The results of a 6-month treatment for depression on symptoms, life satisfaction, and community activities among individuals aging with a disability.

Objective: To evaluate the results of treating major depression in individuals aging with a disability. Design: Pre-post quasi-experimental design with a treatment and comparison group over 6 months. Participants: Participants were people with a disability living in a community in Southern California. Fifty-four participants who accepted treatment were compared with 22 individuals who declined treatment. Interventions: Combination of psychotherapy and antidepressant medication. Measures: Depressive symptoms, life satisfaction, and community activities. Results: Treated individuals improved significantly on all 3 measures. Average depression scores declined 50% (p = .001). There was a nonsignificant 12% decline in the comparison group. Conclusion: These results suggest that depression is treatable in this population. Studies that overcome obstacles to randomized clinical trials are needed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Role of perfectionism and personality disorder features in response to brief treatment for depression.

Using data from the Treatment of Depression Collaborative Research Program (TDCRP), the authors compared the role of patients' perfectionism and features of personality disorder (PD) in the outcome of brief treatment for depression. Data were extracted as to patients' intake levels of symptoms; perfectionism; and PD features, measured as continuous variables, as well as their symptoms at termination; their contribution to the therapeutic alliance; and their satisfaction with social relations. Poorer therapeutic outcome was demonstrated for patients with elevated levels of perfectionism and odd-eccentric and depressive PD features. Patients' contribution to therapeutic alliance and satisfaction with social relations were predicted by perfectionism but not by PD features. Results highlight the central role played by patients' personality in the course of brief treatment for depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Long-term correlated change in personality traits in old age.

The present study examines long-term correlated change in personality traits in old age across a time period of 12 years. Data from the Interdisciplinary Study on Adult Development were used to investigate different aspects of personality change and stability. The sample consisted of 300 adults ranging from 60 to 64 years of age at Time 1. Personality was measured with the NEO Five-Factor Inventory. Longitudinal structural stability, differential stability, change in interindividual differences, mean-level change, and correlated change of the 5 personality traits were examined utilizing structural equation modeling. After having established strict measurement invariance, factor variances in Openness to Experience and Conscientiousness were found to be different across testing occasions, implying variant covariation patterns over time. Stability coefficients were around .70, indicating high but not perfect differential stability. The amount of interindividual differences increased with respect to Openness to Experience and Conscientiousness. Both mean-level change and stability in personality were observed. Eventually, except for Neuroticism, a number of medium effect-sized correlations among changes in personality traits emerged, implying that personality changes share a substantial amount of commonality. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The role of readiness to change in response to treatment of adolescent depression.

The effect of readiness to change on treatment outcome was examined among 332 adolescents (46% male, 74% Caucasian), ages 12 through 17 years (M = 14.6, SD = 1.5), with major depressive disorder who were participating in the Treatment for Adolescents With Depression Study (TADS). TADS is a randomized clinical trial comparing the effectiveness of fluoxetine (an antidepressant medication), cognitive–behavioral therapy, their combination, and a pill placebo. An abbreviated Stages of Change Questionnaire was used to obtain 4 readiness to change scores: precontemplation, contemplation, action, and maintenance. The association between each readiness score and depression severity across 12 weeks of acute treatment for depression, as measured by the Children’s Depression Rating Scale—Revised, was examined. Although treatment response was not moderated by any of the readiness scores, baseline action scores predicted outcome: Higher action scores were associated with better outcome regardless of treatment modality. Furthermore, treatment effects were mediated by change in action scores during the first 6 weeks of treatment, with increases in action scores related to greater improvement in depression. Assessing readiness to change may have implications for tailoring treatments for depressed adolescents. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Benchmarks for psychotherapy efficacy in adult major depression.

