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Depression: HELP
Articles by Robert J. Gallop
Based on 30 articles published since 2010
(Why 30 articles?)
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Between 2010 and 2020, Robert Gallop wrote the following 30 articles about Depression.
 
+ Citations + Abstracts
Pages: 1 · 2
1 Clinical Trial Predicting Change in an Integrated Dual Diagnosis Substance Abuse Intensive Outpatient Program. 2017

Wise, Edward A / Streiner, David L / Gallop, Robert J. ·a Mental Health Resources , PLLC , Memphis , Tennessee , USA. · b Department of Psychiatry , McMaster University , Hamilton , Canada. · c Applied Statistics Program , West Chester University , West Chester , Pennsylvania , USA. ·Subst Use Misuse · Pubmed #28426362.

ABSTRACT: Research on routine outcome monitoring in psychotherapy settings is plentiful but not without implementation obstacles. In fact, there is a relative dearth of real-time outcome monitoring in substance use treatment settings. Numerous barriers to the development and implementation of clinical decision support tools and outcome monitoring of substance use patients, including the need to establish expected trajectories of change and use of reliable change indices have been identified (Goodman, McKay, & DePhilippis, 2013 ). The current study was undertaken to develop expected trajectories of change and to demonstrate the treatment effectiveness of a dual diagnosis intensive outpatient program. The expected trajectories of change for days of substance use and depression scores were developed using predictive equation models from derivation samples and then applied to cross-validation samples. Predictive equations to monitor substance use were developed and validated for all patients and for only patients who were actively using substance at the time of admission, as well as to monitor severity of their depression symptom on a weekly basis. Validation of the equations was assessed through the use of Cohen's kappa (κ), receiver operating characteristic curves, reliable change index, and percentage improvement. Large effect sizes for reductions in substance use (Cohen's d = .76) and depressive symptoms (d = 1.10) are reported. The best predictive models we developed had absolute accuracy rates ranging from 95 to 100%. The findings from this study indicate that predictive equations for depressive symptoms and days of substance use can be derived and validated on dual diagnosis samples.

2 Article Instrumental variable analyses for causal inference: Application to multilevel analyses of the alliance-outcome relation. 2020

Crits-Christoph, Paul / Gallop, Robert / Gaines, Averi / Rieger, Agnes / Connolly Gibbons, Mary Beth. ·Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA. · Department of Mathematics, West Chester University, West Chester, PA, USA. ·Psychother Res · Pubmed #30451094.

ABSTRACT:

3 Article Predictors of treatment attendance in cognitive and dynamic therapies for major depressive disorder delivered in a community mental health setting. 2019

Gibbons, Mary Beth Connolly / Gallop, Robert / Thompson, Donald / Gaines, Averi / Rieger, Agnes / Crits-Christoph, Paul. ·Department of Psychiatry. · Merakey. ·J Consult Clin Psychol · Pubmed #31204838.

ABSTRACT: OBJECTIVE: Our goal was to evaluate treatment attendance patterns, including both treatment completion and premature termination from treatment, for 2 evidence-based psychotherapies for major depressive disorder (MDD) delivered in a community mental health setting. We explored rates of premature termination across the course of treatment as well as the factors that predicted and moderated premature termination and treatment completion. METHOD: This investigation included 237 patients with MDD who participated in a noninferiority trial comparing short-term dynamic psychotherapy (DT) to cognitive therapy (CT). Patients in both conditions were offered 16 sessions of treatment and had up to 5 months to complete treatment. All patients completed an extensive self-report battery at treatment baseline as well as measures of the therapeutic alliance and opinions about treatment following Session 2. RESULTS: Premature termination from both treatments was high with 27% of patients discontinuing treatment very early after only an intake session or a single treatment session. Patients in CT were significantly more likely to terminate treatment prematurely, χ²(3) = 14.35, CONCLUSIONS: Very early termination from services was higher in CT compared with DT. Including techniques to improve engagement in both therapies and matching patients to treatment based on predictors/moderators may be effective ways to optimize treatment engagement. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

4 Article Trajectories of change in maternal and adolescent depressive symptoms in the depression prevention initiative. 2019

Spiro-Levitt, Carolyn / Gallop, Robert / Young, Jami F. ·Department of Child and Adolescent Psychiatry, Hassenfeld Children's Hospital at New York University Langone, United States. Electronic address: carolyn.spiro@nyulangone.org. · Department of Mathematics, West Chester University, United States. · Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, United States; Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, United States. ·J Affect Disord · Pubmed #31051322.

