (95%, 19/20), clear (100%, 20/20), and comprehensive (85%, 17/20). Significant correlations were found between relationship and caregivers’ program opinion (P=.01). Thus, positive opinions were provided by husbands and sons (3/3), whereas qualified opinions were primarily reported by daughters (8/11). Female spouses expressed negative (2/3) or neutral opinions (1/3). Caregivers expected more dynamic content and further interaction with staff and peers.ConclusionsIn this study, quantitative results were inconclusive owing to small sample size. Qualitative results indicated/showed little acceptance of the program and high expectations from caregivers. Caregivers did not rule out their interest in this kind of intervention provided that it met their needs. More dynamic, personalized, and social interventions are desirable. Our recruitment issues pointed out the necessity of in-depth studies about caregivers’ help-seeking behaviors and readiness factors.Trial RegistrationClinicaltrials.gov NCT01430286; http://clinicaltrials.gov/ct2/show/NCT01430286 (Archived by WebCite at http://www.webcitation/6KxHaRspL).

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Section: Methodsmentioning

confidence: 99%

A Web-Based Psychoeducational Program for Informal Caregivers of Patients With Alzheimer’s Disease: A Pilot Randomized Controlled Trial

Wrobel²,

et al. 2015

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“…One such predictor of change, dysfunctional cognitions, has been shown to affect outcome in CT, BA, and antidepressant treatment (Hamilton & Dobson, 2002; Jacobson et al, 1996; Pedrelli, Feldman, Vorono, Fava, & Petersen, 2008). Despite the absence of interventions to target cognitions, research participants in the component analysis who responded positively to BA also demonstrated significant reduction in depressive cognitive styles.…”

Section: Introductionmentioning

confidence: 99%

Exploring sudden gains in behavioral activation therapy for Major Depressive Disorder

Hunnicutt-Ferguson

Hoxha

Gollan

2012

Behaviour Research and Therapy

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Understanding the onset and course of sudden gains in treatment provides clinical information to the patient and clinician, and encourages clinicians to strive for these sudden clinical gains with their patients. This study characterizes the occurrence of sudden gains with Behavioral Activation (BA; Martell, Addis, & Jacobson, 2001), and the extent to which pre-treatment dysfunctional depressive thinking predicts sudden gains during treatment. We enrolled a sample of adults (n = 42) between ages 18–65 diagnosed with primary Major Depressive Disorder. All participants completed a 16-week course of BA, with clinical and self-report assessments at pre-, mid- and post-treatment. Results indicated that sudden gain and non-sudden gain participants showed differential improvement across treatment. No significant effects emerged for the dysfunctional cognitive style as a predictor of sudden gain status. Sudden gains may result from interaction of non-specific factors with the BA techniques implemented during early phases of therapy.

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“…By comparison, chronic stressors measured at baseline, including medical illness, family conflicts, housing, and disability almost universally predict worse outcomes (Billings and Moos 1985; Gonzales et al 1985; Schoevers et al 2003; Swindle et al 1989). Finally, studies in adults show that higher levels of perceived stress both at baseline and during follow-up predict poor outcomes (Candrian et al 2007, Pedrelli et al 2008), whereas decrease in perceived stress during antidepressant treatment correlates with MDD remission (Reno and Halaris 1990). …”

Section: Introductionmentioning

confidence: 99%

Stressful life events, perceived stress, and 12-month course of geriatric depression: Direct effects and moderation by the 5-HTTLPRandCOMTVal158Met polymorphisms

Zannas

McQuoid

Steffens

et al. 2012

Stress

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Although the relation between stressful life events (SLEs) and risk of major depressive disorder (MDD) is well-established, important questions remain about the effects of stress on the course of geriatric depression. Our objectives were: 1) to examine how baseline stress and change in stress is associated with course of geriatric depression; and 2) to test whether polymorphisms of serotonin transporter (5-HTTLPR) and catechol-O-methyltransferase (COMT Val158Met) genes moderate this relation. 216 depressed subjects age 60 years or older were categorized by remission status (MADRS ≤ 6) at 6 and 12 months. At 6 months, greater baseline numbers of self-reported negative and total SLEs and greater baseline perceived stress severity were associated with lower odds of remission. At 12 months, only baseline perceived stress predicted remission. When we examined change in stress, 12-month decrease in negative SLEs and level of perceived stress were associated with improved odds of 12-month remission. When genotype data were included, COMT Val158Met genotype did not influence these relations. However, when compared with 5-HTTLPR L/L homozygotes, S allele carriers with greater baseline numbers of negative SLEs and with greater decrease in negative SLEs were more likely to remit at 12 months. This study demonstrates that baseline SLEs and perceived stress severity may influence the 12-month course of geriatric depression. Moreover, changes in these stress measures over time correlate with depression outcomes. 5-HTTLPR S carriers appear to be more susceptible to both the effects of enduring stress and the benefit of interval stress reduction.

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Dysfunctional attitudes and perceived stress predict depressive symptoms severity following antidepressant treatment in patients with chronic depression

Cited by 30 publications

References 34 publications

A Web-Based Psychoeducational Program for Informal Caregivers of Patients With Alzheimer’s Disease: A Pilot Randomized Controlled Trial

A Web-Based Psychoeducational Program for Informal Caregivers of Patients With Alzheimer’s Disease: A Pilot Randomized Controlled Trial

Exploring sudden gains in behavioral activation therapy for Major Depressive Disorder

Stressful life events, perceived stress, and 12-month course of geriatric depression: Direct effects and moderation by the 5-HTTLPRandCOMTVal158Met polymorphisms

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