This study estimates pretreatment-posttreatment effect size benchmarks for the treatment of major depression in adults that may be useful in evaluating psychotherapy effectiveness in clinical practice. Treatment efficacy benchmarks for major depression were derived for 3 different types of outcome measures: the Hamilton Rating Scale for Depression (M. A. Hamilton, 1960, 1967), the Beck Depression Inventory (A. T. Beck, 1978; A. T. Beck & R. A. Steer, 1987), and an aggregation of low reactivity-low specificity measures. These benchmarks were further refined for 3 conditions: treatment completers, intent-to-treat samples, and natural history (wait-list) conditions. The study confirmed significant effects of outcome measure reactivity and specificity on the pretreatment-posttreatment effect sizes. The authors provide practical guidance in using these benchmarks to assess treatment effectiveness in clinical settings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Five types of personality continuity in childhood and adolescence.

This study examines 5 types of personality continuity--structural, mean-level, individual-level, differential, and ipsative--in a representative population (N=498) and a twin and sibling sample (N=548) of children and adolescents. Parents described their children on 2 successive occasions with a 36-month interval using the Hierarchical Personality Inventory for Children (I. Mervielde & F. De Fruyt, 1999). There was evidence for structural continuity in the 2 samples, and personality was shown to be largely differentially stable. A large percentage had a stable trait profile indicative of ipsative stability, and mean-level personality changes were generally small in magnitude. Continuity findings were explained mainly by genetic and nonshared environmental factors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comments on "The necessary and sufficient conditions of therapeutic personality change."

This commentary describes the impact of Carl Rogers' classic article (see record 2007-14630-002) on the field of psychotherapy in general and on control-mastery theory and research in particular. The relevance of Rogers' model in the current psychotherapy literature and debates is addressed as are some of the limitations of the model. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive–behavioral treatment for depression in smoking cessation.

Cigarette smokers with past major depressive disorder (MDD) received 8 group sessions of standard, cognitive–behavioral smoking cessation treatment (ST; n?=?93) or standard, cognitive–behavioral smoking cessation treatment (ST) plus cognitive–behavioral treatment for depression (CBT-D; n?=?86). Although abstinence rates were high in both conditions (ST, 24.7%; CBT-D, 32.5%, at 1 year) for these nonpharmacological treatments, no main effect of treatment was found. However, secondary analyses revealed significant interactions between treatment condition and both recurrent depression history and heavy smoking (≥25 cigarettes a day) at baseline. Smokers with recurrent MDD and heavy smokers who received CBT-D were significantly more likely to be abstinent than those receiving ST (odds ratios?=?2.3 and 2.6, respectively). Results suggest that CBT-D provides specific benefits for some, but not all, smokers with a history of MDD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Stability and change of personality across the life course: The impact of age and major life events on mean-level and rank-order stability of the Big Five.

Does personality change across the entire life course, and are those changes due to intrinsic maturation or major life experiences? This longitudinal study investigated changes in the mean levels and rank order of the Big Five personality traits in a heterogeneous sample of 14,718 Germans across all of adulthood. Latent change and latent moderated regression models provided 4 main findings: First, age had a complex curvilinear influence on mean levels of personality. Second, the rank-order stability of Emotional Stability, Extraversion, Openness, and Agreeableness all followed an inverted U-shaped function, reaching a peak between the ages of 40 and 60 and decreasing afterward, whereas Conscientiousness showed a continuously increasing rank-order stability across adulthood. Third, personality predicted the occurrence of several objective major life events (selection effects) and changed in reaction to experiencing these events (socialization effects), suggesting that personality can change due to factors other than intrinsic maturation. Fourth, when events were clustered according to their valence, as is commonly done, effects of the environment on changes in personality were either overlooked or overgeneralized. In sum, our analyses show that personality changes throughout the life span, but with more pronounced changes in young and old ages, and that this change is partly attributable to social demands and experiences. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The kids are alright: Growth and stability in personality development from adolescence to adulthood.

This longitudinal study provides a comprehensive analysis of continuity and change in personality functioning from age 18 to age 26 in a birth cohort (N?=?921) using the Multidimensional Personality Questionnaire (A. Tellegen, 1982). Data were analyzed using 4 different methods: differential continuity, mean-level change, individual differences in change, and ipsative change. Convergent evidence pointing toward personality continuity, as opposed to change, was found. The personality changes that did take place from adolescence to adulthood reflected growth in the direction of greater maturity; many adolescents became more controlled and socially more confident and less angry and alienated. Consistent with this, greater initial levels of maturity were associated with less personality change over time. The results indicate that the transition from adolescence to young adulthood is marked by continuity of personality and growth toward greater maturity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Frequency of treatment and change in psychotherapy.

