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Werson AD, Meiser-Stedman R, Laidlaw K. A meta-analysis of CBT efficacy for depression comparing adults and older adults. J Affect Disord 2022; 319:189-201. [PMID: 36113691 DOI: 10.1016/j.jad.2022.09.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 09/03/2022] [Accepted: 09/11/2022] [Indexed: 11/16/2022]
Abstract
INTRODUCTION This meta-analysis investigates CBT treatment efficacy fordepression, and compares outcomes between adults (young and middle aged) and older adults (OA). METHODOLOGY Effect sizes (Hedges' g) were obtained from 37 peer-reviewed RCTs, 25 adult papers (participant n = 2948) and 12 OA papers (participant n = 551), and analysed with the random effects model. RESULTS No significant difference between age groups is reported in terms of CBT efficacy for depression compared to other treatments (Qbetween (1) = 0.06, p = .89), with the overall effect favouring CBT over any other treatments (g = 0.48, 95 % CI = 0.29-0.68). The same pattern of results was found when restricting studies to those which used active control conditions (Qbetween (1) = 0.03, p = .86) or passive control conditions (Q (1) = 2.45, p = .12). DISCUSSION No significant differences in efficacy for CBT treatment for depression are found when comparing adults and OA. CBT is as efficacious with OA as with adults.
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Affiliation(s)
- Alessa D Werson
- Norwich Medical School, University of East Anglia, United Kingdom; Department of Psychology: College of Life and Environmental Sciences, University of Exeter, United Kingdom.
| | - Richard Meiser-Stedman
- Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, United Kingdom
| | - Ken Laidlaw
- Department of Psychology: College of Life and Environmental Sciences, University of Exeter, United Kingdom
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2
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Recht S, Jovanovic L, Mamassian P, Balsdon T. Confidence at the limits of human nested cognition. Neurosci Conscious 2022; 2022:niac014. [PMID: 36267224 PMCID: PMC9574785 DOI: 10.1093/nc/niac014] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 09/14/2022] [Indexed: 11/18/2022] Open
Abstract
Metacognition is the ability to weigh the quality of our own cognition, such as the confidence that our perceptual decisions are correct. Here we ask whether metacognitive performance can itself be evaluated or else metacognition is the ultimate reflective human faculty. Building upon a classic visual perception task, we show that human observers are able to produce nested, above-chance judgements on the quality of their decisions at least up to the fourth order (i.e. meta-meta-meta-cognition). A computational model can account for this nested cognitive ability if evidence has a high-resolution representation, and if there are two kinds of noise, including recursive evidence degradation. The existence of fourth-order sensitivity suggests that the neural mechanisms responsible for second-order metacognition can be flexibly generalized to evaluate any cognitive process, including metacognitive evaluations themselves. We define the theoretical and practical limits of nested cognition and discuss how this approach paves the way for a better understanding of human self-regulation.
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Affiliation(s)
| | | | | | - Tarryn Balsdon
- *Correspondence address. School of Psychology and Neuroscience, University of Glasgow, Scotland G12 8QB, UK. E-mail:
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3
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Does childhood emotional abuse moderate the effect of cognitive behavioral analysis system of psychotherapy versus meta-cognitive therapy in depression? A propensity score analysis on an observational study. J Affect Disord 2022; 300:71-75. [PMID: 34952120 DOI: 10.1016/j.jad.2021.12.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 11/20/2021] [Accepted: 12/19/2021] [Indexed: 10/19/2022]
Abstract
Background Cognitive Behavioral Analysis System of Psychotherapy (CBASP) and Metacognitive Therapy (MCT) are effective for depression. CBASP might offer most benefit in patients reporting childhood emotional abuse (CEA). This needs to be confirmed in real-world settings and in comparisons with depression-specific psychotherapies. This study examines the moderating influence of CEA on the effectiveness of CBASP versus MCT. Methods In this observational study, we recruited patients treated with either CBASP or MCT in an intensive day treatment program for depression. CEA was assessed using the Childhood Trauma Questionnaire (CTQ). Patients reported symptoms weekly using the Quick Inventory of Depressive Symptoms (QIDS-SR). Mixed model analysis was run on the Intention to Treat dataset (ITT) using propensity matching to overcome baseline imbalances. Results A total of 141 patients were included in the analysis (MCT n = 78, CBASP n = 63). CEA moderated the treatment effect (time x CEA x treatment: β = 0.03, SE = 0.01, p = 0.014). Post-hoc analyses revealed that CBASP was more effective than MCT in patients without CEA (time x treatment: β = -0.01, SE = 0.007, p = .045). The difference between CBASP and MCT was not statistically significant for patients with CEA (β = 0.015, SE = 0.008, p = .11). Limitations Because of non-random treatment allocation the differences between CBASP and MCT can be due to unobserved baseline imbalances. Conclusions Our findings suggest that in patients reporting CEA, CBASP might not offer additional benefits above other depression-specific psychotherapies. Public Health Significance Statements This study shows that, on average, individuals with depression benefit equally from CBASP and MCT under the conditions of routine practice. Yet, CBASP was more effective than MCT for those without childhood emotional abuse. If childhood emotional abuse was present, CBASP and MCT were equally effective.
