Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ASCO Annual Meeting 2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

2024 ASCO Annual Meeting

Keep up to date with all the top stories and latest evidence with our hub page, including official congress videos and expert takeaways.
ADVANCED SEARCH
Log in
Top
Child and Adolescent Psychiatry and Mental Health
Published in: Child and Adolescent Psychiatry and Mental Health 1/2008

Open Access 01-12-2008 | Research

The effects of cognitive-behavioural therapy on mood-related ruminative response style in depressed adolescents

Authors: Paul O Wilkinson, Ian M Goodyer

Published in: Child and Adolescent Psychiatry and Mental Health | Issue 1/2008

Login to get access

Abstract

Background

A mood-related ruminative response style increases the risk of onset and persistence of depression. This preliminary study investigated whether, in depressed adolescents, cognitive-behaviour therapy reduces mood-related ruminative response style. Whether specific factors within the rumination scale were differentially affected by CBT is also reported.

Methods

26 depressed adolescents were randomised to receiving serotonin-specific reuptake inhibitor antidepressants (SSRI) plus psychosocial treatment as usual or SSRI and psychosocial treatment as usual plus CBT. Ruminative response style and depressive symptoms were measured at baseline and after 30 weeks of treatment, with the Responses to Depression Questionnaire and Mood and Feelings Questionnaire.

Results

There were significantly greater reductions in ruminations in the CBT group compared to the non-CBT group (p = .002). There was no significant difference in the reduction in self-reported depressive symptoms between the groups. Rumination was reduced to levels of never-depressed controls in adolescents who had recovered from depression and received CBT. There were greater falls in the CBT group in the more pathological 'brooding' factor of rumination.

Conclusion

These findings suggest that adding CBT to SSRI medication in the presence of active clinical care causes a greater reduction in mood-related ruminative response style in depressed adolescents. This may reduce the risk of future relapse.

