Research Interests: Psychology, Clinical Psychology, Interpersonal Communication, Depression, Family, and 15 moreFriendship, Adolescent, Medicine, Interpersonal Relationship, Humans, Business and Management, Major Depressive Disorder, Female, Male, Attitude, Interpersonal Relations, Chronic Stress, Dysfunctional Family, Friends, and Behaviour Therapy
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Research Interests: Psychology, Clinical Psychology, Interpersonal Communication, Personality, Personality Assessment, and 15 morePersonality Disorders, Adolescent, Medicine, Interpersonal Relationship, Social behavior, Humans, Female, Male, Social Skills, Young Adult, Depressive Disorder, Interpersonal Relations, Questionnaires, Social Behavior, and Personality Pathology
Research Interests: Psychology, Clinical Psychology, Cognitive Behavioral Therapy, Depression, Adolescent, and 15 moreMedicine, Prevention, Students, Humans, Affective Disorders, Major Depressive Disorder, Female, Cognitive Therapy, Male, Psychological Intervention, Universities, SECONDARY PREVENTION, Interpersonal Psychotherapy, Psychology and Cognitive Sciences, and Medical and Health Sciences
Research Interests: Family Therapy, Communication, Bipolar Disorder, Cognition, Evolution, and 15 moreAdolescent, Comparative Study, Medicine, Humans, Affective Disorders, Mania, Female, Male, Family Relations, Affective, Outpatients, EXPRESSED EMOTION, Adolescent Behavior, Antipsychotic agents, and Medical and Health Sciences
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Patients with bipolar disorder are prone to recurrences even when they are maintained on lithium or anticonvulsant regimens. The authors argue that the outpatient treatment of bipolar disorder should involve both somatic and psychosocial... more
Patients with bipolar disorder are prone to recurrences even when they are maintained on lithium or anticonvulsant regimens. The authors argue that the outpatient treatment of bipolar disorder should involve both somatic and psychosocial components. Psychosocial interventions can enhance patients' adherence to medications, ability to cope with environmental stress triggers, and social-occupational functioning. Family and marital psychoeducational interventions and individual interpersonal and social rhythm therapy have received the most empirical support in experimental trials. These interventions, when combined with medications, appear effective in improving symptomatic functioning during maintenance treatment. A beginning literature also supports the utility of individual cognitive-behavioral and psychoeducational approaches, particularly in enhancing medication adherence. Identifying the optimal format for psychosocial treatments and elucidating their mechanisms of action are topics for further study.
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This study examined the test-retest reliability, consensual, convergent and divergent validities, sensitivity, specificity, positive and negative predictive values, and accuracy of the Portuguese version of the Schedule for Affective... more
This study examined the test-retest reliability, consensual, convergent and divergent validities, sensitivity, specificity, positive and negative predictive values, and accuracy of the Portuguese version of the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime version (K-SADS-PL). Eighty-nine children/adolescents (65 psychiatric outpatients and 24 healthy controls) were interviewed with K-SADS-PL and completed measures of depressive and anxiety symptoms. The child's parent/caretaker completed the Child Behavior Checklist. Good to excellent values were obtained for test-retest reliability and consensual validity. For the convergent validity, moderate correlations between the K-SADS-PL and the corresponding self-report measures were observed. Divergent validity was acceptable for the K-SADS-PL diagnoses. The lowest values of sensitivity, specificity, and accuracy of the K-SADS-PL were 88, 88, and 91, respectively. The Portuguese version of K-SADS-PL proved to be a valid and reliable assessment instrument for children and adolescents, and was sensitive, specific and accurate when diagnosing mood, anxiety, adjustment, and attention-deficit/hyperactivity disorders.
