Personality profiles as potential targets for intervention: Identification and replication.

The alternative dimensional model of personality disorder (PD) diagnosis, based on personality-functioning impairment and pathological traits, opens the door for tailoring treatments to individuals with more homogeneous personality profiles than diagnostic categories. Such a transdiagnostic PD treatment approach requires robust, replicable, personality-relevant dimensions, which we found using a large battery of self-report measures: Self-pathology and negative affectivity (NA) traits, interpersonal pathology and detachment traits, and interpersonal pathology and antagonism traits. Using these dimensions, we identified three groups that had, respectively, elevations on (1) all three dimensions, (2) self-pathology/NA (with/without interpersonal-pathology elevation(s)) and (3) either or both interpersonal-pathology dimensions, without elevated self-pathology/NA.

The symptom-specific efficacy of antidepressant medication vs. cognitive behavioral therapy in the treatment of depression: results from an individual patient data meta-analysis.

A recent individual patient data meta-analysis showed that antidepressant medication is slightly more efficacious than cognitive behavioral therapy (CBT) in reducing overall depression severity in patients with a DSM-defined depressive disorder. We used an update of that dataset, based on seventeen randomized clinical trials, to examine the comparative efficacy of antidepressant medication vs. CBT in more detail by focusing on individual depressive symptoms as assessed with the 17-item Hamilton Rating Scale for Depression.

Translating the BDI and BDI-II into the HAMD and vice versa with equipercentile linking.

Aims: The Hamilton Depression Rating Scale (HAMD) and the Beck Depression Inventory (BDI) are the most frequently used observer-rated and self-report scales of depression, respectively. It is important to know what a given total score or a change score from baseline on one scale means in relation to the other scale.

Methods: We obtained individual participant data from the randomised controlled trials of psychological and pharmacological treatments for major depressive disorders.

Experimentally unpacking cognitive behavioral therapy: The effects of completing a thought record on affect and neuroendocrine responses to stress.

Despite overall effectiveness of cognitive behavioral therapy (CBT), little is known about the effects of specific techniques used in CBT. Thought records are widely employed in CBT across disorders to target cognitions. The current study examined the effects of thought record completion on affective and physiological responses to a laboratory stressor.

Cognitive Behavioural Therapy Competency: Pilot Data from a Comparison of Multiple Perspectives.

Background: Measurement of cognitive behavioural therapy (CBT) competency is often resource intensive. A popular emerging alternative to independent observers' ratings is using other perspectives for rating competency.

Aims: This pilot study compared ratings of CBT competency from four perspectives - patient, therapist, supervisor and independent observer using the Cognitive Therapy Scale (CTS).

Divergent Outcomes in Cognitive-Behavioral Therapy and Pharmacotherapy for Adult Depression.

Objective: Although the average depressed patient benefits moderately from cognitive-behavioral therapy (CBT) or pharmacotherapy, some experience divergent outcomes. The authors tested frequencies, predictors, and moderators of negative and unusually positive outcomes.

Method: Sixteen randomized clinical trials comparing CBT and pharmacotherapy for unipolar depression in 1,700 patients provided individual pre- and posttreatment scores on the Hamilton Depression Rating Scale (HAM-D) and/or Beck Depression Inventory (BDI).

Baseline Depression Severity as Moderator of Depression Outcomes Between Cognitive Behavioral Therapy vs Pharmacotherapy: An Individual Patient Data Meta-analysis.

Importance: Current guidelines recommend treating severe depression with pharmacotherapy. Randomized clinical trials as well as traditional meta-analyses have considerable limitations in testing for moderators of treatment outcomes.

Objectives: To conduct a systematic literature search, collect primary data from trials, and analyze baseline depression severity as a moderator of treatment outcomes between cognitive behavioral therapy (CBT) and antidepressant medication (ADM).

What Did They Learn? Effects of a Brief Cognitive Behavioral Therapy Workshop on Community Therapists' Knowledge.