Trial registration

Current Controlled Trials ISRCNT83809224.
Appendix
Available only for authorised users
Literature
1.
Nolen-Hoeksema S: The role of rumination in depressive disorders and mixed anxiety/depressive symptoms. J Abnorm Psychol. 2000, 109: 504-511. 10.1037/0021-843X.109.3.504.CrossRefPubMed
2.
Nolen-Hoeksema S: The Response Styles Theory. Depressive Rumination Nature, Theory and Treatment. Edited by: Papageorgiou C and Wells A. 2004, Chichester, UK, Wiley
3.
Nolen-Hoeksema S, Morrow J: A Prospective Study of Depression and Posttraumatic Stress Symptoms After a Natural Disaster: The 1989 Loma Prieta Earthquake. Journal of Personality and Social Psychology. 1991, 61: 115-121. 10.1037/0022-3514.61.1.115.CrossRefPubMed
4.
Nolen-Hoeksema S, Parker LE, Larson J: Ruminative coping with depressed mood following loss. J Pers Soc Psychol. 1994, 67: 92-104. 10.1037/0022-3514.67.1.92.CrossRefPubMed
5.
Nolen-Hoeksema S: Responses to depression and their effects on the duration of depressive episodes. Journal of Abnormal Psychology. 1991, 109: 504-511. 10.1037/0021-843X.109.3.504.CrossRef
6.
Spasojevic J, Alloy LB: Rumination as a common mechanism relating depressive risk factors to depression. Emotion. 2001, 1: 25-37. 10.1037/1528-3542.1.1.25.CrossRefPubMed
7.
Abela JR, Brozina K, Haigh EP: An examination of the response styles theory of depression in third- and seventh-grade children: a short-term longitudinal study. J Abnorm Child Psychol. 2002, 30: 515-527. 10.1023/A:1019873015594.CrossRefPubMed
8.
Burwell RA, Shirk SR: Subtypes of rumination in adolescence: associations between brooding, reflection, depressive symptoms, and coping. J Clin Child Adolesc Psychol. 2007, 36: 56-65. 10.1207/s15374424jccp3601_6.CrossRefPubMed
9.
Goodyer IM, Herbert J, Tamplin A, Altham PME: First-episode major depression in adolescents. Affective, cognitive and endocrine characteristics of risk status and predictors of onset. British Journal of Psychiatry. 2000, 176: 142-149. 10.1192/bjp.176.2.142.CrossRefPubMed
10.
Goodyer IM, Herbert J, Tamplin A: Psychoendocrine antecedents of persistent first-episode major depression in adolescents: a community-based longitudinal enquiry. Psychological Medicine. 2003, 33: 601-610. 10.1017/S0033291702007286.CrossRefPubMed
11.
Lam D, Smith N, Checkley S, Rijsdijk F, Sham P: Effect of neuroticism, response style and information processing on depression severity in a clinically depressed sample. Psychol Med. 2003, 33: 469-479. 10.1017/S0033291702007304.CrossRefPubMed
12.
Kuyken W, Watkins E, Holden E, Cook W: Rumination in adolescents at risk for depression. J Affect Disord. 2006, 96: 39-47. 10.1016/j.jad.2006.05.017.CrossRefPubMed
13.
Papadakis AA, Prince RP, Jones NP, Strauman TJ: Self-regulation, rumination, and vulnerability to depression in adolescent girls. Dev Psychopathol. 2006, 18: 815-829.CrossRefPubMed
14.
Nolen-Hoeksema S, Morrow J: Effects of rumination and distraction on naturally occurring depressed mood. Cognition and Emotion. 1993, 7: 561-570. 10.1080/02699939308409206.CrossRef
15.
Moberly NJ, Watkins ER: Processing mode influences the relationship between trait rumination and emotional vulnerability. Behav Ther. 2006, 37: 281-291. 10.1016/j.beth.2006.02.003.CrossRefPubMed
16.
Treynor W, Gonzales R, Nolen-Hoeksema S: Rumination reconsidered: a psychometric analysis. Cognitive Therapy and Research. 2003, 27: 247-259. 10.1023/A:1023910315561.CrossRef
17.
Roberts JE, Gilboa E, Gotlib IH: Ruminative Response Style and Vulnerability to Episodes of Dysphoria: Gender, Neuroticism, and Episode Duration. Cognitive Therapy and Research. 1998, 22: 401-423. 10.1023/A:1018713313894.CrossRef
18.
Fresco M, Frankel AN, Mennin DS, Turk CL, Heimberg RG: Distinct and overlapping features of rumination and worry: the relationship of cognitive production to negative affective states. Cognitive Therapy and Research. 2002, 26: 179-188. 10.1023/A:1014517718949.CrossRef
