title: The Techniques for Overcoming Depression Questionnaire: Mokken Scale Analysis, Reliability, and Concurrent Validity in Depressed Cardiac Patients.
abstract: OBJECTIVE
  The Techniques for Overcoming Depression (TOD) questionnaire assesses the frequency with which patients being treated for depression use cognitive-behavioral techniques in daily life. This study examined its latent structure, reliability and concurrent validity in depressed cardiac patients.
  
  
  METHODS
  The TOD was administered at the initial and final treatment sessions in three trials of cognitive behavior therapy (CBT) (n = 260) for depression in cardiac patients. Mokken scaling was used to determine its dimensionality.
  
  
  RESULTS
  The TOD is unidimensional in depressed cardiac patients, both at the initial evaluation (H = .46) and the end of treatment (H = .47). It is sensitive to change and the total score correlates with therapist ratings of the patient's socialization to CBT (r=.40, p<.05), homework adherence (r=0.36, p<0.05), and use of cognitive-behavioral techniques (r=.51, p<.01). TOD scores were associated with post-treatment depression scores in two of the trials (p<.01 in both analyses).
  
  
  CONCLUSIONS
  The TOD is a unidimensional, reliable, valid, and clinically informative measure of self-reported use of cognitive-behavioral techniques for overcoming depression in cardiac patients. Studies of the TOD in other depressed patient populations are needed.
authors.affiliation: Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri USA.
authors.forename: Kenneth E
authors.initials: KE
authors.lastname: Freedland
authors.affiliation: Universidad EAFIT, Medellín, Colombia.
authors.forename: Mariantonia
authors.initials: M
authors.lastname: Lemos
authors.affiliation: Division of Population Health Sciences (Psychology), Royal College of Surgeons in Ireland, Dublin, Ireland.
authors.forename: Frank
authors.initials: F
authors.lastname: Doyle
authors.affiliation: Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri USA.
authors.forename: Brian C
authors.initials: BC
authors.lastname: Steinmeyer
authors.affiliation: Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri USA.
authors.forename: Iris
authors.initials: I
authors.lastname: Csik
authors.affiliation: Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri USA.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Carney
keywords: cognitive therapy; depressive disorder; heart diseases; patient compliance; psychometrics; questionnaires