Practice of therapy acquired regulatory skills and depressive relapse/recurrence prophylaxis following cognitive therapy or mindfulness based cognitive therapy.
Study Goal
The researchers aimed to determine whether the use of therapy-acquired regulatory skills, particularly decentering and distress tolerance, could prevent depressive relapse/recurrence in remitted depressed outpatients.
Results Summary
The study found that posttreatment growth in decentering (DC) and distress tolerance (DT) was associated with a reduced risk of depressive relapse/recurrence over 24 months, while residual symptoms (RS) showed no significant change. Continued practice of regulatory skills indirectly reduced relapse risk by strengthening DC.
Population
Remitted depressed outpatients (N = 166; 84 in cognitive therapy, 82 in mindfulness-based cognitive therapy).
Effective Dosage
8 weekly group sessions.
Duration
24-month follow-up after the 8-week intervention.
Interactions
None mentioned.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
cognitive therapy (CT) | increase | decentering (DC) | remitted depressed outpatients | β = .177 | posttreatment growth | #1 |
cognitive therapy (CT) | increase | distress tolerance (DT) | remitted depressed outpatients | β = .259 | posttreatment growth | #2 |
cognitive therapy (CT) | no change | residual symptoms (RS) | remitted depressed outpatients | β = -.017 | no change | #3 |
mindfulness-based cognitive therapy (MBCT) | increase | decentering (DC) | remitted depressed outpatients | β = .177 | posttreatment growth | #4 |
mindfulness-based cognitive therapy (MBCT) | increase | distress tolerance (DT) | remitted depressed outpatients | β = .259 | posttreatment growth | #5 |
mindfulness-based cognitive therapy (MBCT) | no change | residual symptoms (RS) | remitted depressed outpatients | β = -.017 | no change | #6 |
decentering (DC) slope | decrease | relapse/recurrence | remitted depressed outpatients | Hazard Ratio (HR) = .232 | significant predictor of relapse/recurrence prophylaxis | #7 |
practice of therapy-acquired regulatory skills | no change | relapse/recurrence | remitted depressed outpatients | β = .028 | had no direct effect | #8 |
practice of therapy-acquired regulatory skills | increase | decentering (DC) | remitted depressed outpatients | β = .462 | promoted increases | #9 |
decentering (DC) | decrease | relapse/recurrence | remitted depressed outpatients | β = -.270 | predicted a reduced risk | #10 |
BACKGROUND: To investigate whether usage of treatment-acquired regulatory skills is associated with prevention of depressive relapse/recurrence. METHOD: Remitted depressed outpatients entered a 24-month clinical follow up after either 8 weekly group sessions of cognitive therapy (CT; N = 84) or mindfulness-based cognitive therapy (MBCT; N = 82). The primary outcome was symptom return meeting the criteria for major depression on Module A of the SCID. RESULTS: Factor analysis identified three latent factors (53% of the variance): decentering (DC), distress tolerance (DT), and residual symptoms (RS), which were equivalent across CT and MBCT. Latent change score modeling of factor slopes over the follow up revealed positive slopes for DC (β = .177), and for DT (β = .259), but not for RS (β = -.017), indicating posttreatment growth in DC and DT, but no change in RS. Cox regression indicated that DC slope was a significant predictor of relapse/recurrence prophylaxis, Hazard Ratio (HR) = .232 90% Confidence Interval (CI) [.067, .806], controlling for past depressive episodes, treatment group, and medication. The practice of therapy-acquired regulatory skills had no direct effect on relapse/recurrence (β = .028) but predicted relapse/recurrence through an indirect path (β = -.125), such that greater practice of regulatory skills following treatment promoted increases in DC (β = .462), which, in turn, predicted a reduced risk of relapse/recurrence over 24 months (β = -.270). CONCLUSIONS: Preventing major depressive disorder relapse/recurrence may depend upon developing DC in addition to managing residual symptoms. Following the acquisition of therapy skills during maintenance psychotherapies, DC is strengthened by continued skill utilization beyond treatment termination. (PsycINFO Database Record (c) 2019 APA, all rights reserved).