Temporal and specific pathways of change in cognitive behavioral therapy (CBT) and interpersonal psychotherapy (IPT) for depression

Bruijniks, Sanne J. E.; Meeter, Martijn; Lemmens, Lotte H.J.M.; Peeters, Frenk; Cuijpers, Pim; Huibers, Marcus J.H.

doi:10.1016/j.brat.2021.104010

Cited by 11 publications

(8 citation statements)

References 69 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Third, the correlation between negative cognition and depression outcomes appeared to be roughly twice as large as the correlations between other CMs and depression outcomes in CBT trials (though in IPT trials, negative cognition appeared to have a smaller correlation with depression outcomes compared with other CMs). Our findings resemble some results from a recent trial comparing CBT and IPT for depressed adults (Bruijniks et al, 2022)—IPT led to larger reductions in dysfunctional thinking than CBT. However, these reductions were associated with subsequent increase in depressive symptoms, in contrast to what we found.…”

Section: Discussionsupporting

confidence: 88%

“…Interestingly, the same study that found cognitive change to be nonspecific to treatment of adults also found that CBT increased use of CBT skills relative to IPT, which in turn mediated subsequent decrease in depression symptoms (Bruijniks et al, 2022). In addition, three small CBT trials in the present meta-analysis had, in addition to a control condition, a behavioral treatment condition (e.g., relaxation, problem solving, and activity scheduling) that was not included in our analyses; two of them found that the CBT condition was superior to the behavioral treatment in improving negative cognition (Kahn et al, 1990; Stark et al, 1987), suggesting that cognitive therapy strategies may have a unique impact on cognitive change.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

How do cognitive behavioral therapy and interpersonal psychotherapy improve youth depression? Applying meta-analytic structural equation modeling to three decades of randomized trials.

Ng,

DiVasto,

Gonzalez

et al. 2023

Psychological Bulletin

View full text Add to dashboard Cite

Investigating the mechanisms through which psychotherapy brings about desired change can inform efforts to improve therapies. We applied meta-analytic structural equation modeling (MASEM) to assess putative change mechanisms for cognitive behavioral therapy (CBT) as mediators of youth depression treatment outcome. Then, we tested whether candidate mediators (CMs) showed evidence of treatment-specificity to CBT versus interpersonal psychotherapy (IPT). Literature searches identified 34 randomized trials (27 CBT, 6 IPT, 1 CBT/ IPT, 3,868 participants, published 1982IPT, 3,868 participants, published -2020 that measured seven CMs: negative cognition, social engagement, family functioning, pleasant activity engagement, problem solving, reframing, or avoidance. We assessed mediational pathways and whether posttreatment CMs mediated treatment effects on posttreatment depression symptoms, covarying pretreatment CMs, and symptoms. Treatment type was tested as a moderator of mediational pathways. Results show that negative cognition (24 trials) and pleasant activities (3 trials) mediated depression symptom outcome in CBT. Social engagement and family functioning showed stronger mediation in IPT (5 and 6 trials) than in CBT (14 and 13 trials). We conclude that negative cognition is a robust mediator of CBT but may not be treatment-specific; pleasant activities may also be a mediator of CBT. However, the lack of treatment or mediation effects involving problem solving and reframing contradicts CBT theory. In contrast, social and family mechanisms appear to be IPT-specific mediators. These conclusions are provisional due to small samples examining IPT and several CMs, limitations in CM measurement (i.e., posttreatment retrospective report), and assumptions of MASEM-and will need to be confirmed when more and better evidence accumulates. Public Significance StatementTo understand how psychotherapy impacts youth depression, we used a new approach to maximize and evaluate information gained from studies of two prominent therapies published over 3 decades. We found that cognitive behavioral therapy reliably reduced negative thinking-though it is unclear through what process-and in some cases, increased engagement in pleasant activities, with both changes in turn reducing depression symptoms. Interpersonal psychotherapy (IPT) appeared to improve depression via similar pathways to those posited for CBT (reducing negative thinking) as well as different pathways, specifically by improving young people's interpersonal skills and their peer and family relationships. Because few studies were available for some analyses, and because of limitations in the way the data were collected and analyzed, these findings are tentative and need to be confirmed in the future when more and better quality studies are conducted.

show abstract

Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

How do cognitive behavioral therapy and interpersonal psychotherapy improve youth depression? Applying meta-analytic structural equation modeling to three decades of randomized trials.

