This is a request for five years of salary support via a NIH Independent Scientist Award (K02). I have long sought to integrate psychosocial and biological models of depression, and I hope to use the RCA to enhance my understanding of basic neurobiology and developmental issues relevant to its nature and treatment. I also want to enhance the relevance of my work to applied clinical settings (effectiveness). In particular, I am interested in whether cognitive therapy has a more enduring effect than drugs in the treatment of depression. Earlier studies suggested that this might be the case, but the recent NIH TDCRP found cognitive therapy to be less effective than drugs in the treatment of more severely depressed outpatients and reported little evidence of any enduring effect. Both sets of studies have been criticized for failing to provide optimal implementations of the respective modalities, drugs in the earlier studies and cognitive therapy in the TDCRP. We are currently conducting (with colleagues at Penn) a placebo-controlled comparison of cognitive therapy versus drugs in the treatment of more severely depressed outpatients that seek to address both sets of concerns. I am also collaborating with Neil Jacobson in Seattle in a similar placebo-controlled trial designed to determine whether behavioral activation (which is simpler to implement) carries the full weight of change in cognitive therapy. Further, we plan to examine (with colleagues at Penn and Rush) whether adding cognitive therapy to drugs can both enhance the breadth of response and obviate the need to keep patients on long-term maintenance medications. Finally, we are collaborating with colleagues at each of these sites to study the impact of treatment on the offspring of our depressed patients. We think that more can be done to study the full range of benefits associated with successful treatment. My goal has been to examine the role of both psychological and biological processes in the moderation and medication of treatment effects and to do so in a manner that has the greatest possible impact on actual clinical practice. I hope to use my growing expertise in neurobiology and development to better understand the processes that underlie the treatment and prevention of depression and to use that understanding to enhance the effectiveness of clinical practice in applied settings.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Scientist Development Award - Research (K02)
Project #
5K02MH001697-05
Application #
6740278
Study Section
Special Emphasis Panel (ZMH1-ITV-D (01))
Program Officer
Street, Linda L
Project Start
2000-05-01
Project End
2005-04-30
Budget Start
2004-05-01
Budget End
2005-04-30
Support Year
5
Fiscal Year
2004
Total Cost
$113,425
Indirect Cost
Name
Vanderbilt University Medical Center
Department
Psychology
Type
Schools of Arts and Sciences
DUNS #
004413456
City
Nashville
State
TN
Country
United States
Zip Code
37212
Porter, Eliora; Chambless, Dianne L; McCarthy, Kevin S et al. (2017) Psychometric Properties of the Reconstructed Hamilton Depression and Anxiety Scales. J Nerv Ment Dis 205:656-664
Furukawa, Toshi A; Weitz, Erica S; Tanaka, Shiro et al. (2017) Initial severity of depression and efficacy of cognitive-behavioural therapy: individual-participant data meta-analysis of pill-placebo-controlled trials. Br J Psychiatry 210:190-196
Cooper, Andrew A; Strunk, Daniel R; Ryan, Elizabeth T et al. (2016) The therapeutic alliance and therapist adherence as predictors of dropout from cognitive therapy for depression when combined with antidepressant medication. J Behav Ther Exp Psychiatry 50:113-9
Vittengl, Jeffrey R; Jarrett, Robin B; Weitz, Erica et al. (2016) Divergent Outcomes in Cognitive-Behavioral Therapy and Pharmacotherapy for Adult Depression. Am J Psychiatry 173:481-90
Sasso, Katherine E; Strunk, Daniel R; Braun, Justin D et al. (2016) A re-examination of process-outcome relations in cognitive therapy for depression: Disaggregating within-patient and between-patient effects. Psychother Res 26:387-98
Keefe, John R; Webb, Christian A; DeRubeis, Robert J (2016) In cognitive therapy for depression, early focus on maladaptive beliefs may be especially efficacious for patients with personality disorders. J Consult Clin Psychol 84:353-64
Hollon, Steven D; DeRubeis, Robert J; Fawcett, Jan et al. (2014) Effect of cognitive therapy with antidepressant medications vs antidepressants alone on the rate of recovery in major depressive disorder: a randomized clinical trial. JAMA Psychiatry 71:1157-64
Forand, Nicholas R; Derubeis, Robert J (2013) Pretreatment anxiety predicts patterns of change in cognitive behavioral therapy and medications for depression. J Consult Clin Psychol 81:774-82
Webb, Christian A; Derubeis, Robert J; Hollon, Steven D et al. (2013) Convergence and divergence in the delivery of cognitive therapy in two randomized clinical trials. Behav Res Ther 51:493-8
Ponniah, Kathryn; Magiati, Iliana; Hollon, Steven D (2013) An update on the efficacy of psychological therapies in the treatment of obsessive-compulsive disorder in adults. J Obsessive Compuls Relat Disord 2:207-218

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