Avoidance and processing as predictors of symptom change and positive growth in an integrative therapy for depression
Abstract
Depression is a leading cause of disability worldwide and can worsen the course of a variety of medical illnesses. There is a clear need to develop more potent treatments for this debilitating disorder and prevent its return. We are developing a promising psychotherapy that integrates components of current, empirically supported therapies for depression and also teaches healthy lifestyle and emotion regulation habits to promote psychological health. In the 1st open trial, growth curve analyses revealed a significant linear decrease in symptoms of depression in a sample of 29 clients who completed the therapy. Participants wrote essays about their depression each week, and the content was analyzed using a new coding system of change processes. Hierarchical linear modeling (HLM) revealed that peak levels of processing in the essays were associated with more improvement in depression and with the expression of more hope and of both negative and positive views of the self, presumably as clients explored their depressive views of self. Peak levels of avoidance were associated with less improvement in depression and with more hopelessness and negative views of the self. These preliminary results suggest possible targets of change that can facilitate symptom reduction and perhaps also promote psychological health.
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In an acceptance-based therapy for depression, objective coding of weekly essays showed that high levels of adaptive emotion processing in specific weeks of treatment were linked to greater improvement in depressive symptoms, positive self-views, and hope, whereas greater avoidance in a specific week was linked to reduced improvement in depressive symptoms, greater hopelessness, and more negative自
“Objective coding of those essays demonstrated that high levels of adaptive emotion processing in specific weeks of treatment were linked to greater improvement in depressive symptoms, positive self-views, and hope whereas greater avoidance on a specific”
From Examining domains of psychological flexibility and inflexibility as treatment mechanisms in acceptance and commitment therapy: A comprehensive systematic and meta-analytic review (2024) · cites this paper as Hayes et al., 2005
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Implicit cognition and depression: A meta-analysis
Phillips, W. J., Hine, D. W., & Thorsteinsson, E. B. (2010) · Clinical Psychology Review · doi:10.1016/j.cpr.2010.05.002 · Cited by 182 · see citing works
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“This issue is particularly important in light of the potential role of avoidance as both a defining feature of depressive episodes and a maladaptive coping strategy that serves to prolong depressive episodes.([20,21]) To address these questions, we compared depressed and nondepressed participants’ emotional reactivity…”
BackgroundAn adaptationist perspective on the etiology of depression
Durisko, Z., Mulsant, B. H., & Andrews, P. W. (2015) · Journal of Affective Disorders · doi:10.1016/j.jad.2014.09.032 · Cited by 140 · see citing works
“This theoretical framework may explain data showing the potential benefits of “exposure-based” ruminative processing for treating depression (Baikie et al., 2012; Grosse Holtforth et al., 2012; Hayes et al., 2007, 2005; Pennebaker, 1997; Resick et al., 2002).”
BackgroundMerry, S., Hetrick, S. E., Cox, G., Brudevold‐Iversen, T., Bir, J. J., & McDowell, H. (2012) · Evidence-Based Child Health A Cochrane Review Journal · doi:10.1002/ebch.1867 · Cited by 129 · see citing works
Hayes, A. M., Yasinski, C. W., Barnes, J. B., & Bockting, C. (2015) · Clinical Psychology Review · doi:10.1016/j.cpr.2015.06.007 · Cited by 130 · see citing works
“In addition, higher levels of processing were associated with lower levels of avoidance and with more hope and positive view of self (Hayes et al., 2005).”
