Conclusions

In this chapter we have presented a model for the assessment and case conceptualization of depression that focuses on different manifestations of depression. Specifically in assessing depressed patients, cognitive therapists are encouraged to consider depression parameters (e.g., severity, persistence), comorbid conditions (Axis I and II disorders, medical conditions, social functioning), and aspects associated with different demographic variables. Information gathered from this assessment can then be integrated by the clinician in formulating his/her case conceptualization.

We have also discussed how case conceptualization can be used in treatment planning, including ways to adapt standard CT in working with various presentations of depression. We have provided a general discussion of the parameters that might be modified or adapted in working with depressed patients in clinical practice; specific recommendations for specific presentations of depression are covered in the remaining chapters of this book. We hope that the assessment-driven case conceptualization described in this chapter aids in treatment planning and results in improved outcomes for treating depression in everyday practice.

REFERENCES

Abramowitz, J. S. (2006). Toward a functional analytic approach to psychologically complex patients: A comment on Ruscio and Holohan. Clinical Psychology: Science and Practice, 13, 163-166.

Alford, B. A., & Beck, A. T. (1997). The integrative power of cognitive therapy New York: Guilford Press.

Alford, B. A., & Gerrity, D. M. (1995). The specificity of sociotropy-autonomy personality dimensions to depression vs. anxiety. Journal of Clinical Psychology, 51, 190-195.

Alloy, L. B., Kelly, K. A., Mineka, S., & Clements, C. M. (1990). Comorbidity of anxiety and depressive disorders: A helplessness-hopelessness perspective. In J. D. Maser & C. R. Cloninger (Eds.), Comorbidity of mood and anxiety disorders (pp. 499-543). Washington, DC: American Psychiatric Press.

Beck, A. T. (1976). Cognitive therapy and the emotional disorders. Madison, CT: International Universities Press.

Beck, A. T. (1983). Cognitive therapy of depression: New perspectives. In P.J. Clayton & J. E. Barrett (Eds.), Treatment of depression: Old controversies and new perspectives (pp. 265-290). New York: Raven Press.

Beck, A. T. (1991). Cognitive therapy: A 30-year retrospective. American Psychologist, 46, 368-375.

Beck, A. T., Butler, A. C., Brown, G. K., Dahlsgaard, K. K., Newman, C. F, & Beck,J. S. (2001). Dysfunctional beliefs discriminate personality disorders. Behaviour Research and Therapy, 39, 1213-1225.

Beck, A. T., Freeman, A., Davis, D. D., & Associates. (2003). Cognitive therapy of personality disorders: Second edition. New York: Guilford Press.

Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression. New York: Guilford Press.

Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Beck Depression Inventory—!! manual. San Antonio, TX: Psychological Corporation.

Beck, J. S. (1995). Cognitive therapy: Basics and beyond. New York: Guilford Press.

Beck, J. S. (2005). Cognitive therapy for challenging problems: What to do when the basics don't work. New York: Guilford Press.

Beck, R., & Perkins, T. S. (2001). Cognitive content-specificity for anxiety and depression: A meta-analysis. Cognitive Therapy and Research, 25, 651-663.

Clark, D. A., & Beck, A. T. (1991). Personality factors in dysphoria: A psychometric refinement of Beck's Sociotropy-Autonomy Scale. Journal of Psychopathology and Behavioral Assessment, 13, 369-388.

Clark, D. A., Beck, A. T., & Alford, B. A. (1999). Scientific foundations of cognitive theory and therapy of depression. Hoboken, NJ: Wiley.

Corruble, E., Ginestet, D., & Guelfi, J. D. (1996). Comorbidity of personality disorders and unipolar major depression: A review Journal of Affective Disorders, 37, 157-170.

Dozois, D.J. A., Covin, R., & Brinker,J. K. (2003). Normative data on cognitive measures of depression. Journal of Consulting and Clinical Psychology, 71,71—80.

First, M. B., Spitzer, R. L., Gibbon, M., & Williams,J. B. W (1996). Structured Clinical Interview for DSM-IV Axis I Disorders, Clinician Version (SCID-CV). Washington, DC: American Psychiatric Press.

Hayaki, J., Friedman, M. A., Whisman, M. A., Delmsky, S. S., & Brownell, K. D. (2003). Sociotropy and bulimic symptoms in clinical and nonclinical samples. International Journal of Eating Disorders, 34, 172—176.

Hirschfeld, R. M. A., Montgomery, S. A., Keller, M. B., Kasper, S., Schatzberg, A. F., Moller, H.-J., et al. (2000). Social functioning in depression: A review. Journal of Clinical Psychiatry, 61, 268—275.

Jacobson, N. S., Dobson, K. S., Truax, P. A., Addis,M. E., Koerner, K., Gollan,J. K., et al. (1996). A component analysis of cognitive-behavioral treatment for depression. Journal of Consulting and Clinical Psychology, 64, 295—304.