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Depression in adolescence is a worldwide phenomenon, expressed by cognitive, behavioral and physical symptoms that cause significant impairment. Additionally, some adolescents show chronic levels of depressive symptoms and are more likely... more
Depression in adolescence is a worldwide phenomenon, expressed by cognitive, behavioral and physical symptoms that cause significant impairment. Additionally, some adolescents show chronic levels of depressive symptoms and are more likely to experience mood disorders in adulthood. Thus, prevention of depression in adolescence is essential to avoid these life patterns. The Program for the Prevention of Depression in Adolescents (PPDA) was adapted for the Portuguese population from the preventive program for adolescents “Mind and Health” developed by Arnarson and Craighead [1]. It’s a selective prevention program, with a cognitive-behavioral basis, composed by 14 sessions. This study aims to assess the efficacy of the PPDA, from baseline to 12-month follow-up. The sample was composed by 52 at-risk adolescents (scores between the 75th and the 90th percentiles on the CDI), attending the eight or the ninth grade in public and private schools in Portugal, that never had depression or dyst...
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Research Interests: Psychology and Portuguese
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Edited by high caliber experts, and contributed to by quality researchers and practitioners in psychology and related fields. Includes over 500 topical entries Each entry features suggested readings and extensive cross-referencing... more
Edited by high caliber experts, and contributed to by quality researchers and practitioners in psychology and related fields. Includes over 500 topical entries Each entry features suggested readings and extensive cross-referencing Accessible to students and general readers Edited by two outstanding scholars and clinicians
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The effects of a structured exercise program on the cognitive functioning of 84 clinically depressed middle-aged and older adults (mean age = 57 years) were examined. Participants were randomized to either 4 months of aerobic exercise (n... more
The effects of a structured exercise program on the cognitive functioning of 84 clinically depressed middle-aged and older adults (mean age = 57 years) were examined. Participants were randomized to either 4 months of aerobic exercise (n = 42) or antidepressant medication (n = 42). Assessments of cognitive functioning (memory, psychomotor speed, executive functioning, and attention/concentration), depression, and physical fitness (aerobic capacity and exercise endurance) were conducted before and after the intervention. Exercise-related changes (accounting for baseline levels of cognitive functioning and depression) were observed for memory (p = .01) and executive functioning (p = .03). There were no treatment-group differences on tasks measuring either attention/concentration or psychomotor speed. Results indicate that exercise can exert influence on specific areas of cognitive functioning among depressed older adults. Further research is necessary to clarify the kinds of cognitive...
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... W. Edward Craighead, Alisha B. Hart y Joshua W. Madsen University of Colorado, Boulder (Estados Unidos) ... Además, la prevalencia del TDM ha ido incrementándose en las cohortes más recientes (Klerman, 1988; Lewinsohn, Rohde, Seeley y... more
... W. Edward Craighead, Alisha B. Hart y Joshua W. Madsen University of Colorado, Boulder (Estados Unidos) ... Además, la prevalencia del TDM ha ido incrementándose en las cohortes más recientes (Klerman, 1988; Lewinsohn, Rohde, Seeley y Fischer, 1993; Wickramaratne ...
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A review and critique of the cognitive research among adolescent depressives are presented. It is concluded that the cognitive data and other research indicate a cooccurrence of depression, anxiety and conduct disorders among adolescents.... more
A review and critique of the cognitive research among adolescent depressives are presented. It is concluded that the cognitive data and other research indicate a cooccurrence of depression, anxiety and conduct disorders among adolescents. Implications for clinical classification and gender differences among these diagnoses are discussed. Suggestions are offered for how these diagnoses among adolescents relate to diagnoses during young adulthood. It is argued that the cooccurrence of disorders must be taken into account in the study of adolescent depression both as a continuous personality construct and as a diagnosed conduct disorder.
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Causal attributions (i.e., locus, stability, globality) and responsibility attributions (i.e., bad intent, selfish motivation, blame) were assessed in the spouses of 27 depressed psychiatric inpatients and 30 nondepressed dyads to test... more
Causal attributions (i.e., locus, stability, globality) and responsibility attributions (i.e., bad intent, selfish motivation, blame) were assessed in the spouses of 27 depressed psychiatric inpatients and 30 nondepressed dyads to test predictions derived from Hooley's (1987) “symptom-controllability” model of marital distress. Results indicated that (1) depressed patients and their spouses were less dyadically adjusted than nondepressed spouses, (2) causal and responsibility attributions about depressive behaviors predicted lower dyadic adjustment, and (3) attributions of causality mediated the relationship between group status (depressed or nondepressed) and dyadic adjustment among spouses who had higher expectations for their partner to change. Results suggest that among spouses with a high expectancy for change, depression may be a risk factor for marital distress.
