Depressive Symptoms and Emotion Regulation Following Cognitive Behavioral Therapy

Purpose Past studies demonstrated the efficacy of integrated cognitive-behavioral therapy (CBT) for substance use disorder (SUD) and intimate partner violence (IPV) as well as high rates of depressive symptoms in this population. However, little is known about how depressive symptoms impact treatment outcomes. The authors hypothesized that integrated CBT, but not standard drug counseling (DC), would buffer the negative effects of depressive symptoms on treatment response. Design/methodology/approach A secondary analysis of a randomized trial compared men assigned to 12 weeks of integrated CBT for SUD and IPV (n = 29) to those in DC (n = 34). Findings Most (60%) of the sample reported any depressive symptoms. Controlling for baseline IPV, reporting any depressive symptoms was associated with more positive cocaine screens during treatment. Among men with depressive symptoms, integrated CBT but not DC was associated with fewer positive cocaine screens. Controlling for baseline alcohol variables, integrated CBT and depressive symptoms were each associated with less aggression outside of intimate relationships (family, strangers, etc.) during treatment. For men without depressive symptoms, integrated CBT was associated with less non-IPV aggression compared to DC. Effects were not significant for other substances, IPV, or at follow-up. Research limitations/implications This study found some evidence for differential response to CBT by depressive symptoms on cocaine and aggression at end of treatment, which did not persist three months later. Future studies should explore mechanisms of integrated CBT for SUD and IPV, including mood regulation, on depressive symptoms in real-world samples. Practical implications Integrated CBT buffered depressive symptoms’ impact on cocaine use, yet only improved non-IPV aggression in men without depressive symptoms. Originality/value Although integrated CBT’s efficacy for improving SUD and IPV has been established, moderators of treatment response have not been investigated.

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Cognitive behavioral therapy improves diverse profiles of depressive symptoms in Parkinson's disease

International Journal of Geriatric Psychiatry ◽

10.1002/gps.5077 ◽

2019 ◽

Vol 34 (5) ◽

pp. 722-729 ◽

Cited By ~ 6

Author(s):

Roseanne D. Dobkin ◽

Sarah L. Mann ◽

Alejandro Interian ◽

Michael A. Gara ◽

Matthew Menza

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Depressive Symptoms ◽

Cognitive Behavioral Therapy ◽

Behavioral Therapy ◽

Cognitive Behavioral

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Application of Cognitive-behavioral Therapy in a Case of Obsessive-compulsive Disorder

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.1067 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S644-S644

Author(s):

L. Rodríguez Andrés ◽

A. Rodriguez Campos ◽

I. Sevillano Benito ◽

H. De la Red Gallego ◽

C. Noval Canga ◽

...

Keyword(s):

Depressive Symptoms ◽

Cognitive Behavioral Therapy ◽

Obsessive Compulsive Disorder ◽

Behavioral Therapy ◽

Psychiatric Inpatient ◽

Normal Function ◽

Cognitive Behavioral ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Competing Interest

We present the case report of a 46-year-old woman who experienced obsessive-compulsive symptoms for over twenty years, with multiple relapses, severe depressive symptoms and many hospitalizations in the psychiatric Inpatient Unit. Treatment with different SSRIs, tricyclic antidepressants, atypical antipsychotics and even electroconvulsive therapy were administered with poor results.After her last hospitalization a Cognitive-Behavioral Therapy, including exposure and response prevention and cognitive therapy, is initiated combined with medication, improving depressive symptoms, the ritual behaviors and levels of anxiety.Modern treatments for Obsessive-Compulsive Disorder (OCD) have radically changed how the disorder is viewed. While in the past OCD was regarded as chronic and untreatable, a diagnosis of OCD may now be regarded with hope. Cognitive and behavior therapy and antidepressant medications are currently used to treat the disorder. They can be used to control the symptoms and enable people with OCD to restore normal function in their lives.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Neural predictors and effects of cognitive behavioral therapy for depression: the role of emotional reactivity and regulation

Psychological Medicine ◽

10.1017/s0033291718004154 ◽

2019 ◽

Vol 50 (1) ◽

pp. 146-160 ◽

Cited By ~ 3

Author(s):

Harry Rubin-Falcone ◽

Jochen Weber ◽

Ronit Kishon ◽

Kevin Ochsner ◽

Lauren Delaparte ◽

...

