Conclusions

In this chapter, we have described how to reduce the likelihood of relapse using C-CT for adults with recurrent MDD. We have outlined the theoretical model that serves as the foundation of C-CT and discussed assessment for and implementation of C-CT. Finally, we have provided a review of the empirical support for C-CT in preventing relapse.

Although we have no data on the concurrent use of C-CT plus pharmacotherapy, we think it is a reasonable treatment option for patients who do not achieve complete remission and/or recovery with C-CT alone. We look forward to promoting opportunities to apply and adapt what we have learned in working with adults with recurrent depression to preventing relapse and recurrence effectively and to promoting remission and recovery in other at-risk groups, including adolescents and children (see Kennard, Stewart, Hughes, Jarrett, & Emslie, in press, for initial efforts).

ACKNOWLEDGMENTS

We are grateful to Robin Jarrett's patients and team at The University of Texas Southwestern Medical Center (Psychosocial Research and Depression Clinic in the Department of Psychiatry), where the data we detail were collected. Our thanks to Amy McSpadden, BS, for her careful manuscript preparation. We appreciate the support provided by the National Institute of Mental Health that made this work and writing possible (Grant Nos. R01-MH-38238, R01-MH-58397, and K24-01571 [to Robin B. Jarrett, PhD]).

REFERENCES

Baldessarini, R. J., Tondo, L., Faedda, G. L., Suppes, T. R., Floris, G., & Rudis, N. (1996). Effects of the rate of discontinuing lithium maintenance treatment in bipolar disorders. Journal of Clinical Psychiatry, 57, 441—448. Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioral change.

Psychological Review, 2, 191—215. 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). Manual for the BDI-II. San Antonio,

TX: Psychological Corporation. Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561— 571.

Beck, J. S. (1995). Cognitive therapy: Basics and beyond. New York: Guilford Press. Blackburn, I. M., & Moore, R. G. (1997). Controlled acute and follow-up trial of cognitive therapy and pharmacotherapy in outpatients with recurrent depression. British Journal of Psychiatry, 171, 328—334. Bockting, C. L., Schene, A. H., Spinhoven, P., Koeter, M. W, Wouters, L. F., Huyser, J., et al. (2005). Preventing relapse/recurrence in recurrent depression with cognitive therapy: A randomized controlled trial. Journal of Consulting and Clinical Psychology, 73, 647—657. Clarke, G. N., Rohde, P., Lewmsohn, P. M., Hops, H., & Seeley, J. R. (1999). Cognitive-behavioral treatment of adolescent depression: Efficacy of acute treatment and booster sessions. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 272—279. Elkin, I., Shea, M. T., Watkins, J. T., Imber S. D., Sotsky, S. M., Collins, J. F, et al. (1989). National Institute ofMental Health Treatment of Depression Collabo rative Research Program: General effectiveness of treatments. Archives of General Psychiatry, 46, 971-982.

Fava, G. A., Grandi, S., Zielezny, M., Rafanelli, C., & Canestrari, R. (1996). Four-year outcome for cognitive behavioral treatment of residual symptoms in major depression. American Journal of Psychiatry, 153, 945-947.

Ferster, C. B. (1973). A functional analysis of depression. American Psychologist, 28, 856-870.

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.

Hamilton, M. (1960). A rating scale for depression. Journal of Neurology, Neurosurgery, and Psychiatry, 23, 56-61.

Hayes, S. C., Barlow, D. H., & Nelson-Gray, R. O. (1999). The scientist practitioner: Research and accountability in the age of managed care. Boston: Allyn & Bacon.

Hirschfeld, R. M. A., Williams, J. B. W, Spitzer, R. L., Calabrese, J. R., Flynn, L., Keck, P. E., Jr., et al. (2000). Development and validation of a screening instrument for bipolar spectrum disorder: The Mood Disorder Questionnaire. American Journal of Psychiatry, 157, 1873-1875.

Jarrett, R. B. (1989). Cognitive therapy for recurrent unipolar major depressive disorder: The continuation/maintenance phase. Unpublished treatment manual, University of Texas Southwestern Medical Center at Dallas.