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Research Interests: Psychology, Abnormal Psychology, Research Methodology, Speech Pathology, Psychopathology, and 15 moreMedicine, Situational Ethics, Anxiety, Electrocardiography, Humans, Cues, Galvanic Skin Response, Personality Development, Female, Male, Verbal behavior, Pulse, Measurement and Calibration of Instruments, ANXIETY, and Environment
Sixty-five young adults with remitted major depressive disorder (MDD) were followed for 18 months. Recurrence of MDD was reported by 41.5% of the initial sample and 49.1% of those who completed the study (n = 53). Survival analyses were... more
Sixty-five young adults with remitted major depressive disorder (MDD) were followed for 18 months. Recurrence of MDD was reported by 41.5% of the initial sample and 49.1% of those who completed the study (n = 53). Survival analyses were used to identify predictors of recurrence so that individuals at greatest risk could be targeted for intervention. Potential predictors included measures of comorbid psychopathology (Axis II pathology, and current and lifetime nonmood Axis I diagnoses), depression-specific clinical features (number of episodes, past treatment, and suicidality), and self-reported cognitive and interpersonal constructs (hope, dysfunctional attitudes, and interpersonal problems). Only personality pathology (specifically, the total dimensional and Cluster B dimensional scores on the International Personality Disorder Examination) significantly predicted hazard of recurrence.
Research Interests: Psychology, Abnormal Psychology, Clinical Psychology, Forecasting, Adolescent, and 15 moreMedicine, Prospective studies, Humans, Major Depressive Disorder, Female, Personality Disorder, Male, Recurrence, Abnormal, Adult, Pilot Projects, Prospective Study, Random Allocation, Severity of Illness Index, and Psychiatric Status Rating Scales
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... This article reviews the role of nonspecific treatment factors in cognitive-behavior therapy (CBT) for depression. ... Treatments: CBT=Cognitive-Behavior Therapy, IMI=lmipramine, NOR=Nortriptyline, PLA=Placebo, TRI=Tricydic,... more
... This article reviews the role of nonspecific treatment factors in cognitive-behavior therapy (CBT) for depression. ... Treatments: CBT=Cognitive-Behavior Therapy, IMI=lmipramine, NOR=Nortriptyline, PLA=Placebo, TRI=Tricydic, TAU=Treatment As Usual. ...
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The rank ordering of psychology programs based on the number of “core” clinical program faculty they produce is interesting and valuable. It is important to emphasize, as the Hard! et al. (this issue) did, that this is only one measure of... more
The rank ordering of psychology programs based on the number of “core” clinical program faculty they produce is interesting and valuable. It is important to emphasize, as the Hard! et al. (this issue) did, that this is only one measure of program quality. The study was based only on faculty of university doctoral training programs, and there are other programs and locations in which faculty are involved in training future clinical psychology program faculty. It is most interesting that even the best programs train very few future clinical program faculty per year. Because of temporal shifts in program quality, when making evaluative decisions, it is essential for consumers of rank-ordered lists to obtain the most recent and direct information regarding programs. I also discuss some future implications of these and other data for future directions in training clinical psychology program faculty.
