Differential role of CBT skills, DBT skills and psychological flexibility in predicting depressive versus anxiety symptom improvement
Open accessAbstract
Objective: Studies have reported associations between cognitive behavioral therapy (CBT) skill use and symptom improvement in depressed outpatient samples. However, little is known regarding the temporal relationship between different subsets of therapeutic skills and symptom change among relatively severely depressed patients receiving treatment in psychiatric hospital settings. Method: Adult patients with major depression (N = 173) receiving combined psychotherapeutic and pharmacological treatment at a psychiatric hospital completed repeated assessments of traditional CBT skills, DBT skills and psychological flexibility, as well as depressive and anxiety symptoms. Results: Results indicated that only use of behavioral activation (BA) strategies significantly predicted depressive symptom improvement in this sample; whereas DBT skills and psychological flexibility predicted anxiety symptom change. In addition, a baseline symptom severity X BA strategies interaction emerged indicating that those patients with higher pretreatment depression severity exhibited the strongest association between use of BA strategies and depressive symptom improvement. Conclusions: Findings suggest the importance of emphasizing the acquisition and regular use of BA strategies with severely depressed patients in short-term psychiatric settings. In contrast, an emphasis on the development of DBT skills and the cultivation of psychological flexibility may prove beneficial for the amelioration of anxiety symptoms. © 2016 Elsevier Ltd.
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Claims the paper makes
14 of 52 cited sources checked · 10 supported · 0 flagged · accuracy not yet measured
- Premisecitation
ACT has comparable outcomes to CBT for anxiety.
“Several reviews and meta-analyses have concluded that ACT has comparable outcomes to CBT for anxiety (A-Tjak, Davis, Morina, Powers, Smits & Emmelkamp, 2015; Ruiz, 2012; Swain, Hancock, Hainsworth, & Bowman, 2013).”
Quote in the paperSubstantial claim2 of 3 sources checked- cites A-Tjak, Davis, Morina, Powers, Smits & Emmelkamp, 2015 source
The Discussion (page unavailable) says the findings suggest ACT can provide similar outcomes to established psychological interventions for anxiety disorders, but it also notes that anxiety-specific trials were limited. The paper reports no significant overall difference between ACT and established treatments such as CBT; it does not establish comparable ACT–CBT outcomes specifically for anxiety as firmly as the citing sentence states. (LLM, conf=0.84)
Experimental — accuracy not yet measured - cites Ruiz, 2012
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites Swain, Hancock, Hainsworth, & Bowman, 2013 source
- Premisecitation
The finding that DBT skills and psychological flexibility predicted anxiety improvement is consistent with growing evidence supporting the efficacy of newer generation cognitive behavioral approaches, particularly ACT and DBT, for anxiety symptoms and disorders.
“The latter finding is consistent with the growing body of evidence supporting the efficacy of newer generation cognitive behavioral approaches, in particular ACT and DBT, for anxiety symptoms and disorders (Arch et al., 2012; Landy, Schneider & Arch, 2015; Roemer, Orsillo & Salters-Pedneault, 2008; Swain, Hancock, Hainsworth, & Bowman, 2013).”
Quote in the paperSubstantial claim2 of 3 sources checked- cites Arch et al., 2012 source
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measured - cites Landy, Schneider & Arch, 2015 source
- cites Roemer, Orsillo & Salters-Pedneault, 2008 source
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measured
- Premisecitation
Self-reported CBT skills measures may inadvertently measure and be confounded with concurrent symptoms.
“others have noted how measures of self-reported CBT skills may inadvertently measure and be confounded with concurrent symptoms (Strunk et al., 2014).”
Quote in the paperSubstantial claim1 of 1 sources checked- cites Strunk et al., 2014 source
- Study design and conductcitation
The study controlled for two plausible confounds: prior symptom change and concurrent symptoms.
“we controlled for two plausible confounds: prior symptom change and concurrent symptoms (Strunk et al., 2014).”
Quote in the paperSubstantial claim1 of 1 sources checked- cites Strunk et al., 2014 source
In Results, “Does the CCTS merely measure symptom severity?” (page unavailable), Strunk et al. report controlling for depressive symptoms measured at the same assessment. In “Relation of the CCTS and Change in Depressive Symptoms” (page unavailable), they control for intake symptom scores when examining intake-to-post-treatment change, but do not report controlling for prior symptom change. Thus the citation supports the concurrent-symptoms part, not both stated confounds. (LLM, conf=0.83)
Experimental — accuracy not yet measured
- Findingown data
There were no significant interactions between baseline depression severity and cognitive restructuring, psychological flexibility, or DBT skills scores.
“there were no significant interactions between baseline depression severity and the CR subscale of the CBTSQ, nor between baseline depression and either AAQ-II or DBT-WCCL scores (all ps > .15).”
Quote in the paperSubstantial claim- Rests on an assumption: The CES-D-10 and GAD-7 are valid measures of depressive and anxiety symptoms.
- Findingown data
In this sample, only use of behavioral activation strategies significantly predicted depressive symptom improvement.
“Results indicated that only use of behavioral activation (BA) strategies significantly predicted depressive symptom improvement in this sample”
Quote in the paperSubstantial claim - Findingown data
A baseline symptom severity by BA strategies interaction emerged, indicating that patients with higher pretreatment depression severity had the strongest association between BA strategy use and depressive symptom improvement.
“a baseline symptom severity X BA strategies interaction emerged indicating that those patients with higher pretreatment depression severity exhibited the strongest association between use of BA strategies and depressive symptom improvement.”
Quote in the paperSubstantial claim - Findingown data
Pretreatment depression severity significantly moderated the relationship between behavioral activation strategies and depressive symptom improvement.
“The baseline CES-D-10 X BA strategies interaction term was significant (b = −0.12, standard error [SE] = .04, t = −3.01; p = .003).”
Quote in the paperSubstantial claim- Rests on an assumption: The CES-D-10 and GAD-7 are valid measures of depressive and anxiety symptoms.
- Findingown data
Neither behavioral activation nor cognitive restructuring skills predicted subsequent anxiety symptom change.
“However, neither BA nor CR skills predicted anxiety symptom change.”
Quote in the paperSubstantial claim- Rests on an assumption: The CES-D-10 and GAD-7 are valid measures of depressive and anxiety symptoms.
- Findingown data
Greater psychological flexibility, as measured by the AAQ-II, significantly predicted subsequent improvement in anxiety symptoms.
“both the AAQ-II and DBT skills significantly predicted subsequent anxiety symptom improvement”
Quote in the paperSubstantial claim- Rests on an assumption: The CES-D-10 and GAD-7 are valid measures of depressive and anxiety symptoms.
