Cognitive reactivity, dysfunctional attitudes, and depressive relapse and recurrence in cognitive therapy responders
Cognitive reactivity, dysfunctional attitudes, and depressive relapse and recurrence in cognitive therapy responders
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DOI：
10.1016/j.brat.2012.01.008
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发表时间：
2012-05-01
影响因子：
4.1
通讯作者：
Thase, Michael E.
中科院分区：
文献类型：
--
作者：
Jarrett, Robin B.;Minhajuddin, Abu;Thase, Michael E.
不正常的态度可以预示抑郁症的复发。通过归纳范式，启动情绪被假设激活功能失调的态度。认知反应性（CR）是指启动后与情绪相关的功能失调态度的增加。在这里，我们探讨了CR以及残余的、未启动的、功能失调的态度在多大程度上预测了对急性期认知治疗（CT）有反应的抑郁症患者的抑郁复发/复发。年龄在18-70岁的复发性重度抑郁症患者（n = 523）自愿参加了一项检查继续期治疗持久性的双中心随机对照试验。患者接受16-20次CT检查。在245名未完全缓解的应答者中，213人同意接受情绪诱导范式。在8个月的持续治疗后，参与者被额外随访了24个月。虽然情绪诱导显著降低了80%的应答者的情绪，但预期的CR并不明显。相比之下，CT后较高的未启动功能障碍态度确实预测了随机化后20和32个月的复发/复发。这项对未完全缓解的CT应答者进行的大型纵向研究的结果挑战了这样一种观点，即为了最大限度地预测功能失调态度的复发和/或复发，有必要启动情绪。虽然研究结果不能推广到CT应答者之外，但他们强调了减少功能失调态度在预防抑郁症中的临床重要性。(C) 2012 Elsevier Ltd.版权所有。
Dysfunctional attitudes can foreshadow depressive relapse/recurrence. Priming mood, through induction paradigms, is hypothesized to activate dysfunctional attitudes. Cognitive reactivity (CR) refers to mood-linked increases in dysfunctional attitudes after priming. Here we explored the extent to which CR as well as residual, unprimed, dysfunctional attitudes predicted depressive relapse/recurrence among depressed patients who responded to acute phase cognitive therapy (CT). Consenting adults, aged 18-70, with recurrent major depressive disorder (n = 523) participated in a two-site randomized controlled trial examining the durability of continuation phase treatments. Patients received 16-20 sessions of CT. Among the 245 incompletely remitted responders, 213 agreed to undergo a mood induction paradigm. After 8 months of continuation phase treatments, participants were followed an additional 24 months. Although the mood induction significantly lowered mood in 80% of responders, the expected CR was not evident. By contrast, higher unprimed dysfunctional attitudes following CT did predict relapse/recurrence over 20 and 32 months post-randomization. The findings of this large longitudinal study of incompletely remitted CT responders challenge the notion that it is necessary to prime mood in order to maximize dysfunctional attitudes' prediction of relapse and/or recurrence. While findings cannot be generalized beyond CT responders, they emphasize the clinical importance of reducing dysfunctional attitudes in preventing depression. (C) 2012 Elsevier Ltd. All rights reserved.