Predicting Outcomes of Group Cognitive Behavior Therapy for Patients with Affective and Neurotic Disorders

Abstract

An attempt was made to predict outcomes following group Cognitive Behavior Therapy (CBT) for patients with affective and neurotic disorders.Agroup of 348 patients at a private psychiatric clinic, treated in a group CBT program, completed the Depression, Anxiety, and Stress Scale (DASS) before and after treatment. Prior to treatment, data from the Locus of Control of Behavior (LCB), a Global Assessment of Function (GAF), the Health of the Nation Outcome Scales (HoNOS), and the Rosenberg Self Esteem Scale (RSE) were also collected. Results indicated that posttreatment stress scores of all patients were predicted by pretreatment stress and selfesteem. Among patients with neurotic disorders, posttreatment anxiety was predicted by initial anxiety and self-esteem whereas among patients with affective disorders, posttreatment anxiety scores were predicted by initial anxiety and GAF. For patients with neurotic disorders, selfesteem did not predict variance in posttreatment depression in addition to that explained by pretreatment depression. In contrast, for patients with affective disorders, pretreatment depression and Locus of Control predicted posttreatment depression.

References

Abramson, L. Y. , Seligman, M. E. P. , & Teasdale, J. D. (1978).Learned helplessness in humans: Critique and reformulation. Journal of Abnormal Psychology, 87,49-74.

American Psychiatric Association . (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.

Andrew, B. , Hawton, K. , Fagg, J. , & Westbrook, D. (1993).Do psychosocial factors influence outcome in depressed psychiatric inpatients? British Journal of Psychiatry, 163, 747-754.

Andrews, G. (1999). Efficacy, effectiveness and efficiency in mental health services. Australian and New Zealand Journal of Psychiatry, 33,316-322.

Andrews, G. , Crino, R. , Hunt, C. , Lampe, L. , & Page, A. (1994). The treatment of anxiety disorders: Clinician’s guide and patient manuals. New York: Cambridge University Press.

Bisno, B. , Thompson, L. W. , Breckenridge, J. , & Gallagher, D. (1985).Cognitive variables and the prediction of outcome following an intervention for controlling depression. Cognitive Therapy and Research, 9,527-538.

Bothwell, R. , & Scott, J. (1997).The influence of cognitive variables on recovery in depressed inpatients. Journal of Affective Disorders, 43,207-212.

Brown, G. W. , Andrews, B. , Harris, T. O. , Adler, Z. , & Bridge, L. (1986).Social support, selfesteem and depression. Psychological Medicine, 16,813-831.

Butler, G. (1993).Predicting outcome after treatment for Generalised Anxiety Disorder. Behaviour Research and Therapy, 31,211-213.

10.

Craig, A. , Franklin, J. , & Andrews, G. (1984).A scale to measure Locus of Control of behaviour.British Journal of Medical Psychology, 57,173-180.

11.

Johnson, S. , Meyer, B. , Winett, C. , & Small, J. (2000).Social support and self esteem predict changes in bipolar depression but not mania. Journal of Affective Disorders, 58,79-86.

12.

Lovibond, P. F. , & Lovibond, S. H. (1995).The structure of negative emotional states: Comparison of the depression anxiety stress scales (DASS) with the Beck depression and anxiety inventories. Behaviour Research and Therapy, 33,335-343.

13.

Manning, J. J. , Hooke, G. R. , Tannenbaum, D. A. , Blythe, T. H. , & Clarke, T. R. (1994).Intensive cognitive behavioural group therapy for diagnostically heterogeneous groups patients with psychiatric disorder. Australian and New Zealand Journal of Psychiatry, 28,667-674.

14.

March, J. S. , & Curry, J. F. (1998).Predicting the outcome of treatment. Journal of Abnormal Child Psychology, 26,39-51.

15.

Miller, P. , Kreitman, N. , Ingham, J. , & Sashidharan, S. (1989).Self-esteem, life stress and psychiatric disorder. Journal of Affective Disorders, 17,767-770.

16.

Nathan, P. E. , & Gorman, J. M. (1998). A Guide to treatments that work. New York: Oxford University Press.

17.

Neimeyer, R. , & Weiss, M. (1990) Cognitive and symptomatic predictors of outcome of group therapies for depression. Journal of Cognitive Psychotherapy: An International Quarterly, 4,23-32.

18.

Page, A. C. (1998).Assessment of panic disorder. Current Opinion in Psychiatry, 11,137-141.

19.

Page, A. C. , Hooke, G. R. , & Rutherford, E. (2001).Measuring mental health outcomes in a private psychiatric clinic: Health of the Nation Outcome Scales and Medical Outcomes Short Form SF36. Australian and New Zealand Journal of Psychiatry, 35, 373-381.

20.

Roberts, J. , Kassel, J. D. , & Gotlib, I. H. (1995).Level and stability of self esteem as predictors of depressive symptoms. Personality and Individual Differences, 19,217-224.

21.

Roberts, J. , Shapiro, A. M. , & Gamble, S. A. (1999).Level and perceived stability of self esteem prospectively predict depressive symptoms during psychoeducational group treatment. British Journal of Clinical Psychology, 38,425-429.

22.

Rosenberg M. (1979). Conceiving of the self. New York: Basic Books.

23.

Steinmetz, J. L. , Lewinsohn, P. M. , & Antonuccio, D. O. (1983). Prediction of individual outcomes in group intervention for depression. Journal of Consulting and Clinical Psychology, 51,331-337.

24.

Vostanis, P. , Feehan, C. , & Grattan, E. (1998).Two-year outcome of children treated for depression. European Journal of Adolescent Psychiatry, 7,12-18.

25.

Wing, J. K. , Beevor, A. S. , Curtis, R. H. , Park, S. B. G. , Hadden, S. , & Burns, A. (1998).Health of the Nation Outcome Scales (HoNOS). British Journal of Psychiatry, 172, 11-18.

26.

Wong, J. , & Whitaker, J. (1994). The stability and prediction of depressive mood states in college students. Journal of Clinical Psychology, 50,715-722.