Self-citationBerking, M., Neacsiu, A., Comtois, K. A., & Linehan, M. M. (2009) · Behaviour Research and Therapy · doi:10.1016/j.brat.2009.04.011 · Cited by 124 · see citing works
Research on psychotherapy integration: Building on the past, looking to the future
Castonguay, L. G., Eubanks, C. F., Goldfried, M. R., Muran, J. C., & Lutz, W. (2015) · Psychotherapy Research · doi:10.1080/10503307.2015.1014010 · Cited by 127 · see citing works
“…validation of integrative models built on basic research (social and developmental psychology, dynamic sciences; e.g., Constantino & Westra, 2012; Hayes et al., 2005) should, for epistemological reasons alone, offer approaches that many EST proponents—especially cognitive-behavior therapists—may…”
BackgroundOngoing Narrative Meaning-Making Within Events and Across the Life Span
Fivush, R., Booker, J., & Graci, M. E. (2017) · Imagination Cognition and Personality · doi:10.1177/0276236617733824 · Cited by 93 · see citing works
“…their complexity in expression across narratives of the same event over time (e.g., differentiation of thought and processing; Foa et al., 1995; Hayes et al., 2005; McAdams et al., 2006), and narrative exploration, in particular, is related to personal growth and well-being both concurrently…”
BackgroundPrimum Non Nocere: An Evolutionary Analysis of Whether Antidepressants Do More Harm than Good
Andrews, P. W., Thomson, J. A., Amstadter, A., & Neale, M. C. (2012) · Frontiers in Psychology · doi:10.3389/fpsyg.2012.00117 · Cited by 120 · see citing works
“…writing about one’s strongest thoughts and feelings related to the episode) have been found to increase insight and shorten the duration of episodes (Hayes et al., 2005, 2007; Gortner et al., 2006; Graf et al., 2008), suggesting that these interventions address cause (Andrews and Thomson Jr.,…”
BackgroundRadkovsky, A., McArdle, J. J., Bockting, C. L. H., & Berking, M. (2014) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0035828 · Cited by 115 · see citing works
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“Coping with emotions through acceptance is increasingly being understood to have a salutary effect on the resolution of distress (15).”
BackgroundPsychotherapy outcome: An issue worth re-revisiting 50 years later.
Castonguay, L. G. (2013) · Psychotherapy · doi:10.1037/a0030898 · Cited by 93 · see citing works
Psychological therapies for the treatment of depression in chronic obstructive pulmonary disease
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Beliefs about emotion’s malleability influence state emotion regulation
Kneeland, E. T., Nolen–Hoeksema, S., Dovidio, J. F., & Gruber, J. (2016) · Motivation and Emotion · doi:10.1007/s11031-016-9566-6 · Cited by 91 · see citing works
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“These predictions were based on results from previous research using similar writing-based interventions that showed improvements in various therapeutic process and outcome variables (Hayes et al., 2005).”
ResultYasinski, C. W., Hayes, A. M., Ready, C. B., Cummings, J. A., Berman, I. S., McCauley, T. G., Webb, C. P. M., & Deblinger, E. (2016) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000147 · Cited by 86 · see citing works
“Cognitive emotional processing has been proposed as an important mechanism of change in the treatment of adult anxiety, depressive, and trauma-related disorders (Foa, Huppert, & Cahill, 2006; Greenberg, 2002; Hayes et al., 2005; Teasdale, 1999), and our study is the first that we are aware of to suggest a link between…”
BackgroundSelf-citationMacri, J. A., & Rogge, R. D. (2024) · Clinical Psychology Review · doi:10.1016/j.cpr.2024.102432 · Cited by 89 · see citing works
Mixed Emotional Experience Is Associated with and Precedes Improvements in Psychological Well-Being
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“This approach to collecting patients’ perspectives has been touted as a robust vehicle for tapping the private ways in which individuals understand their experiences in both clinical and community samples [26,27,39,40].”
BackgroundThe Role of Mindfulness in Borderline Personality Disorder Features
Wupperman, P., Neumann, C. S., Whitman, J. B., & Axelrod, S. R. (2009) · Journal of Nervous & Mental Disease · doi:10.1097/nmd.0b013e3181b97343 · Cited by 104 · see citing works
“…and situations (Bijttebier and Vertommen, 1999; Chapman et al., 2005); however, chronic avoidance precludes habituation to unpleasant stimuli (Hayes et al., 1996; Wegner, 1994), and consequences of chronic avoidance include the continuation or even escalation of distress (Hayes et al., 2005).”
BackgroundWupperman, P., Marlatt, G. A., Cunningham, A., Bowen, S., Berking, M., Mulvihill‐Rivera, N., & Easton, C. (2012) · Journal of Clinical Psychology · doi:10.1002/jclp.20830 · Cited by 81 · see citing works
Exposure and reorganization: The what and how of effective psychotherapy
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Client emotional productivity—optimal client in-session emotional processing in experiential therapy
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The Role of Personality in Psychotherapy for Anxiety and Depression
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Narrative meaning making, attachment, and psychological growth and stress
Graci, M. E., & Fıvush, R. (2016) · Journal of Social and Personal Relationships · doi:10.1177/0265407516644066 · Cited by 72 · see citing works
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“In the treatment of both anxiety disorders and depression, emotional arousal sets the stage for challenging maladaptive beliefs (Hunt 1998; Hayes et al. 2005; Hunt et al. 2007).”