ABSTRACT: BACKGROUND: Given the prevalence and consequences of adolescent depression, depression prevention has become an important area of research. While prevention programs like Interpersonal Psychotherapy - Adolescent Skills Training (IPT-AST) have demonstrated effectiveness, little research to date has studied the relationship between maternal depression and adolescent outcomes in these programs. METHOD: The current study investigated the relationship between maternal and adolescent depressive symptoms in 167 mother-adolescent dyads who were enrolled in the Depression Prevention Initiative (DPI), a randomized controlled trial that compared IPT-AST to group counseling (GC). First, the study examined the relationship between initial levels of adolescent and maternal depressive symptoms. The study then investigated whether maternal depressive symptoms improved over the two-year study period. Finally, the study assessed whether maternal and adolescent symptoms changed concurrently across time. RESULTS: Results indicated that initial levels of maternal and adolescent symptoms were positively associated. Additionally, maternal symptoms improved across the two-year period. Maternal and adolescent outcomes were related across time: as adolescents improved in our study, their mothers also improved. LIMITATIONS: The study utilized self-report data only and did not allow for the testing of causality in the relationship between mother-youth depression. CONCLUSIONS: These findings add to the literature demonstrating that as one part of the mother-child dyad improves, the other improves as well. These findings extend the current understanding of the relationship between maternal and adolescent depressive symptom outcomes, and have important implications for the prevention and treatment of depression.

5 Article A Randomized Controlled Trial: Attachment-Based Family and Nondirective Supportive Treatments for Youth Who Are Suicidal. 2019

Diamond, Guy S / Kobak, R Roger / Krauthamer Ewing, E Stephanie / Levy, Suzanne A / Herres, Joanna L / Russon, Jody M / Gallop, Robert J. ·Center for Family Intervention Science, Drexel University, Philadelphia, PA. Electronic address: guy.diamond@drexel.edu. · University of Delaware, Newark. · Center for Family Intervention Science, Drexel University, Philadelphia, PA. · The College of New Jersey, Ewing Township. · Virginia Tech, Blacksburg. · Applied Statistics Program, West Chester University, PA. ·J Am Acad Child Adolesc Psychiatry · Pubmed #30768418.

ABSTRACT: OBJECTIVE: To evaluate the efficacy of attachment-based family therapy (ABFT) compared with a family-enhanced nondirective supportive therapy (FE-NST) for decreasing adolescents' suicide ideation and depressive symptoms. METHOD: A randomized controlled trial of 129 adolescents who are suicidal ages 12- to 18-years-old (49% were African American) were randomized to ABFT (n = 66) or FE-NST (n = 63) for 16 weeks of treatment. Assessments occurred at baseline and 4, 8, 12, and 16 weeks. Trajectory of change and clinical recovery were calculated for suicidal ideation and depressive symptoms. RESULTS: There was no significant between-group difference in the rate of change in self-reported ideation (Suicidal Ideation Questionnaire-Jr; F CONCLUSION: Contrary to expectations, ABFT did not perform better than FE-NST. The 2 treatments produced substantial decreases in suicidal ideation and depressive symptoms that were comparable to or better than those reported in other more intensive, multicomponent treatments. The equivalent outcomes could be attributed to common treatment elements, different active mechanisms, or regression to the mean. Future studies will explore long-term follow up, secondary outcomes, and potential moderators and mediators. CLINICAL TRIAL REGISTRATION INFORMATION: Attachment-Based Family Therapy for Suicidal Adolescents; http://clinicaltrials.gov; NCT01537419.

6 Article Symptoms of anhedonia, not depression, predict the outcome of treatment of cocaine dependence. 2018

Crits-Christoph, Paul / Wadden, Steven / Gaines, Averi / Rieger, Agnes / Gallop, Robert / McKay, James R / Gibbons, Mary Beth Connolly. ·Department of Psychiatry, (1)Perelman School of Medicine, University of Pennsylvania, 3535 Market St., 6th Floor, Philadelphia, PA 19104, United States of America. Electronic address: crits@pennmedicine.upenn.edu. · Department of Psychiatry, (1)Perelman School of Medicine, University of Pennsylvania, 3535 Market St., 6th Floor, Philadelphia, PA 19104, United States of America. · Department of Mathematics, West Chester University, 25 University Avenue, Room 180, West Chester, PA 19383, United States of America. ·J Subst Abuse Treat · Pubmed #30032944.

ABSTRACT: The purpose of this paper is to reanalyze data from two studies to determine if anhedonia specifically, rather than depression overall, predicts treatment outcome for patients with cocaine use disorders. Measures of baseline anhedonia symptoms were created using anhedonia items from the Beck Depression Inventory (BDI) to re-examine National Institute on Drug Abuse Cocaine Collaborative Treatment study data (Crits-Christoph et al., 1999) and the contingency management group from the McKay et al. (2010) trial. Baseline anhedonia was used to predict cocaine abstinence rates across the treatment period in both studies. Anhedonia was a significant predictor of cocaine abstinence, even when overall depression scores excluding anhedonia were included in the models. The development of treatments to target individuals with cocaine use disorder who have symptoms of anhedonia has the potential to improve overall outcomes for those with this disorder.

