Dysfunctional cognitions of depressive inpatients and their relationship with treatment outcome

Köhler, Stephan; Unger, Theresa; Hoffmann, Sabine; Mackert, A.; Ross, Barbara; Fydrich, Thomas

doi:10.1016/j.comppsych.2014.12.020

Cited by 16 publications

(12 citation statements)

References 35 publications

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“…At discharge from the hospital, considerable benefits could be shown for depression (BDI-II and PHQ-9), anxiety, quality of life, and self-esteem, but not for other outcomes like depressive thinking styles or work ability. A previous study [52] concluded that dysfunctional cognitions of depressive inpatients are relatively stable compared to depressive symptoms. Similarly, self-perceived work ability is also expected to change slowly [53].…”

Section: Discussionmentioning

confidence: 99%

Online Self-Help as an Add-On to Inpatient Psychotherapy: Efficacy of a New Blended Treatment Approach

Zwerenz¹,

Becker²,

Knickenberg³

et al. 2017

Psychother Psychosom

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Background: Depression is one of the most frequent and costly mental disorders. While there is increasing evidence for the efficacy of online self-help to improve depression or prevent relapse, there is little evidence in blended care settings, especially combined with inpatient face-to-face psychotherapy. Therefore, we evaluated whether an evidence-based online self-help program improves the efficacy of inpatient psychotherapy. Methods: A total of 229 depressed patients were randomly allocated either to an online self-help program (intervention group [IG]; Deprexis) or an active control group (CG; weekly online information on depression) in addition to inpatient psychodynamic psychotherapy. Both groups had access to their respective experimental intervention for 12 weeks, regardless of inpatient treatment duration. Reduction of depressive symptoms, as measured with the Beck Depression Inventory-II, was the primary outcome at the end of the intervention (T2). Results: Depressive symptoms were statistically significantly lower in the IG compared to the active CG at T2 with a moderate between-group effect size of d = 0.44. The same applied to anxiety (d = 0.33), quality of life (d = 0.34), and self-esteem (d = 0.38) at discharge from inpatient treatment (T1). No statistically significant differences were found regarding dysfunctional attitudes (d = 0.14) and work ability (d = 0.08) at T1. Conclusions: This is the first evidence for blended treatment combining online self-help with inpatient psychotherapy. The study opens new and promising avenues for increasing the efficacy of inpatient psychotherapy. Future studies should determine how integration of online self-help into the therapeutic process can be developed further.

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Section: Discussionmentioning

confidence: 99%

Online Self-Help as an Add-On to Inpatient Psychotherapy: Efficacy of a New Blended Treatment Approach

Zwerenz¹,

Becker²,

Knickenberg³

et al. 2017

Psychother Psychosom

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“…Main symptoms of depressive episodes are sad mood, diminished interest in activities, and fatigue or low levels of energy, lasting for at least two weeks [ 4 ]. Cognitive behavioural theories explain the aetiology of depression by diathesis-stress models with dysfunctional attitudes [ 5 – 8 ], rumination [ 9 – 13 ] and attributional style [ 14 – 16 ] as major psychological factors for the onset and persistence of depressive disorders. Lifetime prevalence of depressive disorders is high, ranging from 11.6% [ 17 ] to 17.1% in the German general population [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

Self-directed passive-aggressive behaviour as an essential component of depression: findings from two cross-sectional observational studies

et al. 2022

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Background The self-control model of depression suggests depressive symptoms to derive from distorted self-monitoring, dysfunctional self-evaluation and reduced self-reward as well as increased self-punishment. Building on this model a relationship between self-directed passive-aggressive behaviour, that is, harmful inactivity, and depression has been assumed. This association has been supported by a recent study in an inpatient sample. However, it remains unclear if patients with depressive disorders report more self-directed passive-aggressive behaviour than patients without depressive disorders and if self-directed passive aggression mediates the associations between distorted self-monitoring and dysfunctional self-evaluation with depressive symptoms. Methods Study 1 compared self-directed passive-aggressive behaviour levels between 220 psychotherapy outpatients with (n = 140; 67.9% female; Mage = 40.0) and without (n = 80; 65.0% female; Mage = 36.2) depressive disorders. Diagnoses were made based on the Structured Clinical Interview for DSM-IV. Study 2 examined self-directed passive-aggressive behaviour as a mediator of the relationship between distorted self-monitoring and dysfunctional self-evaluation and self-reported depressive symptoms in 200 undergraduate Psychology students. Results Compared to outpatients without depressive disorders, outpatients with depressive disorder reported significantly more self-directed passive aggression (d = 0.51). Furthermore, Study 2 verified self-directed passive-aggressive behaviour as a partial mediator of the relationship between dysfunctional attitudes (abcs = .22, 95%-CI: .14, .31), attributional style (abcs = .20, 95%-CI: .13, .27), ruminative response style (abcs = .15, 95%-CI: .09, .21) and depressive symptoms. Conclusion Self-directed passive-aggressive behaviour partially mediates the association between distorted self-monitoring and dysfunctional self-evaluation with depressive symptoms. Future longitudinal studies need to examine a potential causal relationship that would form a base to include interventions targeting self-directed passive-aggressive behaviour in prevention and treatment of depression. Trial registration Both studies were preregistered at the German Clinical Trials Register (DRKS00014005 and DRKS00019020).

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“…Although dysfunctional beliefs have been shown to be relatively stable 2 , they do appear to be malleable and, in consequence, represent a major target of cognitive behavioral therapy (CBT). As a result, research until now has converged on the notion that depressive symptoms can be reduced via the modification of cognitive biases 3, 4 .…”

Section: Introductionmentioning

confidence: 99%

Cognitive and Metacognitive Mechanisms of Change in Metacognitive Training for Depression

Jelinek

Quaquebeke

Moritz

2017

Sci Rep

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Metacognitive Training for Depression (D-MCT), a low-threshold group intervention, has been shown to improve depressive symptoms. It aims at the reduction of depression by changing dysfunctional cognitive as well as metacognitive beliefs. The purpose of the present study was to investigate whether the mechanisms of change in D-MCT are cognitive (and thus primarily concern the content of cognition) or metacognitive in nature. Eighty-four outpatients with depression were included in a randomized controlled trial comparing D-MCT to an active control intervention. Level of depression, dysfunctional cognitive beliefs (DAS), and metacognitive beliefs (MCQ subscales: Positive Beliefs, Negative Beliefs, Need for Control) were assessed before (t0) and after treatment (t1). Severity of depression was also assessed 6 months later (t2). Linear regression analyses were used to determine whether change in depression from t0 to t2 was mediated by change in cognitive vs. metacognitive beliefs from t0 to t1. D-MCT’s effect on change in depression was mediated by a decrease in dysfunctional metacognitive beliefs, particularly ‘need for control’. Our findings underline that one of the key mechanisms of improvement in D-MCT is the change in metacognitive beliefs. The current study provides further support for the importance of metacognition in the treatment of depression.

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Dysfunctional cognitions of depressive inpatients and their relationship with treatment outcome

Cited by 16 publications

References 35 publications

Online Self-Help as an Add-On to Inpatient Psychotherapy: Efficacy of a New Blended Treatment Approach

Online Self-Help as an Add-On to Inpatient Psychotherapy: Efficacy of a New Blended Treatment Approach

Self-directed passive-aggressive behaviour as an essential component of depression: findings from two cross-sectional observational studies

Cognitive and Metacognitive Mechanisms of Change in Metacognitive Training for Depression

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