Ng,

DiVasto,

Gonzalez

et al. 2023

Psychological Bulletin

View full text Add to dashboard Cite

show abstract

“…Thus, conducting more gold standard randomized controlled trials can aid in drawing more definitive conclusions on their efficacy to enhance LS and cognitive function at the prevention and treatment stages across adulthood. In addition, based on emerging evidence [ 129 ], clinical science can profit from future studies by testing if cognitive function serves as a treatment predictor, moderator, or mediator, to better understand mechanisms of change and optimize treatments.…”

Section: Discussionmentioning

confidence: 99%

Life satisfaction prevents decline in working memory, spatial cognition, and processing speed: Latent change score analyses across 23 years

Zainal

Newman

2022

Eur. Psychiatr.

View full text Add to dashboard Cite

Background. Within-person growth in life satisfaction (LS) can protect against declines in cognitive functioning, and, conversely, over time. However, most studies have been crosssectional, thereby precluding causal inferences. Thus, we used bivariate dual latent change score modeling to test within-person change-to-future change relations between LS and cognition. Method. Community adults completed in-person tests of verbal working memory (WM), processing speed, spatial cognition, and an LS self-report. Five waves of assessment occurred across 23 years. Results. Reduction in LS predicted future decreases in spatial cognition, processing speed, and verbal WM (|d| = 0.150-0.354). Additionally, depletion in processing speed and verbal WM predicted a future decrease in LS (d = 0.142-0.269). However, change in spatial cognition did not predict change in LS (|d| = 0.085). Discussion. LS and verbal WM and processing speed predicted one another across long durations. Evidence-based therapies can be augmented to target LS and cognition.

show abstract

“…des erweiterten Indikationsspektrums kommt eine Metaanalyse zu dem Schluss, dass die IPT auch als Rückfallprophylaxe und in der Behandlung von Essstörungen (abgesehen von der Anorexia nervosa), Angststörungen und anderen psychischen Störungen wirksam ist [7]. Des Weiteren konnte eine Studie [17] In einer ersten Wirkstudie mit der IPSS-SR zeigte sich ein Zusammenhang zwischen den Veränderungen in der IPSS-SR und der depressiven Symptomatik, wobei dieser Zusammenhang sowohl in der IPT als auch in der parallel durchgeführten kognitiven Verhaltenstherapie gefunden wurde [30]. In einer anderen Vergleichsstudie, die annähernd zu den o. g. Wirkmechanismen passt, verbesserte die IPT die "soziale Anpassung" nicht stärker als die psychiatrische Standardbehandlung in der Selbstauskunft [31].…”

Section: Wirksamkeit Und Wirkmechanismen Der Iptunclassified

Interpersonelle Psychotherapie (IPT)

Brakemeier¹,

Hauck²,

Harder³

2023

PSYCH up2date

View full text Add to dashboard Cite

Temporal and specific pathways of change in cognitive behavioral therapy (CBT) and interpersonal psychotherapy (IPT) for depression

Cited by 11 publications

References 69 publications

How do cognitive behavioral therapy and interpersonal psychotherapy improve youth depression? Applying meta-analytic structural equation modeling to three decades of randomized trials.

How do cognitive behavioral therapy and interpersonal psychotherapy improve youth depression? Applying meta-analytic structural equation modeling to three decades of randomized trials.

Life satisfaction prevents decline in working memory, spatial cognition, and processing speed: Latent change score analyses across 23 years

Interpersonelle Psychotherapie (IPT)

Contact Info

Product

Resources

About