7 Article Cognitive and Interpersonal Vulnerabilities to Adolescent Depression: Classification of Risk Profiles for a Personalized Prevention Approach. 2018

Hankin, Benjamin L / Young, Jami F / Gallop, Robert / Garber, Judy. ·Department of Psychology, University of Illinois at Urbana-Champaign, 603 E Daniel St, Champaign, IL, 61820, USA. hankinb@illinois.edu. · Children's Hospital of Philadelphia, Philadelphia, PA, USA. · West Chester University, West Chester, PA, USA. · Vanderbilt University, Nashville, TN, USA. ·J Abnorm Child Psychol · Pubmed #29368207.

ABSTRACT: Despite interest in psychosocial vulnerabilities to depression, little is known about reliable and valid individualized risk profiles that can be used to match individuals to evidence-based interventions for depression. This study investigated well-established cognitive and interpersonal vulnerabilities to depression among youth to discern an evidence-based risk classification approach which is being used in a personalized depression prevention randomized clinical trial. Data were drawn from a general community sample of adolescents (N = 467; ages 10-16, mean 13.14, SD = 1.62; 57% females) who were followed prospectively for 3 years. Youth completed measures of cognitive (negative cognitive style, dysfunctional attitudes, rumination) and interpersonal (support and conflict with peers and parents, excessive reassurance seeking, social competence, co-rumination) risks to depression, and then were followed longitudinally for onset of depression. Principal axis factor analyses showed that three latent factors--cognitive vulnerability, interpersonal support, and interpersonal conflict--optimally represented the structure of these risk factors. Clinically practical and meaningful cutoffs, based on tertile cut-off scores on cognitive and interpersonal risk measures, were used to categorize youth into relatively balanced high and low cognitive and interpersonal risk groups. These risk classification groups exhibited validity (AUC > 0.70) by predicting prospective onsets of depressive episodes at 18-months follow-ups. These findings demonstrate a reliable and valid approach to synthesize psychosocial vulnerabilities to depression, specifically cognitive and interpersonal risks. Results are discussed in terms of using these risk classifications profiles to test personalized prevention of depression during adolescence.

8 Article A self-report version of the Ways of Responding: Reliability and validity in a clinical sample. 2018

Yin, Seohyun / Connolly Gibbons, Mary Beth / Diehl, Caroline / Gallop, Robert / Crits-Christoph, Paul. ·a Department of Psychiatry , University of Pennsylvania , Philadelphia , PA , USA. · b Department of Mathematics , West Chester University , West Chester , PA , USA. ·Psychother Res · Pubmed #27653284.

ABSTRACT: OBJECTIVE: The Ways of Responding (WOR) instrument measures compensatory skills, a central construct in some theories of the mechanism of cognitive therapy for depression. However, the instrument is time-consuming and expensive to use in community settings, because it requires trained independent judges to rate subjects' open-ended written responses to depressogenic scenarios. The present study evaluated the reliability and validity of a self-report version of the WOR (WOR-SR) in a community mental health sample with depressive symptoms (N = 467). METHOD: Subjects completed the WOR-SR, a modified version of the original WOR, and other measures of depressive symptoms, dysfunctional cognitions, functioning, quality of life, and interpersonal problems at multiple time points. RESULTS: An exploratory factor analysis confirmed the two-factor structure of the WOR-SR. The positive and negative subscales both demonstrated excellent internal consistency (Cronbach's alphas = .91) and moderate convergent validity with other measures. CONCLUSION: The WOR-SR is a reliable and valid measure of compensatory skills in patients receiving treatment for depression at community mental health centers.

9 Article Comprehensive Screening for Suicide Risk in Primary Care. 2017

Diamond, Guy S / Herres, Joanna L / Krauthamer Ewing, E Stephanie / Atte, Tita O / Scott, Syreeta W / Wintersteen, Matt B / Gallop, Robert J. ·Couple and Family Therapy Department, Drexel University, Philadelphia, Pennsylvania. Electronic address: gd342@drexel.edu. · College of Nursing and Health Professions, Health Sciences Department, Drexel University, Philadelphia, Pennsylvania. · Couple and Family Therapy Department, Drexel University, Philadelphia, Pennsylvania. · Department of Psychiatry and Human Behavior, Thomas Jefferson University, Philadelphia, Pennsylvania. · Department of Mathematics, West Chester University, West Chester, Pennsylvania. ·Am J Prev Med · Pubmed #28410860.

ABSTRACT: INTRODUCTION: Suicide is a major public health problem and a complex clinical challenge. Assessment and early identification could be enhanced with screening tools that look beyond depression. The purpose of this study was to identify profiles of risk behaviors and social stress associated with suicidal ideation and behavior using the Behavioral Health Screen. METHODS: The study used screening data from 2,513 primary care patients (aged 14-24 years). Data were collected between 2008 and 2012, and were analyzed in 2016. RESULTS: Latent class analysis identified a high and low risk profile. Domains of primary influence included substance use, sexual assault, same-sex behavior, and unsafe sex. The high-risk group was 11 times more likely to have made a suicide attempt, five times more likely to report a history of suicidal ideation and behavior, and three times more likely to report recent suicidal ideation and behavior. CONCLUSIONS: Risk behaviors and social stress contribute to the risk for suicide above and beyond depression and should be assessed during routine primary care visits with adolescents. The Behavioral Health Screen can screen all these domains and thus assist primary care providers in assessing for both psychiatric and social stress factors associated with youth suicide.

