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Cognitive and psychodynamic mechanisms of change in treated and untreated depression
Author(s) -
Coleman Daniel,
Cole Diane,
Wuest Leslie
Publication year - 2010
Publication title -
journal of clinical psychology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.124
H-Index - 119
eISSN - 1097-4679
pISSN - 0021-9762
DOI - 10.1002/jclp.20645
Subject(s) - psychology , cognition , depression (economics) , psychodynamics , psychodynamic psychotherapy , psychotherapist , clinical psychology , depressive symptoms , cognitive therapy , developmental psychology , psychiatry , economics , macroeconomics
Two patient‐level mechanisms of change, defenses, and cognition were tested over 3 time points in 65 depressed adults, approximately half receiving treatment. Early changes in automatic thoughts and immature defenses were associated with symptom change from time‐one to time‐three. The directionality of early automatic thought change predicting symptom change was partially supported, but immature defense change occurs simultaneously with, or after, symptom change. Given the convergent evidence of cognitive change as a mediator of depression reduction, all depression therapies should consider how they address depressive cognition. To build a more complete understanding of how to ameliorate depression, future studies should continue to include constructs from multiple theories and have measures of therapy process in addition to patient level mechanisms. © 2009 Wiley Periodicals, Inc. J Clin Psychol 66: 215–228, 2010.