A comparison of social-skills training, pharmacotherapy and psychotherapy for depression.
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Biomedical subjects
Publications and source records attributed to M Hersen.
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The current study examined the validity of a subscale for endogenomorphic depression derived from the Hamilton Rating Scale for Depression. In a sample of 147 women outpatients with primary depression, subscale (HES) scores were bimodally distributed around the mean score of 7.38. High-HES patients had significantly elevated scores on measures of depressive symptomatology, generalized symptomatic distress, and social impairment relative to low-HES patients. Classifications based on HES scores significantly predicted RDC and DSM-III subtype diagnoses of endogenous and nonendogenous depression. Diagnostic predictions based on the subscale's items were superior to predictions made using the 'non-endogenomorphic' Hamilton items. Potential applications for research are discussed.
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The results of a behavioral treatment program for two cases of anorexia and bulimia are presented. The program involved inpatient contingency management for weight gain, thought stopping, flooding, response prevention for bulimia and emesis, and training in self-monitoring skills of caloric intake and weight. The results for both cases indicate that the inpatient program was associated with specific increases in body weight and caloric consumption which were generally maintained at 2-year follow-ups. Flooding and response prevention also appeared to be generally successful in reducing both emesis and bulimia urges and episodes, whereas thought stopping did not appreciably change these behaviors. Serum pituitary gonadotropins (follicle-stimulating hormone and luteinizing hormone) were also restored to normal or near normal levels. Self-monitoring of eating behaviors including caloric intake, emesis, and bulimia seemed to be a useful maintenance strategy and provided timely data for the application of booster treatments during later follow-up intervals.
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The authors contrasted four treatments for unipolar (nonpsychotic) depression: 1) amitriptyline, 2) social skills training plus amitriptyline, 3) social skills training plus placebo, and 4) psychotherapy plus placebo. They studied 72 female outpatients, 52 of whom completed the 12 weeks of treatment. The four treatments, conducted by experienced clinicians, were not substantially different from one another. Each treatment produced significant and clinically meaningful changes in symptomatology and social functioning. However, the authors identified several notable differences across groups: a significant difference in dropout rates (from a high of 55.6% for the amitriptyline group to a low of 15% for the social skills plus placebo group) and a significant difference in the proportion of patients who were substantially improved. The social skills plus placebo treatment was the most effective treatment on this dimension.
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Single-case experimental designs were used to evaluate behavioral and pharmacological treatments in obsessive-compulsive disorders. Four patients were treated in variants of ABAB withdrawal design using behavioral and self-report data as dependent variables. Three of the four patients responded to behavioral or pharmacological treatment, whereas one patient responded to neither intervention.
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Explore the source record for details and available documents.