Cognitive predictors and moderators of winter depression treatment outcomes in cognitive-behavioral therapy vs. light therapy.
Study Goal
The researchers aimed to determine whether baseline cognitive vulnerability constructs could predict or moderate treatment outcomes for SAD patients receiving light therapy (LT), cognitive-behavioral therapy (CBT), or their combination.
Results Summary
Cognitive constructs did not predict acute treatment outcomes, but higher baseline dysfunctional attitudes and negative automatic thoughts were associated with worse next-winter depression outcomes for LT alone compared to CBT. Patients with rigid cognitions fared better with CBT than LT.
Population
Seasonal affective disorder (SAD) patients
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
light therapy (LT) | no change | acute treatment outcomes | SAD patients | null | did not predict or moderate | #1 |
cognitive-behavioral therapy (CBT) | no change | acute treatment outcomes | SAD patients | null | did not predict or moderate | #2 |
combination (CBT + LT) | no change | acute treatment outcomes | SAD patients | null | did not predict or moderate | #3 |
cognitive-behavioral therapy (CBT) | decrease | next winter depression outcomes | SAD patients with higher baseline levels of dysfunctional attitudes and negative automatic thoughts | null | had less severe depression | #4 |
light therapy (LT) | increase | next winter depression outcomes | SAD patients with baseline dysfunctional attitudes and negative automatic thoughts at or above the sample mean | null | had more severe depressive symptoms | #5 |
cognitive-behavioral therapy (CBT) | no change | next winter depression outcomes | SAD patients with baseline dysfunctional attitudes and negative automatic thoughts | null | did not predict treatment outcomes | #6 |
combination (CBT + LT) | no change | next winter depression outcomes | SAD patients with baseline dysfunctional attitudes and negative automatic thoughts | null | did not predict treatment outcomes | #7 |
light therapy (LT) | increase | subsequent winter depression | SAD patients with extremely rigid cognitions | null | did not fare as well | #8 |
There is no empirical basis for determining which seasonal affective disorder (SAD) patients are best suited for what type of treatment. Using data from a parent clinical trial comparing light therapy (LT), cognitive-behavioral therapy (CBT), and their combination (CBT + LT) for SAD, we constructed hierarchical linear regression models to explore baseline cognitive vulnerability constructs (i.e., dysfunctional attitudes, negative automatic thoughts, response styles) as prognostic and prescriptive factors of acute and next winter depression outcomes. Cognitive constructs did not predict or moderate acute treatment outcomes. Baseline dysfunctional attitudes and negative automatic thoughts were prescriptive of next winter treatment outcomes. Participants with higher baseline levels of dysfunctional attitudes and negative automatic thoughts had less severe depression the next winter if treated with CBT than if treated with LT. In addition, participants randomized to solo LT who scored at or above the sample mean on these cognitive measures at baseline had more severe depressive symptoms the next winter relative to those who scored below the mean. Baseline dysfunctional attitudes and negative automatic thoughts did not predict treatment outcomes in participants assigned to solo CBT or CBT + LT. Therefore, SAD patients with extremely rigid cognitions did not fare as well in the subsequent winter if treated initially with solo LT. Such patients may be better suited for initial treatment with CBT, which directly targets cognitive vulnerability processes.