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4
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Carter JD, Jordan J, McIntosh VV, Frampton CM, Lacey C, Porter RJ, Mulder RT. Long-term efficacy of metacognitive therapy and cognitive behaviour therapy for depression. Aust N Z J Psychiatry 2022; 56:137-143. [PMID: 34250846 DOI: 10.1177/00048674211025686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To examine the two-year outcomes for depression, anxiety, cognitive and global social functioning after cognitive behavioural therapy (CBT) and metacognitive therapy (MCT) for depression. METHOD Participants were 31 adults with a diagnosis of major depressive disorder in a randomised pilot study comparing MCT and CBT. Therapy modality differences in change in depression and anxiety symptoms, dysfunctional attitudes, metacognitions, rumination, worry and global social functioning were examined at the two-year follow-up for those who completed therapy. RESULTS Significant improvements, with large effect sizes, were evident for all outcome variables. There were no significant differences in outcome between CBT and MCT. The greatest change over time occurred for depression and anxiety. Large changes were evident for metacognitions, rumination, dysfunctional attitudes, worry and global social functioning. Sixty-seven percent had not experienced a major depression and had been well during all of the past year, prior to the follow-up assessment. CONCLUSION The finding at end treatment, of no modality specific differences, was also evident at two-year follow-up. Although CBT and MCT targeted depression, improvements were much wider, and although CBT and MCT take different approaches, both therapies produced positive change over time across all cognitive variables. CBT and MCT provide treatment options, that not only improve the longer-term outcome of depression, but also result in improvements in anxiety, global social functioning and cognitive status.
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Affiliation(s)
- Janet D Carter
- School Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand
| | - Jennifer Jordan
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Virginia Vw McIntosh
- School Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand
| | | | - Cameron Lacey
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Richard J Porter
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Roger T Mulder
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
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Capobianco L, Nordahl H. A Brief History of Metacognitive Therapy: From Cognitive Science to Clinical Practice. COGNITIVE AND BEHAVIORAL PRACTICE 2021. [DOI: 10.1016/j.cbpra.2021.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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6
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Anyan F, Morote R, Hjemdal O. Temporal and Reciprocal Relations Between Worry and Rumination Among Subgroups of Metacognitive Beliefs. Front Psychol 2020; 11:551503. [PMID: 33013595 PMCID: PMC7516079 DOI: 10.3389/fpsyg.2020.551503] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 08/21/2020] [Indexed: 12/25/2022] Open
Abstract
Metacognitive theory provides strong foundation for hypothesizing relations between worry and rumination among subgroups of metacognitive beliefs. However, empirical exploration of prospective and reciprocal relations between worry and rumination are lacking. This study investigated the stability and relations between worry and rumination to better understand how they influence each other over time, and how different levels of metacognitive beliefs affect relations between (i) initial and future worry, and initial and future rumination, and (ii) the cross-lag relations between worry and rumination. Overall, 482 (Females = 63%) participants (Mean age = 26 years) participated in a two-wave data collection and completed the Metacognition Questionnaire (MCQ-30), the Ruminative Response Scale and the Penn State Worry Questionnaire (PSWQ). A multigroup two-wave autoregressive cross-lagged model was estimated. Multigroup autoregression analyses revealed that independent of participants being in the high or low metacognition group, initial levels of worry predicted future levels of worry, as was the case for rumination. Multigroup cross-lagged analyses revealed that initial levels of worry did not predict future levels of rumination in both high and low levels of metacognitions. However, initial rumination predicted future levels of worry in the high metacognitions group, which was not the case for the low metacognitions group. Thus, high levels of metacognitions do not only strengthen the relation between both present and future worry, present and future rumination, but also present rumination with future worry. This finding may imply that those with rumination related conditions at present are more likely in the future to show both rumination and worry related conditions. Conversely, those with worry related conditions show future worry related conditions. These findings may have implications for a clinical sample regarding the high complexity of rumination conditions that may proceed with multifinality causal pathways especially for individuals with high levels of metacognitions. This complexity may be a possible explanation for the limited success in other traditional treatment of rumination related conditions and the relatively high relapse rates for such conditions in clinical samples.
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Affiliation(s)
- Frederick Anyan
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Roxanna Morote
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Odin Hjemdal
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
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Giosan C, Cobeanu O, Wyka K, Muresan V, Mogoase C, Szentagotai A, Malta LS, Moldovan R. Cognitive evolutionary therapy versus standard cognitive therapy for depression: A single-blinded randomized clinical trial. J Clin Psychol 2020; 76:1818-1831. [PMID: 32602592 DOI: 10.1002/jclp.22991] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 02/18/2020] [Accepted: 05/21/2020] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To compare the efficacy of cognitive evolutionary therapy (CET) with cognitive therapy (CT) for depression. METHODS Ninety-seven participants (78 females/19 males) were randomized to a single-blinded controlled trial (CET: n = 51 vs. CT: n = 46). Assessments were conducted at baseline, Sessions 4 and 8, posttreatment, and 3-month follow-up. Clinical diagnoses were made with Structured Clinical Interview for DSM-IV (SCID) and self-reports for depression and secondary outcomes. RESULTS Although both groups showed significant reductions in depressive symptomatology, the overall Time × Treatment group interaction in the intent to treat analysis was not significant (p = .770, posttreatment: d = 0.39). However, CET was superior to CT at increasing engagement in social and enjoyable activities (p = .040, posttreatment: d = 0.83, p = .040) and showed greater reductions than the CT group in behavioral inhibition/avoidance (p = .047, d = 0.62). The between-group differences generally diminished at the 3-month follow-up. CONCLUSIONS CET is a novel therapy for depression that may add therapeutic benefits beyond those of CT.