10 Article Mechanisms of change in cognitive therapy for major depressive disorder in the community mental health setting. 2017

Crits-Christoph, Paul / Gallop, Robert / Diehl, Caroline K / Yin, Seohyun / Gibbons, Mary Beth Connolly. ·Department of Psychiatry, University of Pennsylvania. · Department of Mathematics, West Chester University. ·J Consult Clin Psychol · Pubmed #28406648.

ABSTRACT: OBJECTIVE: This study examined the relation of change in theory-relevant cognitive variables to depressive symptom change over the course of cognitive therapy, as well as the specificity of change mechanisms to cognitive therapy as compared with dynamic therapy. METHOD: There were 237 adult outpatients who were randomized to either cognitive (n = 119) or dynamic (n = 118) therapy for major depressive disorder in a community mental health setting. Assessments of compensatory skills (Ways of Responding Community Version and Self-Report Version), dysfunctional attitudes (Dysfunctional Attitudes Scale), and depressogenic schemas (Psychological Distance Scaling Task) were obtained at baseline and months 1, 2, and 5 following baseline. Primary outcome was measured using the Hamilton Rating Scale for Depression. RESULTS: Across both therapy conditions, change in all 3 cognitive domains was associated with concurrent change in depressive symptoms. After controlling for other cognitive variables, increased interconnectedness of the positive achievement-related schema was significantly associated with concurrent symptom change in cognitive (rp = .26, p < .001) but not dynamic therapy (rp = .08, p = .29). Increases in positive compensatory skills were associated with subsequent change in depressive symptoms in cognitive therapy (rp = -.36, p = .003), but not in dynamic therapy (rp = .11, p = .386). CONCLUSIONS: Results provide support for the compensatory skills model of cognitive therapy (CT) within a community mental health setting. Additional research is necessary to understand other possible mechanisms of change in CT in the community setting. (PsycINFO Database Record

11 Article A pragmatic randomized clinical trial of behavioral activation for depressed pregnant women. 2017

Dimidjian, Sona / Goodman, Sherryl H / Sherwood, Nancy E / Simon, Gregory E / Ludman, Evette / Gallop, Robert / Welch, Stacy Shaw / Boggs, Jennifer M / Metcalf, Christina A / Hubley, Sam / Powers, J David / Beck, Arne. ·Department of Psychology and Neuroscience. · Department of Psychology, Emory University. · HealthPartners Institute for Education and Research. · Group Health Research Institute, Group Health Cooperative. · Department of Mathematics, Applied Statistics Program, West Chester University. · Evidence-Based Treatment Centers of Seattle. · Kaiser Permanente Colorado Institute for Health Research. · Department of Family Medicine, University of Colorado School of Medicine. ·J Consult Clin Psychol · Pubmed #28045285.

ABSTRACT: OBJECTIVE: Depression among pregnant women is a prevalent public health problem associated with poor maternal and offspring development. Behavioral activation (BA) is a scalable intervention aligned with pregnant women's preference for nonpharmacological depression care. This is the first test of the effectiveness of BA for depression among pregnant women, which aimed to evaluate the effectiveness of BA as compared with treatment as usual (TAU). METHOD: Pregnant women (mean age = 28.75 years; SD = 5.67) with depression symptoms were randomly assigned to BA (n = 86) or TAU (n = 77). Exclusion criteria included known bipolar or psychotic disorder or immediate self-harm risk. Follow-up assessment occurred 5 and 10 weeks postrandomization and 3 months postpartum using self-report measures of primary and secondary outcomes and putative targets. RESULTS: Compared with TAU, BA was associated with significantly lower depressive symptoms (d = 0.34, p = .04) and higher remission (56.3% vs. 30.3%, p = .003). BA also demonstrated significant advantage on anxiety and perceived stress. Participants attended most BA sessions and reported high satisfaction. Participants in BA reported significantly higher levels of activation (d = 0.69, p < .0002) and environmental reward (d = 0.54, p < .003) than those who received TAU, and early change in both of these putative targets significantly mediated subsequent depression outcomes. CONCLUSIONS: BA is effective for pregnant women, offering significant depression, anxiety, and stress benefits, with mediation analyses supporting the importance of putative targets of activation and environmental reward. (PsycINFO Database Record

12 Article Methods for Incorporating Patient Preferences for Treatments of Depression in Community Mental Health Settings. 2017

Crits-Christoph, Paul / Gallop, Robert / Diehl, Caroline K / Yin, Seohyun / Gibbons, Mary Beth Connolly. ·Department of Psychiatry, University of Pennsylvania, Room 650, 3535 Market Street, Philadelphia, PA, 19104, USA. crits@mail.med.upenn.edu. · Department of Mathematics, West Chester University, West Chester, USA. · Department of Psychiatry, University of Pennsylvania, Room 650, 3535 Market Street, Philadelphia, PA, 19104, USA. ·Adm Policy Ment Health · Pubmed #27334607.

