ABSTRACT
This study examined the effects of cognitive-behavior therapy (CBT) compared with traditional behavior therapy (exposure and response prevention [ERP]) in the group treatment of obsessive-compulsive disorder. Of the 76 participants who started treatment, 38 were wait-listed for 3 months before treatment to assess possible course effects. Both treatments were superior to the control condition in symptom reduction, with ERP being marginally more effective than CBT by end of treatment and again at 3-month follow-up. In terms of clinically significant improvement, treatment groups were equivalent on the conclusion of treatment, but 3 months later significantly more ERP participants met criteria for recovered status. Only 1 of 7 belief measures changed with treatment improvement, and the extent of this cognitive change was similar between CBT and ERP groups. Discussion includes consideration of optimal formats for the delivery of different types of treatment.
Subject(s)
Behavior Therapy , Cognitive Behavioral Therapy , Obsessive-Compulsive Disorder/therapy , Psychotherapy, Group , Adolescent , Adult , Desensitization, Psychologic , Female , Humans , Male , Middle Aged , Obsessive-Compulsive Disorder/diagnosis , Obsessive-Compulsive Disorder/psychology , Treatment OutcomeABSTRACT
BACKGROUND: Individuals with major depression frequently have panic attacks, and often panic disorder, but rarely have researchers studied the impact of comorbidity of panic on the outcome of psychological treatment of depression. METHODS: In this study, patients with comorbid panic and depression were first treated with cognitive-behavioral therapy (CBT) for panic. Depression symptoms in this treated group were compared to a group of patients with major depression who were on a minimal therapist contact waitlist. In the second phase of the study, patients in both groups (comorbid and depression-only) were treated with CBT for depression. RESULTS: CBT for panic had little effect on co-existing depression, suggesting a specificity of action for CBT directed at different disorders. In addition, the presence of current or recently remitted panic attacks or agoraphobic avoidance did not interfere with the outcome of CBT for depression. CONCLUSION: These findings stand in contrast to previous studies showing greater linkage between depression and panic in treatment outcome. LIMITATIONS: While there are implications for treatment planning, these conclusions may be limited by the exclusion criteria and the highly structured treatment approach of separating treatment for panic from treatment for depression.
Subject(s)
Cognitive Behavioral Therapy/methods , Depressive Disorder, Major/complications , Depressive Disorder, Major/therapy , Panic Disorder/complications , Panic Disorder/therapy , Adult , Depressive Disorder, Major/diagnosis , Female , Humans , Male , Panic Disorder/diagnosis , Psychiatric Status Rating Scales , Severity of Illness IndexABSTRACT
Panic disorder and major depression frequently coexist, yet the implications of comorbidity for psychological treatments have rarely been studied. The objective of this study was to evaluate whether pretreatment comorbidity of major depression affects the outcome of cognitive-behavioral treatment (CBT) of panic disorder. Thirty-seven clients who met diagnostic criteria for both panic and major depression participated in 10 sessions of individual CBT for panic. Treatment outcome was contrasted with the outcome of 53 clients having only panic disorder who received the same treatment. The co-occurrence of depression did not adversely affect CBT for panic. These results have implications for clinical practice and theoretical implications for the nature of the relationship between panic and depression.
Subject(s)
Agoraphobia/therapy , Cognitive Behavioral Therapy , Depressive Disorder, Major/therapy , Panic Disorder/therapy , Adult , Agoraphobia/diagnosis , Agoraphobia/psychology , Comorbidity , Depressive Disorder, Major/diagnosis , Depressive Disorder, Major/psychology , Female , Humans , Male , Middle Aged , Panic Disorder/diagnosis , Panic Disorder/psychology , Personality Inventory , Treatment OutcomeABSTRACT
This study represents a 2.25-year follow-up to a treatment study reported earlier (McLean & Hakstian, 1979) in which 121 unipolar depressed outpatients were treated by either (a) nondirective psychotherapy, (b) behavior therapy, (c) pharmacotherapy, or (d) relaxation therapy. A nondepressed, normal control group was evaluated on the same 28 measures and 6 intervals for contrast purposes. Behavior therapy patients alone were significantly improved in the areas of mood, personal productivity, and social activity, relative to treatment control patients over the follow-up period. Also, twice as many behavior therapy patients (i.e., 64%) fell within one standard deviation of the normal, nondepressed control group distribution on depressed mood, compared with non-directive psychotherapy and pharmacotherapy patients, when scores were aggregated across the 6 assessment points.
Subject(s)
Amitriptyline/therapeutic use , Behavior Therapy , Depressive Disorder/therapy , Psychotherapy , Relaxation Therapy , Adult , Depressive Disorder/psychology , Female , Follow-Up Studies , Humans , Longitudinal Studies , Male , Middle AgedSubject(s)
Depression/therapy , Education, Medical, Continuing , Physicians, Family , Psychotherapy/education , Counseling , Female , Humans , MaleABSTRACT
Ss with a strong fear of snakes were taught to increase and decrease their skin resistance during practice sessions with a continuous visual display. Ss were not aware that they were increasing or decreasing their levels of skin resistance and attempted only to influence the magnitude of the multimeter display, the polarity of which was controlled by the experimenter. The study used a within-subjects reversal design to investigate whether bidirectional control could be acquired over skin resistance level. To investigate whether this acquired control could affect the magnitude of elicited pre-conditioned autonomic responses, a pre- and post-training comparison was made between the GSRs elicited during test sessions in which Ss viewed slides of snakes while attempting to influence their electrodermal activity with the assistance of the visual display. The results suggest that Ss are able to acquire voluntarily bidirectional control of their level of skin resistance with continuous visual feedback and that this control can either depress or facilitate the magnitude of pre-conditioned emotional responses as a function of visual feedback.