To test the hypothesis that frequency of weekly interview has a selective effect on psychological changes in patients in individual psychotherapy, 133 VA outpatients were randomly assigned to 3 schedules: twice, once, and bi-weekly. Changes were measured by tests based on objective evaluation of personality characteristics and assessed after 4 mo., 8 mo., and 12 mo. of therapy. The results failed to confirm that there was any major support for the hypothesis that frequency of contact produced differences in personality changes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The association of neighborhood poverty with personality change in childhood.

The child sample of the National Longitudinal Survey of Youth (n.d.) was analyzed to examine the relation of undesirable personality change in early childhood to neighborhood economic deprivation. Participants in the survey who had complete data at Time 1 (3-4 years of age) and Time 2 (5-6 years of age) and who remained in the same neighborhood during both time periods were included in the analyses. The results indicated that neighborhood economic disadvantage was associated with undesirable personality change even after controlling for family-level variables such as maternal education, family income, and cognitive and emotional support in the home environment for children. The association of personality change with neighborhood economic deprivation was not mediated by maternal depression, Head Start participation, cognitive and emotional support in the home, or maternal trust in the neighborhood. The authors discuss recommendations for future investigations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Response to cognitive therapy in depression: The role of maladaptive beliefs and personality disorders.

This study examined whether personality disorder status and beliefs that characterize personality disorders affect response to cognitive therapy. In a naturalistic study, 162 depressed outpatients with and without a personality disorder were followed over the course of cognitive therapy. As would be hypothesized by cognitive theory (A. T. Beck & A. Freeman, 1990), it was not personality disorder status but rather maladaptive avoidant and paranoid beliefs that predicted variance in outcome. However, pre- to posttherapy comparisons suggested that although patients with or without comorbidity respond comparably to "real-world" cognitive therapy, they report more severe depressive symptomatology at intake and more residual symptoms at termination. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Patterns of mean-level change in personality traits across the life course: A meta-analysis of longitudinal studies.

The present study used meta-analytic techniques (number of samples = 92) to determine the patterns of mean-level change in personality traits across the life course. Results showed that people increase in measures of social dominance (a facet of extraversion), conscientiousness, and emotional stability, especially in young adulthood (age 20 to 40). In contrast, people increase on measures of social vitality (a 2nd facet of extraversion) and openness in adolescence but then decrease in both of these domains in old age. Agreeableness changed only in old age. Of the 6 trait categories, 4 demonstrated significant change in middle and old age. Gender and attrition had minimal effects on change, whereas longer studies and studies based on younger cohorts showed greater change. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Patient interpersonal impacts and the early therapeutic alliance in interpersonal therapy for depression.

The therapeutic alliance consistently predicts positive psychotherapy outcomes. Thus, it is important to uncover factors that relate to alliance development. The goal of this study was to examine the association between patient interpersonal characteristics and alliance quality in interpersonal therapy for depression. Data derive from a subsample (n = 74) of a larger naturalistic database of outpatients treated at a mood disorders clinic of a university-affiliated psychiatric hospital. Following Session 3 of treatment, therapists completed the Impact Message Inventory (Kiesler & Schmidt, 1993) to assess patients' interpersonal impacts on them. Also following Session 3, patients completed the Working Alliance Inventory (Horvath & Greenberg, 1989) to assess alliance quality. As predicted, patients' affiliative interpersonal impacts, as perceived by their therapists, were positively associated with alliance quality, controlling for baseline depression severity. Although unrelated to the initial hypotheses, patients concurrently taking psychotropic medications reported better alliances than patients receiving psychotherapy only. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Are anxiety and depression just as stable as personality during late adolescence? Results from a three-year longitudinal latent variable study.