ABSTRACT: We developed three methods (rating, ranking, and discrete choice) for identifying patients' preferred depression treatments based on their prioritization of specific treatment attributes (e.g., medication side effects, psychotherapy characteristics) at treatment intake. Community mental health patients with depressive symptoms participated in separate studies of predictive validity (N = 193) and short-term (1-week) stability (N = 40). Patients who received non-preferred initial treatments (based on the choice method) switched treatments significantly more often than those who received preferred initial treatments. Receiving a non-preferred treatment at any point (based on rating and choice methods) was a significant predictor of longer treatment duration. All three methods demonstrated good short-term stability.

13 Article Comparative Effectiveness of Cognitive Therapy and Dynamic Psychotherapy for Major Depressive Disorder in a Community Mental Health Setting: A Randomized Clinical Noninferiority Trial. 2016

Connolly Gibbons, Mary Beth / Gallop, Robert / Thompson, Donald / Luther, Debra / Crits-Christoph, Katherine / Jacobs, Julie / Yin, Seohyun / Crits-Christoph, Paul. ·Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia. · NHS Human Services, Erdenheim, Pennsylvania. ·JAMA Psychiatry · Pubmed #27487573.

ABSTRACT: IMPORTANCE: Dynamic psychotherapy (DT) is widely practiced in the community, but few trials have established its effectiveness for specific mental health disorders relative to control conditions or other evidence-based psychotherapies. OBJECTIVE: To determine whether DT is not inferior to cognitive therapy (CT) in the treatment of major depressive disorder (MDD) in a community mental health setting. DESIGN, SETTING, AND PARTICIPANTS: From October 28, 2010, to July 2, 2014, outpatients with MDD were randomized to treatment delivered by trained therapists. Twenty therapists employed at a community mental health center in Pennsylvania were trained by experts in CT or DT. A total of 237 adult outpatients with MDD seeking services at this site were randomized to 16 sessions of DT or CT delivered across 5 months. Final assessment was completed on December 9, 2014, and data were analyzed from December 10, 2014, to January 14, 2016. INTERVENTIONS: Short-term DT or CT. MAIN OUTCOMES AND MEASURES: Expert blind evaluations with the 17-item Hamilton Rating Scale for Depression. RESULTS: Among the 237 patients (59 men [24.9%]; 178 women [75.1%]; mean [SD] age, 36.2 [12.1] years) treated by 20 therapists (19 women and 1 man; mean [SD] age, 40.0 [14.6] years), 118 were randomized to DT and 119 to CT. A mean (SD) difference between treatments was found in the change on the Hamilton Rating Scale for Depression of 0.86 (7.73) scale points (95% CI, -0.70 to 2.42; Cohen d, 0.11), indicating that DT was statistically not inferior to CT. A statistically significant main effect was found for time (F1,198 = 75.92; P = .001). No statistically significant differences were found between treatments on patient ratings of treatment credibility. Dynamic psychotherapy and CT were discriminated from each other on competence in supportive techniques (t120 = 2.48; P = .02), competence in expressive techniques (t120 = 4.78; P = .001), adherence to CT techniques (t115 = -7.07; P = .001), and competence in CT (t115 = -7.07; P = .001). CONCLUSIONS AND RELEVANCE: This study suggests that DT is not inferior to CT on change in depression for the treatment of MDD in a community mental health setting. The 95% CI suggests that the effects of DT are equivalent to those of CT. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01207271.

14 Article Staying well during pregnancy and the postpartum: A pilot randomized trial of mindfulness-based cognitive therapy for the prevention of depressive relapse/recurrence. 2016

Dimidjian, Sona / Goodman, Sherryl H / Felder, Jennifer N / Gallop, Robert / Brown, Amanda P / Beck, Arne. ·Department of Psychology and Neuroscience, University of Colorado Boulder. · Department of Psychology, Emory University. · Department of Mathematics, Applied Statistics Program, West Chester University. · Kaiser Permanente Colorado-Institute for Health Research. ·J Consult Clin Psychol · Pubmed #26654212.