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Affiliation(s)
- Cezar Giosan
- Department of Psychology, University of Bucharest, Bucharest, Romania.,Department of Clinical Psychology and Psychotherapy, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Oana Cobeanu
- Department of Clinical Psychology and Psychotherapy, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Katarzyna Wyka
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York, USA
| | - Vlad Muresan
- Department of Clinical Psychology and Psychotherapy, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Cristina Mogoase
- Department of Clinical Psychology and Psychotherapy, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Aurora Szentagotai
- Department of Clinical Psychology and Psychotherapy, Babes-Bolyai University, Cluj-Napoca, Romania
| | | | - Ramona Moldovan
- Department of Clinical Psychology and Psychotherapy, Babes-Bolyai University, Cluj-Napoca, Romania
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Beard JIL, Delgadillo J. Early response to psychological therapy as a predictor of depression and anxiety treatment outcomes: A systematic review and meta-analysis. Depress Anxiety 2019; 36:866-878. [PMID: 31233263 DOI: 10.1002/da.22931] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 05/10/2019] [Accepted: 05/25/2019] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Previous studies indicate that early symptomatic improvement, typically observed during the first 4 weeks of psychological therapy, is associated with positive treatment outcomes for a range of mental health problems. However, the replicability, statistical significance, and magnitude of this association remain unclear. AIM The current study reviewed the literature on early response to psychological interventions for adults with depression and anxiety symptoms. METHODS A systematic review and random effects meta-analysis were conducted, including studies found in Medline, PsychINFO, SCOPUS, Web of Science, and through reference lists and reverse citations. RESULTS Twenty-five eligible studies including 11,091 patients measured early response and examined associations with posttreatment outcomes. It was possible to extract and/or calculate effect size data from 15 studies to conduct a meta-analysis. A large pooled effect size (g = 0.87 [95% confidence interval: 0.63-1.10], p < .0001) indicated that early responders had significantly better posttreatment outcomes compared to cases without early response, and this effect was larger in anxiety (g = 1.37) compared to depression (g = 0.76) measures. Most studies were of good quality and there was no evidence of publication bias. The main limitations concerned insufficient statistical reporting in some studies, which precluded their inclusion in meta-analysis, and it was not possible to examine effect sizes according to different outcome questionnaires. CONCLUSION There is robust and replicated evidence that early response to therapy is a reliable prognostic indicator for depression and anxiety treatment outcomes.
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Affiliation(s)
- Jessica I L Beard
- Department of Psychology, University of Sheffield, Sheffield, United Kingdom
| | - Jaime Delgadillo
- Clinical Psychology Unit, Department of Psychology, University of Sheffield, Sheffield, United Kingdom
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9
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Winter L, Gottschalk J, Nielsen J, Wells A, Schweiger U, Kahl KG. A Comparison of Metacognitive Therapy in Current Versus Persistent Depressive Disorder - A Pilot Outpatient Study. Front Psychol 2019; 10:1714. [PMID: 31447722 PMCID: PMC6691034 DOI: 10.3389/fpsyg.2019.01714] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 07/09/2019] [Indexed: 01/20/2023] Open
Abstract
Background: Metacognitive therapy (MCT) is a modern approach with demonstrated efficacy in current major depressive disorder (MDD). The treatment aims to modify thinking styles of rumination and worry and their underlying metacognitions, which have been shown to be involved in the initiation and perpetuation of MDD. We hypothesized that metacognitive therapy may also be effective in treating persistent depressive disorder (PDD). Methods: Thirty depressed patients (15 with MDD; 15 with PDD) were included. Patients in both groups were comparable on depression severity and sociodemographic characteristics, but PDD was associated with more former treatments. Metacognitive therapy was applied by trained psychotherapists for a mean of 16 weeks. Results: We observed a significant improvement of depressive symptoms in both groups, and comparable remission rates at the end of treatment and after 6 months follow-up. Furthermore, we observed significant and similar levels of improvement in rumination, dysfunctional metacognitions, and anxiety symptoms in both groups. Limitations: The study is limited by the small sample size and a missing independent control group. The effect of the therapeutic alliance was not controlled. The quality of depression rating could have been higher. Conclusions: We demonstrated that metacognitive therapy can successfully be applied to patients with PDD. The observed results were comparable to those obtained for patients with current major depressive disorder. Further studies with larger groups and a randomized design are needed to confirm these promising initial findings.
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Affiliation(s)
- Lotta Winter
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Julia Gottschalk
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Janina Nielsen
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Adrian Wells
- Division of Psychology and Mental Health, University of Manchester, Manchester, United Kingdom.,Greater Manchester Mental Health NHS Trust, Manchester, United Kingdom
| | - Ulrich Schweiger
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Kai G Kahl
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
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Bernhardt M, Klauke S, Schröder A. Longitudinal course of cognitive function across treatment in patients with MDD: A meta-analysis. J Affect Disord 2019; 249:52-62. [PMID: 30753954 DOI: 10.1016/j.jad.2019.02.021] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 02/01/2019] [Accepted: 02/05/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND The longitudinal change of cognitive function across psychological treatment remains unclear. The aim of this meta-analysis was to synthesize results from longitudinal studies of cognitive deficits in MDD patients across treatment to examine change and determine domains that are most sensitive to change. METHODS A literature search was conducted using PsycINFO, MEDLINE, Science direct, and Google scholar databases. The main analysis included 16 studies and examined the change of cognitive function in 859 patients with MDD by calculating overall test-retest effect sizes (Hedges' g) and using a random effects model. Further analyses were conducted on studies of MDD patients that included a healthy control group, and effect sizes were compared. RESULTS The effect size estimates suggest significant small improvements in all cognitive measures (g = 0.17-0.35). Studies including healthy controls revealed no significant differences in cognitive function between MDD patients and healthy controls, except for the improvements in verbal memory. Moderator analyses revealed that mean age influenced change in some cognitive domains. The change in depression severity did not affect the results. LIMITATIONS Treatments differed with regard to the type and duration of psychological intervention and the influence of additional pharmacological treatment could not be controlled. Due to the small number of included studies, the results should be regarded as preliminary. CONCLUSIONS Cognitive abilities improved during treatments, which included psychological interventions. The improvements may be due to practice effects rather than cognitive recovery, except for verbal memory.