Jarrett, R. B. (1995). Comparing and combining short-term psychotherapy and pharmacotherapy for depression. In E. E. Beckham & W R. Leber (Eds.), Handbook of depression: Treatment, assessment, and research. New York: Guilford Press.

Jarrett, R. B., Basco, M. R., Risser, R., Ramanan, J., Marwill, M., Kraft, D., et al. (1998). Is there a role for continuation-phase cognitive therapy for depressed outpatients? Journal of Consulting and Clinical Psychology, 66, 1036-1040.

Jarrett, R. B., Gershenfeld, H. K., Borman, P. D., Williams, M. J., Friedman, E. S., & Thase, M. E. (2003, November). Cognitive reactivity and depressive relapse: Early signals from a randomized clinical trial. Paper presented at the meeting of the Association for Advancement of Behavioral Therapy, Boston, MA.

Jarrett, R. B., & Kraft, D. (1997). Prophylactic cognitive therapy for major depressive disorder. In Session, 3, 65-79.

Jarrett, R. B., & Kraft, D. (1998). Cognitive Therapy Skills Rating Scale—Patient and Observer Version. Unpublished instruments, The University of Texas Southwestern Medical Center at Dallas.

Jarrett, R. B., Kraft, D., Doyle, J., Foster, B. M., Eaves, G. G., & Silver, P. C. (2001). Preventing recurrent depression using cognitive therapy with and without a continuation phase: A randomized clinical trial. Archives of General Psychiatry, 58, 381-388.

Jarrett, R. B., Vittengl,J. R., & Clark, L. A. (2005, November). Which patients require continuation-phase cognitive therapy for depression?: Levels of residual symptoms pro mote empirical practice and informed consent. Paper presented at the meeting of the Association for Behavioral and Cognitive Therapies, Washington, DC.

Keller, M. B., Lavori, P. W, Friedman, B., Nielsen, E., Endicott, J., et al. (1987). The Longitudinal Interval Follow-Up Evaluation: A comprehensive method for assessing outcome in prospective longitudinal studies. Archives of General Psychiatry, 44, 540-548.

Kennard, B., Stewart, S. M., Hughes, J. L., Jarrett, R. B., & Emslie, G. S. (in press). Developing cognitive behavioral therapy to prevent depressive relapse in youth. Cognitive and Behavioral Practice.

Klein, D. N., Santiago, N. J., Vivian, D., Arnow, B. A., Blalock, J. A., Dunner, D. L., et al. (2004). Cognitive-behavioral analysis system of psychotherapy as a maintenance treatment for chronic depression. Journal of Consulting and Clinical Psychology, 72, 681-688.

Klerman, G. L., DiMascio, A., Weissman, M., Prusoff, B., & Paykel, E. S. (1974). Treatment ofdepression by drugs and psychotherapy. American Journal ofPsychi-atry, 131, 186-191.

Klerman, G. L., Weissman, M. M., Rounsaville, B. J., & Chevron, E. S. (1984). Interpersonal psychotherapy of depression. New York: Basic Books.

Kroenke, K., & Spitzer, R. L. (2002). The PHQ-9: A new depression diagnostic and severity measure. Psychiatric Annals, 32, 509-515.

Kroenke, K., Spitzer, R. L., & Williams, J. B. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16, 606-613.

Kroll, L., Harrington, R., Jayson, D., Fraser, J., & Gowers, S. (1996). Pilot study of continuation cognitive-behavioral therapy for major depression in adolescent psychiatric patients. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 1156-1161.

Ma, S. H., & Teasdale, J. D. (2004). Mindfulness-based cognitive therapy for depression: Replication and exploration of differential relapse prevention effects. Journal of Consulting and Clinical Psychology, 72, 31-40.

Martell, C. R., Addis, M., & Jacobson, N. (2001). Depression in context: Strategies for guided action. New York: Norton.

Miller, P. R., Dasher, R., Collins, R., Griffiths, P., & Brown, F. (2001). Inpatient diagnostic assessments: 1. Accuracy of structured vs. unstructured interviews. Psychiatry Research, 105, 255-264.