ABSTRACT: OBJECTIVE: Clinical decision-making regarding the prevention of depression is complex for pregnant women with histories of depression and their health care providers. Pregnant women with histories of depression report preference for nonpharmacological care, but few evidence-based options exist. Mindfulness-based cognitive therapy has strong evidence in the prevention of depressive relapse/recurrence among general populations and indications of promise as adapted for perinatal depression (MBCT-PD). With a pilot randomized clinical trial, our aim was to evaluate treatment acceptability and efficacy of MBCT-PD relative to treatment as usual (TAU). METHOD: Pregnant adult women with depression histories were recruited from obstetric clinics at 2 sites and randomized to MBCT-PD (N = 43) or TAU (N = 43). Treatment acceptability was measured by assessing completion of sessions, at-home practice, and satisfaction. Clinical outcomes were interview-based depression relapse/recurrence status and self-reported depressive symptoms through 6 months postpartum. RESULTS: Consistent with predictions, MBCT-PD for at-risk pregnant women was acceptable based on rates of completion of sessions and at-home practice assignments, and satisfaction with services was significantly higher for MBCT-PD than TAU. Moreover, at-risk women randomly assigned to MBCT-PD reported significantly improved depressive outcomes compared with participants receiving TAU, including significantly lower rates of depressive relapse/recurrence and lower depressive symptom severity during the course of the study. CONCLUSIONS: MBCT-PD is an acceptable and clinically beneficial program for pregnant women with histories of depression; teaching the skills and practices of mindfulness meditation and cognitive-behavioral therapy during pregnancy may help to reduce the risk of depression during an important transition in many women's lives.

15 Article A Randomized Depression Prevention Trial Comparing Interpersonal Psychotherapy--Adolescent Skills Training to Group Counseling in Schools. 2016

Young, Jami F / Benas, Jessica S / Schueler, Christie M / Gallop, Robert / Gillham, Jane E / Mufson, Laura. ·Rutgers University, New Brunswick, NJ, USA. jfyoung@rci.rutgers.edu. · Rutgers University, New Brunswick, NJ, USA. · West Chester University, West Chester, PA, USA. · Swarthmore College, Swarthmore, PA, USA. · Columbia University College of Physicians and Surgeons, New York, NY, USA. · New York State Psychiatric Institute, New York, NY, USA. ·Prev Sci · Pubmed #26638219.

ABSTRACT: Given the rise in depression disorders in adolescence, it is important to develop and study depression prevention programs for this age group. The current study examined the efficacy of Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST), a group prevention program for adolescent depression, in comparison to group programs that are typically delivered in school settings. In this indicated prevention trial, 186 adolescents with elevated depression symptoms were randomized to receive IPT-AST delivered by research staff or group counseling (GC) delivered by school counselors. Hierarchical linear modeling examined differences in rates of change in depressive symptoms and overall functioning from baseline to the 6-month follow-up assessment. Cox regression compared rates of depression diagnoses. Adolescents in IPT-AST showed significantly greater improvements in self-reported depressive symptoms and evaluator-rated overall functioning than GC adolescents from baseline to the 6-month follow-up. However, there were no significant differences between the two conditions in onset of depression diagnoses. Although both intervention conditions demonstrated significant improvements in depressive symptoms and overall functioning, results indicate that IPT-AST has modest benefits over groups run by school counselors which were matched on frequency and duration of sessions. In particular, IPT-AST outperformed GC in reduction of depressive symptoms and improvements in overall functioning. These findings point to the clinical utility of this depression prevention program, at least in the short-term. Additional follow-up is needed to determine the long-term effects of IPT-AST, relative to GC, particularly in preventing depression onset.

16 Article The therapeutic alliance and therapist adherence as predictors of dropout from cognitive therapy for depression when combined with antidepressant medication. 2016

Cooper, Andrew A / Strunk, Daniel R / Ryan, Elizabeth T / DeRubeis, Robert J / Hollon, Steven D / Gallop, Robert. ·The Ohio State University, USA. · The Ohio State University, USA. Electronic address: strunk.20@osu.edu. · University of Pennsylvania, USA. · Vanderbilt University, USA. · West Chester University, USA. ·J Behav Ther Exp Psychiatry · Pubmed #26164110.

ABSTRACT: BACKGROUND: Previous psychotherapy research has examined the therapeutic alliance and therapist adherence as correlates or predictors of symptom change. While some initial evidence suggests the alliance is associated with risk of dropout in cognitive behavioral treatment for depression, evidence of such relations has been limited to date. We examined the relation of these psychotherapy process variables and dropout in the context of cognitive therapy for depression when provided in combination with pharmacotherapy. METHODS: Patients were randomized to the CT plus pharmacotherapy condition of a clinical trial for chronic or recurrent depression. Consistent with the spirit of personalized medicine, patients were treated until they met remission and recovery criteria (or reached the maximum allowable time in the study). In a sample of 176 patients, we examined observer-rated alliance and therapist adherence in the first three CT sessions as potential predictors of treatment dropout. RESULTS: The therapeutic alliance and one facet of therapist adherence (i.e., Behavioral Methods/Homework) predicted reduced odds of dropout. Therapist use of Negotiating/Structuring predicted greater likelihood of dropout, but only when other variables were included in the model. LIMITATIONS: Process ratings were not available for concurrent pharmacotherapy sessions. A minority of patients did not have session recordings available. CONCLUSIONS: Results are consistent with the possibility that the therapeutic alliance and therapists' focus on homework and behavioral methods promote treatment retention in combined treatment for depression.

