Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
Sci Rep. 2024 Jul 25;14(1):17120. doi: 10.1038/s41598-024-67063-0.
Identifying components of modularized psychological interventions that contribute to symptom reduction is essential to improving depression treatment. In a secondary analysis of a randomized controlled trial (RCT), session-specific effects of Metacognitive Training-Silver, a group intervention for older adults with depression, were investigated. Thirty-eight older adults with major depressive disorder or dysthymia participated in up to eight sessions of MCT-Silver. A clinical assessment of depressive symptoms (Hamilton Depression Rating Scale) as well as additional interviews and questionnaires administered as part of the RCT were completed at pre- and post-intervention. Depressive symptoms, negative (meta)cognitive beliefs, emotion regulation strategies and attitudes toward aging were assessed pre- and post-session. The rate of change in each variable per module, elevation following the module in which the variable was addressed, and the rate of change post module were examined via linear mixed models. Clinician-rated depressive symptoms were significantly reduced from pre- to post-intervention (Cohens d = 1.31). Self-reported depression and negative mental filter measured within sessions improved significantly over treatment, whereas black-and-white thinking improved after module #3 (Should Statements, All or Nothing Thinking and Acceptance). Module-specific within-session effects were found for overgeneralization (module #1: Mental Filter) and rumination (module #6: Rumination and Social Withdrawal). Improvement in mental filter in module #1 was significantly associated with depression reduction. This study provides initial evidence that MCT-Silver partially meets its aims of reducing depression and specific cognitive variables within and across sessions. Improvement of the instrument used to measure change may improve detection of module-specific effects.Trial registration: NCT03691402.
确定模块化心理干预措施中有助于减轻症状的组成部分对于改善抑郁症治疗至关重要。在一项随机对照试验（RCT）的二次分析中，研究了针对老年抑郁症患者的团体干预措施——元认知训练-银版（MCT-Silver）的特定疗程效果。38 名患有重度抑郁症或心境恶劣障碍的老年人参加了最多 8 次的 MCT-Silver 疗程。在干预前后，通过临床评估（汉密尔顿抑郁评定量表）以及作为 RCT 一部分进行的额外访谈和问卷调查，评估了抑郁症状、负性（元）认知信念、情绪调节策略和对衰老的态度。在干预前后的每个模块中，每个变量的变化率、在解决该变量的模块之后的升高率以及模块后的变化率都通过线性混合模型进行了检查。经过治疗，临床医生评定的抑郁症状显著降低（Cohen's d=1.31）。自我报告的抑郁和在疗程内测量的负性心理过滤显著改善，而全或无思维和接纳在模块#3 后得到改善。在疗程内，特定模块的效果包括过度泛化（模块#1：心理过滤）和反刍（模块#6：反刍和社交退缩）。在模块#1 中，心理过滤的改善与抑郁减轻显著相关。这项研究提供了初步证据，表明 MCT-Silver 部分实现了其降低抑郁和特定认知变量的目标，包括在和跨疗程内。改善用于测量变化的工具可能会提高对特定模块效果的检测。
NCT03691402。