Knowledge gain has been identified as necessary but not sufficient for therapist behavior change. Declarative knowledge, or factual knowledge, is thought to serve as a prerequisite for procedural knowledge, the how to knowledge system, and reflective knowledge, the skill refinement system. The study aimed to examine how a 1-day workshop affected therapist cognitive behavioral therapy declarative knowledge.

Gender as predictor and moderator of outcome in cognitive behavior therapy and pharmacotherapy for adult depression: an "individual patient data" meta-analysis.

Background: It has yet to be established whether gender moderates or predicts outcome of psychological and pharmacological treatments for adult depression because: (1) individual randomized trials typically lack sufficient statistical power to detect moderators and predictors and (2) meta-analyses cannot examine such associations directly.

Methods: We conducted an "individual patient data" meta-analysis with the primary data of 1,766 patients from 14 eligible randomized trials comparing cognitive behavior therapy (CBT) with pharmacotherapy. Five studies also compared CBT and pharmacotherapy with pill placebo.

The role of early symptom trajectories and pretreatment variables in predicting treatment response to cognitive behavioral therapy.

Objective: Research has focused on 2 different approaches to answering the question, "Which clients will respond to cognitive behavioral therapy (CBT) for depression?" One approach focuses on rates of symptom change within the 1st few weeks of treatment, whereas the 2nd approach looks to pretreatment client variables (e.g., hopelessness) to identify clients who are more or less likely to respond.

Onset of alcohol or substance use disorders following treatment for adolescent depression.

Objective: This study tested whether positive response to short-term treatment for adolescent major depressive disorder (MDD) would have the secondary benefit of preventing subsequent alcohol use disorders (AUD) or substance use disorders (SUD).

Method: For 5 years, we followed 192 adolescents (56.2% female; 20.

Chronic psychosocial stressors and salivary biomarkers in emerging adults.

We investigated whole saliva as a source of biomarkers to distinguish individuals who have, and who have not, been chronically exposed to severe and threatening life difficulties. We evaluated RNA and DNA metrics, expression of 37 candidate genes, and cortisol release in response to the Trier Social Stress Test, as well as clinical characteristics, from 48 individuals stratified on chronic exposure to psychosocial stressors within the last year as measured by the Life Events and Difficulties Schedule. Candidate genes were selected based on their differential gene expression ratio in circulating monocytes from a published genome-wide analysis of adults experiencing different levels of exposure to a chronic stressor.

A pilot study disseminating cognitive behavioral therapy for depression: therapist factors and perceptions of barriers to implementation.

This preliminary report on dissemination of Cognitive Behavioral Therapy (CBT) for depression assessed numerous therapist factors thought to influence implementation in a community setting. Participants were 24 therapists, aged 26-61 who participated in three, 1-day workshops and 8 months of ongoing group consultation. Attitudes toward empirically supported treatments (ESTs) and readiness to change were positively correlated whereas attitudes toward ESTs were negatively correlated with perceived client barriers to implementation.

Recovery and recurrence following treatment for adolescent major depression.

Context: Major depressive disorder in adolescents is common and impairing. Efficacious treatments have been developed, but little is known about longer-term outcomes, including recurrence.

Objectives: To determine whether adolescents who responded to short-term treatments or who received the most efficacious short-term treatment would have lower recurrence rates, and to identify predictors of recovery and recurrence.

Training and dissemination of cognitive behavior therapy for depression in adults: a preliminary examination of therapist competence and client outcomes.

Objective: In this study, the authors examined the feasibility and effectiveness of training community therapists to deliver cognitive behavior therapy (CBT) for depression.

Method: Participants were therapists (n = 12) and clients (n = 116; mean age = 41 years, 63% women) presenting for treatment of depression at a not-for-profit and designated community mental health center for St. Joseph County, Indiana.

Impact of childhood trauma on treatment outcome in the Treatment for Adolescents with Depression Study (TADS).

Objective: The impact of childhood trauma was examined in 427 adolescents (54% girls, 74% Caucasian, mean = 14.6, SD = 1.5) with major depressive disorder participating in the Treatment for Adolescents with Depression Study (TADS).