- Findingown data
Greater use of DBT skills significantly predicted subsequent improvement in anxiety symptoms.
“both the AAQ-II and DBT skills significantly predicted subsequent anxiety symptom improvement”
Quote in the paperSubstantial claim- Rests on an assumption: The CES-D-10 and GAD-7 are valid measures of depressive and anxiety symptoms.
- Findingown data
The hospitalized sample had high levels of depressive symptoms at intake, double the clinical cutoff on the CES-D-10.
“the present hospitalized sample had high levels of depressive symptoms at intake (i.e., double the clinical cutoff on the CES-D-10).”
Quote in the paperSubstantial claim- Rests on an assumption: The CES-D-10 and GAD-7 are valid measures of depressive and anxiety symptoms.
- Findingown data
Greater self-reported use of behavioral activation strategies significantly predicted greater subsequent improvement in depressive symptoms.
“greater self-reported use of BA strategies significantly predicted greater subsequent depressive symptom improvement”
Quote in the paperSubstantial claim- Rests on an assumption: The CES-D-10 and GAD-7 are valid measures of depressive and anxiety symptoms.
- Findingown data
Behavioral activation strategies significantly predicted subsequent depressive symptom improvement among patients with higher pretreatment depressive symptoms, but not among those with lower pretreatment depressive symptoms.
“BA strategies were a significant predictor of subsequent depressive symptom improvement among those with relatively higher (b = −0.35, SE = .09, t = −4.00; p < .001), but not lower (b = −0.04, SE = .08, t = −0.53; p = .595), levels of pretreatment depressive symptoms.”
Quote in the paperSubstantial claim- Rests on an assumption: The CES-D-10 and GAD-7 are valid measures of depressive and anxiety symptoms.
- Findingown data
DBT skills and psychological flexibility predicted anxiety symptom change.
“whereas DBT skills and psychological flexibility predicted anxiety symptom change.”
Quote in the paperSubstantial claim - Findingnone given
The present depressed sample also had high levels of anxiety.
“the present depressed sample also presented with high levels of anxiety.”
Quote in the paperSubstantial claim - Findingnone given
Approximately 88% of patients attended CBT-based, DBT-based, and ACT-based groups during their stay in the BHP.
“the majority of patients (approximately 88%) attended CBT-based, DBT-based and ACT-based groups during their stay in the BHP.”
Quote in the paperSubstantial claim - Premisereasoning
Most prior studies of CBT skills and symptom improvement used only one or two concurrent assessments of skills and symptoms.
“most of the associations reported within these studies are based on one or two concurrent assessments (e.g., only pre- and post-treatment) of CBT skills and depressive symptoms.”
- Also stated in: § Conclusions · plain
“previous studies commonly rely on one or two (e.g., pre- and post-treatment) assessment timepoints to represent the state of patient CBT skills throughout treatment.”
Quote in the paperSubstantial claim - Also stated in: § Conclusions · plain
- Premisecitation
Most studies of the association between skills and symptom change were conducted in outpatient settings or controlled clinical trials.
“the bulk of studies investigating the association between skills and symptom change are conducted within the context of outpatient settings or in carefully controlled clinical trials (for an exception, see Jacob et al., 2011).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Jacob et al., 2011 source
- Premisecitation
ACT is associated with greater decreases in experiential avoidance relative to cognitive therapy.
“there is evidence that ACT is associated with greater decreases in experiential avoidance relative to cognitive therapy (Lappalainen, Lehtonen, Skarp, Taubert, Ojanen, & Hayes, 2007)”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Lappalainen, Lehtonen, Skarp, Taubert, Ojanen, & Hayes, 2007 source
- Premisecitation
DBT skills training is effective for decreasing anxiety in adults with affective disorders.
“there is also emerging evidence that DBT skills training is effective for decreasing anxiety in adults with affective disorders (Neacsiu, Eberle, Kramer, Weismann, & Linhean, 2014; Ritschel, Cheavens, & Nelson, 2012).”
Quote in the paperSubstantial claim0 of 2 sources checked- cites Neacsiu, Eberle, Kramer, Weismann, & Linhean, 2014
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites Ritschel, Cheavens, & Nelson, 2012 source
- Premisecitation
The development of psychological flexibility has been more frequently linked with anxiety symptom improvement.
“The development of psychological flexibility has been more frequently linked with anxiety symptom improvement (Bluett et al., 2014).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Bluett et al., 2014 source
- Interpretationown data
Behavioral activation strategies may be particularly beneficial for relatively severely depressed patients.
“These findings indicate that BA strategies may be particularly beneficial for relatively severely depressed patients.”
Quote in the paperSubstantial claim- Rests on an assumption: The CES-D-10 and GAD-7 are valid measures of depressive and anxiety symptoms.
- Interpretationown data
Relatively more depressed patients may benefit from treatments that emphasize behavioral activation over cognitive restructuring.
“these findings suggest that relatively more depressed patients may benefit from treatments emphasizing BA strategies over cognitive restructuring.”
Quote in the paperSubstantial claim- Rests on an assumption: The CES-D-10 and GAD-7 are valid measures of depressive and anxiety symptoms.
- Study design and conductreasoning
The analyses controlled for concurrent symptoms and prior symptom change as covariates.
“These two plausible symptom confounds are included as covariates in the analyses reported below.”
Quote in the paperSubstantial claim - Interpretationreasoning
The severity of the sample and the short-term treatment context may have made it more difficult for patients to acquire and competently implement cognitive restructuring skills compared to behavioral activation strategies.
“the psychiatric severity of the sample, coupled with the short-term treatment context (i.e., average length of stay = 11.7 days), may have made it more challenging for these patients to acquire and learn to competently implement cognitive restructuring (CR) skills, in comparison to relatively less complex BA strategies.”
Quote in the paperSubstantial claim- Rests on an assumption: The CES-D-10 and GAD-7 are valid measures of depressive and anxiety symptoms.
- Interpretationreasoning
Prior symptom change may be a third-variable confound because it predicts both subsequent symptom change and CBT skill use.
“Prior symptom change may represent a third variable confound in so far as it predicts both subsequent symptom change and CBT skill use.”
Quote in the paperSubstantial claim - Premisereasoning
This study is the first to test whether patient-reported CBT skill use, assessed repeatedly during therapy, predicts subsequent depressive symptom improvement.
“To our knowledge, the present study is the first to test whether patient-reported CBT skill use, assessed repeatedly throughout the course of therapy, predicts subsequent depressive symptom improvement.”
