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1. Developing Cognitive Behavioral Therapy to Prevent Depressive Relapse in Youth (EJ815860)
Author(s):
Kennard, Betsy D.; Stewart, Sunita M.; Hughes, Jennifer L.; Jarrett, Robin B.; Emslie, Graham J.
Source:
Cognitive and Behavioral Practice, v15 n4 p387-399 Nov 2008
Pub Date:
2008-11-00
Pub Type(s):
Journal Articles; Reports - Evaluative
Peer-Reviewed:
Yes
Descriptors: Cognitive Restructuring; Adolescents; Depression (Psychology); Prevention; Behavior Modification; Counseling Techniques; Children; Symptoms (Individual Disorders); Drug Therapy; Youth; Wellness; Well Being; Skill Development
Abstract: Relapse rates for children and adolescents with major depressive disorder (MDD) range from 30% to 40% within 1 to 2 years after acute treatment. Although relapse rates are high, there have been relatively few studies on the prevention of relapse in youth. While acute phase pharmacotherapy has been shown to reduce symptoms rapidly in depressed youth, children and adolescents frequently report ongoing residual symptoms and often relapse following acute treatment. Recent adult trials have begun examining augmentation with psychosocial treatment after successful medication treatment to enhance medication response and prevent future relapse. This strategy has not yet been examined in youth with depression. Here we present initial efforts to develop a sequential, combination treatment strategy to promote rapid remission and to prevent relapse in depressed youth. We describe efforts to adapt CBT to prevent relapse (RP-CBT) in youth who respond to pharmacotherapy. The goals of RP-CBT include: preventing relapse, increasing wellness, and developing skills to promote and sustain well-being. We describe the rationale for, components of, and methods used to develop RP-CBT. The results from a small open series sample demonstrate feasibility and indicate that youth appear to tolerate RP-CBT well. A future test of the treatment in a randomized controlled trial is described. (Contains 3 tables.) Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract
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2. Mindfulness-Based Cognitive Therapy to Prevent Relapse in Recurrent Depression (EJ823828)
Kuyken, Willem; Byford, Sarah; Taylor, Rod S.; Watkins, Ed; Holden, Emily; White, Kat; Barrett, Barbara; Byng, Richard; Evans, Alison; Mullan, Eugene; Teasdale, John D.
Journal of Consulting and Clinical Psychology, v76 n6 p966-978 Dec 2008
2008-12-00
Journal Articles; Reports - Research
Descriptors: Prevention; Quality of Life; Cognitive Restructuring; Behavior Modification; At Risk Persons; Patients; Cost Effectiveness; Depression (Psychology); Drug Therapy; Outcomes of Treatment; Symptoms (Individual Disorders); Comparative Analysis
Abstract: For people at risk of depressive relapse, mindfulness-based cognitive therapy (MBCT) has an additive benefit to usual care (H. F. Coelho, P. H. Canter, & E. Ernst, 2007). This study asked if, among patients with recurrent depression who are treated with antidepressant medication (ADM), MBCT is comparable to treatment with maintenance ADM (m-ADM) in (a) depressive relapse prevention, (b) key secondary outcomes, and (c) cost effectiveness. The study design was a parallel 2-group randomized controlled trial comparing those on m-ADM (N = 62) with those receiving MBCT plus support to taper/discontinue antidepressants (N = 61). Relapse/recurrence rates over 15-month follow-ups in MBCT were 47%, compared with 60% in the m-ADM group (hazard ratio = 0.63; 95% confidence interval: 0.39 to 1.04). MBCT was more effective than m-ADM in reducing residual depressive symptoms and psychiatric comorbidity and in improving quality of life in the physical and psychological domains. There was no difference in average annual cost between the 2 groups. Rates of ADM usage in the MBCT group was significantly reduced, and 46 patients (75%) completely discontinued their ADM. For patients treated with ADM, MBCT may provide an alternative approach for relapse prevention. (Contains 3 figures, 1 footnote, and 3 tables.) Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract
3. Cognitive-Behavioral Therapy to Prevent Relapse in Pediatric Responders to Pharmacotherapy for Major Depressive Disorder (EJ828897)
Kennard, Betsy D.; Emslie, Graham J.; Mayes, Taryn L.; Nightingale-Teresi, Jeanne; Nakonezny, Paul A.; Hughes, Jennifer L.; Jones, Jessica M.; Tao, Rongrong; Stewart, Sunita M.; Jarrett, Robin B.