James, I. A., Kendell, K., & Katharina, R. F (1999). Conceptualizations of depression in older people: The interaction of positive and negative beliefs. Behavioural and Cognitive Psychotherapy, 27, 285—290.

Kessler, R. C., Berglund, P., Demler, O., Jin, R., Koretz, D., Merikangas, K. R., et al. (2003). The epidemiology of major depressive disorder: Results from the National Comorbidity Survey Replication (NCS-R). Journal of the American Medical Association, 289, 3095-3105.

Kessler, R. C., Mickelson, K. D., & Williams, D. R. (1999). The prevalence, distribution, and mental health correlates of perceived discrimination in the United States. Journal of Health and Social Behavior, 40, 208-230.

Kessler, R. C., Nelson, C. B., McGonagle, K. A., Liu, J., Swartz, M., & Blazer, D. G. (1996). Comorbidity of DSM-III-R major depressive disorder in the general population: Results form the US National Comorbidity Survey. British Journal of Psychiatry, 168, 17-30.

Krueger, R. F., & Markon, K. E. (2006). Reinterpreting comorbidity: A modelbased approach to understanding and classifying psychopathology. Annual Review of Clinical Psychology, 2, 111-133.

Laidlaw, K., Thompson, L. W, & Gallagher-Thompson, D. (2004). Comprehensive conceptualization of cognitive behaviour therapy for late life depression. Behavioural and Cognitive Psychotherapy, 32, 1-11.

Lynch, T. R., Robins, C. J., & Morse,J. Q. (2001). Couple functioning in depression: The roles of sociotropy and autonomy. Journal of Clinical Psychology, 57, 93-103.

Maruish, M. E. (1999). The use of psychological testing for treatment planning and outcomes assessment (2nd ed.). Mahwah, NJ: Erlbaum.

Mineka, S., Watson, D., & Clark, L. A. (1998). Comorbidity of anxiety and unipolar mood disorders. Annual Review of Psychology, 49, 377-412.

Nezu, A. M., Ronan, G. F, Meadows, E. A., & McClure, K. S. (2000). Practitioner's guide to empirically based measures of depression. Dordrecht, The Netherlands: Kluwer Academic.

Nezu, A. M., Wilkins, V M., & Nezu, C. M. (2004). Social problem solving, stress, and negative affect. In E. C. Chang, T.J. D'Zurilla, & L.J. Sanna (Eds.), Social problem solving: Theory, research, and training (pp. 49-65). Washington, DC: American Psychological Association.

Ouimette, P. C., Klein, D. N., Anderson, R., Riso, L. P., & Lizardi, H. (1994). Relationship of sociotropy/autonomy and dependency/self-criticism to DSM-III-R personality disorders. Journal of Abnormal Psychology, 103, 743-749.

Persons, J. B. (1989). Cognitive therapy in practice: A case formulation approach. New York: Norton.

Persons, J. B. (1995). Are all psychotherapies cognitive? Journal of Cognitive Psychotherapy, 9, 185-194.

Persons, J. B. (2006). Case-formulation driven psychotherapy. Clinical Psychology: Science and Practice, 13, 167-170.

Robins, C. J., Ladd, J., Welkowitz, J., Blaney, P. H., Kutcher, D., & Diaz, R. (1994). The Personal Style Inventory: Preliminary validation studies of new measures of sociotropy and autonomy. Journal of Psychopathology and Behavioral Assessment, 16, 277-300.

Salokangas, R. K., Vaahtera, K., Pacriev, S., Sohlman, B., & Lehtinen, V (2002). Gender differences in depressive symptoms: An artifact caused by measurement instruments? Journal of Affective Disorders, 68, 215-220.

Silverstein, B. (1999). Gender difference in the prevalence of clinical depression: The role played by depression associated with somatic symptoms. American Journal of Psychiatry, 156, 480-482.

Stevens, D. E., Merikangas, K. R., & Merikangas, J. R. (1995). Comorbidity of depression and other medical conditions. In E. E. Beckham & W. R. Leber (Eds.), Handbook of depression (2nd ed., pp. 147-199). New York: Guilford Press.

Weinstock, L. M., & Whisman, M. A. (2006). Neuroticism as a common feature of the depressive and anxiety disorders: A test ofthe revised integrative hierarchical model in a national sample. Journal of Abnormal Psychology, 115, 68-74.

Whisman, M. A., & Bruce, M. L. (1999). Marital distress and incidence of major depressive episode in a community sample. Journal of Abnormal Psychology, 108, 674-678.

Widiger, T. A., & Samuel, D. B. (2005). Evidence-based assessment of personality disorders. Psychological Assessment, 17, 278-287.

Young, J. E., Klosko, J. S., & Weishaar, M. E. (2003). Schema therapy: A practitioner's guide. New York: Guilford Press.

Zimmerman, M., & Mattia, J. I. (1999). Psychiatric diagnosis in clinical practice: Is comorbidity being missed? Comprehensive Psychiatry, 40, 182-191.

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