Quote in the paperSubstantial claim- Rests on an assumption: Little is known about how different subsets of CBT skills predict symptom improvement among severely depressed patients in psychiatric hospital settings.
- Premisecitation
Dialectical behavior therapy skills have therapeutic benefit in alleviating depression and anxiety in mixed samples of depressed and anxious adults.
“there is growing evidence of the therapeutic benefit of dialectical behavior therapy (DBT) skills in alleviating depression and anxiety in mixed samples of depressed and anxious adults (Neacsiu, Eberle, Kramer, Weismann, & Linhean, 2014; Ritschel, Cheavens, & Nelson, 2012).”
Quote in the paperSubstantial claim0 of 2 sources checked- cites Neacsiu, Eberle, Kramer, Weismann, & Linhean, 2014
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites Ritschel, Cheavens, & Nelson, 2012 source
- Premisecitation
A recent meta-analysis across 63 studies found a significant association between experiential avoidance and anxiety.
“a recent meta-analysis across 63 studies found a significant association between experiential avoidance and anxiety (Bluett et al., 2014).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Bluett et al., 2014 source
- Interpretationcitation
Given the significant associations between experiential avoidance and anxiety, newer generation mindfulness- and acceptance-based skills may have targeted such avoidance more directly and effectively than cognitive restructuring or behavioral activation.
“Given the significant associations between experiential avoidance and anxiety (Bluett et al., 2014), newer generation mindfulness- and acceptance-based skills may have targeted such avoidance more directly and effectively than CR (or BA).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Bluett et al., 2014 source
- Rests on an assumption: The CES-D-10 and GAD-7 are valid measures of depressive and anxiety symptoms.
- Interpretationreasoning
Interventions focused on cultivating acceptance, mindfulness, and psychological flexibility may be generally more effective than other cognitive interventions in decreasing anxiety when symptoms are acute and/or treatment is brief.
“These findings also suggest that interventions focused on cultivating acceptance, mindfulness, and psychological flexibility may be generally more effective than other cognitive interventions (e.g., cognitive restructuring) in decreasing anxiety when symptoms are acute and/or treatment is brief, as in the present study.”
Quote in the paperSubstantial claim- Rests on an assumption: The CES-D-10 and GAD-7 are valid measures of depressive and anxiety symptoms.
- Interpretationown data
The current findings are consistent with previous findings suggesting that behavioral activation strategies may be a more efficient and effective means of targeting depressive symptoms than cognitive interventions.
“the current findings from an intensive CBT-based partial hospital treatment program are consistent with previous findings suggesting that BA strategies may be a more efficient and effective means of targeting depressive symptoms than cognitive interventions (Coffman et al., 2007; Dimidjian et al., 2006).”
Quote in the paperSubstantial claim0 of 2 sources checked- Rests on an assumption: The CES-D-10 and GAD-7 are valid measures of depressive and anxiety symptoms.
- Interpretationreasoning
The findings highlight the complementary utility of different intervention strategies in treating depressive versus anxiety symptoms.
“These findings highlight the complementary utility of these different intervention strategies in treating depressive versus anxiety symptoms.”
Quote in the paperSubstantial claim- Rests on an assumption: The CES-D-10 and GAD-7 are valid measures of depressive and anxiety symptoms.
- Classified as probably not a substantial claim. 36
- May combine two claims. 17
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationCognitive behavioral therapy is efficacious in reducing depressive symptoms.
“Despite the large body of evidence supporting the overall efficacy of CBT in alleviating depressive symptoms (Cuijpers et al., 2013a)”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites Cuijpers et al., 2013a source
Classified as probably not a substantial claim.
PremisecitationGreater depressive symptom improvement is associated with greater acquisition and use of CBT skills, as measured by the SoCT, CBTSQ, and CCTS.
“Studies using these measures have reported that greater depressive symptom improvement is associated with greater acquisition and use of CBT skills, as assessed by the SoCT (Jarrett et al., 2011; 2013), CBTSQ (Jacob et al., 2011; Webb et al., 2013) and CCTS (Strunk et al., 2014).”
Quote in the paperSubstantial claim1 of 3 sources checked- cites Jarrett et al., 2011; 2013
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites Jacob et al., 2011; Webb et al., 2013
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites Strunk et al., 2014 source
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationThere is some evidence that behavioral activation may help normalize abnormalities in neural reward circuitry implicated in depression.
“There is some evidence that BA may help normalize abnormalities in neural reward circuitry implicated in depression (e.g., striatal functioning; Dichter et al., 2009).”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites Dichter et al., 2009 source
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationThe AAQ-II has satisfactory reliability and validity.
“The reliability and validity of the measure have been found to be satisfactory (Bond et al., 2011).”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites Bond et al., 2011 source
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationAcceptance and commitment therapy is efficacious for both depressive and anxiety symptoms.
“there is evidence that acceptance and commitment therapy (ACT) is efficacious for both depressive and anxiety symptoms (Ost, 2014; Swain, Hancock, Hainsworth, & Bowman, 2013).”
Quote in the paperNot a substantial claim1 of 2 sources checkedProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationThe DBT-WCCL skills subscale has demonstrated adequate to excellent reliability and validity, including the ability to discriminate between treatment conditions that provide DBT skills and those that do not.
“The measure has demonstrated adequate to excellent reliability and validity, including the ability to discriminate from treatment conditions providing DBT skills versus those that do not (Neacsiu, Rizvi, & Linehan, 2010; Neacsiu, Rizvi, Vitaliano, Lynch, & Linehan, 2010).”
Quote in the paperNot a substantial claim1 of 2 sources checkedProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationThere is growing evidence of the efficacy of ACT for depressive symptoms.
“there is a growing evidence of the efficacy of ACT for depressive symptoms (A-Tjak et al., 2015; Forman et al., 2007)”
Quote in the paperNot a substantial claim1 of 2 sources checkedProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductcitationThe CES-D-10 has high internal consistency in similar psychiatric samples and in the current study.
“The CES-D-10 has been shown to have high internal consistency in similar psychiatric samples (α = .87; Webb et al., 2013) and in the current study (α = .85).”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites Webb et al., 2013 source
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Findingown dataThe average duration of treatment was 11.72 days, with a standard deviation of 3.31 and a range of 4 to 26 days.
“The average duration of treatment for these patients was 11.72 (SD = 3.31; Range 4–26) days.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataThe sample had high pretreatment depression severity, with a mean CES-D-10 score double the clinical cutoff.
“The pretreatment mean CES-D-10 depression score for the sample (M = 20.30) was double the suggested clinical cutoff of 10 (Andresen et al., 1994).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Andresen et al., 1994 source
May combine two claims.