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ABSTRACT Tang and DeRubeis (this issue) challenge the Ilardi and Craighead (1994) hypothesis that nonspecific factors mediate a large proportion of clinical improvement In cognitive behavior therapy (CUT) for depression, and argue that... more
ABSTRACT Tang and DeRubeis (this issue) challenge the Ilardi and Craighead (1994) hypothesis that nonspecific factors mediate a large proportion of clinical improvement In cognitive behavior therapy (CUT) for depression, and argue that Beck's cognitive hypothesis is not contradicted by the phenomenon of rapid early treatment response. They propose (a) that cognitive modification techniques are introduced in CBT as early as Session 2, (b) that dose-response analyses are inconsistent with the rapid early response pattern, and (c) that observed heterogeneity of patient temporal response curves is problematic for the nonspecific factors hypothesis. In response, we note that (a) there is no compelling evidence that cognitive modification techniques are routinely implemented prior to Week 3 of CBT, (b) disproportionately rapid improvement In depressive symptoms typically occurs over the first six sessions (3 weeks) of CBT, and (c) the two newly reported heterogeneous temporal response patterns are each consistent with the hypothesis of nonspecific mediation of clinical improvement.
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... NY TOMAS HOKFELT Karolinska Institute Stockholm, Sweden STEVE E. HYMAN Rockville, MD LEWIS JUDD University of California San Diego, CA CLINTON D. KILTS Emory University School of Medicine Atlanta, GA WALTER KINTSCH University of... more
... NY TOMAS HOKFELT Karolinska Institute Stockholm, Sweden STEVE E. HYMAN Rockville, MD LEWIS JUDD University of California San Diego, CA CLINTON D. KILTS Emory University School of Medicine Atlanta, GA WALTER KINTSCH University of Colorado Boulder, CO ...
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The avoidance responses of 40 undergraduate females to a live snake were evaluated on the Levis Phobic Test Apparatus. The measures of interest were the three components of avoidance responses: (1) proximity to the snake; (2) self-report... more
The avoidance responses of 40 undergraduate females to a live snake were evaluated on the Levis Phobic Test Apparatus. The measures of interest were the three components of avoidance responses: (1) proximity to the snake; (2) self-report of fear; and (3) level of physiological arousal. The data indicated that the subjects' level of physiological arousal increased significantly from “basal” to “test” conditions. Additionally, subjects who stopped the snake more quickly, showed the greater increase in arousal, and also reported greater subjective fear. A brief discussion of the theoretical implications of the data is presented.
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ABSTRACT
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This presentation maintains that there is an important place within AABT for all its members, including practitioners, scientists, and scientist-practitioners. Data to support this position are presented from a large-scale membership... more
This presentation maintains that there is an important place within AABT for all its members, including practitioners, scientists, and scientist-practitioners. Data to support this position are presented from a large-scale membership survey and from a review of the unipolar depression treatment outcome data. Based on the conceptual and practical commonalities derived from these data, a heuristic model for understanding and treating depression is outlined. Within that framework some examples of the important interface between clinical practice and research (a cardinal characteristic of members of AABT) are presented.
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Aim:To provide a selected overview of the literature on psychosocial treatments for bipolar disorderMethod:Selective literature reviewResults:Randomised controlled trials of psychosocial interventions in bipolar disorder fall largely into... more
Aim:To provide a selected overview of the literature on psychosocial treatments for bipolar disorderMethod:Selective literature reviewResults:Randomised controlled trials of psychosocial interventions in bipolar disorder fall largely into five categories, namely: psychoeducation, integrated treatments, family based therapy, cognitive behavioural therapy and interpersonal social rhythm therapy. Most studies have shown some benefit in terms of relapse prevention, but have tended to be effective for either the depressed or the manic pole, and not both. Broader outcome parameters such as quality of life have not been reported consistently. The mechanisms whereby treatments might exert their effects have not been clearly delineated. Many studies have excluded patients with bipolar II and other variants, and those with psychiatric and substance use comorbidities, reducing their generalisability.Discussion:Whilst psychosocial treatments show promise in the area of bipolar disorder, more wo...