BackgroundLichtwarck‐Aschoff, A., Hasselman, F., Cox, R. F. A., Pepler, D. J., & Granic, I. (2012) · PubMed · Cited by 69 · see citing works
Meaning making helps cope with COVID-19: A longitudinal study
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Cognitive-Behavioral Therapy: Nature and Relation to Non-Cognitive Behavioral Therapy
Lorenzo‐Luaces, L., Keefe, J. R., & DeRubeis, R. J. (2016) · Behavior Therapy · doi:10.1016/j.beth.2016.02.012 · Cited by 66 · see citing works
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“An explanation for the difference between these maladaptive responses could be that avoidance is caused by a premature inhibition of cognitive processing, whereas hopelessness does take external factors into consideration (Hayes et al., 2005).”
BackgroundYasinski, C. W., Hayes, A. M., Ready, C. B., Abel, A., Görg, N., & Kuyken, W. (2019) · Psychotherapy Research · doi:10.1080/10503307.2019.1699972 · Cited by 59 · see citing works
“In contrast to rumination and avoidance, which can block new learning and experiences, emotional processing has been proposed as a transdiagnostic mechanism that facilitates therapeutic change (Carey, 2011; Foa, Huppert, & Cahill, 2006; Greenberg, 2002; Hayes et al., 2005, 2015).”
BackgroundMethodInfluentialSelf-citationHalfon, S., & Ozer, P. B. (2017) · Psychotherapy Research · doi:10.1080/10503307.2017.1393577 · Cited by 50 · see citing works
“In fact, patients who experienced such a spike also showed more cognitive/emotional processing (a significant shift in perspective and emotional response) than those without a spike (Hayes et al., 2005).”
BackgroundThe Change and Growth Experiences Scale: A Measure of Insight and Emotional Processing.
Hayes, A. M., Feldman, G. C., & Goldfried, M. R. (2007) · American Psychological Association eBooks · doi:10.1037/11532-011 · Cited by 47 · see citing works
Self-citationAlpert, E., Hayes, A. M., Barnes, J. B., & Sloan, D. M. (2019) · Behavior Therapy · doi:10.1016/j.beth.2019.11.003 · Cited by 48 · see citing works
“…et al., 2011), re-experiencing (Garcia et al., 2011) and hyperarousal symptoms (Garcia et al., 2011; Zayfert, DeViva, Becker, Pike, Gillock, & Hayes, 2005), more catastrophic cognitions (Bryant et al., 2003), more anger (Rizvi, Vogt, & Resick, 2009), and greater impairment in social…”
Self-citationPost‐traumatic growth in stroke carers: A comparison of theories
Hallam, W., & Morris, R. C. (2013) · British Journal of Health Psychology · doi:10.1111/bjhp.12064 · Cited by 46 · see citing works
Cognitive-Behavioral Assimilative Integration
Castonguay, L. G., Newman, M. G., Borkovec, T. D., Holtforth, M. G., & Maramba, G. G. (2005) · Oxford University Press eBooks · doi:10.1093/med:psych/9780195165791.003.0011 · Cited by 43 · see citing works
Emotion categories and patterns of change in experiential therapy for depression
Herrmann, I. R., Greenberg, L. S., & Auszra, L. (2014) · Psychotherapy Research · doi:10.1080/10503307.2014.958597 · Cited by 43 · see citing works
Moscardini, E. H., Oakey‐Frost, N., Robinson, A. D., Powers, J. T., Aboussouan, A. B., Rasmussen, S. A., Cramer, R. J., & Tucker, R. P. (2021) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12767 · Cited by 43 · see citing works
Holtforth, M. G., Krieger, T., Zimmermann, J., Altenstein, D., Doerig, N., Meisch, L., & Hayes, A. M. (2017) · Psychotherapy Research · doi:10.1080/10503307.2017.1397796 · Cited by 41 · see citing works
“…previous research has found that this period is associated with increased variability and a transient increase in symptoms, as the affectively charged interventions are introduced to activate, challenge, and process one’s depressive network (grosse Holtforth et al., 2012; Hayes et al., 2005, 2007).”