Findingown dataCognitive restructuring, DBT skills, and psychological flexibility were not significantly associated with depressive symptom improvement.
“There were no significant associations between depressive symptom improvement and the other skill domain/predictor variables (CR, DBT, AAQ-II).”
Quote in the paperSubstantial claim- Rests on an assumption: The CES-D-10 and GAD-7 are valid measures of depressive and anxiety symptoms.
May combine two claims.
Findingown dataThe sample reported relatively large increases in cognitive restructuring skills from intake to discharge, with a numerically larger increase for behavioral activation strategies.
“our sample did report relatively large increases in their use of CR skills (Cohen’s d = .77) from intake to discharge (albeit the increase was numerically larger for BA strategies [d = .89]).”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataDiagnostic comorbidity was common in the sample, with 61.3% meeting criteria for a current anxiety disorder.
“diagnostic comorbidity was also common, in particular for anxiety disorders (61.3% of the sample met criteria for a current anxiety disorder).”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim. May combine two claims.
Findingnone givenThe study was conducted in a short-term naturalistic behavioral health partial hospital program with a sample characterized by high levels of depressive symptoms and comorbidities, particularly anxiety disorders.
“the study was conducted within the context of a short-term naturalistic behavioral health partial hospital program in a sample characterized by high levels of depressive symptoms and comorbidities (in particular, anxiety disorders).”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Findingown dataPatients in the study received individual and group therapy and were also prescribed psychiatric medications.
“patients in our study did not only receive individual and group therapy, but were also prescribed psychiatric medications.”
Quote in the paperNot a substantial claimMay combine two claims.
InterpretationreasoningBecause most prior studies used cross-sectional designs, a significant association between CBT skills and symptom improvement could be due to skill use causing symptom change, symptom change causing skill use, or an unmeasured confound.
“Given the cross-sectional designs used within most studies to date, a significant association between CBT skills and symptom improvement could be due to skill use causing symptom change or vice-versa (or be the result of an unmeasured third variable confound).”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S1 (asserted). May combine two claims.
InterpretationreasoningBA may be particularly beneficial in briefer treatment contexts compared to CR skills, which may require more time to acquire and use competently.
“BA may be particularly beneficial in briefer treatment contexts, in comparison to relatively more complex CR skills, which may require more time to acquire and learn to competently utilize.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationThe DBT-WCCL skills subscale has demonstrated adequate psychometric properties in a transdiagnostic BHP sample.
“The DSS has also demonstrated adequate psychometric properties in a transdiagnostic sample from the BHP (Stein, Hearon, Beard, Hsu, & Björgvinsson, 2016).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Stein, Hearon, Beard, Hsu, & Björgvinsson, 2016 source
Classified as probably not a substantial claim.
PremisecitationThe theoretical literature on CBT and empirical findings highlight the benefit of BA strategies for more severely depressed patients.
“The theoretical literature on CBT (Beck et al., 1979; Coffman et al., 2007) and empirical findings (Dimidjian et al., 2006) highlight the benefit of BA strategies for more severely depressed patients.”
Quote in the paperSubstantial claim0 of 3 sources checkedProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataThe internal consistency for the modified CES-D-10 was good (α = .88).
“Internal consistency for the measure was good (α = .88).”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationThe CBTSQ-16 was validated among patients in the BHP and showed high internal consistency for cognitive restructuring and behavioral activation.
“The CBTSQ-16 was validated among patients within the BHP and demonstrated high internal consistency (α = .84 for cognitive restructuring, α = .80 for behavioral activation; see Jacob et al., 2011).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Jacob et al., 2011 source
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataIn this sample, the DBT-WCCL skills subscale had excellent internal consistency.
“The internal consistency of this subscale in our sample was excellent (α = .94).”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductcitationThe same modification to the instructions of a similar scale did not affect its psychometric properties.
“The same modification to the instructions of a similar scale did not affect its psychometric properties (Beard & Björgvinsson, 2014).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Beard & Björgvinsson, 2014 source
May combine two claims.
Study design and conductown dataNeither treatment duration nor the number of available data points moderated the associations between skill use and symptom change.
“Neither the duration of treatment (i.e., number of days from partial hospital admission to discharge) nor the number of data points available moderated the associations tested below between skill use and symptom change”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductcitationFor partial hospital patients, inter-rater reliability between the MINI and program psychiatrists is .69 for MDD and .75 for Bipolar Disorder-Depressed.
“For the partial hospital patients, inter-rater reliability between the MINI and the program psychiatrists is .69 for MDD and .75 for Bipolar Disorder-Depressed (Kertz, Bigda-Peyton, Rosmarin, & Björgvinsson, 2012).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Kertz, Bigda-Peyton, Rosmarin, & Björgvinsson, 2012 source
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataIn this sample, the CBTSQ overall and its behavioral activation and cognitive restructuring subscales had acceptable to good internal consistency.
“In our sample, the internal consistency of the overall measure was good (α = .89), with acceptable to good consistency of the subscales for behavioral activation (α = .76) and cognitive restructuring (α = .83).”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
PremisecitationDecreases in experiential avoidance mediate anxiety and depression outcomes.
“such decreases mediate anxiety and depression outcomes (Forman et al., 2007).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Forman et al., 2007 source
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationDBT skills use has previously been shown to mediate depressive symptom improvement within a BPD sample.
“DBT skills use has previously been shown to mediate depressive symptom improvement (within a BPD sample; Neacsiu et al., 2010).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Neacsiu et al., 2010
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Classified as probably not a substantial claim.
PremisecitationJarrett et al. (2011; 2013) reported that the SoCT, assessed at one mid-treatment timepoint, prospectively predicted post-treatment depression response while controlling for pre-treatment depression scores.
“Jarrett et al. (2011; 2013) reported that their SoCT measure, assessed at one mid-treatment timepoint, prospectively predicted post-treatment depression response (controlling for pre-treatment depression scores).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Jarrett et al. (2011; 2013)
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationCBT theory emphasizes the benefits of behavioral activation for more severely depressed patients, particularly in early treatment phases.
“CBT theory emphasizes the benefits of BA for more severely depressed patients, in particular in the early phases of treatment to aid patients in gradually re-engaging with antidepressant sources of reward and positive reinforcement in their environment (Beck et al., 1979; Coffman et al., 2007).”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites Beck et al., 1979
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites Coffman et al., 2007 source
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataThe internal consistency for the GAD-7 in the sample was good (α = .84).