Research Interests: Clinical Psychology, Cognitive Behavioral Therapy, Cognitive Science, Medical Sciences, Bipolar Disorder, and 15 moreEvidence Based Nursing, Lithium, Goal Setting, Humans, Female, Cognitive Therapy, Male, Patient Compliance, Clinical Sciences, Middle Aged, Adult, Impairment, Neurosciences, Ambulatory Care, and Medical and Health Sciences
Major depressive disorder (MDD) is among the most frequent and debilitating psychiatric disorders. Efficacious psychotherapy and antidepressant medications have been developed, and two-thirds of depressed patients respond to... more
Major depressive disorder (MDD) is among the most frequent and debilitating psychiatric disorders. Efficacious psychotherapy and antidepressant medications have been developed, and two-thirds of depressed patients respond to single-modality treatment; however, only about one-third of patients remit to single-modality treatments with no meaningful differences in outcomes between treatment types. This article describes the major clinical considerations in choosing between single-modality or combination treatments for MDD. A review of the relevant literature and meta-analyses provides suggestions for which treatment to use for which patient and when each treatment or combination should be provided. The review summarizes the moderators of single-modality and combination-treatment outcomes. We describe models of mechanisms of treatment efficacy and discuss recent treatment-specific neurobiological mechanisms of change.
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Background: Temperament plays an important role in the development and maintenance of adolescent psychopathology, particularly in depression. The temperament dimensions of negative or positive emotionality are associated with depression... more
Background: Temperament plays an important role in the development and maintenance of adolescent psychopathology, particularly in depression. The temperament dimensions of negative or positive emotionality are associated with depression in childhood, adolescence, and in adult life. Early traumatic experiences, such as emotional abuse, constitute risk factors for the development of negative cognitive styles and depressive symptoms. The use of dysfunctional regulation strategies (e.g., self-blame) seems to be a significant factor in the onset and exacerbation of depressive symptoms in multiple samples. Nevertheless, the contribution of these variables for the maintenance of depression remains inadequately studied. Objectives: The present study explored the mediator role of early emotional traumatic experiences and self-blame in the relationship between negative emotionality trait and depressive symptoms in an adolescent sample. Method: A sample of 2318 adolescents from a general commu...
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Side effect profiles of antidepressants are relevant to treatment selection and adherence among patients with major depressive disorder (MDD), but several clinically-relevant characteristics of side effects are poorly understood. We aimed... more
Side effect profiles of antidepressants are relevant to treatment selection and adherence among patients with major depressive disorder (MDD), but several clinically-relevant characteristics of side effects are poorly understood. We aimed to compare the side effect profiles of escitalopram and duloxetine, including frequencies, time to onset, duration, dose responsiveness, and impact on treatment outcomes. Side effects occurring in 211 treatment-naïve patients with MDD randomized to 12 weeks of treatment with flexibly-dosed escitalopram (10–20 mg/day) or duloxetine (30–60 mg/day) as part of the Predictors of Remission in Depression to Individual and Combined Treatments (PReDICT) study were evaluated. Escitalopram- and duloxetine-treated patients experienced a similar mean number of overall side effects and did not differ in terms of the specific side effects observed or their temporal profile. Experiencing any side effect during the first 2 weeks of treatment was associated with inc...
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Major depressive disorder (MDD) is a common and disabling syndrome with multiple etiologies that is defined by clinically elicited signs and symptoms. In hopes of developing a list of candidate biological measures that reflect and relate... more
Major depressive disorder (MDD) is a common and disabling syndrome with multiple etiologies that is defined by clinically elicited signs and symptoms. In hopes of developing a list of candidate biological measures that reflect and relate closely to the severity of depressive symptoms, so-called “state-dependent” biomarkers of depression, this pilot study explored the biochemical underpinnings of treatment response to cognitive behavior therapy (CBT) in medication-freeMDD outpatients. Plasma samples were collected at baseline and week 12 from a subset of MDD patients (N=26) who completed a course of CBT treatment as part of the Predictors of Remission in Depression to Individual and Combined Treatments (PReDICT) study. Targeted metabolomic profiling using the the AbsoluteIDQ® p180 Kit and LC-MS identified eight “co-expressed” metabolomic modules. Of these eight, three were significantly associated with change in depressive symptoms over the course of the 12-weeks. Metabolites found t...