Conceptualizing and treating chronic depression: A naturalistic study of psychotherapy and combination treatment
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- Psykologisk institutt [4366]
- CRIStin høstingsarkiv [31162]
Abstract
Psychotherapy and antidepressant medication (ADM) are different treatments that presumably work through different mechanisms of change, but they seem to work equally well to treat chronic depression. The nature of depression and the mechanisms through which various treatments may affect symptoms, remain largely unknown. Establishing how treatments may act differently on specific symptom groupings could assist therapists in assigning patients to treatments that better fit their needs. The overarching aim of this thesis was to explore how different treatment conditions might affect specific symptoms of chronic depression and discuss possible mechanisms underlying these effects. The results indicate patients with chronic depression may experience oppositional tolerance to ADM and not benefit from continued use, and that psychotherapy may be a viable alternative to combination treatment. Also, self-criticism may be a key factor in maintaining chronic depression, and ADM may have negative effects on psychotherapeutic interventions that target self-criticism. The results challenge the assertion that combination treatment is better than monotherapy for patients with chronic depression.List of papers
Paper 1 Høstmælingen, A., Ulvenes, P., Nissen-Lie, H. A., Eielsen, M., & Wampold, B. E. (2021). Comparing outcomes in chronic depression following inpatient psychotherapy for patients continuing versus discontinuing antidepressant medication. Clinical Psychology and Psychotherapy, 28(5), 1111–1127. The paper is included in the thesis in DUO, and also available at: https://doi.org/https://doi.org/10.1002/cpp.2561 |
Paper 2 Høstmælingen, A., Ulvenes, P., Nissen-Lie, H. A., Eielsen, M., & Wampold, B. E. (2021). Do self-criticism and somatic symptoms play a key role in chronic depression? Exploring the factor structure of Beck depression inventory-II in a sample of chronically depressed inpatients. J Affect Disord, 283, 317–324. The paper is included in the thesis in DUO, and also available at: https://doi.org/https://doi.org/10.1016/j.jad.2021.01.066 |
Paper 3 Høstmælingen, A., Ulvenes, P., Nissen-Lie, H. A., Eielsen, M., & Wampold, B. E. (2021). Trajectories of Change in Chronic Depression: Differences in Self-Criticism and Somatic Symptoms Between Users of Antidepressants and Nonmedicated Patients. Journal of Counseling Psychology, Advance online publication. The paper is removed from the thesis in DUO due to publisher restrictions. The published version is available at: https://doi.org/10.1037/cou0000572 |