“The internal consistency for the GAD-7 in our sample was good (α = .84).”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationClinical trial findings highlight the relative benefits of behavioral activation for higher but not lower levels of depression severity.
“These results are consistent with clinical trial findings highlighting the relative benefits of BA for higher - but not lower - levels of depression severity (Dimidjian et al., 2006).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Dimidjian et al., 2006 source
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationDepression and anxiety co-occur at exceptionally high rates.
“Given the exceptionally high rates of co-occurrence between depression and anxiety (Kessler et al., 2003)”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Kessler et al., 2003 source
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductcitationGroup leaders' adherence to group protocols was rated with excellent inter-rater reliability, and they addressed 83% of protocol components on average.
“Group leaders were rated for adherence to the group protocols twice per year by trained research assistants. Inter-rater reliability is excellent (r = .99), and group leaders, on average, addressed 83% of protocol components during each group (Garner et al., 2014).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Garner et al., 2014
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
May combine two claims.
PremisecitationJarrett et al. did not control for concurrent symptoms or prior symptom change, both of which are plausible confounds.
“However, the authors did not control for (1) concurrent symptoms (i.e., assessed at the time at which the SoCT was measured) or (2) prior symptom change (i.e., symptom improvement prior to the SoCT assessment), both of which represent plausible confounds.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Jarrett et al. (2011; 2013)
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
May combine two claims.
Study design and conductcitationThe GAD-7 has good reliability and validity and is a valid measure of general anxiety in the partial hospital population, including the 24-hour version.
“The GAD-7 has shown good reliability and validity (Kroenke, Spitzer, Williams, Monohan, & Lowe, 2007) and as measure of general anxiety in our partial hospital population, including the 24-hour version (Beard & Björgvinsson, 2014).”
Quote in the paperSubstantial claim0 of 2 sources checkedProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductown dataSeventy-five percent of the sample had at least three data points for CBT skills, 75% for DBT skills, 83% for the AAQ-II, and 100% for the CES-D-10 and GAD-7.
“75% (129/173) of our sample had at least 3 data points for CBT skills (Mean # of data points = 2.9; SD = .67). These values were 75% (130/173) for DBT skills (M = 2.9; SD = .61), 83% (143/173) for the AAQ-II (M = 3.0; SD = .61), and 100% for both the CES-D-10 (M = 6.9; SD = 1.26) and the GAD-7 (M = 6.8; 1.36).”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataIn this sample, the AAQ-II had good internal consistency.
“Internal consistency in our sample was good (α = .84).”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductcitationThe MINI has strong reliability and validity relative to the SCID-IV, with inter-rater reliabilities ranging from kappas of .89 to 1.0.
“The MINI has strong reliability and validity in relation to the Structured Clinical Interview for DSM-IV (SCID-IV), with inter-rater reliabilities ranging from kappas of .89–1.0 (Sheehan et al., 1998).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Sheehan et al., 1998
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Classified as probably not a substantial claim.
Study design and conductnone givenThe analyses exploring anxiety symptom change were exploratory.
“the present study focused on the prediction of depressive symptom improvement and our analyses exploring anxiety symptom change were exploratory.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).
InterpretationreasoningThere are undoubtedly other factors within the partial hospital treatment context that contributed to depressive and anxiety symptom improvement.
“There are undoubtedly other factors within this partial hospital treatment context that contributed to depressive and anxiety symptom improvement (e.g., increased daily structure and social contact, medication changes, reduced internalized stigma).”
Quote in the paperNot a substantial claim- Rests on an assumption: The CES-D-10 and GAD-7 are valid measures of depressive and anxiety symptoms.
Probably not a substantial claim: may not pass S3 (load-bearing).
InterpretationreasoningThe results may not generalize to the typical outpatient setting.
“Although our results may not generalize to the typical outpatient setting”
Quote in the paperNot a substantial claim
The paper relies on this without support.
The mechanisms by which CBT alleviates depressive symptoms are poorly understood.
“the mechanisms that account for symptom improvement remain poorly understood.”
The paper relies on this without support.
Little is known about how different subsets of CBT skills predict symptom improvement among severely depressed patients in psychiatric hospital settings.
“We know surprisingly little about the extent to which different subsets of CBT skills predict symptom improvement among more severely depressed patients receiving treatment in psychiatric hospital settings.”
The paper relies on this without support.
The skills-outcome literature to date may not generalize to more acute settings such as inpatient, residential, or partial hospital units.
“a primary impetus for the current study was that the skills-outcome literature to date may not generalize to more acute settings (inpatient, residential, partial hospital units).”
The paper relies on this without support.
The CES-D-10 and GAD-7 are valid measures of depressive and anxiety symptoms.
“The CES-D-10 and GAD-7 were administered everyday of treatment, including admission and discharge.”
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“Acceptance and Action QuestionnairedII (AAQ-II; Bond et al., 2011).”
BackgroundCognitive Therapy in Depression
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“A second group focused on identifying and challenging negative automatic thoughts related to depression and was guided by a protocol adapted from Beck et al. (1979).”
BackgroundMethodDimidjian, S., Hollon, S. D., Dobson, K. S., Schmaling, K. B., Kohlenberg, R. J., Addis, M. E., Gallop, R., McGlinchey, J. B., Markley, D. K., Gollan, J. K., et al. (2006) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.74.4.658 · Cited by 1,607 · cited 4× · see citing works
“…findings from an intensive CBT-based partial hospital treatment program are consistent with previous findings suggesting that BA strategies may be a more efficient and effective means of targeting depressive symptoms than cognitive interventions (Coffman et al., 2007; Dimidjian et al., 2006).”
BackgroundResultInfluentialReconsidering anhedonia in depression: Lessons from translational neuroscience
Treadway, M. T., & Zald, D. H. (2011) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2010.06.006 · Cited by 1,579 · cited 1× · see citing works
“Additional proposed mediators of BA include improvements in the cardinal depressive symptom of anhedonia (Treadway & Zald, 2011) and decreased rumination (Watkins & Nolen-Hoeksema, 2014).”
BackgroundHayes, S. C., Levin, M. E., Plumb-Vilardaga, J., Villatte, J. L., & Pistorello, J. (2013) · Behavior Therapy · doi:10.1016/j.beth.2009.08.002 · Cited by 1,120 · see citing works
Cuijpers, P., Berking, M., Andersson, G., Quigley, L., Kleiboer, A., & Dobson, K. S. (2013) · The Canadian Journal of Psychiatry · doi:10.1177/070674371305800702 · Cited by 1,066 · cited 1× · see citing works
“Despite the large body of evidence supporting the overall efficacy of CBT in alleviating depressive symptoms (Cuijpers et al., 2013), the mechanisms that account for symptom improvement remain poorly understood.”
