Cognitive and psychodynamic mechanisms of change in treated and untreated depression.
Two patient-level mechanisms of change, defenses, and cognition were tested over 3 time points in 65 depressed adults, approximately half receiving treatment. Early changes in automatic thoughts and immature defenses were associated with symptom change from time-one to time-three. The directionality of early automatic thought change predicting symptom change was partially supported, but immature defense change occurs simultaneously with, or after, symptom change. Given the convergent evidence of cognitive change as a mediator of depression reduction, all depression therapies should consider how they address depressive cognition. To build a more complete understanding of how to ameliorate depression, future studies should continue to include constructs from multiple theories and have measures of therapy process in addition to patient level mechanisms.
Coleman
Daniel
D
Portland State University, Portland OR 97207, USA. dcoleman@pdx.edu
Cole
Diane
D
Wuest
Leslie
L
D000328:Adult; D015928:Cognitive Behavioral Therapy; D003674:Defense Mechanisms; D003863:Depression / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders; D011582:Psychological Theory; D012106:Research; D016896:Treatment Outcome