Journal of the American Academy of Child & Adolescent Psychiatry, v47 n12 p1395 Dec 2008
Descriptors: Prevention; Cognitive Restructuring; Drug Therapy; Depression (Psychology); Behavior Modification; Outcomes of Treatment; Youth; Comparative Analysis
Abstract: The outcome of a sequential treatment strategy that included cognitive behavioral therapy (CBT) in the prevention of major depressive disorder relapse among 46 youths is examined. Results show that youths under the antidepressant medication management plus relapse prevention CBT treatment was at lower risk for relapse than those under the antidepressant medication management only. Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract
4. Predictors of Relapse for American Indian Women after Substance Abuse Treatment (EJ782943)
Chong, Jenny; Lopez, Darlene
American Indian and Alaska Native Mental Health Research: The Journal of the National Center, v14 n3 p24-48 2008
2008-00-00
Descriptors: Substance Abuse; Females; Self Efficacy; American Indians; Recidivism; Predictor Variables; Rehabilitation; Outcomes of Treatment; Alcohol Abuse; Drug Abuse; Residential Programs; Interpersonal Relationship; Correlation; Parent Influence; Conflict
Abstract: The objective of this study was to describe the predictors of substance use relapse of American Indian (AI) women up to one year following substance abuse treatment. Relapse is defined as any use of alcohol or drugs in the past 30 days at the follow-up points. Data were collected from AI women in a 45-day residential substance abuse treatment program. Predictors include distal (in time) proximal (recent), and intrapersonal factors. Results indicated that intrapersonal factors showed the strongest relationship with relapse, followed by proximal and distal factors. Negative messages about using alcohol or drugs from the client's father while growing up may have had an impact on whether the client used alcohol at 6 months. Conflicts with other people and being in the company of alcohol or drug users were highly predictive of relapse. While craving was highly predictive of substance use at follow up, self-efficacy was highly predictive of no substance use. Knowledge about predictors of relapse among this population should be used as a guide toward individual treatment planning. (Contains 5 tables.) Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract
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5. Patients' Competence in and Performance of Cognitive Therapy Skills: Relation to the Reduction of Relapse Risk Following Treatment for Depression (EJ772005)
Strunk, Daniel R.; DeRubeis, Robert J.; Chiu, Angela W.; Alvarez, Jennifer
Journal of Consulting and Clinical Psychology, v75 n4 p523-530 Aug 2007
2007-08-00
Descriptors: Therapy; Patients; Depression (Psychology); Cognitive Restructuring; Counseling Techniques; Coping; Symptoms (Individual Disorders); Risk; Outcomes of Treatment; Prevention
Abstract: Cognitive therapy (CT) for depression is designed to teach patients material that is believed to help prevent relapse following successful treatment. This study of 35 moderately to severely depressed patients who responded to CT provides the 1st evidence to suggest that both development and independent use of these competencies predict reduced risk for relapse. Among patients who responded to treatment, both CT coping skills and in-session evidence of the independent implementation of CT material predicted lower risk for relapse in the year following treatment. These relationships were not accounted for by either symptom severity at the end of treatment or symptom change from pre- to posttreatment. Self-esteem, assessed at posttreatment, failed to predict risk for relapse in the year following treatment. Thus, CT coping skills and independent use of CT principles, but not overall satisfaction with oneself, appear to play an important role in relapse prevention. Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract
