1.3 Treatment depression Flashcards
Waar gaat artikel Cuijpers (2016) over?
Cuijpers et al. (2016)
Effects of CBT on:
- MDD
- Generalized anxiety disorder (GAD)
- Panic disorder (PD)
- Social anxiety disorder (SAD)
Wordt alleen op MDD gefocust ofc.
How are the effects of CBT overestimated?
Cuijpers et al. (2016)
- Publication bias: the choice of journals to accept a submitted manuscript by an author, depending on the strength and/or findings.
- Quality of trails is not good
- Waiting list control groups are often used, however, the improvement in these patients have been reported to be less than expected.
Nocebo
Cuijpers et al. (2016)
Opposite of placebo.
The waiting list could develop negative expectations, therefore people believe that their symptoms worsen or do not improve during this period. The anticipation of lack of improvement could lead to more negative (health) outcomes.
Welke 3 resultaten komen naar voren bij Cuijpers 2016?
Cuijpers et al. (2016)
- 44.4% of the MDD vs, CBT studies were based on waiting list control groups, which resulted in a significant larger effect size than people with normal care or pill placebo control groups.
- CBT is ‘probably’ effective in the treatment of MDD, GAD, PD, SAD, with the effects being larger in waiting list control groups, compared to conservative control groups like care as usual and pill placebo.
- Due to the small number of high qualilty studies, the effects are still uncertain.
Waar gaat 2e artikel Cuijpers over (2019)?
Cuijpers et al. (2019)
Common factors and psychotherapy outcomes.
Common factors
Cuijpers et al. (2019)
Factors all therapies have in common, like:
- expectation,
- patient’s understanding of what their problem is and
- what can be done about them,
- and the alliance between the therapist and patient.
Dodo Bird Verdict
Cuijpers et al. (2019)
In 1936, Rosenzweig stated his observation about therapies.
This states that there were comparable effects of all therapies that don’t significally vary from each other.
First common factors model (Jerome Frank)
Cuijpers et al. (2019)
Four nonspecific factors that were common to all therapies and the elements that were believed to be effective in these therapies:
1. Functioning relationship between client and therapist.
2. Explanation that lends credibility to the administered treatment.
3. Specific procedures and routines presented in an organized fashion.
4. Therpeutic environment
Contextual model
Cuijpers et al. (2019)
Therapist and patient have to create bond to work together. After this bond, therapy works in 3 pathways:
1. Real relationship: connection between patient and therapist (has a therapeutic effects on patient).
2. Expectations or hope: therapy teaches patient how to deal with problems + gives them hope that they are able to undertake essential responsibility to complete therapy.
3. Distinct elements of therapy: this creates expectations in patients, activate the second pathway, and also produce some beneficial actions. (this could improve interpersonal therapy, encourage positive thinking (CBT) etc.)
Categories common factors
Cuijpers et al. (2019)
- Support
- Learning
- Action
These are based on the order of change that is believed to happen during therapy (assumption, not yet confirmed)
How many % can be attributed to common factors and how many to specific factors?
Cuijpers et al. (2019)
30% = common factors
15% = specific factors
Bona fide therapies
Cuijpers et al. (2019)
Therapies delivered by trained therapists.
Non-bona fide
Cuijpers et al. (2019)
Are intended to be ineffective. They are used to compare a specific therapy model (bona fide) to a control that mimics the therapeutic setting without meeting bona fide criteria.
Research allegiance
Cuijpers et al. (2019)
The strong belief that one treatment is better than the other and believing that the theory begind the treatment is superior.
When researchers prefer a specific therapy, they might set up or interpret the study in a way that shows their chosen therapy as better than others.
Component studies
Cuijpers et al. (2019)
They break down multicomponent theories (crucial part of research).
If there is a difference between a therapy with or without a component, then the particular component is responsible for the effects of the intervention.
- Supporters of common factor model believe that there will be no difference between studies with or without a specific component.
Component studies
Dismantling studies
Cuijpers et al. (2019)
Compare full therapy with one where a component is excluded