BackgroundA-Tjak, J. G. L., Davis, M. L., Morina, N., Powers, M. B., Smits, J. A. J., & Emmelkamp, P. M. G. (2015) · Psychotherapy and Psychosomatics · doi:10.1159/000365764 · Cited by 921 · cited 2× · see citing works
“Several reviews and meta-analyses have concluded that ACT has comparable outcomes to CBT for anxiety (A-Tjak et al., 2015; Ruiz, 2012; Swain et al., 2013).”
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Zanarini, M. C., Vujanovic, A. A., Parachini, E. A., Boulanger, J. L., Frankenburg, F. R., & Hennen, J. (2003) · Journal of Personality Disorders · doi:10.1521/pedi.17.6.568.25355 · Cited by 720 · see citing works
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“Researchers have speculated that the development of greater psychological flexibility may account for the therapeutic benefits of ACT on anxiety symptoms (For a review, see Bluett et al., 2014; Forman et al., 2007).”
BackgroundRoemer, L., Orsillo, S. M., & Salters-Pedneault, K. (2008) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0012720 · Cited by 502 · see citing works
The efficacy of Acceptance and Commitment Therapy: An updated systematic review and meta-analysis
Öst, L.-G. (2014) · Behaviour Research and Therapy · doi:10.1016/j.brat.2014.07.018 · Cited by 476 · cited 3× · see citing works
“For example, there is evidence that acceptance and commitment therapy (ACT) is efficacious for both depressive and anxiety symptoms (Ost, 2014; Swain, Hancock, Hainsworth, & Bowman, 2013).”
BackgroundArch, J. J., Eifert, G. H., Davies, C., Vilardaga, J. C. P., Rose, R. D., & Craske, M. G. (2012) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0028310 · Cited by 443 · cited 2× · see citing works
“The latter finding is consistent with the growing body of evidence supporting the efficacy of newer generation cognitive behavioral approaches, in particular ACT and DBT, for anxiety symptoms and disorders (Arch et al., 2012; Landy, Schneider, & Arch, 2015; Roemer, Orsillo, & Salters-Pedneault, 2008; Swain et al., 201…”
BackgroundResultNeacsiu, A. D., Rizvi, S. L., & Linehan, M. M. (2010) · Behaviour Research and Therapy · doi:10.1016/j.brat.2010.05.017 · Cited by 426 · see citing works
Neacsiu, A. D., Eberle, J. W., Kramer, R., Wiesmann, T., & Linehan, M. M. (2014) · Behaviour Research and Therapy · doi:10.1016/j.brat.2014.05.005 · Cited by 394 · cited 1× · see citing works
“As previously noted, there is also emerging evidence that DBT skills training is effective for decreasing anxiety in adults with affective disorders (Neacsiu et al., 2014; Ritschel et al., 2012).”
BackgroundBeard, C., & Björgvinsson, T. (2014) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2014.06.002 · Cited by 360 · see citing works
Self-citationHandbook of cognitive-behavioral therapies
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A habit-goal framework of depressive rumination.
Watkins, E. R., & Nolen–Hoeksema, S. (2014) · Journal of Abnormal Psychology · doi:10.1037/a0035540 · Cited by 342 · cited 1× · see citing works
“Additional proposed mediators of BA include improvements in the cardinal depressive symptom of anhedonia (Treadway & Zald, 2011) and decreased rumination (Watkins & Nolen-Hoeksema, 2014).”
BackgroundBehavioral Activation for Depression: A Clinician's Guide
Dahl, J. C. (2010) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2010.514119 · Cited by 334 · see citing works
Glasner, S. V. (2011) · Drug and Alcohol Review · doi:10.1111/j.1465-3362.2010.00284_2.x · Cited by 333 · see citing works
Acceptance and commitment therapy for anxiety and OCD spectrum disorders: An empirical review
Bluett, E. J., Homan, K. J., Morrison, K. L., Levin, M. E., & Twohig, M. P. (2014) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2014.06.008 · Cited by 306 · cited 7× · see citing works
“…of ACT for anxiety symptoms (€Ost, 2014; Swain et al., 2013), in particular the therapeutic benefits of the development of psychological flexibility for anxiety (Bluett et al., 2014), we expected that increased psychological flexibility may be associated with improvement in anxiety symptoms.”
BackgroundMethodInfluentialBockting, C. L., Hollon, S. D., Jarrett, R. B., Kuyken, W., & Dobson, K. (2015) · Clinical Psychology Review · doi:10.1016/j.cpr.2015.02.003 · Cited by 295 · see citing works
The effects of psychotherapy on neural responses to rewards in major depression
Dichter, G. S., Felder, J. N., Petty, C., Bizzell, J., Ernst, M., & Smoski, M. J. (2009) · Biological Psychiatry · doi:10.1016/j.biopsych.2009.06.021 · Cited by 278 · cited 1× · see citing works
“There is some evidence that BA may help normalize abnormalities in neural reward circuitry implicated in depression (e.g., striatal functioning; Dichter et al., 2009).”
Background(2012) · Re-Unir (International University of La Rioja) · Cited by 262 · see citing works
Cuijpers, P., Hollon, S. D., van Straten, A., Bockting, C., Berking, M., & Andersson, G. (2013) · BMJ Open · doi:10.1136/bmjopen-2012-002542 · Cited by 253 · cited 1× · see citing works
“Despite the large body of evidence supporting the overall efficacy of CBT in alleviating depressive symptoms (Cuijpers et al., 2013), the mechanisms that account for symptom improvement remain poorly understood.”
BackgroundAcceptance and Commitment Therapy in the treatment of anxiety: A systematic review
Swain, J., Hancock, K., Hainsworth, C., & Bowman, J. (2013) · Clinical Psychology Review · doi:10.1016/j.cpr.2013.07.002 · Cited by 207 · cited 5× · see citing works
“In light of growing data on the efficacy of ACT for anxiety symptoms (€Ost, 2014; Swain et al., 2013), in particular the therapeutic benefits of the development of psychological flexibility for anxiety (Bluett et al., 2014), we expected that increased psychological flexibility may be associated…”
BackgroundResultInfluentialBehavioral Activation for Depression: A Clinician's Guide
Rodgman, C. (2012) · Psychiatric Services · doi:10.1176/appi.ps.2012p837a · Cited by 205 · cited 1× · see citing works
“Of these, one group per day focused on behavioral activation (BA) strategies, based on a protocol adapted from Martell, Dimidjian, and Herman-Dunn (2010).”