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Affiliation(s)
- Maren Bernhardt
- Department of Clinical Psychology and Psychotherapy, University of Koblenz-Landau, Ostbahnstraße 10, Landau 76829, Germany.
| | - Selina Klauke
- Department of Clinical Psychology and Psychotherapy, University of Koblenz-Landau, Ostbahnstraße 10, Landau 76829, Germany
| | - Annette Schröder
- Department of Clinical Psychology and Psychotherapy, University of Koblenz-Landau, Ostbahnstraße 10, Landau 76829, Germany
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11
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Averill IRE, Beaglehole B, Douglas KM, Jordan J, Crowe MT, Inder M, Lacey CJ, Frampton CM, Bowie CR, Porter RJ. Activation therapy for the treatment of inpatients with depression - protocol for a randomised control trial compared to treatment as usual. BMC Psychiatry 2019; 19:52. [PMID: 30709391 PMCID: PMC6359820 DOI: 10.1186/s12888-019-2038-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 01/25/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Inpatients with depression have a poor long term outcome with high rates of suicide, high levels of morbidity and frequent re-admission. Current treatment often relies on pharmacological intervention and focuses on observation to maintain safety. There is significant neurocognitive deficit which is linked to poor functional outcomes. As a consequence, there is a need for novel psychotherapeutic interventions that seek to address these concerns. METHODS We combined cognitive activation and behavioural activation to create activation therapy (AT) for the treatment of inpatient depression and conducted a small open label study which demonstrated acceptability and feasibility. We propose a randomised controlled trial which will compare treatment as usual (TAU) with TAU plus activation therapy for adult inpatients with a major depressive episode. The behavioural activation component involves therapist guided re-engagement with previously or potentially rewarding activities. The cognitive activation aspect utilises computer based exercises which have been shown to improve cognitive function. DISCUSSION The proposed randomised controlled trial will examine whether or not the addition of this therapy to TAU will result in a reduced re-hospitalisation rate at 12 weeks post discharge. Subjective change in activation and objectively measured change in activity levels will be rated, and the extent of change to neurocognition will be assessed. TRIAL REGISTRATION Unique trial number: U1111-1190-9517. Australian New Zealand Clinical Trials Registry (ANZCTR) number: ACTRN12617000024347p .
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Affiliation(s)
- Ian R. E. Averill
- 0000 0004 1936 7830grid.29980.3aDepartment of Psychological Medicine, University of Otago, PO Box 4345, Christchurch, 8140 New Zealand ,0000 0001 0040 0934grid.410864.fSpecialist Mental Health Services, Canterbury District Health Board, Christchurch, New Zealand
| | - Ben Beaglehole
- 0000 0004 1936 7830grid.29980.3aDepartment of Psychological Medicine, University of Otago, PO Box 4345, Christchurch, 8140 New Zealand ,0000 0001 0040 0934grid.410864.fSpecialist Mental Health Services, Canterbury District Health Board, Christchurch, New Zealand
| | - Katie M. Douglas
- 0000 0004 1936 7830grid.29980.3aDepartment of Psychological Medicine, University of Otago, PO Box 4345, Christchurch, 8140 New Zealand
| | - Jennifer Jordan
- 0000 0004 1936 7830grid.29980.3aDepartment of Psychological Medicine, University of Otago, PO Box 4345, Christchurch, 8140 New Zealand
| | - Marie T. Crowe
- 0000 0004 1936 7830grid.29980.3aDepartment of Psychological Medicine, University of Otago, PO Box 4345, Christchurch, 8140 New Zealand
| | - Maree Inder
- 0000 0004 1936 7830grid.29980.3aDepartment of Psychological Medicine, University of Otago, PO Box 4345, Christchurch, 8140 New Zealand
| | - Cameron J. Lacey
- 0000 0004 1936 7830grid.29980.3aDepartment of Psychological Medicine, University of Otago, PO Box 4345, Christchurch, 8140 New Zealand
| | - Christopher M. Frampton
- 0000 0004 1936 7830grid.29980.3aDepartment of Psychological Medicine, University of Otago, PO Box 4345, Christchurch, 8140 New Zealand
| | - Christopher R. Bowie
- 0000 0004 1936 8331grid.410356.5Department of Psychology, Queen’s University, Kingston, Canada
| | - Richard J. Porter
- 0000 0004 1936 7830grid.29980.3aDepartment of Psychological Medicine, University of Otago, PO Box 4345, Christchurch, 8140 New Zealand ,0000 0001 0040 0934grid.410864.fSpecialist Mental Health Services, Canterbury District Health Board, Christchurch, New Zealand
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12
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Philipp R, Kriston L, Lanio J, Kühne F, Härter M, Moritz S, Meister R. Effectiveness of metacognitive interventions for mental disorders in adults-A systematic review and meta-analysis (METACOG). Clin Psychol Psychother 2018; 26:227-240. [PMID: 30456821 DOI: 10.1002/cpp.2345] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 11/12/2018] [Accepted: 11/12/2018] [Indexed: 01/08/2023]
Abstract
We evaluated the effectiveness and acceptability of metacognitive interventions for mental disorders. We searched electronic databases and included randomized and nonrandomized controlled trials comparing metacognitive interventions with other treatments in adults with mental disorders. Primary effectiveness and acceptability outcomes were symptom severity and dropout, respectively. We performed random-effects meta-analyses. We identified Metacognitive Training (MCTrain), Metacognitive Therapy (MCTherap), and Metacognition Reflection and Insight Therapy (MERIT). We included 49 trials with 2,609 patients. In patients with schizophrenia, MCTrain was more effective than a psychological treatment (cognitive remediation, SMD = -0.39). It bordered significance when compared with standard or other psychological treatments. In a post hoc analysis, across all studies, the pooled effect was significant (SMD = -0.31). MCTrain was more effective than standard treatment in patients with obsessive-compulsive disorder (SMD = -0.40). MCTherap was more effective than a waitlist in patients with depression (SMD = -2.80), posttraumatic stress disorder (SMD = -2.36), and psychological treatments (cognitive-behavioural) in patients with anxiety (SMD = -0.46). In patients with depression, MCTherap was not superior to psychological treatment (cognitive-behavioural). For MERIT, the database was too small to allow solid conclusions. Acceptability of metacognitive interventions among patients was high on average. Methodological quality was mostly unclear or moderate. Metacognitive interventions are likely to be effective in alleviating symptom severity in mental disorders. Although their add-on value against existing psychological interventions awaits to be established, potential advantages are their low threshold and economy.
