title: Exploring mechanisms of change: the relationships between cognitions, symptoms, and quality of life over the course of group cognitive-behaviour therapy.
abstract: BACKGROUND
  This study aimed to explain how quality of life changes during psychotherapy, using a cognitive-behavioural theoretical framework, and examined whether changes in symptoms or changes in cognitions were more influential with regard to quality of life change. Three different hypotheses were tested that might explain the mechanisms by which quality of life changes during group cognitive-behaviour therapy (CBT) for anxiety and depression.
  
  
  METHODS
  127 outpatients with anxiety and/or depression enrolled in a four-week group CBT programme participated. Measures of anxiety and depression symptoms, cognitive change, and quality of life were administered at baseline and post-treatment. Baseline to post-treatment change scores were calculated and entered into multiple regression analyses.
  
  
  RESULTS
  Reductions in anxiety and depression symptoms were related to increases in quality of life, whereas cognitive changes were not consistently related to changes in quality of life.
  
  
  CONCLUSIONS
  The main limitation was that the study׳s design was not able to assess whether changes in cognitions or symptoms preceded changes in quality of life, as all variables were measured at the same two points in time.
  
  
  CONCLUSIONS
  These results provided evidence that quality of life changes as a result of or, simultaneously with, symptom change. It appears that group CBT does not improve quality of life through strategies designed to change patients׳ cognitions.
authors.affiliation: School of Psychology, The University of Queensland, Brisbane, Queensland, Australia; CBT Unit, Toowong Private Hospital, PO Box 882, Toowong, Brisbane, Queensland, Australia. Electronic address: oei@psy.uq.edu.au.
authors.forename: Tian Po S
authors.initials: TP
authors.lastname: Oei
authors.affiliation: School of Psychology, The University of Queensland, Brisbane, Queensland, Australia.
authors.forename: Niamh M
authors.initials: NM
authors.lastname: McAlinden
authors.affiliation: School of Psychology, The University of Queensland, Brisbane, Queensland, Australia.
authors.forename: Tegan
authors.initials: T
authors.lastname: Cruwys
mesh_terms: D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000523:psychology* / Q000628:therapy*; D003071:Cognition / Q000502:physiology*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003866:Depressive Disorder / Q000523:psychology* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011615:Psychotherapy, Group; D011788:Quality of Life / Q000523:psychology*; D012044:Regression Analysis; D055815:Young Adult
keywords: Anxiety; Cognitive theory; Component analysis; Depression; Mechanisms of change; Psychotherapy