Autonomous and controlled motivation and interpersonal therapy for depression: moderating role of recurrent depression.
OBJECTIVE
We examined the moderating role of depression recurrence on the relation between autonomous and controlled motivation and interpersonal therapy (IPT) treatment outcome.


METHODS
The investigation was conducted in an out-patient mood disorders clinic of a large university-affiliated psychiatric hospital. The sample represents a subset of a larger naturalistic database of patients seen in the clinic.


METHODS
We examined 74 depressed out-patients who received 16 sessions of IPT. The Beck Depression Inventory-II, administered at pre-treatment and post-treatment, served as a measure of depressive severity. Measures of motivation and therapeutic alliance were collected at the third session.


RESULTS
In the entire sample, both the therapeutic alliance and autonomous motivation predicted higher probability of achieving remission; however, the relation differed for those with highly recurrent depression compared to those with less recurrent depression. For those with highly recurrent depression, the therapeutic alliance predicted remission whereas autonomous motivation had no effect on remission. For those with less recurrent depression, both autonomous motivation and the therapeutic alliance predicted better achieving remission. Controlled motivation emerged as a significant negative predictor of remission across both groups.


CONCLUSIONS
Taken together, these results highlight the possible use of motivation theory to inform and enrich therapeutic conceptualizations and interventions in clinical practice, but also point to the importance of modifying interventions based on the chronicity of a client's depression.
McBride
Carolina
C
Centre for Addiction and Mental Health and Department of Psychiatry, University of Toronto, Ontario, Canada. carolina_mcbride@camh.net
Zuroff
David C
DC
Ravitz
Paula
P
Koestner
Richard
R
Moskowitz
Debbie S
DS
Quilty
Lena
L
Bagby
R Michael
RM
D000328:Adult; D000553:Ambulatory Care; D002908:Chronic Disease; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D005260:Female; D006778:Hospitals, Psychiatric; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010349:Patient Compliance / Q000523:psychology; D010358:Patient Participation; D026684:Personal Autonomy; D010555:Personality Inventory; D011369:Professional-Patient Relations; D011613:Psychotherapy / Q000379:methods*; D055502:Secondary Prevention; D016896:Treatment Outcome