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Affiliation(s)
- Rebecca Philipp
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Levente Kriston
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jana Lanio
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Franziska Kühne
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Potsdam, Potsdam, Germany
| | - Martin Härter
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ramona Meister
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Schaich A, Heikaus L, Assmann N, Köhne S, Jauch-Chara K, Hüppe M, Wells A, Schweiger U, Klein JP, Fassbinder E. PRO *MDD Study Protocol: Effectiveness of Outpatient Treatment Programs for Major Depressive Disorder: Metacognitive Therapy vs. Behavioral Activation a Single-Center Randomized Clinical Trial. Front Psychiatry 2018; 9:584. [PMID: 30510523 PMCID: PMC6252351 DOI: 10.3389/fpsyt.2018.00584] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 10/24/2018] [Indexed: 01/19/2023] Open
Abstract
Background: Major depressive Disorder (MDD) is a severe mental disorder associated with considerable disability and high costs. Over the last decades, various psychotherapies for MDD have been developed and researched, among others Behavioral Activation (BA) and Metacognitive Therapy (MCT). MCT and BA target different maintaining factors of MDD and have not been compared to date. The PRO*MDD randomized controlled trial will compare MCT and BA in the routine clinical setting of an outpatient clinic. Methods and Design: We aim to recruit 128 MDD patients, who will be randomly assigned to either MCT or BA. In both conditions, patients will receive one individual therapy session and one group therapy session per week for a maximum of 6 months. Assessments will take place at baseline, pre-treatment, mid-treatment, post-treatment as well as at 12, 18, and 30 months after start of treatment as follow-up. The primary outcome is reduction of depression severity assessed with the Hamilton Rating Scale for Depression; secondary outcomes address quality of life, psychosocial functioning and participation as well as comorbidity. Discussion: The PRO*MDD study is the first randomized controlled trial to compare the effectiveness of MCT and BA. The outcome of this trial will increase our knowledge on the effectiveness and applicability of both treatment modalities and therefore contribute to the improvement of treatment for depressive patients. Ethics and dissemination: The study has been reviewed and approved on 11 August 2016 by the Ethics Committee of the Lübeck University (reference number: 16-176). The results will be discussed through peer-reviewed publications. Trial registration: German Clinical Trials Register DRKS-ID: DRKS00011536 (retrospectively registered).
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Affiliation(s)
- Anja Schaich
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Laura Heikaus
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Nele Assmann
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Sandra Köhne
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Kamila Jauch-Chara
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Michael Hüppe
- Department of Anaesthesiology, University of Lübeck, Lübeck, Germany
| | - Adrian Wells
- Division of Psychology and Mental Health, University of Manchester, Manchester, United Kingdom
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
| | - Ulrich Schweiger
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Jan Philipp Klein
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Eva Fassbinder
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
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14
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Normann N, Morina N. The Efficacy of Metacognitive Therapy: A Systematic Review and Meta-Analysis. Front Psychol 2018; 9:2211. [PMID: 30487770 PMCID: PMC6246690 DOI: 10.3389/fpsyg.2018.02211] [Citation(s) in RCA: 108] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 10/25/2018] [Indexed: 12/14/2022] Open
Abstract
Background: Metacognitive therapy (MCT) continues to gain increased ground as a treatment for psychological complaints. During the last years, several clinical trials on the efficacy of MCT have been published. The aim of the current study was to provide an updated meta-analytic review of the effect of MCT for psychological complaints. Methods: We conducted a systematic search of trials on MCT for young and adult patients with psychological complaints published until January 2018, using PsycINFO, PubMed, the Cochrane Library, and Google Scholar. Trials with a minimum of 10 participants in the MCT condition were included. Results: A total of 25 studies that examined a variety of psychological complaints met our inclusion criteria, of which 15 were randomized controlled trials. We identified only one trial that was conducted with children and adolescents. In trials with adult patients, large uncontrolled effect size estimates from pre- to post-treatment and follow-up suggest that MCT is effective at reducing symptoms of the targeted primary complaints, anxiety, depression, and dysfunctional metacognitions. The comparison with waitlist control conditions also resulted in a large effect (Hedges' g = 2.06). The comparison of MCT to cognitive and behavioral interventions at post-treatment and at follow-up showed pooled effect sizes (Hedges' g) of 0.69 and 0.37 at post-treatment (k = 8) and follow-up (k = 7), respectively. Conclusions: Our findings indicate that MCT is an effective treatment for a range of psychological complaints. To date, strongest evidence exists for anxiety and depression. Current results suggest that MCT may be superior to other psychotherapies, including cognitive behavioral interventions. However, more trials with larger number of participants are needed in order to draw firm conclusions.
