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Effects of Rumination and Initial Severity on Remission to Cognitive Therapy for Depression

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Abstract

Trait rumination, a tendency to focus on depressive symptoms and negative information, is associated with longer and more severe episodes of depression. This study examined whether trait rumination was also associated with initial remission from unipolar depression in Cognitive Therapy, which we hypothesized would target this coping style. Eighty one patients completed measures of depressive severity and rumination before and after 16–20 sessions of procedurally determined Cognitive Therapy. Pre-treatment rumination and severity were generally associated with later initial remission and lower odds of achieving remission. Limited evidence also suggested that for the most severe patients, rumination was associated with earlier initial remission and greater odds of achieving initial remission. Cognitive Therapy was associated with significant reductions in both rumination and severity. Results suggest that (1) pre-treatment assessment of rumination and severity could help to plan treatment course and (2) Cognitive Therapy is associated with changes in cognitive coping styles.

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Notes

  1. Patients who did not complete the full protocol were compared in terms of baseline demographic variables, initial rumination, initial severity scores (Beck Depression Inventory; (Beck et al. 1961) total number of episodes, and duration of current episode. No significant differences were found for gender, initial severity, pre-treatment rumination, total number of episodes, and duration of current episode. Patients who complete the full protocol were significantly older (M = 44.7, SD = 11.8), than did the 32 patients who did not complete the full protocol (M = 36.3, SD = 11.6), t(118) = −3.46, p < .0008.

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Acknowledgements

We thank the University of Pittsburgh Mood Disorders Treatment and Research Program for help in recruitment and administration of rumination and severity measures. We also thank the reviewers for their thoughtful comments which greatly improved this article. This research was supported by MH16804, MH58356, MH58397, MH69618, MH064159, MH074807.

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Authors and Affiliations

  1. Western Psychiatric Institute and Clinic, the University of Pittsburgh Medical Center, 3811 O’Hara Street, Pittsburgh, PA, 15213, USA

    Neil P. Jones, Greg J. Siegle & Michael E. Thase

  2. University of Pennsylvania and the Philadelphia Veterans Affairs Medical Center, Philadelphia, PA, USA

    Michael E. Thase

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  1. Neil P. Jones
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  2. Greg J. Siegle
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  3. Michael E. Thase
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Correspondence to Neil P. Jones.

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Jones, N.P., Siegle, G.J. & Thase, M.E. Effects of Rumination and Initial Severity on Remission to Cognitive Therapy for Depression. Cogn Ther Res 32, 591–604 (2008). https://doi.org/10.1007/s10608-008-9191-0

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