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Biomedical subjects

Christopher G Beevers

Publications and source records attributed to Christopher G Beevers.

12 recordsLinked to original sources
PubMed2006

The prevention of depressive symptoms in low-income, minority children: two-year follow-up.

We present 2-year follow-up data on the efficacy of the Penn Resiliency Program (PRP), a school-based depression prevention program, with low-income, racial/ethnic minority children. This program taught cognitive and social problem-solving skills to 168 Latino and African American middle school children who were at-risk for developing depressive symptoms by virtue of their low-income status. We had previously reported beneficial effects of the PRP up to 6 months after the conclusion of the program for the Latino children, but no clear effect for the African American children. In this paper, we extend the analyses to 24 months after the conclusion of the PRP. We continue to find some beneficial effects for the Latino children and no differentially beneficial effect for the African American children. Implications of findings and future research directions are discussed.

Adaptation, Psychological↗
PubMed2006

Family functioning in bipolar I disorder.

In a sample of 62 patients with Bipolar I disorder, the authors used a repeated measures longitudinal design to examine whether global family functioning was associated with the presence of a concurrent bipolar episode as well as whether global family functioning was associated with the presence of manic and depressive episodes in the following 3 months. Participants were recruited for a randomized clinical trial examining the efficacy of family treatments combined with pharmacotherapy for bipolar disorder. Global family functioning was repeatedly measured with both clinician-rated and patient-rated assessment instruments over the 28-month study period. Results indicated that mood episodes were associated with concurrent global family functioning within individuals, but global family functioning was not associated with episode status in the subsequent 3 months. The repeated measures nature of these results suggests that global family functioning and bipolar episodes may fluctuate in concert with each other but that global family functioning is not associated with subsequent change in episode status.

Adult↗
PubMed2005

Cognitive vulnerability to depression: a dual process model.

Dual process models offer powerful accounts of cognitive phenomena in social and personality psychology but they have not been widely adapted to clinical phenomena. This review presents a dual process model of cognitive vulnerability to unipolar depression. According to dual process theories, humans possess two modes of information processing. An associative mode involves quick, effortless processing that rests on well-learned associations. A reflective mode involves slow, effortful processing that rests on symbolic rule-based inferences. Whereas the associative mode occurs automatically, the reflective mode operates when expectancies are violated and sufficient cognitive resources are available to respond. A cognitive vulnerability to depression is observed when negatively biased associative processing is uncorrected by reflective processing. The circumstances when this is likely to occur are reviewed. New insights and implications for assessment, etiology, and treatment of cognitive vulnerability to depression are discussed.

Association↗
PubMed2005

Unlinking negative cognition and symptoms of depression: evidence of a specific treatment effect for cognitive therapy.

In this study, the authors examined whether cognitive therapy alters the association between negative cognition and symptoms of depression. Participants were recruited during psychiatric hospitalization for depression. Following discharge, they were randomly assigned to 6 months of outpatient treatment. Treatment consisted of pharmacotherapy either alone or in combination with cognitive therapy and/or family therapy. Following this 6-month treatment period, negative cognition and symptoms of depression were assessed monthly for 1 year. Hierarchical linear modeling indicated that the association between negative cognition and depression during follow-up was weaker for patients randomized to cognitive therapy than for patients who did not receive cognitive therapy. Cognitive therapy appeared to unlink negative cognition and symptoms of depression to a greater extent than other forms of treatment.

Adult↗
PubMed2005

Differential response to combined treatment in patients with psychotic versus nonpsychotic major depression.

Research has demonstrated that depressed patients with psychotic features show poorer outcomes when treated with pharmacotherapy alone compared with those without psychotic features. However, research has not investigated whether this differential response also applies to combined treatment that includes pharmacotherapy and psychotherapy. In the current study, data were pooled from two clinical trials in which patients diagnosed with major depressive disorder with or without psychotic features were treated with combined treatment. Although similar in severity at pretreatment, results indicated that patients with psychotic depression showed a poorer response in terms of depression severity at postoutpatient treatment and at 6-month follow-up compared with those with nonpsychotic depression. Following treatment, patients with psychotic depression were over four times as likely to exhibit high levels of depression and suicidal ideation. Current state-of-the-art combined treatments have poorer efficacy in depressed patients with psychotic symptoms, and adapted treatment approaches are needed.

Adult↗
PubMed2005

Treatment matching in the posthospital care of depressed patients.

OBJECTIVE: This study assessed the efficacy of 1) matching patients to treatments and 2) adding additional family therapy or cognitive therapy in a group of recently discharged patients with major depression. METHOD: Patients with major depression were recruited during a psychiatric hospitalization. After discharge, they were randomly assigned to one of four treatment conditions that were either "matched" or "mismatched" to their pattern of cognitive distortion and family impairment. The four treatment conditions were 1) pharmacotherapy alone; 2) combined pharmacotherapy and cognitive therapy; 3) combined pharmacotherapy and family therapy; and 4) combined pharmacotherapy, cognitive therapy, and family therapy. Randomly assigned treatment continued for 24 weeks on an outpatient basis. RESULTS: Among patients with at least moderate depressive symptoms at hospital discharge, low rates of remission (16%) and improvement (29%) were obtained. Matched treatment led to a significantly greater proportion of patients who improved and greater reductions over time in interviewer-rated depressive symptoms than mismatched treatment. However, matched treatment did not produce greater change in self-reported depression or interviewer-rated suicidal ideation. Treatment that included a family therapy component also led to a greater proportion of patients who improved and to significant reductions in interviewer-rated depression and suicidal ideation than treatment without family therapy. CONCLUSIONS: These results suggest that 1) current treatments are not very efficacious in the aftercare of hospitalized depressed patients, 2) treatment matching moderately improves outcome for patients who are symptomatic at hospital discharge, and 3) inclusion of family therapy improves the outcome of posthospital care for depressed patients.