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Affiliation(s)
- Nicoline Normann
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Nexhmedin Morina
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Münster, Münster, Germany
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15
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Haukaas RB, Gjerde IB, Varting G, Hallan HE, Solem S. A Randomized Controlled Trial Comparing the Attention Training Technique and Mindful Self-Compassion for Students With Symptoms of Depression and Anxiety. Front Psychol 2018; 9:827. [PMID: 29887823 PMCID: PMC5982936 DOI: 10.3389/fpsyg.2018.00827] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 05/07/2018] [Indexed: 11/13/2022] Open
Abstract
The Attention Training Technique (ATT) and Mindful Self-Compassion (MSC) are two promising psychological interventions. ATT is a 12-min auditory exercise designed to strengthen attentional control and promote external focus of attention, while MSC uses guided meditation and exercises designed to promote self-compassion. In this randomized controlled trial (RCT), a three-session intervention trial was conducted in which university students were randomly assigned to either an ATT-group (n = 40) or a MSC-group (n = 41). The students were not assessed with diagnostic interviews but had self-reported symptoms of depression, anxiety, or stress. Participants listened to audiotapes of ATT or MSC before discussing in groups how to apply these principles for their everyday struggles. Participants also listened to audiotapes of ATT and MSC as homework between sessions. Participants in both groups showed significant reductions in symptoms of anxiety and depression accompanied by significant increases in mindfulness, self-compassion, and attention flexibility post-intervention. These results were maintained at 6-month follow-up. Improvement in attention flexibility was the only significant unique predictor of treatment response. The study supports the use of both ATT and MSC for students with symptoms of depression and anxiety. Further, it suggests that symptom improvement is related to changes in attention flexibility across both theoretical frameworks. Future studies should focus on how to strengthen the ability for attention flexibility to optimize treatment for emotional disorder.
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Affiliation(s)
- Ragni B Haukaas
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ingrid B Gjerde
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Grunde Varting
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Håvard E Hallan
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Stian Solem
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
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16
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Groves SJ, Pitcher TL, Melzer TR, Jordan J, Carter JD, Malhi GS, Johnston LC, Porter RJ. Brain activation during processing of genuine facial emotion in depression: Preliminary findings. J Affect Disord 2018; 225:91-96. [PMID: 28802727 DOI: 10.1016/j.jad.2017.07.049] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 07/25/2017] [Accepted: 07/26/2017] [Indexed: 01/22/2023]
Abstract
OBJECTIVE The current study aimed to examine the neural correlates of processing genuine compared with posed emotional expressions, in depressed and healthy subjects using a novel functional magnetic resonance imaging (fMRI) paradigm METHOD: During fMRI scanning, sixteen depressed patients and ten healthy controls performed an Emotion Categorisation Task, whereby participants were asked to distinguish between genuine and non-genuine (posed or neutral) facial displays of happiness and sadness. RESULTS Compared to controls, the depressed group showed greater activation whilst processing genuine versus posed facial displays of sadness, in the left medial orbitofrontal cortex, caudate and putamen. The depressed group also showed greater activation whilst processing genuine facial displays of sadness relative to neutral displays, in the bilateral medial frontal/orbitofrontal cortex, left dorsolateral prefrontal cortex, right dorsal anterior cingulate, bilateral posterior cingulate, right superior parietal lobe, left lingual gyrus and cuneus. No differences were found between the two groups for happy facial displays. LIMITATIONS Relatively small sample sizes and due to the exploratory nature of the study, no correction was made for multiple comparisons. CONCLUSION The findings of this exploratory study suggest that depressed individuals may show a different pattern of brain activation in response to genuine versus posed facial displays of sadness, compared to healthy individuals. This may have important implications for future studies that wish to examine the neural correlates of facial emotion processing in depression.
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Affiliation(s)
- Samantha J Groves
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Toni L Pitcher
- Department of Medicine, University of Otago, Christchurch, New Zealand; New Zealand Brain Research Institute, Christchurch, New Zealand
| | - Tracy R Melzer
- Department of Medicine, University of Otago, Christchurch, New Zealand; New Zealand Brain Research Institute, Christchurch, New Zealand
| | - Jennifer Jordan
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand; Canterbury District Health Board, New Zealand
| | - Janet D Carter
- Psychology Department, University of Canterbury, New Zealand
| | - Gin S Malhi
- Sydney Medical School, University of Sydney, Australia
| | | | - Richard J Porter
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.
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17
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Mulder R, Murray G, Rucklidge J. Common versus specific factors in psychotherapy: opening the black box. Lancet Psychiatry 2017; 4:953-962. [PMID: 28689019 DOI: 10.1016/s2215-0366(17)30100-1] [Citation(s) in RCA: 85] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 01/12/2017] [Accepted: 02/06/2017] [Indexed: 12/22/2022]
Abstract
Do psychotherapies work primarily through the specific factors described in treatment manuals, or do they work through common factors? In attempting to unpack this ongoing debate between specific and common factors, we highlight limitations in the existing evidence base and the power battles and competing paradigms that influence the literature. The dichotomy is much less than it might first appear. Most specific factor theorists now concede that common factors have importance, whereas the common factor theorists produce increasingly tight definitions of bona fide therapy. Although specific factors might have been overplayed in psychotherapy research, some are effective for particular conditions. We argue that continuing to espouse common factors with little evidence or endless head-to-head comparative studies of different psychotherapies will not move the field forward. Rather than continuing the debate, research needs to encompass new psychotherapies such as e-therapies, transdiagnostic treatments, psychotherapy component studies, and findings from neurobiology to elucidate the effective process components of psychotherapy.
