Social problem solving and depressive symptoms over time: A randomized clinical trial of cognitive-behavioral analysis system of psychotherapy, brief supportive psychotherapy, and pharmacotherapy.
Open accessAbstract
OBJECTIVE: Depression is associated with poor social problem solving, and psychotherapies that focus on problem-solving skills are efficacious in treating depression. We examined the associations between treatment, social problem solving, and depression in a randomized clinical trial testing the efficacy of psychotherapy augmentation for chronically depressed patients who failed to fully respond to an initial trial of pharmacotherapy (Kocsis et al., 2009). METHOD: Participants with chronic depression (n = 491) received cognitive-behavioral analysis system of psychotherapy (CBASP; McCullough, 2000), which emphasizes interpersonal problem solving, plus medication; brief supportive psychotherapy (BSP) plus medication; or medication alone for 12 weeks. RESULTS: CBASP plus pharmacotherapy was associated with significantly greater improvement in social problem solving than BSP plus pharmacotherapy, and a trend for greater improvement in problem solving than pharmacotherapy alone. In addition, change in social problem solving predicted subsequent change in depressive symptoms over time. However, the magnitude of the associations between changes in social problem solving and subsequent depressive symptoms did not differ across treatment conditions. CONCLUSIONS: It does not appear that improved social problem solving is a mechanism that uniquely distinguishes CBASP from other treatment approaches.
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Deficits in social problem solving are associated with anxiety disorders and depression in clinical and nonclinical samples.
“previous work in clinical (i.e., chronic depressed patients) and nonclinical (student) samples has found that deficits in social problem solving are associated with anxiety disorders and depression (e.g., Klein et al., 2011).”
From Do anxiety, depression, and intolerance of uncertainty contribute to social problem solving in adult women with anorexia nervosa? (2020) · cites this paper as Klein et al., 2011
The paper's introductory discussion (page unavailable) says numerous studies associate social problem-solving deficits with depressive disorders and symptoms, and its Discussion reports a link in chronically depressed patients. It does not establish the claimed association with anxiety disorders or explicitly describe the cited evidence as covering both clinical and nonclinical student samples. (LLM, conf=0.86)
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“As described elsewhere (Kocsis et al., 2009), the three treatment conditions (CBASP plus pharmacotherapy, BSP plus pharmacotherapy, and pharmacotherapy alone) produced similar change in depressive symptoms.”
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Kahl, K. G., Winter, L., & Schweiger, U. (2012) · Current Opinion in Psychiatry · doi:10.1097/yco.0b013e328358e531 · Cited by 265 · see citing works
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Cuijpers, P. (2015) · Current Opinion in Psychiatry · doi:10.1097/yco.0000000000000121 · Cited by 64 · see citing works
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“Conversely, in line with our study (Figure 2), avoidant strategies, including denial, substance, self-blame, and behavioral disengagement, were associated with increased anxiety and depression [61,69,70].”
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“This is an issue because previous work in clinical (i.e., chronic depressed patients) and nonclinical (student) samples has found that deficits in social problem solving are associated with anxiety disorders and depression (e.g., Klein et al., 2011).”
Result
- Authors
- Klein, D. N., Leon, A. C., Li, C., D'Zurilla, T. J., Black, S. R., Vivian, D., Dowling, F., Arnow, B. A., Manber, R., Markowitz, J. C., & Kocsis, J. H.
- Affiliations
- Stony Brook University (US)
- Weill Cornell Medicine (US)
- Stanford Medicine (US)
- Columbia University Irving Medical Center (US)
- ORCID
- Venue
- Journal of Consulting and Clinical Psychology
- Published
- 2011
- Volume
- 79
- Issue
- 3
- Pages
- 342-352
- ISSN
- 0022-006X (ISSN-L)
- 1939-2117
- PMC
- PMC3109172
- OpenAlex
- W2071302139
- Cited by
- 44
- References
- 5
- Citations by year
- 2026: 2 · 2023: 3 · 2022: 2 · 2021: 4 · 2020: 1 · 2019: 1 · 2018: 3 · 2017: 4 · 2016: 3 · 2015: 4 · 2014: 1 · 2013: 9 · 2012: 4
- FWCI
- 7.01
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Consulting and Clinical Psychology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (U01 MH62475; U01 MH61587; U01 MH62546; U01 MH61562; U01 MH63481; U01 MH62465; U01 MH61590; U01 MH61504; U01 MH62491)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Health Sciences › Health Professions › Speech and Hearing › Problem Solving Skills Development
- Keywords
- social problem solving, depressive symptoms, chronic depression, CBASP, pharmacotherapy, treatment response, mechanisms of change
- MeSH terms
- Adolescent, Adult, Aged, Antidepressive Agents, Combined Modality Therapy, Depression, Depressive Disorder, Female, Humans, Male, Middle Aged, Problem Solving, Psychotherapy, Brief, Social Perception, Cognitive Behavioral Therapy, Treatment Outcome, Selective Serotonin Reuptake Inhibitors
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