19.
Armey M, Fresco M, Mennin DS, Turk CL, Heimberg RG, Spasojevic J, Alloy LB: Brooding and Pondering: Isolating the Active Ingredients of Depressive Rumination with Confirmatory Factor Analysis. Conference Presentation, Annual Meeting of the Association for Advancement of Behaviour Therapy: ; Boston, MA. 2003.
20.
Armey M: Further psychometric refinement of depressive rumination: Support for the Brooding and Pondering factor solution in a diverse community sample with clinician-assessed psychopathology. Conference Presentation, Annual Meeting of the Association for Advancement of Behaviour Therapy: ; New Orleans, LA. 2004.
21.
Bagby RM, Parker JDA: Relation of rumination and distraction with neuroticism and extroversion in a sample of patients with major depression. Cognitive Therapy and Research. 2001, 13: 441-457.
22.
NICE: Depression in Children and Young People: identification and management in primary, community and secondary care. 2005, London, British Psychological Society, Royal College of Psychiatrists
23.
Weisz JR, McCarty CA, Valeri SM: Effects of psychotherapy for depression in children and adolescents: a meta-analysis. Psychol Bull. 2006, 132: 132-149. 10.1037/0033-2909.132.1.132.PubMedCentralCrossRefPubMed
24.
Weisz JR, Weiss B, Han SS, Granger DA, Morton T: Effects of psychotherapy with children and adolescents revisited: a meta-analysis of treatment outcome studies. Psychol Bull. 1995, 117: 450-468. 10.1037/0033-2909.117.3.450.CrossRefPubMed
25.
Harrington R, Whittaker J, Shoebridge P, Campbell F: Systematic review of efficacy of cognitive behaviour therapies in childhood and adolescent depressive disorder. BMJ. 1998, 316: 1559-1563.PubMedCentralCrossRefPubMed
26.
March J, Silva S, Petrycki S, Curry J, Wells K, Fairbank J, Burns B, Domino M, McNulty S, Vitiello B, Severe J: Fluoxetine, cognitive-behavioral therapy, and their combination for adolescents with depression: Treatment for Adolescents With Depression Study (TADS) randomized controlled trial. Journal of the American Medical Association. 2004, 292: 807-820. 10.1001/jama.292.21.2578-c.CrossRefPubMed
27.
Goodyer I, Dubicka B, Wilkinson P, Kelvin R, Roberts C, Byford S, Breen S, Ford C, Barrett B, Leech A, Rothwell J, White L, Harrington R: Selective serotonin reuptake inhibitors (SSRIs) and routine specialist care with and without cognitive behaviour therapy in adolescents with major depression: randomised controlled trial. Bmj. 2007, 335: 142-10.1136/bmj.39224.494340.55.PubMedCentralCrossRefPubMed
28.
Clarke G, Debar L, Lynch F, Powell J, Gale J, O'Connor E, Ludman E, Bush T, Lin EH, Von Korff M, Hertert S: A randomized effectiveness trial of brief cognitive-behavioral therapy for depressed adolescents receiving antidepressant medication. J Am Acad Child Adolesc Psychiatry. 2005, 44: 888-898.CrossRefPubMed
29.
Goodyer IM, Herbert J, Secher SM, Pearson J: Short-Term Outcome of Major Depression: I. Comorbidity and Severity at Presentation as Predictors of Persistent Disorder. J Am Acad Child Adolesc Psychiatry. 1997, 36: 179-187.CrossRefPubMed
30.
Park RJ, Goodyer IM, Teasdale JD: Self-devaluative dysphoric experience and the prediction of persistent first-episode major depressive disorder in adolescents. Psychol Med. 2005, 35: 539-548. 10.1017/S003329170400371X.CrossRefPubMed
31.
Kaufman J, Birmaher B, Brent D, Rao U, Flynn C, Moreci P, Williamson D, Ryan N: Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry. 1997, 36: 980-988. 10.1097/00004583-199707000-00021.CrossRefPubMed
32.
Costello EJ, Angold A: Scales to Assess Child and Adolescent Depression: Checklists, Screens, and Nets. Journal of the American Academy of Child and Adolescent Psychiatry. 1988, 27: 726-737. 10.1097/00004583-198811000-00011.CrossRefPubMed
33.
Daviss WB, Birmaher B, Melhem NA, Axelson DA, Michaels SM, Brent DA: Criterion validity of the Mood and Feelings Questionnaire for depressive episodes in clinic and non-clinic subjects. J Child Psychol Psychiatry. 2006, 47: 927-934. 10.1111/j.1469-7610.2006.01646.x.CrossRefPubMed