BackgroundMethodResultInfluentialSelf-citationHoltforth, M. G., Hayes, A. M., Sutter, M., Wilm, K., Schmied, E., Laurenceau, J., & Caspar, F. (2012) · Psychotherapy and Psychosomatics · doi:10.1159/000336813 · Cited by 41 · see citing works
Self-citationSpecific Techniques Vs. Common Factors? Psychotherapy Integration and its Role in Ethical Practice
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Depression sudden gains and transient depression spikes during treatment for PTSD.
Keller, S. M., Feeny, N. C., & Zoellner, L. A. (2013) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0035286 · Cited by 40 · see citing works
Avoidance motivation in psychological problems and psychotherapy
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“Hayes, Beevers, Feldman, Laurenceau, & Perlman, 2005 ; Ottenbreit & Dobson, 2004 ).”
Clarke, S., Kingston, J. L., Wilson, K. G., Bolderston, H., & Remington, B. (2012) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2012.03.001 · Cited by 39 · see citing works
Shan, G., Lina, Z., & Zhang, D. (2020) · Information & Management · doi:10.1016/j.im.2020.103349 · Cited by 36 · see citing works
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The form and function of depressive rumination
Bartošková, M., Ševčíková, M., Durisko, Z., Maslej, M. M., Barbic, S., Preiss, M., & Andrews, P. W. (2018) · Evolution and Human Behavior · doi:10.1016/j.evolhumbehav.2018.01.005 · Cited by 34 · see citing works
Brockmeyer, T., Holtforth, M. G., Krieger, T., Altenstein, D., Doerig, N., Zimmermann, J., Backenstrass, M., Friederich, H., & Bents, H. (2015) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.1885 · Cited by 35 · see citing works
Vîslă, A., Flückiger, C., Constantino, M. J., Krieger, T., & Holtforth, M. G. (2018) · Psychotherapy Research · doi:10.1080/10503307.2018.1428379 · Cited by 35 · see citing works
Facilitating emotional processing in depression: the application of exposure principles
Hayes, A. M. (2015) · Current Opinion in Psychology · doi:10.1016/j.copsyc.2015.03.032 · Cited by 35 · see citing works
Self-citationDu, Y., Yang, Y., Wang, X., Xie, C., Liu, C., Hu, W., & Li, Y. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.600837 · Cited by 35 · see citing works
Vanaken, L., Bijttebier, P., & Hermans, D. (2020) · PLoS ONE · doi:10.1371/journal.pone.0232214 · Cited by 32 · see citing works
“27,51,52], or suggests that coherence is a consequence or symptom of different forms of psychopathology [66–68], for instance mediated by working memory load [69–71], avoidance [72] or cognitive impairment [73].”
BackgroundEmotion and the Acceptance-Based Approaches to the Anxiety Disorders
Mennin, D. S. (2007) · Springer eBooks · doi:10.1007/0-387-25989-9_2 · Cited by 34 · see citing works
Hayes, A. M., Yasinski, C. W., Grasso, D. J., Ready, C. B., Alpert, E., McCauley, T. G., Webb, C. P. M., & Deblinger, E. (2016) · Behavior Therapy · doi:10.1016/j.beth.2016.06.004 · Cited by 31 · see citing works
Self-citationExpressive writing in psychotherapy: A tool to promote and track therapeutic change.
Cummings, J. A., Hayes, A. M., Saint, D. S., & Park, J. (2014) · Professional Psychology Research and Practice · doi:10.1037/a0037682 · Cited by 31 · see citing works
Self-citationPersons, J., Marker, C., & Bailey, E. (2023) · Behaviour Research and Therapy · doi:10.1016/j.brat.2023.104338 · Cited by 22 · see citing works
Szczęśniak, M., Falewicz, A., Strochalska, K., & Rybarski, R. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19106065 · Cited by 33 · see citing works
“For example, among patients diagnosed with depression, it has been noted that higher levels of meaning making were related to subsequent reductions in depression [85].”
