Changes in Self-Schema Structure in Cognitive Therapy for Major Depressive Disorder: A Randomized Clinical Trial

• Published in: Journal of consulting and clinical psychology 2009-12, Vol.77 (6), p.1078-1088
• Main Authors: Dozois, David J. A, Bieling, Peter J, Patelis-Siotis, Irene, Hoar, Lori, Chudzik, Susan, McCabe, Katie, Westra, Henny A
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Analysis of Variance; Attitude; Automatic thought; Beck Depression Inventory; Behavior Modification; Behavior therapy. Cognitive therapy; Biological and medical sciences; Clinical psychology; Cognitive Processes; Cognitive Restructuring; Cognitive Structures; Cognitive Therapy; Depression; Depression (Psychology); Depressive Disorder, Major - diagnosis; Depressive Disorder, Major - therapy; Diagnostic and Statistical Manual of Mental Disorders; Drug Therapy; Female; Hamilton Rating Scale for Depression; Human; Humans; Interpersonal Relations; Major Depression; Male; Measures (Individuals); Medical research; Medical sciences; Mental depression; Middle Aged; Models, Psychological; Negative cognition; Patient Selection; Patients; Personality; Personality Inventory; Pharmacology; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Rating Scales; Schema; Schemata (Cognition); Self Concept; Social Behavior; Surveys and Questionnaires; Therapy; Treatment Outcome; Treatment Outcomes; Treatments; Vulnerability
• ISSN: 0022-006X; 1939-2117
• DOI: 10.1037/a0016886

Negative cognitive structure (particularly for interpersonal content) has been shown in some research to persist past a current episode of depression and potentially to be a stable marker of vulnerability for depression ( D. J. A. Dozois, 2007 ; D. J. A. Dozois & K. S. Dobson, 2001a ). Given that cognitive therapy (CT) is highly effective for treating the acute phase of a depressive episode and that this treatment also reduces the risk of relapse and recurrence, it is possible that CT may alter these stable cognitive structures. In the current study, patients were randomly assigned to CT+ pharmacotherapy ( n = 21) or to pharmacotherapy alone ( n = 21). Both groups evidenced significant and similar reductions in level of depression (as measured with the Beck Depression Inventory-II and the Hamilton Rating Scale for Depression), as well as automatic thoughts and dysfunctional attitudes. However, group differences were found on cognitive organization in favor of individuals who received the combination of CT+ pharmacotherapy. The implications of these results for understanding mechanisms of change in therapy and the prophylactic nature of CT are discussed.