Although considerable evidence shows that affective symptoms and personality traits demonstrate moderate to high relative stabilities during adolescence and early adulthood, there has been little work done to examine differential stability among these constructs or to study the manner in which the stability of these constructs is expressed. The present study used a three-year longitudinal design in an adolescent/young adult sample to examine the stability of depression symptoms, social phobia symptoms, specific phobia symptoms, neuroticism, and extraversion. When considering one-, two-, and three-year durations, anxiety and personality stabilities were generally similar and typically greater than the stability of depression. Comparison of various representations of a latent variable trait-state-occasion (TSO) model revealed that whereas the full TSO model was the best representation for depression, a trait stability model was the most parsimonious of the best-fitting models for the anxiety and personality constructs. Over three years, the percentages of variance explained by the trait component for the anxiety and personality constructs (73–84%) were significantly greater than that explained by the trait component for depression (46%). These findings indicate that symptoms of depression are more episodic in nature, whereas symptoms of anxiety are more similar to personality variables in their expression of stability. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Comparative outcomes for individual cognitive-behavior therapy, supportive-expressive group psychotherapy, and sertraline for the treatment of depression in multiple sclerosis.

This study compared the efficacy of 3 16-week treatments for depression in 63 patients with multiple sclerosis (MS) and major depressive disorder (MDD): individual cognitive- behavioral therapy (CBT), supportive expressive group therapy (SEG), and the antidepressant sertraline. Significant reductions were seen from pre- to posttreatment in all measures of depression. Intent-to-treat and completers analyses using the Beck Depression Inventory (BDI; A. T. Beck, C. H. Ward, M. Medelson, J. Mock, & J. Erbaugh, 1961) and MDD diagnosis found that CBT and sertraline were more effective than SEG at reducing depression. These results were largely supported by the BDI-18, which eliminates BDI items confounded with MS. However, the Hamilton Rating Scale for Depression (M. Hamilton, 1960) did not show consistent differences between treatments. Reasons for this inconsistency are discussed. These findings suggest that CBT or sertraline is more likely to be effective in treating MDD in MS compared with supportive group treatments. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Interpersonal problems, personality pathology, and social adjustment after cognitive therapy for depression.

The authors examined the level and structure- of the Inventory of Interpersonal Problems--Circumplex version (IIP-C; L. M. Horowitz. L. E. Alden, J. S. Wiggins, & A. L. Pincus, 2000) before and after 20 sessions of acute-phase cognitive therapy for depression (N=118), as well as associations with the Schedule for Nonadaptive and Adaptive Personality (L. A. Clark, 1993b) and the Social Adjustment Scale--Self-Report version (M. M. Weissman & S. Bothwell, 1976). Interpersonal problems had a 3-factor structure (Interpersonal Distress, Love, and Dominance), with the latter 2 factors approximating a circumplex, both before and after therapy. Interpersonal Distress decreased and social adjustment increased with therapy, but the Love and Dominance dimensions were relatively stable, similar to personality constructs. Social adjustment related negatively to Interpersonal Distress but not to Love or Dominance. Personality pathology related broadly to Interpersonal Distress and discriminantly to Love and Dominance. These findings support the reliability and validity of the IIP-C and are discussed in the context of personality theory and measurement. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Child Anxiety Treatment: Outcomes in Adolescence and Impact on Substance Use and Depression at 7.4-Year Follow-Up.

Research suggests that the sequelae of childhood anxiety disorders, if left untreated, can include chronic anxiety, depression, and substance abuse. The current study evaluated the maintenance of outcomes of children who received a 16-week cognitive-behavioral treatment for primary anxiety disorders (generalized, separation, and social anxiety disorders) an average of 7.4 years earlier. The 86 participants (ages 15 to 22 years; 91% of the original sample) and their parents completed diagnostic interviews and self- and parent-report measures. According to the diagnostic interviews, a meaningful percentage of participants maintained significant improvements in anxiety at long-term follow-up. With regard to sequelae, positive responders to anxiety treatment, as compared with less positive responders, had a reduced amount of substance use involvement and related problems at long-term follow-up. The findings are discussed with regard to child anxiety and some of its sequelae. (PsycINFO Database Record (c) 2010 APA, all rights reserved)