Clinical and Applied Psychology Unit, Department of Psychology, University of Sheffield, UK.
Leeds Community Healthcare NHS Trust, UK.
Psychol Psychother. 2022 Mar;95(1):98-112. doi: 10.1111/papt.12368. Epub 2021 Oct 7.
In theory, depression is thought to be associated with deficits in adaptive and excesses in maladaptive coping strategies. This study aimed to investigate associations between coping strategies and depression treatment outcomes.
Participants (N = 126) completed measures of adaptive and maladaptive coping strategies before and after accessing evidence-based psychotherapies for depression. The primary outcome was self-reported depression severity measured with the Patient Health Questionnaire (PHQ-9). Hierarchical regression was used to investigate associations between coping strategies and post-treatment depression symptoms, controlling for therapeutic alliance and relevant demographics.
Lower pre-treatment engagement coping and higher rumination predicted higher post-treatment depression, but both of these effects became non-significant after controlling for baseline depression severity. Similarly, correlations between change in rumination and change in depression were no longer significant after controlling for baseline severity.
Deficits in adaptive (engagement) and excesses in maladaptive (rumination) coping strategies may simply be proxy indicators (epiphenomena) of depression severity.
Lower pre-treatment engagement coping predicted higher post-treatment depression Higher pre-treatment rumination predicted higher post-treatment depression Change in rumination during treatment correlated with change in depression symptoms However, none of the above associations remained statistically significant after controlling for baseline depression severity.
从理论上讲，抑郁被认为与适应不良的应对策略不足和过度有关。本研究旨在探讨应对策略与抑郁治疗结果之间的关系。
参与者（N=126）在接受基于证据的抑郁症心理治疗之前和之后完成了适应性和适应性应对策略的测量。主要结果是使用患者健康问卷（PHQ-9）测量的自我报告的抑郁严重程度。使用分层回归来研究应对策略与治疗后抑郁症状之间的关联，控制治疗联盟和相关人口统计学因素。
较低的治疗前参与应对和较高的反刍思维预测了较高的治疗后抑郁，但在控制基线抑郁严重程度后，这两种影响均变得不显著。同样，在控制基线严重程度后，反刍思维变化与抑郁变化之间的相关性也不再显著。
适应性（参与）应对策略的不足和适应不良（反刍）应对策略的过度可能只是抑郁严重程度的代理指标（现象）。
较低的治疗前参与应对预测了更高的治疗后抑郁更高的治疗前反刍预测了更高的治疗后抑郁治疗期间反刍的变化与抑郁症状的变化相关然而，在控制基线抑郁严重程度后，上述关联均不再具有统计学意义。