Adult↗
PubMed2005

Avoidance and processing as predictors of symptom change and positive growth in an integrative therapy for depression.

Depression is a leading cause of disability worldwide and can worsen the course of a variety of medical illnesses. There is a clear need to develop more potent treatments for this debilitating disorder and prevent its return. We are developing a promising psychotherapy that integrates components of current, empirically supported therapies for depression and also teaches healthy lifestyle and emotion regulation habits to promote psychological health. In the 1st open trial, growth curve analyses revealed a significant linear decrease in symptoms of depression in a sample of 29 clients who completed the therapy. Participants wrote essays about their depression each week, and the content was analyzed using a new coding system of change processes. Hierarchical linear modeling (HLM) revealed that peak levels of processing in the essays were associated with more improvement in depression and with the expression of more hope and of both negative and positive views of the self, presumably as clients explored their depressive views of self. Peak levels of avoidance were associated with less improvement in depression and with more hopelessness and negative views of the self. These preliminary results suggest possible targets of change that can facilitate symptom reduction and perhaps also promote psychological health.

Affect↗
PubMed2004

Cognitive vulnerability to depression: a taxometric analysis.

Although there is increasing support for the hypothesis that negative cognitive styles contribute vulnerability to depression, it remains unclear how best to conceptualize the heterogeneity in cognitive vulnerability to depression. Specifically, does this heterogeneity reflect quantitative or qualitative differences among individuals? The goal of this study was to address this question by examining whether the underlying structure of cognitive vulnerability to depression is best conceptualized as dimensional or categorical. Taxometric analyses provided consistent support for the dimensional nature of negative cognitive styles. It appears, therefore, that cognitive vulnerability to depression is best conceptualized as a dimensional construct, present to a greater or lesser extent in all individuals. Despite this, the strength of the relationship between negative cognitive styles and depressive symptoms does appear to vary as a function of where along the cognitive style continuum one falls.

Adult↗
PubMed2004

What's in a (neutral) face? Personality disorders, attachment styles, and the appraisal of ambiguous social cues.

Attachment theory suggests that borderline, avoidant, and schizoid personality disorders are differentially associated with anxious and avoidant attachment styles. The variations of insecure attachment in these disorders, in turn, might influence how others are perceived or appraised. To test these ideas, 176 college students completed questionnaires measuring attachment styles and personality disorder features, and each rated 10 emotionally neutral faces on 18 bipolar appraisal dimensions. As expected, borderline personality was associated with anxious attachment, avoidant personality was associated with anxious and avoidant attachment, and schizoid personality was weakly associated only with avoidant attachment. Furthermore, path analyses showed that borderline and avoidant personality features were associated with anxious attachment, which in turn related to negative face appraisals (e.g., tendencies to rate faces as less friendly and more rejecting). Discussion highlights the potential of simultaneously studying biases in social information processing and attachment disturbances among individuals with personality disorders.

Adolescent↗
PubMed2004

Perfectionism, cognitive bias, and hopelessness as prospective predictors of suicidal ideation.

Perfectionism, negative cognitive bias, and hopelessness were assessed among people hospitalized for depression (N = 121). Hopelessness and suicidal ideation were assessed 6 months after discharge. Path analyses indicated that higher perfectionism as an inpatient was directly associated with higher suicidal ideation 6 months later. Cognitive bias, in contrast, led to greater hopelessness 6 months later, which in turn led to higher concurrent suicidal ideation. Alternative models examined whether hopelessness partially or fully mediated the effect of perfectionism, whether hopelessness partially mediated the effect of cognitive bias, and whether inpatient depression and suicidal ideation severity explained the observed relationships. These alternative models were not supported. Perfectionism and negative cognitive bias both uniquely contributed to the prospective prediction of suicidal ideation.

Adult↗
PubMed2003

Cognitive predictors of symptom return following depression treatment.

This study tested whether poor cognitive change during depression treatment predicted time to return of depressive symptoms. Depressed participants (N = 121) completed assessments of dysfunctional attitudes and extreme thinking (i.e., number of totally agree and totally disagree responses) during hospitalization and again after 6 months of outpatient treatment. Participants then completed monthly depression assessments for 1 year. Survival analyses for time to symptom recurrence during follow-up were conducted among participants who reported 50% improvement in their depressive symptoms and were at least partially asymptomatic at the end of treatment (n = 53). Poor change in dysfunctional attitudes and poor change in extreme thinking both predicted shorter time to return of depressive symptoms.

Adult↗