Pilot study of a treatment for psychological depression.

Abstract

Depression, defined as a dysphoric subjective reaction to a loss of reinforcement, was assessed and treated using a functional problem-solving approach. College students seeking counseling were selected on the bases of self-report and test scale scores (e.g., Minnesota Multiphasic Personality Inventory Depression scale) and treated in two controlled experiments. Treatment was the only variable associated with significant improvement. Suggestions for further research involved, among other issues, palieiil population data and treatment components.According to most learning-theory-based explanations, depression results directly or indirectly from inadequate reinforcement ('see also Seitz, 1971). Ferster (1966 suggested that insufficient reinforcement results from any of three conditions: An increase in the ratio of responses to reinforcements (i.e., more work is required); frequent aversive contingencies (i.e.. the cost and/or risk is greater); and a change in the stimuli controlling responding (i.e.. confusion and/or disruption). A depression associated with an apparent success might appear to be an exception to this analysis. However, by illustration. a promotion with 20% more pay but 40% more work might be seen to be a net loss of reinforcement. Both Lazarus C1968) and Phillips (1956) appear to agree with Ferster's analysis and emphasize the importance of the disruption factor. Lewinsohn and Atwood (1969). Folsom (1970), and Stuart (1967 stress factors associated with the maintenance of depressive behaviors once they have been initiated or precipitated (e.g., "secondary gain"). In general, treatment techniques used by these investigators involve either disrupting depressive behaviors or reinforcing appropriate behaviors. However, learning-theory-derived approaches appear to be at best metaphors, to use London's (1972) de-

Behavioral formulations of depression.

“…The majority of theorists have conceived of depression as a function of a reduced frequency of social reinforcement (Hersen, Eisler, Alford, & Agras, 1973;Lewinsohn & Graf, 1973;Lewinsohn, Weinstein, & Alper, 1970;Lewinsohn, Weinstein, & Shaw, 1969;Liberman & Raskin, 1971;McLean, Ogston, & Grauer, 1973;Shipley & Fazio, 1973). As a consequence, therapy consists of social skills training and involves the patient's family in the therapeutic process since the family is a major source of social reinforcement.…”

Group Cognitive Therapy for Depression Produces Clinically Significant Reliable Change in Community-based Settings

“…Most outcome studies of cognitive therapy have utilized individual administration of treatment, but if comparable effects can be demonstrated for treatment administered in small groups the improvement in patient throughput may go some way to meeting Teasdale et al 's stricture, increasing the social good attendant on therapist effort. A number of studies have attested to the efficacy of cognitive therapy in group format, whether by clinical report [Shaw and Hollon (1978), using symptomatically depressed outpatients], or by comparison with control groups [Shipley and Fazio (1973); Gioe (1975), using depressed college student volunteers; Morris (1975); Shaw (1977), using depressed psychiatric clinic patients}. Only a handful of trials, though, have directly compared group and individual cognitive therapy.…”

Cognitive Therapy of Depression: The Mechanisms of Change

“…I do not intend to review in any detail the outcome studies of cognitive therapy for depression. Suffice it to say that there is now promising evidence of its effectiveness, both with relatively mildly depressed student volunteers (Shipley and Fazio, 1973;Taylor and Marshall, 1977), and with moderately to severely depressed clinical populations [Blackburn et al, 1981;Rush et al, 1977;Shaw, 1977;Shaw, 1978(reported in Beck et al. 1979; Rush and Watkins, 1981)].…”