Change in Seasonal Beliefs Mediates the Durability Advantage of Cognitive-Behavioral Therapy Over Light Therapy for Winter Depression.
Study Goal
The researchers aimed to compare the enduring benefits of CBT-SAD and light therapy for winter depression, specifically examining whether improvements in seasonal beliefs during CBT-SAD contributed to its long-term efficacy.
Results Summary
Light therapy was found to be comparably efficacious to CBT-SAD in treating acute winter depression, but CBT-SAD showed greater long-term benefits, mediated by improved seasonal beliefs. Changes in seasonal beliefs during CBT-SAD were associated with reduced depression symptoms at follow-ups.
Population
Adults with Major Depression, Recurrent with Seasonal Pattern (N = 177).
Effective Dosage
Not specified
Duration
6 weeks
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
cognitive-behavioral therapy for seasonal affective disorder (CBT-SAD) | decrease | depression symptoms | Currently depressed adults with Major Depression, Recurrent with Seasonal Pattern | - | improvement in depression symptoms during CBT-SAD mediated by reduced seasonal beliefs | #1 |
light therapy | decrease | depression symptoms | Currently depressed adults with Major Depression, Recurrent with Seasonal Pattern | - | comparably efficacious | #2 |
cognitive-behavioral therapy for seasonal affective disorder (CBT-SAD) | decrease | seasonal beliefs | Currently depressed adults with Major Depression, Recurrent with Seasonal Pattern | overall change in seasonal beliefs in the medium-effect range | larger improvements in seasonal beliefs | #3 |
cognitive-behavioral therapy for seasonal affective disorder (CBT-SAD) | decrease | depression symptoms | Currently depressed adults with Major Depression, Recurrent with Seasonal Pattern | - | greater change towards more flexible seasonal beliefs during active treatment was associated with less severe depression symptoms following treatment | #4 |
In treating an acute episode of winter depression, cognitive-behavioral therapy for seasonal affective disorder (CBT-SAD) and light therapy are comparably efficacious, with improvement in depression symptoms during CBT-SAD mediated by reduced seasonal beliefs (i.e., maladaptive thoughts about the seasons, light availability, and weather). Here, we tested whether the enduring benefit of CBT-SAD over light therapy following treatment is associated with offsetting seasonal beliefs during CBT-SAD. Currently depressed adults with Major Depression, Recurrent with Seasonal Pattern (N = 177) were randomized to 6 weeks of light therapy or group CBT-SAD and followedup one and two winters after treatment. Outcomes measured during treatment and at each follow-up included depression symptoms on the Structured Clinical Interview for the Hamilton Rating Scale for Depression-SAD Version and Beck Depression Inventory-Second Edition. Candidate mediators measured at pre-, mid-, and posttreatment were SAD-specific negative cognitions (Seasonal Beliefs Questionnaire; SBQ); general depressogenic cognitions (Dysfunctional Attitudes Scale; DAS); brooding rumination (Ruminative Response Scale-Brooding subscale; RRS-B); and chronotype (Morningness-Eveningness Questionnaire; MEQ). Latent growth curve mediation models found a significant positive path from treatment group to the slope of SBQ during treatment, with CBT-SAD showing larger improvements in seasonal beliefs with overall change in seasonal beliefs in the medium-effect range, and significant positive paths from SBQ slope to depression scores at the first and second winter follow-ups, indicating greater change towards more flexible seasonal beliefs during active treatment was associated with less severe depression symptoms following treatment. Estimated indirect effects (treatment group → SBQ change * SBQ change → outcome) were also significant at each follow-up for each outcome with β