17 Article The effectiveness of clinician feedback in the treatment of depression in the community mental health system. 2015

Connolly Gibbons, Mary Beth / Kurtz, John E / Thompson, Donald L / Mack, Rachel A / Lee, Jacqueline K / Rothbard, Aileen / Eisen, Susan V / Gallop, Robert / Crits-Christoph, Paul. ·Department of Psychiatry, University of Pennsylvania. · Department of Psychology, Villanova University. · NHS Human Services. · Department of Health Policy and Management, Boston University. ·J Consult Clin Psychol · Pubmed #26052874.

ABSTRACT: OBJECTIVE: We describe the development and evaluation of a clinician feedback intervention for use in community mental health settings. The Community Clinician Feedback System (CCFS) was developed in collaboration with a community partner to meet the needs of providers working in such community settings. METHOD: The CCFS consists of weekly performance feedback to clinicians, as well as a clinical feedback report that assists clinicians with patients who are not progressing as expected. Patients in the randomized sample (N = 100) were predominantly female African Americans, with a mean age of 39 years. RESULTS: Satisfaction ratings of the CCFS indicate that the system was widely accepted by clinicians and patients. A hierarchical linear models (HLM) analysis comparing rates of change across conditions controlling for baseline gender, age, and racial group indicated a moderate effect in favor of the feedback condition for symptom improvement, t(94) = 2.41, p = .017, d = .50. Thirty-six percent of feedback patients compared with only 13% of patients in the no-feedback condition demonstrated clinically significant change across treatment, χ2(1) = 6.13, p = .013. CONCLUSIONS: These results indicate that our CCFS is acceptable to providers and patients of mental health services and has the potential to improve the effectiveness of services for clinically meaningful depression in the community mental health setting.

18 Article Dialectical behavior therapy for high suicide risk in individuals with borderline personality disorder: a randomized clinical trial and component analysis. 2015

Linehan, Marsha M / Korslund, Kathryn E / Harned, Melanie S / Gallop, Robert J / Lungu, Anita / Neacsiu, Andrada D / McDavid, Joshua / Comtois, Katherine Anne / Murray-Gregory, Angela M. ·Department of Psychology, Behavioral Research and Therapy Clinics, University of Washington, Seattle. · Department of Mathematics, West Chester University, West Chester, Pennsylvania. · Department of Psychology, Behavioral Research and Therapy Clinics, University of Washington, Seattle3Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina. · Department of Psychology, Behavioral Research and Therapy Clinics, University of Washington, Seattle4Department of State, Washington, DC. ·JAMA Psychiatry · Pubmed #25806661.

ABSTRACT: IMPORTANCE: Dialectical behavior therapy (DBT) is an empirically supported treatment for suicidal individuals. However, DBT consists of multiple components, including individual therapy, skills training, telephone coaching, and a therapist consultation team, and little is known about which components are needed to achieve positive outcomes. OBJECTIVE: To evaluate the importance of the skills training component of DBT by comparing skills training plus case management (DBT-S), DBT individual therapy plus activities group (DBT-I), and standard DBT which includes skills training and individual therapy. DESIGN, SETTING, AND PARTICIPANTS: We performed a single-blind randomized clinical trial from April 24, 2004, through January 26, 2010, involving 1 year of treatment and 1 year of follow-up. Participants included 99 women (mean age, 30.3 years; 69 [71%] white) with borderline personality disorder who had at least 2 suicide attempts and/or nonsuicidal self-injury (NSSI) acts in the last 5 years, an NSSI act or suicide attempt in the 8 weeks before screening, and a suicide attempt in the past year. We used an adaptive randomization procedure to assign participants to each condition. Treatment was delivered from June 3, 2004, through September 29, 2008, in a university-affiliated clinic and community settings by therapists or case managers. Outcomes were evaluated quarterly by blinded assessors. We hypothesized that standard DBT would outperform DBT-S and DBT-I. INTERVENTIONS: The study compared standard DBT, DBT-S, and DBT-I. Treatment dose was controlled across conditions, and all treatment providers used the DBT suicide risk assessment and management protocol. MAIN OUTCOMES AND MEASURES: Frequency and severity of suicide attempts and NSSI episodes. RESULTS: All treatment conditions resulted in similar improvements in the frequency and severity of suicide attempts, suicide ideation, use of crisis services due to suicidality, and reasons for living. Compared with the DBT-I group, interventions that included skills training resulted in greater improvements in the frequency of NSSI acts (F1,85 = 59.1 [P < .001] for standard DBT and F1,85 = 56.3 [P < .001] for DBT-S) and depression (t399 = 1.8 [P = .03] for standard DBT and t399 = 2.9 [P = .004] for DBT-S) during the treatment year. In addition, anxiety significantly improved during the treatment year in standard DBT (t94 = -3.5 [P < .001]) and DBT-S (t94 = -2.6 [P = .01]), but not in DBT-I. Compared with the DBT-I group, the standard DBT group had lower dropout rates from treatment (8 patients [24%] vs 16 patients [48%] [P = .04]), and patients were less likely to use crisis services in follow-up (ED visits, 1 [3%] vs 3 [13%] [P = .02]; psychiatric hospitalizations, 1 [3%] vs 3 [13%] [P = .03]). CONCLUSIONS AND RELEVANCE: A variety of DBT interventions with therapists trained in the DBT suicide risk assessment and management protocol are effective for reducing suicide attempts and NSSI episodes. Interventions that include DBT skills training are more effective than DBT without skills training, and standard DBT may be superior in some areas. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00183651.

