Department of Clinical Psychological Science, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands.
Behav Res Ther. 2017 Jul;94:81-92. doi: 10.1016/j.brat.2017.05.005. Epub 2017 May 8.
The present study explored the temporal relationships between change in five candidate causal mechanisms and change in depressive symptoms in a randomized comparison of individual Cognitive Therapy (CT) and Interpersonal Psychotherapy (IPT) for adult depression. Furthermore, hypotheses concerning the mediation of change in these treatments were tested. Patients were 151 depressed adult outpatients treated with either CT (n = 76) or IPT (n = 75). Depression severity was assessed with the BDI-II. Candidate mediators included both therapy-specific as well as common factors. Measures were taken multiple times over the course of treatment (baseline, mid-, and post-treatment). Pearson's correlations and Latent-Difference-Score models were used to examine the direct and indirect relationships between (change in) the candidate mediators and (subsequent) (change in) depression. Patients showed improvement on all measures. No differential effects in pre- to post-treatment changes were observed between the two conditions. However, change in interpersonal functioning occurred more rapidly in IPT. Only little empirical support for the respective theoretical models of change in CT and IPT was found. Future studies should pay special attention to the timing of assessments and within-patient variance.
本研究探讨了在个体认知疗法（CT）和人际心理治疗（IPT）治疗成人抑郁症的随机比较中，五种候选因果机制的变化与抑郁症状变化之间的时间关系。此外，还测试了这些治疗方法中变化的中介作用的假设。患者为 151 名接受 CT（n=76）或 IPT（n=75）治疗的抑郁成年门诊患者。抑郁严重程度采用 BDI-II 评估。候选中介因素包括特定于治疗和共同因素。在治疗过程中多次测量（基线、中期和治疗后）。使用 Pearson 相关系数和潜在差异评分模型来检验候选中介因素（变化）与（随后的）（变化）抑郁之间的直接和间接关系。患者在所有评估中均显示出改善。两种治疗条件之间在治疗前至治疗后的变化中未观察到差异。然而，IPT 中人际功能的变化更快。仅为 CT 和 IPT 的变化的各自理论模型提供了很少的经验支持。未来的研究应特别注意评估的时间和患者内变异性。