MethodThe dialectical behavior therapy ways of coping checklist: development and psychometric properties
Neacsiu, A. D., Rizvi, S. L., Vitaliano, P. P., Lynch, T. R., & Linehan, M. M. (2010) · Journal of Clinical Psychology · doi:10.1002/jclp.20685 · Cited by 200 · see citing works
Lappalainen, R., Lehtonen, T., Skarp, E., Taubert, E., Ojanen, M., & Hayes, S. C. (2007) · Behavior Modification · doi:10.1177/0145445506298436 · Cited by 162 · cited 1× · see citing works
“Further, there is evidence that ACT is associated with greater decreases in experiential avoidance relative to cognitive therapy (Lappalainen et al., 2007) and such decreases mediate anxiety and depression outcomes (Forman, Herbert, Moitra, Yeomans, & Geller, 2007).”
BackgroundStrunk, D. R., DeRubeis, R. J., Chiu, A. W., & Alvarez, J. (2007) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.75.4.523 · Cited by 159 · see citing works
(2010) · Research Online (University of Wollongong) · Cited by 143 · see citing works
Coffman, S. J., Martell, C. R., Dimidjian, S., Gallop, R., & Hollon, S. D. (2007) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.75.4.531 · Cited by 141 · cited 4× · see citing works
“…findings from an intensive CBT-based partial hospital treatment program are consistent with previous findings suggesting that BA strategies may be a more efficient and effective means of targeting depressive symptoms than cognitive interventions (Coffman et al., 2007; Dimidjian et al., 2006).”
BackgroundResultInfluentialKertz, S. J., Bigda-Peyton, J. S., Rosmarin, D. H., & Björgvinsson, T. (2012) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2011.10.005 · Cited by 100 · see citing works
Self-citationStrunk, D. R., Hollars, S. N., Adler, A. D., Goldstein, L. A., & Braun, J. D. (2014) · Cognitive Therapy and Research · doi:10.1007/s10608-014-9617-9 · Cited by 95 · see citing works
Development and validation of the cognitive-behavioral therapy skills questionnaire
Jacob, K. L., Christopher, M. S., & Neuhaus, E. C. (2011) · Behavior Modification · doi:10.1177/0145445511419254 · Cited by 94 · cited 5× · see citing works
“…these measures have reported that greater depressive symptom improvement is associated with greater acquisition and use of CBT skills, as assessed by the SoCT (Jarrett et al., 2011; 2013), CBTSQ (Jacob et al., 2011; Webb, Kertz, BigdaPeyton, & Bj€orgvinsson, 2013) and CCTS (Strunk et al., 2014).”
BackgroundMethodInfluentialSkills of Cognitive Therapy (SoCT): a new measure of patients' comprehension and use
Jarrett, R. B., Vittengl, J. R., Clark, L. A., & Thase, M. E. (2011) · Psychological Assessment · doi:10.1037/a0022485 · Cited by 79 · cited 6× · see citing works
“Several relatively brief patient-report measures of CBT skills have recently been developed, including the Skills of Cognitive Therapy scale (SoCT; Jarrett, Vittengl, Clark, & Thase, 2011), the Cognitive Behavioral Therapy Skills Questionnaire (CBTSQ; Jacob, Christopher, & Neuhaus, 2011) and the Competencies of Cognit…”
BackgroundMethodInfluentialChange in compensatory skills in cognitive therapy for depression.
Barber, J. P., & DeRubeis, R. J. (2001) · PubMed Central · Cited by 77 · see citing works
Strunk, D. R., Cooper, A. A., Ryan, E. T., DeRubeis, R. J., & Hollon, S. D. (2012) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0029281 · Cited by 77 · see citing works
Webb, C. A., Kertz, S. J., Bigda-Peyton, J. S., & Björgvinsson, T. (2013) · Journal of Affective Disorders · doi:10.1016/j.jad.2013.02.016 · Cited by 55 · see citing works
Self-citationDialectical behavior therapy in an intensive outpatient program with a mixed-diagnostic sample
Ritschel, L. A., Cheavens, J. S., & Nelson, J. (2012) · Journal of Clinical Psychology · doi:10.1002/jclp.20863 · Cited by 52 · cited 1× · see citing works
“As previously noted, there is also emerging evidence that DBT skills training is effective for decreasing anxiety in adults with affective disorders (Neacsiu et al., 2014; Ritschel et al., 2012).”
BackgroundWebb, C. A., DeRubeis, R. J., Dimidjian, S., Hollon, S. D., Amsterdam, J. D., & Shelton, R. C. (2012) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0027663 · Cited by 51 · cited 1× · see citing works
“…of these skills are either therapeutically inert, or are moderated by important patient characteristics (e.g., pretreatment depression severity [Webb et al., 2012], comorbid personality disorders [Keefe, Webb, & DeRubeis, 2016]) or treatment setting (e.g., short-term, intensive inpatient or…”
BackgroundSelf-citationJarrett, R. B., Minhajuddin, A., Kangas, J. L., Friedman, E. S., Callan, J. A., & Thase, M. E. (2013) · Behaviour Research and Therapy · doi:10.1016/j.brat.2013.01.006 · Cited by 48 · cited 5× · see citing works
“Several relatively brief patient-report measures of CBT skills have recently been developed, including the Skills of Cognitive Therapy scale (SoCT; Jarrett, Vittengl, Clark, & Thase, 2011), the Cognitive Behavioral Therapy Skills Questionnaire (CBTSQ; Jacob, Christopher, & Neuhaus, 2011) and the Competencies of Cognit…”
BackgroundInfluentialWebb, C. A., Beard, C., Auerbach, R. P., Menninger, E., & Björgvinsson, T. (2014) · Behaviour Research and Therapy · doi:10.1016/j.brat.2014.07.015 · Cited by 38 · see citing works
Self-citationKeefe, J. R., Webb, C. A., & DeRubeis, R. J. (2016) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000071 · Cited by 37 · see citing works
Self-citationAcceptance and commitment therapy for the treatment of anxiety disorders: A concise review
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The evidence base for cognitive-behavioral therapy.
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Self-citationPsychological vulnerability: An integrative approach.
Beard, C., & Björgvinsson, Þ. (2013) · Journal of Psychotherapy Integration · doi:10.1037/a0032361 · Cited by 22 · cited 1× · see citing works
“…a psychiatrist, all patients also received two to three weekly individual therapy sessions from graduatelevel psychologists to reinforce and tailor the skills and lessons learned in groups to the patient's unique needs (for additional details on the BHP program, see Beard & Bj€orgvinsson, 2013).”
