title: EFFECTS OF RELIGIOUS VERSUS STANDARD COGNITIVE-BEHAVIORAL THERAPY ON OPTIMISM IN PERSONS WITH MAJOR DEPRESSION AND CHRONIC MEDICAL ILLNESS.
abstract: BACKGROUND
  We compared the effectiveness of religiously integrated cognitive behavioral therapy (RCBT) versus standard CBT (SCBT) on increasing optimism in persons with major depressive disorder (MDD) and chronic medical illness.
  
  
  METHODS
  Participants aged 18-85 were randomized to either RCBT (n = 65) or SCBT (n = 67) to receive ten 50-min sessions remotely (94% by telephone) over 12 weeks. Optimism was assessed at baseline, 12 and 24 weeks by the Life Orientation Test-Revised. Religiosity was assessed at baseline using a 29-item scale composed of religious importance, individual religious practices, intrinsic religiosity, and daily spiritual experiences. Mixed effects growth curve models were used to compare the effects of treatment group on trajectory of change in optimism.
  
  
  RESULTS
  In the intention-to-treat analysis, both RCBT and SCBT increased optimism over time, although there was no significant difference between treatment groups (B = -0.75, SE = 0.57, t = -1.33, P = .185). Analyses in the highly religious and in the per protocol analysis indicated similar results. Higher baseline religiosity predicted an increase in optimism over time (B = 0.07, SE = 0.02, t = 4.12, P < .0001), and higher baseline optimism predicted a faster decline in depressive symptoms over time (B = -0.61, SE = 0.10, t = -6.30, P < .0001), both independent of treatment group.
  
  
  CONCLUSIONS
  RCBT and SCBT are equally effective in increasing optimism in persons with MDD and chronic medical illness. While baseline religiosity does not moderate this effect, religiosity predicts increases in optimism over time independent of treatment group.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina.|Department of Medicine, Duke University Medical Center, Durham, North Carolina.|Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.|School of Public Health, Ningxia Medical University, Yinchuan, P.R. China.|Center for Spirituality, Theology and Health, Duke University, Durham, North Carolina.
authors.forename: Harold G
authors.initials: HG
authors.lastname: Koenig
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina.|Center for Spirituality, Theology and Health, Duke University, Durham, North Carolina.|School of Medicine, University of Maryland, Baltimore, Maryland.
authors.forename: Michelle J
authors.initials: MJ
authors.lastname: Pearce
authors.affiliation: Department of Research, Glendale Adventist Medical Center, Glendale, California.
authors.forename: Bruce
authors.initials: B
authors.lastname: Nelson
authors.affiliation: Department of Epidemiology, Biostatistics, and Population Medicine, School of Public Health, Loma Linda University, Loma Linda, California.|Allied Health Studies, School of Allied Health Professions, Loma Linda University, Loma Linda, California.
authors.forename: Noha
authors.initials: N
authors.lastname: Daher
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000523:psychology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003865:Major Depressive Disorder / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000067656:Optimism / Q000523:psychology*; D012069:Religion and Psychology; D026443:Spiritual Therapies / Q000379:methods* / Q000523:psychology; D016896:Treatment Outcome; D055815:Young Adult
keywords: chronic disease; cognitive behavioral therapy; depression; optimism; pessimism; religion; spirituality