Cognitive Vulnerabilities as Prognostic Predictors of Acute and Follow-up Outcomes in Seasonal Affective Disorder Treatment with Light Therapy or Cognitive-Behavioral Therapy.

Autor: Camuso JA; Department of Psychological Science, University of Vermont, Burlington, VT 05405., Rohan KJ; Department of Psychological Science, University of Vermont, Burlington, VT 05405.
Jazyk: angličtina
Zdroj: Cognitive therapy and research [Cognit Ther Res] 2020 Jun; Vol. 44 (3), pp. 468-482. Date of Electronic Publication: 2020 Mar 02.
DOI: 10.1007/s10608-020-10086-4
Abstrakt: Background: First-line treatments for winter seasonal affective disorder include light therapy and cognitive-behavioral therapy; however, it is unclear whether particular patient profiles respond differentially to each treatment type. This study examined baseline patient cognitive and chronobiological vulnerabilities as prognostic and prescriptive predictors of acute and follow-up treatment outcomes.
Methods: 177 adults with seasonal affective disorder were randomized to 6-weeks of either light therapy or cognitive-behavioral therapy. Participants completed baseline measures of cognitive vulnerabilities (Dysfunctional Attitudes Scale; Ruminative Response Scale; Seasonal Belief Questionnaire) and chronobiological vulnerability (Morningness-Eveningness Questionnaire). Depression was assessed at pre- and post-treatment and at follow-ups one and two winters later.
Results: Pre-treatment depression severity correlated significantly with each cognitive vulnerability measure, and significantly predicted future depression. After controlling for pre-treatment depression, higher scores on the Morningness-Eveningness Questionnaire were prognostic of lower depression at treatment endpoint, but no cognitive vulnerability emerged as a prognostic or prescriptive predictor of outcome.
Conclusions: Greater morningness was associated with less severe post-treatment depression in both cognitive-behavior therapy and light therapy. No cognitive vulnerability emerged as a prognostic or prescriptive predictor, perhaps because they correlated with pre-treatment depression severity, a robust predictor of outcome. Future research should test alternative cognitive constructs.
Competing Interests: Conflict of Interest: Julia A. Camuso declares no conflicts of interest to disclose. Kelly J. Rohan receives book royalties from Oxford University Press for the treatment manual for the cognitive-behavioral therapy for SAD intervention.
Databáze: MEDLINE
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