Keyword(s):

Emotion Regulation ◽

Treatment Outcome ◽

Cognitive Behavioral Therapy ◽

Emotional Reactivity ◽

Behavioral Therapy ◽

Occipital Cortex ◽

Neural Correlates ◽

Cognitive Behavioral ◽

Longitudinal Change ◽

Bold Signal

AbstractBackgroundCognitive behavioral therapy (CBT) is an effective treatment for many patients suffering from major depressive disorder (MDD), but predictors of treatment outcome are lacking, and little is known about its neural mechanisms. We recently identified longitudinal changes in neural correlates of conscious emotion regulation that scaled with clinical responses to CBT for MDD, using a negative autobiographical memory-based task.MethodsWe now examine the neural correlates of emotional reactivity and emotion regulation during viewing of emotionally salient images as predictors of treatment outcome with CBT for MDD, and the relationship between longitudinal change in functional magnetic resonance imaging (fMRI) responses and clinical outcomes. Thirty-two participants with current MDD underwent baseline MRI scanning followed by 14 sessions of CBT. The fMRI task measured emotional reactivity and emotion regulation on separate trials using standardized images from the International Affective Pictures System. Twenty-one participants completed post-treatment scanning. Last observation carried forward was used to estimate clinical outcome for non-completers.ResultsPre-treatment emotional reactivity Blood Oxygen Level-Dependent (BOLD) signal within hippocampus including CA1 predicted worse treatment outcome. In contrast, better treatment outcome was associated with increased down-regulation of BOLD activity during emotion regulation from time 1 to time 2 in precuneus, occipital cortex, and middle frontal gyrus.ConclusionsCBT may modulate the neural circuitry of emotion regulation. The neural correlates of emotional reactivity may be more strongly predictive of CBT outcome. The finding that treatment outcome was predicted by BOLD signal in CA1 may suggest overgeneralized memory as a negative prognostic factor in CBT outcome.

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Changes in Judgment Biases and Use of Emotion Regulation Strategies During Cognitive-Behavioral Therapy for Social Anxiety Disorder: Distinguishing Treatment Responders from Nonresponders

Cognitive Therapy and Research ◽

10.1007/s10608-011-9371-1 ◽

2011 ◽

Vol 36 (4) ◽

pp. 261-271 ◽

Cited By ~ 34

Author(s):

David A. Moscovitch ◽

Dubravka L. Gavric ◽

Jessica M. Senn ◽

Diane L. Santesso ◽

Vladimir Miskovic ◽

...

Keyword(s):

Emotion Regulation ◽

Anxiety Disorder ◽

Social Anxiety ◽

Cognitive Behavioral Therapy ◽

Social Anxiety Disorder ◽

Behavioral Therapy ◽

Cognitive Behavioral ◽

Emotion Regulation Strategies ◽

Judgment Biases ◽

Regulation Strategies

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Does Homework “Matter” in Cognitive Behavioral Therapy for Adolescent Depression?

Journal of Cognitive Psychotherapy ◽

10.1891/0889-8391.26.4.390 ◽

2012 ◽

Vol 26 (4) ◽

pp. 390-404 ◽

Cited By ~ 15

Author(s):

Anne D. Simons ◽

C. Nathan Marti ◽

Paul Rohde ◽

Cara C. Lewis ◽

John Curry ◽

...

Keyword(s):

Depressive Symptoms ◽

Cognitive Behavioral Therapy ◽

Clinical Improvement ◽

Adolescent Depression ◽

Behavioral Therapy ◽

Antidepressant Medication ◽

Self Report ◽

Cognitive Behavioral ◽

Homework Completion ◽

Over Time

Objective: Examine the degree to which homework completion is associated with various indices of clinical improvement in adolescents with depression treated with cognitive behavioral therapy (CBT) either as a monotherapy and in combination with antidepressant medication. Method: This study used data from the Treatment of Adolescents with Depression Study (TADS), which compared the efficacy of CBT, fluoxetine (FLX), the combination of CBT and FLX (COMB), and a pill placebo (PBO; TADS Team, 2003, 2004, 2005). Current analyses included only TADS participants in the CBT (n = 111) or COMB (n = 107) conditions. Analyses focused on the relations between partial and full homework completion and a dichotomized measure of clinical response, evaluator and self-report ratings of depressive symptoms, hopelessness, and suicidality. Results: Homework completion significantly predicted clinical improvement, decrease in self-reported hopelessness, suicidality, and depression—but not in evaluator-rated depressive symptoms—in adolescents treated with CBT only. These relationships were almost completely absent in the COMB condition. The only significant COMB finding was that partially completed homework was related to decrease in hopelessness over time. Conclusions: These findings suggest that the ability of therapists and clients to collaboratively develop and complete between-session assignments is associated with response to CBT, self-report of severity of depressive symptoms, hopelessness, and suicidality and may be integral to optimizing the effects of CBT when delivered as a monotherapy.

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