Forrest Scogin

Efficacy of psychosocial treatments for geriatric depression : a quantitative review

A meta-analysis of 17 studies examined the efficacy of psychosocial treatments for depression among older adults. Studies were included only if a comparison was made to a control condition (no-, delayed-, or placebo-treatment) or another psychosocial intervention. Results indicated that treatments were reliably more effective than no-treatment on self-rated and clinician-rated measures of depression. Effect sizes for studies involving participants with major depression disorder were also reliably different from zero, as were effect sizes from studies involving participants with less severe levels of depression. These findings compare favorably with several other quantitative reviews of treatments for depression. Results suggest more balanced presentations of the potential benefits of psychosocial interventions are warranted.

Efficacy of self-administered treatment programs : meta-analytic review

Using meta-analysis, we examined the efficacy of self-administered treatments. Self-administered treatments were compared with no treatment and with therapist-administered treatments. Results suggest that self-administered treatments in general are effective in comparison with no treatment. The limitations of this review are noted, including those that preclude the conclusion that self-administered treatments are as effective as therapist-administered programs

Cognitive bibliotherapy for mild and moderate adolescent depressive symptomatology.

The efficacy of cognitive bibliotherapy for adolescents experiencing mild and moderate depressive symptomatology was examined with a group of 22 community-dwelling adolescents. Cognitive bibliotherapy was determined to be superior to a delayed-treatment control condition. The treatment produced both statistically and clinically significant improvements in depressive symptoms. Treatment gains were maintained at 1-month follow-up. A significant decrease in dysfunctional thoughts, but not in negative automatic thoughts, was found after treatment. These results contribute to converging evidence on the efficacy of cognitive-behavioral treatments for adolescents experiencing depressive symptoms.

The outcome of cognitive bibliotherapy with depressed adults.

The effectiveness of minimal-contact cognitive bibliotherapy was examined with a group of 80 depressed adults who were recruited from the community. Minimal-contact cognitive bibliotherapy was found to be superior to a waiting-list control group. The results were both statistically and clinically significant, and the treatment group maintained their levels of improvement at 3-month follow-up. The results also indicated significant decreases in dysfunctional attitudes and automatic negative thoughts after treatment. It appeared that the treatment also served a psychoeducational function. The interventive and preventive implications of these results are discussed.

Cognitive Therapy for Depression: A Comparison of Individual Psychotherapy and Bibliotherapy for Depressed Older Adults

Thirty-one community-residing older adults age 60 or over either received 16 sessions of individual cognitive psychotherapy (Beck, Rush, Shaw, & Emery, 1979) or read Feeling Good (Burns, 1980) for bibliotherapy. Posttreatment comparisons with the delayed-treatment control indicated that both treatments were superior to a delayed-treatment control. Individual psychotherapy was superior to bibliotherapy at posttreatment on self-reported depression, but there were no differences on clinician-rated depression. Further, bibliotherapy participants continued to improve after posttreatment, and there were no differences between treatments at 3-month follow-up. Results suggest that bibliotherapy and that individual psychotherapy are both viable treatment options for depression in older adults.

Reliability and validity of the short form beck depression inventory with older adults

This study investigated the reliability and validity of the short form Beck Depression Inventory with older adults. Sixty-one clinically depressed older outpatients and 57 non-patient older volunteers comprised the sample. The patient group completed the BDI prior to and at completion of depression treatment. Estimates of internal reliability suggest that the short form BDI possesses adequate Spearman-Brown and alpha coefficients. Congruent validity estimates were less satisfactory, as the correlation between the BDI and the HRSD was statistically significant, but low. Criterion group validity, diagnostic sensitivity, and sensitivity to change estimates were all acceptable. Thus, the short form BDI is adequately reliable to suggest its use as a research and clinical tool with older adults, although further study of the instruments validity is needed.

A three-year follow-up of older adult participants in a memory-skills training program.

