Predictors of treatment response for depression and inadequate social support - The ENRICHD randomized clinical trial
Abstract
Objective To determine whether the 'dose' of treatment exposure, delivery of specific components of cognitive behavior therapy (CBT), patient adherence and/or use of antidepressants predict favorable depression and social support outcomes after 6 months of cognitive behavioral treatment. Methods Secondary analyses of the intervention arm of the Enhancing Recovery in Coronary Heart Disease (ENRICHD) clinical trial involving persons with acute myocardial infarction (MI): n = 641 for the depression outcomes and n = 523 for the social support outcomes. The outcome measures were, for depression: the Beck Depression Inventory (BDI) and Hamilton Rating Scale for Depression (HAM-D); for social support: the ENRICHD Social Support Instrument (ESSI) and Perceived Social Support Scale (PSSS). Results Better depression outcomes (measured by the BDI) were receiving a high number of depression-specific intervention components, p Conclusions The standard components of CBT for depression are useful in treating comorbid depression in post-MI patients. Working on communication skills may help to improve depression but not necessarily social support outcomes in this patient population, while adherence to cognitive-behavioral homework assignments is important for both outcomes. Other components of the ENRICHD intervention that were designed to improve social support had no discernible effects on outcomes. Intervention refinements may be needed in order to achieve better results in future post-MI…
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Perceived social support changes following treatment and has been studied as a moderator of treatment.
“Perceived social support changes following treatment, and it has been studied as a moderator of treatment.21–23”
The current findings are consistent with prior studies that found direct predictive relations among variables.
“The current findings are consistent with prior studies that found direct predictive relations among variables.11,22”
Most prior studies have examined social support as a moderator or outcome of treatment.
“Most prior studies have examined social support as a moderator or outcome of treatment.22,25”
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Self-citation
- Authors
- Cowan, M. J., Freedland, K. E., Burg, M. M., Saab, P. G., Youngblood, M. E., Cornell, C. E., Powell, L. H., & Czajkowski, S. M.
- Affiliations
- University of California, Los Angeles (US)
- Washington University in St. Louis (US)
- Yale University (US)
- University of Miami (US)
- University of North Carolina at Chapel Hill (US)
- University of Arkansas for Medical Sciences (US)
- Rush University (US)
- National Institutes of Health (US)
- Venue
- Psychotherapy and Psychosomatics
- Publisher
- S. Karger AG
- Published
- 2007-12-14
- Volume
- 77
- Issue
- 1
- Pages
- 27-37
- ISSN
- 0033-3190 (ISSN-L)
- 1423-0348
- OpenAlex
- W1980980253
- Cited by
- 93
- References
- 38
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 4 · 2023: 2 · 2022: 9 · 2021: 2 · 2020: 5 · 2019: 2 · 2018: 7 · 2017: 6 · 2016: 4 · 2015: 6 · 2014: 7 · 2013: 4 · 2012: 6
- FWCI
- 3.74
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychotherapy and Psychosomatics (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (n01hc055141-005, n01hc055144-006, n01hc055143-000, n01hc055145-005, n01hc055140-003, n01hc055148-000, n01hc055146-001, n01hc055147-000, n01hc055142-002)
- National Heart, Lung, and Blood Institute (N01-HC-55147, N01-HC-55140, N01-HC-55146, N01-HC-55144, N01-HC-55142, N01-HC-55143, N01-HC-55141, N01-HC-55148, N01-HC-55145)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- depression, social support, cognitive behavioral therapy, acute myocardial infarction, predictors of treatment response, homework adherence, social communication, assertiveness training, racial and ethnic minorities, coronary artery disease
- MeSH terms
- Adult, Aged, Antidepressive Agents, Assertiveness, Combined Modality Therapy, Communication, Coronary Disease, Depressive Disorder, Female, Follow-Up Studies, Humans, Male, Middle Aged, Myocardial Infarction, Personality Inventory, Social Support, Cognitive Behavioral Therapy, Treatment Outcome, Sertraline
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