Mechanisms of change in the treatment of major depressive disorder with metacognitive therapy and behavioral activation - a random intercept cross-lagged panel and mediation analyses.

IF 2.6 1区心理学 Q2 PSYCHOLOGY, CLINICAL

Psychotherapy Research Pub Date : 2025-07-15 DOI:10.1080/10503307.2025.2530543

Anja Schaich, Maya Antia-Frese, Carlotta Gebauer, Gina Schippmann, Nele Assmann, Kamila Jauch-Chara, Daniel Alvarez-Fischer, Jan P Klein, Eva Fassbinder

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引用次数: 0

Abstract

Objectives: Metacognitive Therapy (MCT) and Behavioural Activation (BA) are effective treatments for depression. This exploratory study aimed to investigate proposed mechanisms and mediators of change in MCT and BA.

Method: Data were used from 122 patients randomized to six months of treatment with either MCT or BA for depression. Analyses were based on monthly assessments of the Quick Inventory of Depressive Symptoms (QIDS-SR16), Major Depressive Disorder Scale (MDD-S, for MCT-specific variables), and Behavioral Activation for Depression Scale (BADS, for BA-specific variables).

Results: Random intercept cross-lagged panel models (RI-CLPMs) indicated bidirectional relationships between most of the proposed mechanism variables and outcomes. Linear mixed models revealed greater changes in the MDD-S variables rumination time, dysfunctional coping strategies, and negative metacognitions in the MCT condition. RI-CLPM mediation analyses suggested that the subscales avoidance, rumination time, and negative metacognitions of the MDD-S mediate the relationship between treatment condition and depressive symptoms.

Conclusion: Our results suggest that the examined variables are change mechanisms in the treatment of depression. They also suggest that the effect of MCT might be mediated by changes in rumination. If confirmed in further studies, it might emerge that targeting these change mechanisms can increase the effectiveness of depression treatments.

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元认知疗法和行为激活治疗重度抑郁症的改变机制——随机截点交叉滞后面板和中介分析。

目的：元认知疗法（MCT）和行为激活疗法（BA）是治疗抑郁症的有效方法。本探索性研究旨在探讨MCT和BA变化的机制和介质。方法：数据来自122例随机分为MCT或BA治疗6个月的抑郁症患者。分析基于每月对抑郁症状快速量表（QIDS-SR16）、重度抑郁障碍量表（MDD-S，针对mct特异性变量）和抑郁行为激活量表（BADS，针对ba特异性变量）的评估。结果：随机截距交叉滞后面板模型（ri - clpm）显示，大多数提出的机制变量与结果之间存在双向关系。线性混合模型显示MCT条件下MDD-S变量反刍时间、功能失调应对策略和负性元认知的变化更大。RI-CLPM中介分析表明，MDD-S的逃避、反刍时间和负性元认知在治疗条件与抑郁症状之间起中介作用。结论：我们的研究结果表明，研究变量是抑郁症治疗的改变机制。他们还认为，MCT的效果可能是通过反刍的变化来调节的。如果在进一步的研究中得到证实，针对这些变化机制可能会增加抑郁症治疗的有效性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Psychotherapy Research PSYCHOLOGY, CLINICAL-

CiteScore

7.80

自引率

10.30%

发文量

期刊介绍： Psychotherapy Research seeks to enhance the development, scientific quality, and social relevance of psychotherapy research and to foster the use of research findings in practice, education, and policy formulation. The Journal publishes reports of original research on all aspects of psychotherapy, including its outcomes, its processes, education of practitioners, and delivery of services. It also publishes methodological, theoretical, and review articles of direct relevance to psychotherapy research. The Journal is addressed to an international, interdisciplinary audience and welcomes submissions dealing with diverse theoretical orientations, treatment modalities.