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Affiliation(s)
- Roger Mulder
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.
| | - Greg Murray
- Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Julia Rucklidge
- Psychology Department, University of Canterbury, Christchurch, New Zealand
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18
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Hjemdal O, Hagen R, Solem S, Nordahl H, Kennair LEO, Ryum T, Nordahl HM, Wells A. Metacognitive Therapy in Major Depression: An Open Trial of Comorbid Cases. COGNITIVE AND BEHAVIORAL PRACTICE 2017. [DOI: 10.1016/j.cbpra.2016.06.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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19
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Belvederi Murri M, Ferrigno G, Penati S, Muzio C, Piccinini G, Innamorati M, Ricci F, Pompili M, Amore M. Mentalization and depressive symptoms in a clinical sample of adolescents and young adults. Child Adolesc Ment Health 2017; 22:69-76. [PMID: 32680319 DOI: 10.1111/camh.12195] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/01/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND Increasing evidence supports that mentalization deficits may have a role in the genesis of young age depression; however, few studies examined this issue in clinical populations. METHODS Outpatients aged 14-21, suffering from various psychiatric disorders, were assessed using the Mentalization Questionnaire (MZQ), the Beck Depression Inventory (BDI), and the Childhood Trauma Questionnaire (CTQ), using data from age-matched healthy students for comparison. The relationship between CTQ, MZQ, and BDI scores was examined at the cross-sectional level, including mediation analyses, and longitudinally, in a subsample who underwent a psychotherapy intervention. RESULTS Of 83 subjects, 33 (39.8%) had mentalization levels that were 1 standard deviation below those of comparison subjects. In the whole sample, the levels of mentalization were inversely associated with BDI (r = -.68, p < .001) and CTQ scores (r = -.30, p = .006). Moreover, MZQ scores mediated a large part of the effect of childhood trauma on depression (total effect: 10.6, 95% CI: 5.3, 15.9; direct effect: 6.5, 95% CI: 2.1, 10.8; indirect effect: 4.1, 95% CI: 1.5, 7.4). This effect was almost entirely explained by the Affect Regulation subscale. In patients re-evaluated after four sessions (n = 37), the decrease in BDI scores correlated with the increase in MZQ scores (r = .40, p = .02). CONCLUSIONS In a juvenile clinical sample, deficits of mentalization abilities were associated with the severity of depression and explained part of the depressogenic effects of childhood trauma.
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Affiliation(s)
- Martino Belvederi Murri
- Section of Psychiatry, Department of Neuroscience, Ophthalmology, Genetics and Infant-Maternal Science, University of Genoa, Largo Rosanna Benzi, 10, Genova, 16132, Italy
| | - Gabriella Ferrigno
- Section of Psychiatry, Department of Neuroscience, Ophthalmology, Genetics and Infant-Maternal Science, University of Genoa, Largo Rosanna Benzi, 10, Genova, 16132, Italy
| | - Simona Penati
- Section of Psychiatry, Department of Neuroscience, Ophthalmology, Genetics and Infant-Maternal Science, University of Genoa, Largo Rosanna Benzi, 10, Genova, 16132, Italy
| | - Caterina Muzio
- Section of Psychiatry, Department of Neuroscience, Ophthalmology, Genetics and Infant-Maternal Science, University of Genoa, Largo Rosanna Benzi, 10, Genova, 16132, Italy
| | - Giulia Piccinini
- Section of Psychiatry, Department of Neuroscience, Ophthalmology, Genetics and Infant-Maternal Science, University of Genoa, Largo Rosanna Benzi, 10, Genova, 16132, Italy
| | - Marco Innamorati
- Department of Human Sciences, European University of Rome, Rome, Italy
| | - Federica Ricci
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Mario Amore
- Section of Psychiatry, Department of Neuroscience, Ophthalmology, Genetics and Infant-Maternal Science, University of Genoa, Largo Rosanna Benzi, 10, Genova, 16132, Italy
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20
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Chow KW, Lo BCY. Parental Factors Associated with Rumination Related Metacognitive Beliefs in Adolescence. Front Psychol 2017; 8:536. [PMID: 28443049 PMCID: PMC5385378 DOI: 10.3389/fpsyg.2017.00536] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 03/23/2017] [Indexed: 11/13/2022] Open
Abstract
An increasing number of research studies have suggested that metacognition is associated with individuals' mental health. Specifically, metacognitive beliefs about rumination was proposed to link to the onset and maintenance of depression according to the metacognitive model of depression. The current study aimed to serve as a pilot study exploring how parents' metacognitive beliefs and parenting characteristics are associated with rumination related metacognitive beliefs in adolescents. Eighty-five parent-youth dyads were invited to complete a set of questionnaires examining their metacognitive beliefs about rumination followed by a difficult puzzle task, in which parent-adolescent interaction patterns were recorded to examine the parenting style. Results found that parents' and adolescents' positive metacognitive beliefs about rumination were significantly associated with each other. In addition, parental negativity was significantly associated with adolescents' positive metacognitive beliefs of rumination and parental over-involvement was marginally associated with adolescents' negative metacognitive beliefs of rumination. The findings highlighted the association between parental factors and adolescents' metacognitive beliefs about rumination. Implications on the prevention of adolescent's depression were discussed.
