Psychosocial predictors of treatment response to cognitive-behavior therapy for late-life depression: an exploratory study

Abstract

Objective The primary objective of this study was to examine a variety of potential predictors of response to Cognitive Behavioral Therapy (CBT) in depressed older adults. Method Sixty older adults with a clinical diagnosis of major or minor depression or dysthymic disorder received 12 individual sessions of CBT over a 3 to 4 month period. The BDI-II was administered pre and post intervention to assess change in level of depression. A cut-off score of 13 or less at post was used to determine positive treatment response. A variety of measures (obtained at baseline) were evaluated using hierarchical regression techniques to predict improvement following treatment Results Individuals who showed greater improvement were: a) more open to new experiences; b) less negatively affected by past stressors; c) less inclined to have an external locus of control but more likely to cite others as responsible for negative stress in their lives; and d) were more likely to seek emotional support when symptomatic. Lower education level and reported use of active coping strategies at baseline were associated with less improvement. Other variables (e.g., age, overall physical health, and cognitive status) were not associated with treatment response. Use of logistic regression to predict responders vs. non-responders yielded a similar pattern. Conclusion These findings agree with prior research confirming the effectiveness of a brief CBT intervention for older depressed persons and suggest further exploration of several psychosocial factors that may contribute to a stronger response to CBT.

Does cognitive‐behavioural therapy promote meaning making? A preliminary test in the context of geriatric depression

“…This investigation includes 51 individuals (17 men and 34 women), who participated in a larger study of 60 participants (Marquett et al., ). Excluded participants (with incomplete information) did not significantly differ from the rest of the sample with regard to demographics.…”

“…Although CBT is effective at alleviating MDD, questions remain as to whether it similarly promotes meaning making. Drawing on Holland, Currier, Coleman, & Neimeyer's () Integration of Stressful Life Experiences Scale (ISLES), this study explored whether a CBT intervention with demonstrated efficacy for addressing geriatric depression (Marquett et al., ) also enhanced clients’ meaning made of stress. Demographic factors were examined as potential moderators of these changes.…”

A randomized clinical trial of interventions for improving well-being in custodial grandfamilies.

“…A key goal of CBT is to improve the ability to regulate negative affect in the face of both daily and major stressful events. Importantly, CBT is effective at reducing older caregiver distress and improving performance on care-related tasks to which anxiety about failure is attached (Marquett et al, 2013).…”

Cognitive Behavioral Therapies in older adults with depression and cognitive deficits: a systematic review

“…Furthermore, it would be interesting that future studies investigate factors that influence the response to psychotherapy in elders. Marquett et al () investigated psychosocial predictors of CBT response for LLD and suggest that individuals who showed greater improvement were more open to new experiences, less negatively affected by past stressors, more likely to cite others as responsible for negative stress in their lives and to seek emotional support when symptomatic.…”