Patterns of Change and Their Relationship to Outcome and Follow-up in Group and Individual Psychotherapy for Depression
The study explored the presence of different patterns of change in a sample of patients who received cognitive therapy for depression in group and individual sequential formats. Our hypothesis was that some patients would respond better to group than to individual therapy, and that for others the op...
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| Tipo de recurso: | tesis doctoral |
| Estado: | Versión publicada |
| Fecha de publicación: | 2019 |
| País: | España |
| Institución: | CBUC, CESCA |
| Repositorio: | TDR. Tesis Doctorales en Red |
| OAI Identifier: | oai:www.tdx.cat:10803/666746 |
| Acceso en línea: | http://hdl.handle.net/10803/666746 |
| Access Level: | acceso abierto |
| Palabra clave: | Psicoteràpia Psicoterapia Psychotherapy Depressió psíquica Depresión mental Mental depression Psicoteràpia basada en l'evidència Psicoterapia basada en la evidencia Evidence-based psychotherapy Psicoteràpia de grup Psicoterapia de grupo Group psychotherapy Ciències de la Salut 159.9 |
| Sumario: | The study explored the presence of different patterns of change in a sample of patients who received cognitive therapy for depression in group and individual sequential formats. Our hypothesis was that some patients would respond better to group than to individual therapy, and that for others the opposite trend would be found. OBJECTIVE: To identify differential patterns of response, to describe the differences in the patients’ characteristics in each pattern, and to predict pattern membership from these characteristics. Also, we wanted to gauge the relationship between each pattern and treatment outcome at termination and follow-up. METHOD: 108 adults who met criteria for major depressive disorder and/or dysthymia completed the treatments included in a randomized controlled trial combining group and individual therapy. They were assessed with the Structured Clinical Interview for DSM-IV Axis I Disorders, the Beck Depression Inventory-II, the Clinical Outcome in Routine Evaluation, the Global Assessment of Functioning, and the Repertory Grid Technique. Growth mixture modeling was used to identify the patterns of change in each treatment phase. Mixed linear models and repeated measures analysis of variance were performed to compare patients’ characteristics in each pattern. Multinomial logistic regression was used to compute predictive models for the patterns from patients’ baseline characteristics. Finally, hierarchical linear regression was used to establish the power of each pattern to predict treatment outcome at termination and at 3-month and 1-year follow-up. Results: A 3-class solution was obtained: group therapy improvers, individual therapy improvers and non-improvers. Patients in each pattern differed in terms of initial symptom severity, psychological distress, functioning, self-ideal discrepancy, perception of social isolation, and conflictual construction of the self. Some of these variables also worked as predictors for pattern membership. More than half of the explained variance of the outcome at termination and at 1-year follow-up was accounted for by initial depression scores and pattern of change. CONCLUSIONS: The results supported the hypothesis of differential patterns of response to cognitive therapy. Profiles of patients who obtained better results in group or individual therapy for depression could be identified as well. |
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