This study examined the long-term effects of participation in a self-taught memory training program. In all, 27 memory training and 13 nontraining participants were assessed at approximately 3-year follow-ups. Assessment of these groups prior to the introduction of training had revealed nonsignificant differences in memory performance but marked differences in level of memory complaints, with training participants evidencing higher levels of complaints. The current assessment again demonstrated overall nonsignificant differences in memory performance but significant differences in memory complaints between the two groups. More specifically, the training group evidenced significant decreases in memory performance over the 3-year interval, but no significant changes in memory complaints were observed for either group. Thus, memory training appeared to have little long-term effect on memory functioning. Future research should explore long-term maintenance strategies in memory training with older adults.

The Efficacy of Self-Examination Therapy and Cognitive Bibliotherapy in the Treatment of Mild to Moderate Depression

To determine the efficacy of two self-administered treatments in the treatment of mild to moderate depression, thirty-two middle aged adults volunteered for a study in which they were randomly assigned to either cognitive bibliotherapy, self-examination therapy, or a wait list control group. After a one-month wait, participants in the wait list control group received one of the two self-administered treatments. Analyses indicated that participants in cognitive bibliotherapy and self-examination therapy differed significantly from participants in the wait list control group, and symptomatic improvement in these two groups was maintained for two months after treatment ended. The wait list control group also showed improvement in depressive symptoms after receiving one of the self-administered treatments. Cognitive bibliotherapy and self-examination therapy were nondifferentially efficacious. The brevity and flexibility of self-examination therapy suggests that this self-administered treatment may be a viabl...

Mindfulness-based cognitive therapy for the treatment of headache pain: a pilot study.

Objective:This pilot study reports the findings of a randomized controlled trial (RCT) investigating the feasibility, tolerability, acceptability, and initial estimates of efficacy of mindfulness-based cognitive therapy (MBCT) compared to a delayed treatment (DT) control for headache pain. It was hypothesized that MBCT would be a viable treatment approach and that compared to DT, would elicit significant improvement in primary headache pain-related outcomes and secondary cognitive-related outcomes. Materials and Methods:RCT methodology was employed and multivariate analysis of variance models were conducted on daily headache diary data and preassessment and postassessment data for the intent-to-treat sample (N=36), and on the completer sample (N=24). Results:Patient flow data and standardized measures found MBCT for headache pain to be feasible, tolerable, and acceptable to participants. Intent-to-treat analyses showed that compared to DT, MBCT patients reported significantly greater improvement in self-efficacy (P=0.02, d=0.82) and pain acceptance (P=0.02, d=0.82). Results of the completer analyses produced a similar pattern of findings; additionally, compared to DT, MBCT completers reported significantly improved pain interference (P<0.01, d=−1.29) and pain catastrophizing (P=0.03, d=−0.94). Change in daily headache diary outcomes was not significantly different between groups (P’s>0.05, d’s⩽−0.24). Discussion:This study empirically examined MBCT for the treatment of headache pain. Results indicated that MBCT is a feasible, tolerable, acceptable, and potentially efficacious intervention for patients with headache pain. This study provides a research base for future RCTs comparing MBCT to attention control, and future comparative effectiveness studies of MBCT and cognitive-behavioral therapy.

Improving quality of life in diverse rural older adults: a randomized trial of a psychological treatment.

The efficacy of home-delivered cognitive-behavioral therapy (CBT) in improving quality of life and reducing psychological symptoms in older adults was examined in this study. One hundred thirty-four participants, predominately African American and characterized as primarily rural, low resource, and physically frail, were randomly assigned to either CBT or a minimal support control condition. Results indicate that CBT participants evidenced significantly greater improvements in quality of life and reductions in psychological symptoms. Mediation of treatment through cognitive and behavioral variables was not found despite the acceptable delivery of CBT by research therapists. These data suggest that treatment can be effective with a disadvantaged sample of older adults and extend efficacy findings to quality of life domains. Creating access to evidence-based treatments through nontraditional delivery is an important continuing goal for geriatric health care.