BackgroundBarbic, S. P., Durisko, Z., & Andrews, P. W. (2014) · PLoS ONE · doi:10.1371/journal.pone.0112077 · Cited by 29 · see citing works
Erkkilä, J., Brabant, O., Saarikallio, S. H., Ala-Ruona, E., Hartmann, M., Letulė, N., Geretsegger, M., & Gold, C. (2019) · Trials · doi:10.1186/s13063-019-3323-6 · Cited by 27 · see citing works
Sudden gains in two trauma-focused treatments for posttraumatic stress disorder
Sloan, D., Thompson-Hollands, J., Hayes, A. M., Lee, D. J., Alpert, E., & Marx, B. P. (2021) · The Behavior Therapist · doi:10.1016/j.beth.2021.08.003 · Cited by 21 · see citing works
Self-citationTherapeutic effects of extinction learning as a model of exposure therapy in rats
Fucich, E. A., Paredes, D., & Morilak, D. A. (2016) · Neuropsychopharmacology · doi:10.1038/npp.2016.127 · Cited by 24 · see citing works
Systematic Review of In-Session Affect Experience in Cognitive Behavioral Therapy for Depression
Doorn, K. A., & Barber, J. P. (2017) · Cognitive Therapy and Research · doi:10.1007/s10608-017-9865-6 · Cited by 26 · see citing works
Friedl, N., Berger, T., Krieger, T., Caspar, F., & Holtforth, M. G. (2019) · Psychotherapy Research · doi:10.1080/10503307.2019.1664782 · Cited by 25 · see citing works
“Even though the application of exposure principles in depression treatment is fairly new, EBCT-R has been associated with significant reductions in depressive symptoms and has shown to be equally effective as CBT and produce effect sizes of similar size (Grosse Holtforth et al., 2012; Grosse Holtforth et al., 2019; Ha…”
MethodAlpert, E., Hayes, A. M., Yasinski, C. W., Webb, C. P. M., & Deblinger, E. (2021) · Clinical Psychological Science · doi:10.1177/2167702620957315 · Cited by 24 · see citing works
Self-citationRestoring meaning in life by meaning‐focused coping: The role of self‐distancing
Wang, Y., Lippke, S., Miao, M., & Gan, Y. (2019) · PsyCh Journal · doi:10.1002/pchj.296 · Cited by 27 · see citing works
An interview study investigating experiences of psychological change without psychotherapy
Gianakis, M., & Carey, T. A. (2011) · Psychology and Psychotherapy: Theory, Research and Practice · doi:10.1111/j.2044-8341.2010.02002.x · Cited by 34 · see citing works
Examining emotional processing theory and predictors of outcome in prolonged exposure for PTSD
Alpert, E., Hayes, A. M., & Foa, E. B. (2023) · Behaviour Research and Therapy · doi:10.1016/j.brat.2023.104341 · Cited by 21 · see citing works
Self-citationRöthlin, P., Holtforth, M. G., Bergomi, C. R., Berking, M., Ottenbreit, N. D., & Caspar, F. (2010) · Diagnostica · doi:10.1026/0012-1924/a000008 · Cited by 21 · see citing works
Evolutionary psychiatry and depression: testing two hypotheses
Varga, S. (2011) · Medicine Health Care and Philosophy · doi:10.1007/s11019-010-9305-9 · Cited by 21 · see citing works
Aberrant Long-Range Temporal Correlations in Depression Are Attenuated after Psychological Treatment
Gärtner, M., Irrmischer, M., Winnebeck, E., Fissler, M., Huntenburg, J. M., Schroeter, T. A., Bajbouj, M., Linkenkaer-Hansen, K., Nikulin, V., & Barnhofer, T. (2017) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2017.00340 · Cited by 21 · see citing works
“Clinical interventions in acutely depressed patients tend to produce strong effects at the early stages of the interventions, a phenomenon that is referred to as early gains (Hayes et al., 2005), and it is possible that the strong reductions in symptoms observed in our study might have overshadowedmore specific effect…”
BackgroundA Latent Profile Analysis of Implicit and Explicit Cognitions Associated with Depression
Phillips, W. J., Hine, D., & Bhullar, N. (2012) · Cognitive Therapy and Research · doi:10.1007/s10608-011-9381-z · Cited by 19 · see citing works
“For example, Emotion-Focused Therapy (Greenberg and Watson 2005) and Exposure-Based Cognitive Therapy (Hayes et al. 2005) aim to generate new cognitive structures by focussing on emotional experiences and the meanings attributed to them.”