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Affiliation(s)
| | - Barbara C. Y. Lo
- Department of Psychology, The University of Hong KongPokfulam, Hong Kong
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21
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Hagen R, Hjemdal O, Solem S, Kennair LEO, Nordahl HM, Fisher P, Wells A. Metacognitive Therapy for Depression in Adults: A Waiting List Randomized Controlled Trial with Six Months Follow-Up. Front Psychol 2017; 8:31. [PMID: 28174547 PMCID: PMC5258745 DOI: 10.3389/fpsyg.2017.00031] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 01/05/2017] [Indexed: 12/02/2022] Open
Abstract
This randomized controlled trial examines the efficacy of metacognitive therapy (MCT) for depression. Thirty-nine patients with depression were randomly assigned to immediate MCT (10 sessions) or a 10-week wait list period (WL). The WL-group received 10 sessions of MCT after the waiting period. Two participants dropped out from WL and none dropped out of immediate MCT treatment. Participants receiving MCT improved significantly more than the WL group. Large controlled effect sizes were observed for both depressive (d = 2.51) and anxious symptoms (d = 1.92). Approximately 70–80% could be classified as recovered at post-treatment and 6 months follow-up following immediate MCT, whilst 5% of the WL patients recovered during the waiting period. The results suggest that MCT is a promising treatment for depression. Future controlled studies should compare MCT with other active treatments.
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Affiliation(s)
- Roger Hagen
- Department of Psychology, Norwegian University of Science and Technology Trondheim, Norway
| | - Odin Hjemdal
- Department of Psychology, Norwegian University of Science and Technology Trondheim, Norway
| | - Stian Solem
- Department of Psychology, Norwegian University of Science and Technology Trondheim, Norway
| | | | - Hans M Nordahl
- Department of Psychology, Norwegian University of Science and Technology Trondheim, Norway
| | - Peter Fisher
- Institute of Psychology Health and Society, University of Liverpool Liverpool, England
| | - Adrian Wells
- School of Psychological Sciences, University of Manchester Manchester, England
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22
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Kennair LEO, Kleppestø TH, Larsen SM, Jørgensen BEG. Depression: Is Rumination Really Adaptive? EVOLUTIONARY PSYCHOLOGY 2017. [DOI: 10.1007/978-3-319-60576-0_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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23
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Simons M. [The powerlessness of thoughts – metacognitive therapy for children and adolescents]. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2016; 44:423-431. [PMID: 27299518 DOI: 10.1024/1422-4917/a000438] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Metacognitive therapy (MCT) is a further development of cognitive therapy and was developed by Adrian Wells in the 1990s to treat adults suffering from anxiety disorders and depression. For the first time, this paper introduces a transdiagnostic adaptation of MCT to children and adolescents. Instead of focusing on the content of thoughts or beliefs, as in cognitive therapy, the treatment focuses on reducing negative perseverating thought processes as well as maladaptive attention strategies and coping behaviors. The empirical verification of MCT for children and adolescents is still in a very early stage.
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Affiliation(s)
- Michael Simons
- 1 Klinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Uniklinik der RWTH Aachen
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24
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Mulder R. Does methodology influence the outcome of psychotherapy randomised controlled trials: A look at Australian and New Zealand Studies. Aust N Z J Psychiatry 2015; 49:963-4. [PMID: 26450941 DOI: 10.1177/0004867415609428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Roger Mulder
- Department of Psychological Medicine, University of Otago - Christchurch, Christchurch, New Zealand
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25
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Groves SJ, Porter RJ, Jordan J, Knight R, Carter JD, McIntosh VVW, Fernando K, Frampton CMA, Mulder RT, Lacey C, Joyce PR. Changes in neuropsychological function after treatment with metacognitive therapy or cognitive behavior therapy for depression. Depress Anxiety 2015; 32:437-44. [PMID: 25677736 DOI: 10.1002/da.22341] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Revised: 08/11/2014] [Accepted: 11/12/2014] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Metacognitive therapy (MCT) is an innovative treatment model addressing patterns of negative thinking seen in emotional disorders. Unlike cognitive behavior therapy (CBT), MCT has strategies targeting dysfunctional cognitive and metacognitive processes underlying perseverative thinking patterns and attentional biases. The aim of this pilot study was to compare changes in neuropsychological functioning related to executive function and attention in outpatients with depression following treatment with MCT or CBT. METHODS Forty-eight participants referred for outpatient treatment of depression were randomized to 12 weeks of MCT (n = 23) or CBT (n = 25). Mood severity and neuropsychological functioning were assessed at pretreatment, 4 weeks, and at end treatment (12 weeks). RESULTS There were no significant group differences at pretreatment or 4 weeks on any neuropsychological test, although overall both groups showed a small improvement by 4 weeks. At end treatment, the MCT group demonstrated significantly greater improvement in performance on a task requiring spatial working memory and attention than the CBT group. Changes in executive functioning and attention were independent of change in mood symptoms. CONCLUSIONS MCT may have an advantage over CBT in improving aspects of executive function, including attention. MCT's emphasis on attentional training and flexible control of thinking may have a beneficial effect on neuropsychological functioning, consistent with the purported mechanism of action.
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Affiliation(s)
- Samantha J Groves
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.,Psychology Department, University of Otago, Dunedin, Dunedin, New Zealand
| | - Richard J Porter
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.,Canterbury District Health Board, Christchurch, New Zealand
| | - Jennifer Jordan
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.,Canterbury District Health Board, Christchurch, New Zealand
| | - Robert Knight
- Psychology Department, University of Otago, Dunedin, Dunedin, New Zealand
| | - Janet D Carter
- Psychology Department, University of Canterbury, Christchurch, New Zealand
| | | | - Kumari Fernando
- Department of Psychological Medicine, University of Otago, Dunedin, Dunedin, New Zealand
| | | | - Roger T Mulder
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.,Canterbury District Health Board, Christchurch, New Zealand
| | - Cameron Lacey
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.,Canterbury District Health Board, Christchurch, New Zealand
| | - Peter R Joyce
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
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26
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Henderson S. What really happens. Aust N Z J Psychiatry 2014; 48:887-8. [PMID: 25258418 DOI: 10.1177/0004867414551668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Scott Henderson
- National Institute for Mental Health Research, The Australian National University, Canberra, Australia
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