The temporal order of emotional, cognitive, and behavioral gains in daily life during treatment of depression.

IF 4.5 1区心理学 Q1 PSYCHOLOGY, CLINICAL Journal of consulting and clinical psychology Pub Date : 2024-08-01 Epub Date: 2024-05-23 DOI:10.1037/ccp0000890

Evelien Snippe, Timon Elmer, Eva Ceulemans, Arnout C Smit, Wolfgang Lutz, Marieke A Helmich

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Abstract

Objective: Despite the importance for understanding mechanisms of change, little is known about the order of change in daily life emotions, cognitions, and behaviors during treatment of depression. This study examined the within-person temporal order of emotional, cognitive, and behavioral improvements using ecological momentary assessment data.

Method: Thirty-two individuals with diagnosed depression completed ecological momentary assessment questions on emotions (sad mood, happy mood), behaviors (social interaction, number of activities), and cognitive variables (worrying, negative self-thoughts) 5 times a day during a 4-month period in which they underwent psychotherapy for depression. Nonparametric change-point analyses were used to determine the timing of gains (i.e., improvements in the mean of each variable) for each individual. We then established whether the first (i.e., earliest) gains in emotions preceded, followed, or occurred in the same week as cognitive and behavioral gains for each individual.

Results: Contrary to our hypotheses, first gains in behaviors did not precede first emotional gains (3 times, 8%) more often than they followed them (26 times, 70%). Cognitive gains often occurred in the same week as first emotional gains (43 times, 58%) and less often preceded (13 times, 18%) or followed emotional gains (18 times, 24%).

Conclusion: The first improvements in behaviors did not tend to precede the first improvements in emotions likely because fewer behavioral gains were found. The finding that cognitive variables tend to improve around the same time as sad mood may explain why many studies failed to find that cognitive change predicts later change in depressive symptoms. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

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在治疗抑郁症期间，日常生活中的情绪、认知和行为改善的时间顺序。

目的：尽管了解变化机制非常重要，但人们对抑郁症治疗期间日常生活中情绪、认知和行为的变化顺序知之甚少。本研究利用生态学瞬间评估数据，研究了人体内情绪、认知和行为改善的时间顺序：32名确诊为抑郁症的患者在接受为期4个月的抑郁症心理治疗期间，每天5次完成有关情绪（悲伤情绪、快乐情绪）、行为（社会交往、活动次数）和认知变量（担忧、消极的自我想法）的生态瞬间评估问题。我们使用非参数变化点分析来确定每个人的收益时间（即每个变量平均值的改善）。然后，我们确定了每个人情绪方面的首次（即最早）改善是在认知和行为改善之前、之后还是在同一周内出现：结果：与我们的假设相反，行为方面的首次进步并不比情绪方面的首次进步（3 次，8%）更早（26 次，70%）。认知能力的提高往往与情绪能力的提高发生在同一周（43 次，58%），而在情绪能力提高之前（13 次，18%）或之后（18 次，24%）的情况则较少：结论：行为方面的首次改善往往不会先于情绪方面的首次改善，这可能是因为行为方面的改善较少。认知变量的改善往往与悲伤情绪的改善时间相近，这一发现可能解释了为什么许多研究未能发现认知变化能预测抑郁症状的后期变化。(PsycInfo Database Record (c) 2024 APA，保留所有权利）。

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来源期刊

Journal of consulting and clinical psychology PSYCHOLOGY, CLINICAL-

CiteScore

9.00

自引率

3.40%

发文量

期刊介绍： The Journal of Consulting and Clinical Psychology® (JCCP) publishes original contributions on the following topics: the development, validity, and use of techniques of diagnosis and treatment of disordered behaviorstudies of a variety of populations that have clinical interest, including but not limited to medical patients, ethnic minorities, persons with serious mental illness, and community samplesstudies that have a cross-cultural or demographic focus and are of interest for treating behavior disordersstudies of personality and of its assessment and development where these have a clear bearing on problems of clinical dysfunction and treatmentstudies of gender, ethnicity, or sexual orientation that have a clear bearing on diagnosis, assessment, and treatmentstudies of psychosocial aspects of health behaviors. Studies that focus on populations that fall anywhere within the lifespan are considered. JCCP welcomes submissions on treatment and prevention in all areas of clinical and clinical–health psychology and especially on topics that appeal to a broad clinical–scientist and practitioner audience. JCCP encourages the submission of theory–based interventions, studies that investigate mechanisms of change, and studies of the effectiveness of treatments in real-world settings. JCCP recommends that authors of clinical trials pre-register their studies with an appropriate clinical trial registry (e.g., ClinicalTrials.gov, ClinicalTrialsRegister.eu) though both registered and unregistered trials will continue to be considered at this time.