6. Maintenance of Gains Following Experiential Therapies for Depression (EJ827057)
Ellison, Jennifer A.; Greenberg, Leslie S.; Goldman, Rhonda N.; Angus, Lynne
Journal of Consulting and Clinical Psychology, v77 n1 p103-112 Feb 2009
2009-02-00
Descriptors: Maintenance; Outcomes of Treatment; Probability; Therapy; Depression (Psychology); Adults; Self Esteem; Symptoms (Individual Disorders); Emotional Response; Intervention
Abstract: Follow-up data across an 18-month period are presented for 43 adults who had been randomly assigned and had responded to short-term client-centered (CC) and emotion-focused (EFT) therapies for major depression. Long-term effects of these short-term therapies were evaluated using relapse rates, number of asymptomatic or minimally symptomatic weeks, survival times across an 18-month follow-up, and group comparisons on self-report indices at 6- and 18-month follow-up among those clients who responded to the acute treatment phase. EFT treatment showed superior effects across 18 months in terms of less depressive relapse and greater number of asymptomatic or minimally symptomatic weeks, and the probability of maintaining treatment gains was significantly more likely in the EFT treatment than in the CC treatment. In addition, follow-up self-report results demonstrated significantly greater effects for EFT clients on reduction of depression and improvement of self-esteem, and there were trends in favor of EFT, in comparison with CC, on reduction of general symptom distress and interpersonal problems. Maintenance of treatment gains following an empathic relational treatment appears to be enhanced by the addition of specific experiential and gestalt-derived emotion-focused interventions. Clinical and theoretical implications of these findings are presented. (Contains 6 figures and 5 tables.) Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract
7. A Behavioral Economic Reward Index Predicts Drinking Resolutions: Moderation Revisited and Compared with Other Outcomes (EJ833333)
Tucker, Jalie A.; Roth, David L.; Vignolo, Mary J.; Westfall, Andrew O.
Journal of Consulting and Clinical Psychology, v77 n2 p219-228 Apr 2009
2009-04-00
Descriptors: Intervals; Rewards; Alcohol Abuse; Outcomes of Treatment; Behavior Change; Prediction; Resource Allocation; Regression (Statistics); Models; Money Management; Comparative Analysis
Abstract: Data were pooled from 3 studies of recently resolved community-dwelling problem drinkers to determine whether a behavioral economic index of the value of rewards available over different time horizons distinguished among moderation (n = 30), abstinent (n = 95), and unresolved (n = 77) outcomes. Moderation over 1- to 2-year prospective follow-up intervals was hypothesized to involve longer term behavior regulation processes than abstinence or relapse and to be predicted by more balanced preresolution monetary allocations between short-term and longer term objectives (i.e., drinking and saving for the future). Standardized odds ratios (ORs) based on changes in standard deviation units from a multinomial logistic regression indicated that increases on this "Alcohol-Savings Discretionary Expenditure" index predicted higher rates of abstinence (OR = 1.93, p = 0.004) and relapse (OR = 2.89, p less than 0.0001) compared with moderation outcomes. The index had incremental utility in predicting moderation in complex models that included other established predictors. The study adds to evidence supporting a behavioral economic analysis of drinking resolutions and shows that a systematic analysis of preresolution spending patterns aids in predicting moderation. (Contains 4 tables and 1 figure.) Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract
8. Reducing Relapse and Recurrence in Unipolar Depression: A Comparative Meta-Analysis of Cognitive-Behavioral Therapy's Effects (EJ766096)
Vittengl, Jeffrey R.; Clark, Lee Anna; Dunn, Todd W.; Jarrett, Robin B.
