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Assessing in-session rumination and its effects on CBT for depression.
J C Kennedy1, B W Dunlop2, L W Craighead3
1Department of Psychiatry and Behavioral Sciences, School of Medicine, Emory University School of Medicine, Atlanta, GA, United States; Department of Psychology, Emory University, Atlanta, GA, United States.
Behaviour Research and Therapy
|October 25, 2022
Summary
Patients who ruminate during cognitive behavioral therapy (CBT) sessions may experience worse outcomes. In-session rumination intensity and duration predicted higher depressive symptoms, suggesting a need for targeted interventions.
Area of Science:
- Psychiatry
- Clinical Psychology
- Behavioral Science
Background:
- Rumination is a maladaptive cognitive process associated with depression.
- In-session rumination, or repetitive negative self-talk during therapy, has not been well-quantified.
- Understanding in-session rumination's impact is crucial for optimizing cognitive behavioral therapy (CBT).
Purpose of the Study:
- To develop and validate a reliable observational measure for in-session rumination.
- To investigate the relationship between in-session rumination and treatment outcomes in major depressive disorder (MDD).
Main Methods:
- Developed a reliable observational measure for in-session rumination (intensity and duration).
- Assessed 63 treatment-naïve MDD patients undergoing CBT in the PReDICT study.
- Rated rumination in initial (session 1) and mid-treatment (session 8) sessions.
Main Results:
- Observational ratings of in-session rumination were reliable (ICCs > 0.69).
- Higher initial in-session rumination intensity predicted greater subsequent clinician-rated depressive symptoms (p < .023).
- Greater in-session rumination intensity and duration at session 8 predicted higher end-of-treatment clinician-rated symptoms (p's < .02).
Conclusions:
- In-session rumination, particularly early in treatment, is a significant predictor of poorer treatment outcomes in CBT for MDD.
- Clinician-rated depressive symptoms, but not self-reported symptoms, were linked to in-session rumination.
- Findings support the development of interventions targeting in-session rumination to improve CBT efficacy.
Keywords:
Behavioral ratings in-session ruminationIn-session ruminationRumination durationRumination during CBTRumination intensityMore Related Videos
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