BackgroundSelf-citationLinehan, P. (1993) · History and the Historians of Medieval Spain · doi:10.1093/acprof:oso/9780198219453.003.0003
Flagged first, then by citations
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Cited by
Sorted by citations
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“Conversely, Webb et al. (2016) reported that behavioral activation strategies — but not psychological flexibility — predicted depressive symptom improvement in their sample.”
BackgroundFacets of Mindfulness Predict Depressive and Anxiety Symptom Improvement Above CBT Skills
Webb, C. A., Beard, C., Forgeard, M., & Björgvinsson, T. (2019) · Mindfulness · doi:10.1007/s12671-018-1005-1 · Cited by 23 · see citing works
“Concurrent symptom severity and prior symptom improvement represent important third variable confounds insofar as they predict both patientreported use of skills and subsequent symptom improvement (Strunk et al. 2012; Webb et al. 2016).”
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“, only pretreatment and posttreatment) of CBT skills and depressive symptoms (for exceptions, see Hawley et al., 2017; Webb et al., 2016).”
InfluentialSelf-citationDanitz, S. B., Orsillo, S. M., Beard, C., & Björgvinsson, Þ. (2018) · Journal of Clinical Psychology · doi:10.1002/jclp.22627 · Cited by 23 · see citing works
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A Review of Transdiagnostic Mechanisms in Cognitive Behavior Therapy
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Toward Greater Clarity in Defining and Understanding Nonattachment
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Feasibility study of a new behavioural activation programme for young people with depressed mood
Dubicka, B., Marwedel, S., Banares, S. A., McCulloch, A., Tahoun, T., Hearn, J. H., & Kroll, L. (2021) · Child and Adolescent Mental Health · doi:10.1111/camh.12474 · Cited by 14 · see citing works
Positive Interpretation Bias Predicts Longitudinal Decreases in Social Anxiety
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“…finding various forms of CBT skills usage to be related to depression and anxiety symptom outcomes of varying levels of severity, in adults and adolescents, receiving individual CBT, group-based CBT or internet-delivered CBT (Hawley et al., 2017; Terides et al., 2018; Webb et al., 2016, 2019).”
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“…Group, LLC 2014), suicidal behavior (DeCou et al., 2019), substance abuse and comorbid BPD (Linehan et al., 2002, 1999), anxiety (Lothes & Mochrie, 2017; Webb et al., 2016), treatment-resistant depression (Harley et al., 2008), and bipolar disorder (Eisner et al., 2017; Goldstein et al., 2007).”
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Changes in suicide capability during short-term partial hospital treatment
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“…Mindful Emotion Awareness, Cognitive Flexibility, and Countering Emotional Behaviors led to numerically larger reductions in depression than anxiety and Confronting Physical Sensations led to numerically larger reductions in anxiety than depression, although all confidence intervals overlapped.”
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“BATD-based protocols have been shown to be feasible for reducing depressive symptoms in drug abusers in residential care (Daughters et al. 2008; Magidson et al. 2011) and in a short-term inpatient setting with high severity participants (Webb et al. 2016).”
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“Earlier studies focused on either one or a combination of the four techniques [42,43].”
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“More frequent use of CBT and DBT skills has also predicted reductions in anxiety whereas more frequent use of adaptive and behavioral skills has predicted reductions in depression in inpatient and outpatient CBT-based treatments [19,18,20,21].”
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Examining item content across nine psychological (in)flexibility scales: What do they measure?
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“Moreover, psychological flexibility has been shown to positively influence patients’ adaptation to diseases, reduce emotional stress [21], and improve healthy behavior, so it is closely related to negative emotions such as depression and anxiety [22, 23].”
Personalizing a mental health texting intervention using reinforcement learning
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Psychological interventions for patients living with prostate cancer
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“Group therapy usually includes a DBT component as it incorporates more emotional regulation, while CBT requires behavioral interventions and changes but may have more effective treat-ment outcomes in mood disorders [3].”
BackgroundChanges in suicide capability during short-term partial hospital treatmentPreprint
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Self-citationTransdiagnostic Treatment Models for Child and Adolescent Anxiety Disorders
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From systems thinking to P4 medicine
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“More frequent use of CBT skills is associated with greater improvements in anxiety and depressive symptoms in inpatient (Radkovsky et al., 2014; Webb et al., 2016; Wirtz et al., 2014) and outpatient (Neacsiu et al., 2010; Southward & Sauer-Zavala, 2022) samples of people with a range of emotional…”
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“DBT focuses on helping individuals regulate their emotions, improve interpersonal effectiveness, develop distress tolerance, and practice mindfulness and has been studied for its efficacy in treating mood disorders, such as depression and anxiety [27-30].”
Psychiatric evaluation and personality in psoriasis patients
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“One of the treatment goals of cognitive behavioural therapy for psychiatric disorders is to increase cognitive and behavioural plasticity (Webb et al., 2016). in samples of psoriasis patients, cognitive behavioural therapy practices are associated with reductions in stress, disability, and even…”
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- Authors
- Webb, C. A., Beard, C., Kertz, S. J., Hsu, K. J., & Björgvinsson, T.
- Affiliations
- Harvard University (US)
- Southern Illinois University Carbondale (US)
- Corresponding author
- Webb, Christian A.
- Venue
- Behaviour Research and Therapy
- Publisher
- Elsevier BV
- Published
- 2016-06
- Volume
- 81
- Pages
- 12-20
- ISSN
- 0005-7967 (ISSN-L)
- PMC
- PMC4860036
- OpenAlex
- W2321094580
- Cited by
- 59
- References
- 65
- Citations by year
- 2026: 6 · 2025: 9 · 2024: 9 · 2023: 10 · 2022: 5 · 2021: 8 · 2020: 4 · 2019: 3 · 2018: 4 · 2017: 1
- FWCI
- 3.79
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- Locations
- Behaviour Research and Therapy (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Behavioral Health Partial Program
- McLean Hospital
- NIMH National Research Service Award (1F32MH099810-01)
- Career Development Award (K23MH108752-01)
- Klingenstein Third Generation Foundation Adolescent Depression Fellowship
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Keywords
- psychological flexibility, behavioral activation, major depressive disorder, anxiety symptoms, symptom severity, psychiatric inpatients, combined psychotherapy and pharmacotherapy, treatment response prediction
- MeSH terms
- Adaptation, Psychological, Adolescent, Adult, Aged, Anxiety, Behavior Therapy, Combined Modality Therapy, Major Depressive Disorder, Female, Humans, Male, Middle Aged, Psychotropic Drugs, Cognitive Behavioral Therapy, Treatment Outcome, Young Adult, Acceptance and Commitment Therapy
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