Evidence for the cognitive mediational model of cognitive behavioural therapy for depression
Evidence for the cognitive mediational model of cognitive behavioural therapy for depression
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DOI：
10.1017/s0033291708003772
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发表时间：
2008-11-01
影响因子：
6.9
通讯作者：
Bagby, R. M.
中科院分区：
文献类型：
--
作者：
Quilty, L. C.;McBride, C.;Bagby, R. M.
背景虽然认知行为疗法（CBT）作为治疗重度抑郁症（MDD）的有效性的经验支持是建立良好的，其作用机制是不确定的。在这项调查中，我们在一项涉及CBT、人际治疗（IPT）和药物治疗（PHT）的随机对照试验中研究了认知中介模型的证据。130名被诊断患有抑郁症的参与者接受了CBT、IPT或PHT治疗。参与者在治疗前后完成汉密尔顿抑郁量表、贝克抑郁量表- II和功能失调态度量表。认知中介模型，其中功能失调的态度，提出调解抑郁症状的减少，以应对治疗，提供了一个很好的适合的数据时，对比CBT与IPT，结果支持功能失调的态度改变抑郁症状减少的中介作用。并发症模型，其中功能失调的态度提出了抑郁症状减少的后果，提供了一个很好的拟合数据时，对比CBT与PHT，结果支持抑郁症状减少功能失调的态度改变的中介作用。没有证据表明IPT中功能失调的态度变化具有中介作用。伴随CBT和PHT功能失调的态度的变化，然而，经验证据表明，态度在治疗结果中的作用可能会有所不同，这两种治疗。
Background. Although empirical support for the efficacy of cognitive behavioural therapy (CBT) as a treatment for major depressive disorder (MDD) is well established, its mechanism of action is uncertain. In this investigation, we examined evidence for the cognitive mediational model in a randomized control trial involving CBT, interpersonal therapy (IPT) and pharmacotherapy (PHT) in patients with MDD.Method. One hundred and thirty participants diagnosed with MDD were treated with CBT, IPT or PHT. Participants completed the Hamilton Depression Rating Scale, Beck Depression Inventory - II and Dysfunctional Attitudes Scale prior to and following treatment.Results. The cognitive mediational model, in which dysfunctional attitudes are proposed to mediate depressive symptom reduction in response to treatment, provided a good fit to the data when contrasting CBT v. IPT, with results supporting a mediational role for dysfunctional attitude change in depressive symptom reduction. The complication model, in which dysfunctional attitudes are proposed to be a consequence of depressive symptom reduction, provided a good fit to the data when contrasting CBT v. PHT, with results supporting a mediational role for depressive symptom reduction in dysfunctional attitude change.Conclusions. There was no evidence for a mediational role for dysfunctional attitude change in IPT. Changes in dysfunctional attitudes accompanied both CBT and PHT; however, empirical evidence suggests that the role of attitudes in treatment outcome may differ between these two treatments.