Journal of Consulting and Clinical Psychology, v75 n3 p475-488 Jun 2007
2007-06-00
Descriptors: Therapy; Depression (Psychology); Cognitive Restructuring; Behavior Modification; Outcomes of Treatment; Meta Analysis; Adults; Research Methodology
Abstract: Relapse and recurrence following response to acute-phase treatment for major depressive disorder (MDD) are prevalent and costly. In a meta-analysis of 28 studies including 1,880 adults, the authors reviewed the world's published literature on cognitive-behavioral therapies (CT) aimed at preventing relapse-recurrence in MDD. Results indicate that after discontinuation of acute-phase treatment, many responders to CT relapse-recur (29% within 1 year and 54% within 2 years). These rates appear comparable to those associated with other depression-specific psychotherapies but lower than those associated with pharmacotherapy. Among acute-phase treatment responders, continuation-phase CT reduced relapse-recurrence compared with assessment only at the end of continuation treatment (21% reduction) and at follow-up (29% reduction). Continuation-phase CT also reduced relapse-recurrence compared with other active continuation treatments at the end of continuation treatment (12% reduction) and at follow-up (14% reduction). The authors discuss implications for research and patient care and suggest directions, with methodological refinements, for future studies. Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract
9. Sexual Offending Theories and Offenders with Intellectual Disabilities (EJ851099)
Keeling, Jenny A.; Rose, John L.; Beech, Anthony R.
Journal of Applied Research in Intellectual Disabilities, v22 n5 p468-476 Sep 2009
2009-09-00
Descriptors: Sexual Abuse; Mental Retardation; Social Theories; Etiology; Criminals; Crime; Theories; At Risk Persons; Intervention; Social Influences; Self Control; Recidivism
Abstract: Background: There have been limited theoretical developments with respect to sexual offending by people with intellectual disabilities [Lindsay (2005) Mental Retardation, Vol. 43, pp. 428-441], especially when compared with the development of theories for mainstream sexual offenders. This paper aims at examining a range of theories in their application to sexual offenders with an intellectual disability. Method and Results: Three levels of theory are discussed. These include multifactor theories, discussed in the light of a recent model proposed by Lindsay for sexual offenders with intellectual disabilities, as well as single-factor theories associated with socio-affective functioning and an offence process theory, the self-regulation model of relapse prevention. Finally, a recent theoretical development called the "integrated theory of sexual offending" (ITSO) is discussed and applied to sexual offenders with intellectual disabilities. This theory combines theories from all three levels in an effort to provide a comprehensive explanation of the aetiology and maintenance of sexual offending. Conclusion: Theories at all three levels, as well as the ITSO, appear to have relevance to sexual offenders with intellectual disabilities. Some tentative suggestions are made for future research to assist in the application of theory to this client group. It is argued that a more complete understanding of theory in relation to this client group will lead to the development of more effective intervention programmes. Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract
10. Excessive Use of Massively Multi-Player Online Role-Playing Games: A Pilot Study (EJ861569)
Hussain, Zaheer; Griffiths, Mark D.
International Journal of Mental Health and Addiction, v7 n4 p563-571 Oct 2009
2009-10-00
Descriptors: Youth Programs; Substance Abuse; Games; Measures (Individuals); Video Games; Role Playing; Questionnaires; Addictive Behavior; Psychological Patterns; Correlation; At Risk Persons
Abstract: Massively multiplayer online role-playing games (MMORPGs) are one of the most interesting innovations in the area of online computer gaming. This pilot study set out to examine the psychological and social effects of online gaming using an online questionnaire with particular reference to excessive and "dependent" online gaming. A self-selecting sample of 119 online gamers ranging from 18 to 69 years (mean = 28.5 years) completed the questionnaire. The results showed that 41% of gamers played online to escape and 7% of gamers were classified as "dependent" individuals who were at risk of developing a psychological and behavioural dependence for online gaming using an adapted "addiction" scale. Further analysis showed that excessive online gaming was significantly correlated with psychological and behavioural "dependence". It was also found that "dependent" gamers appear to possess some core components of addiction to MMORPGs (e.g., mood modification, tolerance and relapse). Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract
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