BackgroundMiklowitz, D. J., Otto, M. W., Wisniewski, S. R., Araga, M., Frank, E., Reilly-Harrington, N. A., Lembke, A., & Sachs, G. S. (2006) · Psychiatric Services · doi:10.1176/ps.2006.57.7.959 · Cited by 20 · see citing works
Shape of change in internet based behavioral activation treatment for depression
O'Mahen, H. A., Wilkinson, E., Bagnall, K., Richards, D. A., & Swales, A. (2017) · Behaviour Research and Therapy · doi:10.1016/j.brat.2017.05.011 · Cited by 25 · see citing works
Disabled at Work: Body-Centric Cycles of Meaning-Making
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“Meaning-making has been extensively studied in response to a broad range of dramatic and traumatic life events that directly affect one’s own body, such as miscarriage (Nikčević & Nicolaides, 2014), depression (Hayes et al., 2005), and cancer (Park et al.”
BackgroundEmotion suppression, not reappraisal, predicts psychotherapy outcome
Scherer, A., Boecker, M., Pawelzik, M. R., Gauggel, S., & Forkmann, T. (2015) · Psychotherapy Research · doi:10.1080/10503307.2015.1080875 · Cited by 19 · see citing works
Schema Therapy with Emotionally Inhibited and Fearful Patients
Faßbinder, E., & Arntz, A. R. (2018) · Journal of Contemporary Psychotherapy · doi:10.1007/s10879-018-9396-9 · Cited by 18 · see citing works
Canale, C. A., Hayes, A. M., Yasinski, C., Grasso, D. J., Webb, C. P. M., & Deblinger, E. (2021) · Behavior Therapy · doi:10.1016/j.beth.2021.06.001 · Cited by 17 · see citing works
Self-citationDepression: Is Rumination Really Adaptive?
Kennair, L. E. O., Kleppestø, T. H., Larsen, S. M., & Jørgensen, B. E. G. (2017) · Evolutionary psychology · doi:10.1007/978-3-319-60576-0_3 · Cited by 17 · see citing works
Processing and Resolving Major Life Stressors: An Examination of Meaning-Making Strategies
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Tracking the implicit self using event-related potentials
Egenolf, Y., Stein, M., Koenig, T. W., Holtforth, M. G., Dierks, T., & Caspar, F. (2013) · Cognitive Affective & Behavioral Neuroscience · doi:10.3758/s13415-013-0169-3 · Cited by 17 · see citing works
Clients' and therapists' stories about psychotherapy.
Adler, J. M. (2013) · Journal of Personality · doi:10.1111/j.1467-6494.2012.00803.x · Cited by 18 · see citing works
Hosogoshi, H., Takebayashi, Y., Ito, M., Fujisato, H., Kato, N., Nakajima, S., Oe, Y., Miyamae, M., Kanie, A., & Horikoshi, M. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.07.132 · Cited by 17 · see citing works
- Authors
- Hayes, A. M., Beevers, C. G., Feldman, G. C., Laurenceau, J.-P., & Perlman, C.
- Affiliations
- University of Delaware (US)
- The University of Texas at Austin (US)
- University of Miami (US)
- Massachusetts General Hospital (US)
- Corresponding author
- Hayes, Adele M.
- Venue
- International Journal of Behavioral Medicine
- Published
- 2005-06
- Volume
- 12
- Issue
- 2
- Pages
- 111-122
- ISSN
- 1070-5503 (ISSN-L)
- 1532-7558
- OpenAlex
- W1998058368
- Cited by
- 163
- References
- 106
- Citations by year
- 2025: 4 · 2024: 4 · 2023: 8 · 2022: 4 · 2021: 12 · 2020: 11 · 2019: 9 · 2018: 6 · 2017: 11 · 2016: 13 · 2015: 14 · 2014: 10 · 2013: 8 · 2012: 10
- FWCI
- 6.94
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Behavioral Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (R21MH062662, R21-MH62662)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Social Psychology › Mental Health via Writing
- Keywords
- depression, integrative psychotherapy, avoidance, processing, symptom change, positive growth, hope, hopelessness, self-view, emotion regulation, healthy lifestyle, change processes
- MeSH terms
- Affect, Cognition, Major Depressive Disorder, Depressive Disorder, Major, Female, Humans, Male, Perception, Social Behavior, Verbal Behavior
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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