(provided by candidate): This is a request for five more years of support via a NIH Independent Scientist Award (K02). I have long sought to integrate psychosocial and biological models of depression. I want to enhance my understanding of neurobiology and developmental processes in the nature and treatment of depression and to gain a better sense of basic genetic factors. I also want to continue to enhance the clinical realism (effectiveness) of my work. I am interested in whether cognitive therapy (CT) has a more enduring effect than antidepressant medications (ADM) and whether that enduring effect can extend to the prevention of depression in at-risk adolescents. We recently completed a placebo-controlled trial that showed that CT is as efficacious as ADM in the treatment moderate to severe depression and good as continuation ADM and better than ADM withdrawal in the prevention of subsequent relapse following treatment termination. I also completed a trial with colleagues in Seattle that largely replicated these findings and further suggested that behavioral activation (BA) may be superior to CT in the treatment of more complex patients. We are conducting a multisite trial with colleagues at Penn and Rush that asks whether adding CT to ADM can eliminate the need to keep patients on maintenance medications. We continue to study the impact of treatment on the offspring of our depressed patients and we plan to examine the genetic factors that moderate and the neurobiological processes that mediate CT's enduring effect. Finally, we are conducting a study to see if CBT can be used to prevent the onset of depression in at-risk adolescents and also plan to implement a placebo-controlled comparison of BA and ADM (alone and in combination) in the treatment of adolescent depression with colleagues in Seattle. My goal throughout has been to examine the role of both psychological and biological processes in the moderation and mediation of treatment effects and to do so in a manner that has the greatest possible impact on actual clinical practice.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Scientist Development Award - Research (K02)
Project #
5K02MH001697-10
Application #
7656826
Study Section
Interventions Research Review Committee (ITV)
Program Officer
Pearson, Jane L
Project Start
2005-09-29
Project End
2010-06-30
Budget Start
2009-07-01
Budget End
2010-06-30
Support Year
10
Fiscal Year
2009
Total Cost
$120,355
Indirect Cost
Name
Vanderbilt University Medical Center
Department
Psychiatry
Type
Schools of Medicine
DUNS #
004413456
City
Nashville
State
TN
Country
United States
Zip Code
37212
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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
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
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

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