An exploratory analysis of the impact of family functioning on treatment for depression in adolescents.

This article explores aspects of family environment and parent-child conflict that may predict or moderate response to acute treatments among depressed adolescents (N = 439) randomly assigned to fluoxetine, cognitive behavioral therapy, their combination, or placebo. Outcomes were Week 12 scores on measures of depression and global impairment. Of 20 candidate variables, one predictor emerged: Across treatments, adolescents with mothers who reported less parent-child conflict were more likely to benefit than their counterparts.

The Treatment for Adolescents With Depression Study (TADS): outcomes over 1 year of naturalistic follow-up.

Objective: The Treatment for Adolescents With Depression Study (TADS) evaluates the effectiveness of fluoxetine, cognitive-behavioral therapy (CBT), and their combination in adolescents with major depressive disorder. The authors report effectiveness outcomes across a 1-year naturalistic follow-up period.

Method: The randomized, controlled trial was conducted in 13 academic and community sites in the United States.

Sexual dysfunction in depression and anxiety: conceptualizing sexual dysfunction as part of an internalizing dimension.

Sexual dysfunction is often implicated in depression and anxiety disorders, but the current nosology of sexual dysfunction, depression, and anxiety (i.e., DSM-IV) does not adequately address these relationships.

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).

Depressed adolescents and comorbid psychiatric disorders: are there differences in the presentation of depression?

Patterns and correlates of comorbidity, as well as differences in manifest depressive profiles were investigated in a sample of depressed adolescents. A sub-sample of the youth were characterized as belonging to either a Pure depression group, an Internalizing group (depression and co-occurring internalizing disorders), or an Externalizing group (depression and co-occurring externalizing disorders). Item response theory (IRT) and differential item functioning (DIF) were used to assess whether the depressed adolescents from the different comorbidity groups presented with different depressive symptoms.

Achievement and maintenance of sustained response during the Treatment for Adolescents With Depression Study continuation and maintenance therapy.

Context: The Treatment for Adolescents With Depression Study evaluated fluoxetine (FLX), cognitive behavioral therapy (CBT), and FLX/CBT combination (COMB) vs pill placebo in 439 adolescents with major depressive disorder. Treatment consisted of 3 stages: (1) acute (12 weeks), (2) continuation (6 weeks), and (3) maintenance (18 weeks).

Objective: To examine rates of achieving and maintaining sustained response during continuation and maintenance treatments.

A manual-based intervention to address clinical crises and retain patients in the Treatment of Adolescents With Depression Study (TADS).

Objective: To describe a manual-based intervention to address clinical crises and retain participants in the Treatment for Adolescents With Depression Study (TADS).

Method: The use of adjunct services for attrition prevention (ASAP) is described for adolescents (ages 12-17 years) during the 12-week acute treatment in TADS, from 2000 to 2003. Logistic regression, controlling for site, was used to predict use.

Predictors and moderators of acute outcome in the Treatment for Adolescents with Depression Study (TADS).

Objective: To identify predictors and moderators of response to acute treatments among depressed adolescents (N = 439) randomly assigned to fluoxetine, cognitive-behavioral therapy (CBT), both fluoxetine and CBT, or clinical management with pill placebo in the Treatment for Adolescents With Depression Study (TADS).

Method: Potential baseline predictors and moderators were identified by a literature review. The outcome measure was a week 12 predicted score derived from the Children's Depression Rating Scale-Revised (CDRS-R).

Functioning and quality of life in the Treatment for Adolescents with Depression Study (TADS).

Objective: To test whether 12-week treatment of major depression improved the level of functioning, global health, and quality of life of adolescents.

Method: The Treatment for Adolescents With Depression Study was a multisite, randomized clinical trial of fluoxetine, cognitive-behavioral therapy (CBT), their combination (COMB), or clinical management with placebo in 439 adolescents with major depression. Functioning was measured with the Children's Global Assessment Scale (CGAS), global health with the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA), and quality of life with the Pediatric Quality of Life Enjoyment and Satisfaction Questionnaire (PQ-LES-Q).