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An Initial Study of Symptom Accommodation in Adults with Depression

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Abstract

While symptom accommodation has been examined within obsessive-compulsive disorder (OCD) and anxiety disorders, this concept has yet to be studied as it applies to depression. This study provided an initial examination of the nature, incidence, clinical correlates, and predictors of symptom accommodation among adults with depression, and validated a self-report measure of symptom accommodation related to depression, the Symptom Accommodation Scale–Depression–Patient Version (SAS-D-PV). Sixty-nine adults who were diagnosed with a mood disorder upon entry to a residential treatment program completed the SAS-D-PV along with measures of depression severity, anxiety, and anger outbursts. An exploratory factor analysis yielded a six-item scale with two factors (frequency and impact), with good internal consistency for the total score, Frequency subscale, and Impact subscale (α = .81, .87, and .85, respectively). Participants reported accommodation behaviors taking place on average two to three times over the past week. Symptom accommodation was associated with greater depression severity, anxiety sensitivity, social anxiety, and anger outbursts. Depression severity emerged as a significant predictor of symptom accommodation. These results suggest that symptom accommodation does apply to depression. Additional research is warranted to determine the impact accommodation has on symptom course and treatment outcome.

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Correspondence to Rachel C. Leonard.

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This research was approved by the University of South Florida Institutional Review Board as well as the treatment facility’s internal human subjects and clinical steering committees. Informed consent was obtained from all individual participants included in the study. This study specifically did not receive funding, although one of the authors has received research support through several grants as disclosed elsewhere.

Conflict of Interest

Rachel C. Leonard, PhD, Andrea Guastello, PhD, Danielle Cooke, Eli R. Lebowitz, PhD, and Bradley C. Riemann, PhD declare that they have no conflict of interest. Eric A. Storch, PhD is a consultant for Levo Therapeutics. He has grant support from the National Institutes of Health, Red Cross, ReBuild Texas, Texas Educational Coordinating Board, and the Greater Houston Community Foundation. He also receives royalties from APA, Elsevier, Lawrence Erlbaum, Springer, and Wiley.

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Leonard, R.C., Guastello, A., Cooke, D. et al. An Initial Study of Symptom Accommodation in Adults with Depression. J Cogn Ther 14, 537–551 (2021). https://doi.org/10.1007/s41811-020-00097-0

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  • DOI: https://doi.org/10.1007/s41811-020-00097-0

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