Depressive Disorders: Treatment with Nonpharmacological Alternatives

The purpose of this article is to provide a review of current social psychology theories explaining depressive disorders and to describe selected nonpharmacological approaches that may be useful in treating disorders related to these causes. It is essential that providers of health care are alert to the signs and symptoms of depression. For many cases of depression, the presentation is not straightforward. Early recognition by both provider and client is important to the successful treatment of depressive disorders. The cognitive-behavioral and interpersonal therapies discussed in this article may be useful to augment other types of alternative and complementary healing modalities or for clients who prefer nonpharmacological treatment.

Does Negative Mood Influence Self-Report Assessment of Individual and Relational Measures? An Experimental Analysis

The present study was designed to test the influence of negative mood on the self-report of individual and relational correlates of depression and marital distress. The authors applied a combined experimental mood induction procedure, based on music, autobiographical recall, and environmental manipulation. Results showed that the mood manipulation was effective, and the depressed Mood Induction Procedure (MIP) and neutral MIP groups did not differ in their self-rated measures of the above-mentioned variables. In conclusion, the authors argue that these measures are generally insensitive to depressed mood, providing an important contribution to this literature.

Augmenting antidepressant medication treatment of depressed women with emotionally focused therapy for couples: a randomized pilot study

This is the first study to evaluate adding emotionally focused therapy for couples (EFT) to antidepressant medication in the treatment of women with major depressive disorder and comorbid relationship discord. Twenty-four women and their male partners were randomized to 6 months of medication management alone (MM) or MM augmented with EFT (MM + EFT). MM followed the Texas Medication Algorithm Project guidelines. Fifteen EFT sessions were delivered following the EFT treatment manual. The primary outcome was severity of depressive symptoms (assessed by the 30-item Inventory of Depressive Symptomatology-Clinician Rated version [IDS-C(30) ] administrated by evaluators blinded to cell assignment). Secondary outcome was relationship quality as assessed by the Quality of Marriage Index. Results from assessments at intake, termination, and two posttreatment follow-ups were analyzed using growth analysis techniques. IDS-C(30) scores improved over 6 months of treatment, regardless of the treatment assignment, and women receiving MM + EFT experienced significantly more improvement in relationship quality compared with women in MM. Because relationship discord after depression treatment predicts worse outcome, interventions improving relationship quality may reduce depression relapse and recurrence. Testing this hypothesis in larger samples with longer follow-up could contribute to knowledge on the mechanisms involved in determining the course of depressive illness.

An interpersonal perspective on depression: the role of marital adjustment, conflict communication, attributions, and attachment within a clinical sample

Previous studies have focused on the difficulties in psychosocial functioning in depressed persons, underscoring the distress experienced by both spouses. We selected conflict communication, attribution, and attachment as important domains of depression in the context of marital adjustment, and we analyzed two hypotheses in one single study. First, we analyzed whether a clinical sample of couples with a depressed patient would differ significantly from a control group on these variables. Second, we explored to what degree these variables mediate/moderate the relationship between depressive symptoms and marital adjustment. The perspectives of both spouses were taken into account, as well as gender differences. In total, 69 clinical and 69 control couples were recruited, and a series of multivariate analyses of variance and regression analyses were conducted to test both hypotheses. Results indicated that both patients and their partners reported less marital adjustment associated with more negative perceptions on conflict communication, causal attributions, and insecure attachment. In addition, conflict communication and causal attributions were significant mediators of the association between depressive symptoms and marital adjustment for both depressed men and women, and causal attributions also moderated this link. Ambivalent attachment was a significant mediator only for the female identified patients. Several sex differences and clinical implications are discussed.

Cognitive-behavioral therapy for depression. Applications and outcome

This article discusses cognitive-behavioral therapy for depression, including evidence for its efficacy and how to choose between this therapy and antidepressants. The use of this therapy to prevent relapse also is presented.