title: Social problem solving and depressive symptoms over time: a randomized clinical trial of cognitive-behavioral analysis system of psychotherapy, brief supportive psychotherapy, and pharmacotherapy.
abstract: OBJECTIVE
  Depression is associated with poor social problem solving, and psychotherapies that focus on problem-solving skills are efficacious in treating depression. We examined the associations between treatment, social problem solving, and depression in a randomized clinical trial testing the efficacy of psychotherapy augmentation for chronically depressed patients who failed to fully respond to an initial trial of pharmacotherapy (Kocsis et al., 2009).
  
  
  METHODS
  Participants with chronic depression (n = 491) received cognitive-behavioral analysis system of psychotherapy (CBASP; McCullough, 2000), which emphasizes interpersonal problem solving, plus medication; brief supportive psychotherapy (BSP) plus medication; or medication alone for 12 weeks.
  
  
  RESULTS
  CBASP plus pharmacotherapy was associated with significantly greater improvement in social problem solving than BSP plus pharmacotherapy, and a trend for greater improvement in problem solving than pharmacotherapy alone. In addition, change in social problem solving predicted subsequent change in depressive symptoms over time. However, the magnitude of the associations between changes in social problem solving and subsequent depressive symptoms did not differ across treatment conditions.
  
  
  CONCLUSIONS
  It does not appear that improved social problem solving is a mechanism that uniquely distinguishes CBASP from other treatment approaches.
authors.affiliation: Department of Psychology, Stony Brook University, Stony Brook, NY 11794-2500, USA. daniel.klein@stonybrook.edu
authors.forename: Daniel N
authors.initials: DN
authors.lastname: Klein
authors.forename: Andrew C
authors.initials: AC
authors.lastname: Leon
authors.forename: Chunshan
authors.initials: C
authors.lastname: Li
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: D'Zurilla
authors.forename: Sarah R
authors.initials: SR
authors.lastname: Black
authors.forename: Dina
authors.initials: D
authors.lastname: Vivian
authors.forename: Frank
authors.initials: F
authors.lastname: Dowling
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Arnow
authors.forename: Rachel
authors.initials: R
authors.lastname: Manber
authors.forename: John C
authors.initials: JC
authors.lastname: Markowitz
authors.forename: James H
authors.initials: JH
authors.lastname: Kocsis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003131:Combined Modality Therapy; D003863:Depression / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D003866:Depressive Disorder / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011340:Problem Solving; D011614:Psychotherapy, Brief / Q000379:methods*; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D012938:Social Perception; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents; D017367:Selective Serotonin Reuptake Inhibitors