34.
Wood A, Kroll L, Moore A, Harrington R: Properties of the mood and feelings questionnaire in adolescent psychiatric outpatients: a research note. J Child Psychol Psychiatry. 1995, 36: 327-334. 10.1111/j.1469-7610.1995.tb01828.x.CrossRefPubMed
35.
Raven JC, Court JH, Raven J: Manual for Raven's Progresive Matrices and Vocabulary Scales, Section 3 Standard Progressive Matrices, 1996 Edition. 1996, Oxford, Oxford Psychologists Press
36.
Vallis TM, Shaw BF, Dobson KS: The Cognitive Therapy Scale: psychometric properties. J Consult Clin Psychol. 1986, 54: 381-385. 10.1037/0022-006X.54.3.381.CrossRefPubMed
37.
Schmaling KB, Dimidjian S, Katon W, Sullivan M: Response styles among patients with minor depression and dysthymia in primary care. J Abnorm Psychol. 2002, 111: 350-356. 10.1037/0021-843X.111.2.350.CrossRefPubMed
38.
Watkins E, Scott J, Wingroveb J, Rimes K, Bathurst N, Steiner H, Kennell–Webb S, Moulds M, Malliaris Y: Rumination-focused cognitive behaviour therapy for residual depression: A case series. Behaviour Research and Therapy. 2007, In Press.
39.
Kingston T, Dooley B, Bates A, Lawlor E, Malone K: Mindfulness-based cognitive therapy for residual depressive symptoms. Psychol Psychother. 2007, 80: 193-203. 10.1348/147608306X116016.CrossRefPubMed
40.
Jain S, Shapiro SL, Swanick S, Roesch SC, Mills PJ, Bell I, Schwartz GER: A Randomized Controlled Trial of Mindfulness Meditation Versus Relaxation Training: Effects on Distress, Positive States of Mind, Rumination, and Distraction. Annals of Behavioral Medicine. 2007, 33: 11-21. 10.1207/s15324796abm3301_2.CrossRefPubMed
41.
Ramana R, Paykel ES, Cooper Z, Hayhurst H, Saxty M, Surtees PG: Remission and relapse in major depression: a two-year prospective follow-up study. Psychol Med. 1995, 25: 1161-1170.CrossRefPubMed
42.
Paykel ES, Ramana R, Cooper Z, Hayhurst H, Kerr J, Barocka A: Residual symptoms after partial remission: an important outcome in depression. Psychol Med. 1995, 25: 1171-1180.CrossRefPubMed
43.
Fava GA, Ruini C, Rafanelli C, Finos L, Conti S, Grandi S: Six-year outcome of cognitive behavior therapy for prevention of recurrent depression. Am J Psychiatry. 2004, 161: 1872-1876. 10.1176/appi.ajp.161.10.1872.CrossRefPubMed
44.
Dimidjian S, Hollon SD, Dobson KS, Schmaling KB, Kohlenberg RJ, Addis ME, Gallop R, McGlinchey JB, Markley DK, Gollan JK, Atkins DC, Dunner DL, Jacobson NS: Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the acute treatment of adults with major depression. J Consult Clin Psychol. 2006, 74: 658-670. 10.1037/0022-006X.74.4.658.CrossRefPubMed
Metadata
Title
The effects of cognitive-behavioural therapy on mood-related ruminative response style in depressed adolescents
Authors
Paul O Wilkinson
Ian M Goodyer
Publication date
01-12-2008
Publisher
BioMed Central
Published in
Child and Adolescent Psychiatry and Mental Health / Issue 1/2008
Electronic ISSN: 1753-2000
DOI
https://doi.org/10.1186/1753-2000-2-3

Other articles of this Issue 1/2008

Child and Adolescent Psychiatry and Mental Health 1/2008 Go to the issue

Research

Lack of association of genetic variants in genes of the endocannabinoid system with anorexia nervosa

Editorial

Child and Adolescent Psychiatry and Mental Health – development of a new open-access journal

Review

Effects of school-based interventions on mental health stigmatization: a systematic review

Review

Off-label psychopharmacologic prescribing for children: History supports close clinical monitoring

Research

The occurrence and nature of early signs of schizophrenia and psychotic mood disorders among former child and adolescent psychiatric patients followed into adulthood

Research

Psychiatrists' attitudes towards autonomy, best interests and compulsory treatment in anorexia nervosa: a questionnaire survey