Paykel, E. S., Scott, J., Teasdale, J. D., Johnson, A. L., Garland, A., Moore, R., et al. (1999). Prevention of relapse in residual depression by cognitive therapy: A controlled trial. Archives of General Psychiatry, 56, 829-835.

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

Rush, A. J., Giles, D. E., Schlesser, M. A., Fulton, C. L., Weissenburger, J. E., & Burns, C. T. (1986). The Inventory for Depressive Symptomatology (IDS): Preliminary findings. Psychiatry Research, 18, 65-87.

Rush, A. J., Gullion, C. M., Basco, M. R.,Jarrett, R. B., & Trivedi, M. H. (1996), The

Inventory of Depressive Symptomatology (IDS): Psychometric properties. Psychological Medicine, 26, 477—486.

Rush, A. J., Trivedi, M. H., Ibrahim, H. M., Carmody, T. J., Arnow, B., Klein, D. N., et al. (2003). The 16-item Quick Inventory of Depressive Symptomatology (QIDS), Clinician Rating (QIDS-C), and Self-Report (QIDS-SR): A psychometric evaluation in patients with chronic major depression. Biological Psychiatry, 54, 573-583.

Spitzer, R. L., Kroenke, K., & Williams, J. B. W (1999). Validation and utility of a self-report version of PRIME-MD: The PHQ Primary Care Study. Journal of the American Medical Association, 282, 1737-1744.

Spitzer, R. L., Williams, J. B., Gibbon, M., & First, M. B. (1992). The Structured Clinical Interview for DSM-III-R (SCID): I. History, rationale, and description. Archives of General Psychiatry, 49, 624-629.

Spitzer, R. L., Williams, J. B. W, Kroenke, K., Linzer, M., deGruy, F V, Hahn, S. R., et al. (1994). Utility of a new procedure for diagnosing mental disorders in primary care: The PRIME-MD 1000 study. Journal of the American Medical Association, 272, 1749-1756.

Teasdale, J. D., Segal, Z. V, Williams, J. M. G., Ridgeway, V. A., Soulsby, J. M., & Lau, M. A. (2000). Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Journal of Consulting and Clinical Psychology, 68, 615-623.

Thase,M. E., Simons, A. D.,McGeary,J., Cahalane,J. F, Hughes, C., Harden, T., et al. (1992). Relapse after cognitive behavior therapy of depression: Potential implications for longer courses of treatment. American Journal of Psychiatry, 149, 1046-1052.

Trivedi, M. H., Rush, A. J., Ibrahim, H. M., Carmody, T. J., Biggs, M. M., Suppes, T., et al. (2004). The Inventory of Depressive Symptomatology, Clinician Rating (IDS-C) and Self-Report (IDS-SR), and the Quick Inventory of Depressive Symptomatology, Clinician Rating (QIDS-C) and Self-Report (QIDS-SR) in public sector patients with mood disorders: A psychometric evaluation. Psychological Medicine, 34, 73-82.

Vittengl, J. R., Clark, L. A., Dunn, T. W, & Jarrett, R. B. (2007). Reducing relapse and recurrence in unipolar depression: A comparative meta-analysis of cognitive therapy's effects. Journal of Consulting and Clinical Psychology, 75,475-488.

Vittengl, J. R., Clark, L. A., Kraft, D., & Jarrett, R. B. (2005). Multiple measures, methods, and moments: A factor-analytic investigation of change in depressive symptoms during A-CT. Psychological Medicine, 35, 693-704.

Young, J., & Beck, A. T. (1980). Cognitive Therapy Scale: Rating manual. Philadelphia: Center for Cognitive Therapy.

Zanarini, M. C., Skodol, A. E., Bender, D., Dolan, R., Sanislow, C., Schaefer, E., et al. (2000). The Collaborative Longitudinal Personality Disorders Study: Reliability of Axis I and II disorders. Journal of Personality Disorders, 14, 291-299.

Beat Depression Now

Beat Depression Now

Let me be up front. My intention is to sell you something. Normally, it's not wise to come out and say that. However, I can do so because I have such an incredible deal for you that you'd be crazy to pass on it.

Get My Free Ebook


Post a comment