19 Article An open trial of mindfulness-based cognitive therapy for the prevention of perinatal depressive relapse/recurrence. 2015

Dimidjian, Sona / Goodman, Sherryl H / Felder, Jennifer N / Gallop, Robert / Brown, Amanda P / Beck, Arne. ·Department of Psychology and Neuroscience, University of Colorado Boulder, 345 UCB Muenzinger, Boulder, CO, 80309-0345, USA, sona.dimidjian@colorado.edu. ·Arch Womens Ment Health · Pubmed #25298253.

ABSTRACT: Pregnant women with histories of depression are at high risk of depressive relapse/recurrence during the perinatal period, and options for relapse/recurrence prevention are limited. Mindfulness-based cognitive therapy (MBCT) has strong evidence among general populations but has not been studied among at-risk pregnant women to prevent depression. We examined the feasibility, acceptability, and clinical outcomes of depression symptom severity and relapse/recurrence associated with MBCT adapted for perinatal women (MBCT-PD). Pregnant women with depression histories were recruited from obstetrics clinics in a large health maintenance organization at two sites and enrolled in MBCT-PD (N = 49). Self-reported depressive symptoms and interview-based assessments of depression relapse/recurrence status were measured at baseline, during MBCT-PD, and through 6-months postpartum. Pregnant women reported interest, engagement, and satisfaction with the program. Retention rates were high, as were rates of completion of daily homework practices. Intent to treat analyses indicated a significant improvement in depression symptom levels and an 18 % rate of relapse/recurrence through 6 months postpartum. MBCT-PD shows promise as an acceptable, feasible, and clinically beneficial brief psychosocial prevention option for pregnant women with histories of depression. Randomized controlled trials are needed to examine the efficacy of MBCT-PD for the prevention of depressive relapse/recurrence during pregnancy and postpartum.

20 Article Web-based Mindfulness-based Cognitive Therapy for reducing residual depressive symptoms: An open trial and quasi-experimental comparison to propensity score matched controls. 2014

Dimidjian, Sona / Beck, Arne / Felder, Jennifer N / Boggs, Jennifer M / Gallop, Robert / Segal, Zindel V. ·Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO 80309, USA. Electronic address: sona.dimidjian@colorado.edu. · Kaiser Permanente Colorado Institute for Health Research, USA. · Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO 80309, USA. · Department of Mathematics, West Chester University, USA. · Department of Psychology, University of Toronto Scarborough, Canada. ·Behav Res Ther · Pubmed #25461782.

ABSTRACT: Mindfulness-based Cognitive Therapy (MBCT) has been shown to effectively prevent relapse and reduce residual depressive symptoms (RDS), yet it faces barriers to dissemination. The present study examined Mindful Mood Balance (MMB), the first web-based approach to deliver the core content of MBCT. Of the 107 recurrently depressed individuals screened, 100 elected to enroll in the study and received MMB in an 8-session open trial with 6-month follow-up. Outcomes included depressive symptom severity, rumination and mindful awareness, and program engagement. A quasi-experimental comparison between MMB participants and propensity matched case-controls receiving usual depression care (UDC) (N = 100) also was conducted. The full sample and the subgroup with residual depressive symptoms (N = 42) showed significantly reduced depressive severity, which was sustained over six months, and improvement on rumination and mindfulness. Examination of acceptability of MMB indicated that 42% of participants within the full sample and 36% of the RDS subgroup completed all 8 sessions and 53% within the full sample and 50% within the RDS subgroup completed at least 4 sessions, and that participants engaged with daily mindfulness practice. MMB also was associated with significant reduction in RDS severity as compared to quasi-experimental propensity matched controls. Although the use of a non-randomized design, with potential unmeasured differences between groups, and short interval of clinical follow-up were limitations, findings from this study support the web-based delivery of MBCT and suggest clinical benefits for participants with histories of depression and with RDS, relative to those receiving usual care alone.

21 Article Extreme nonresponse to acute phase cognitive therapy for depression: an attempt to replicate and extend. 2014

Koenig, Aaron M / Jarrett, Robin B / Gallop, Robert / Barrett, Marna S / Thase, Michael E. ·Perelman School of Medicine at the University of Pennsylvania, University of Pittsburgh Medical Center. Electronic address: koenigam@upmc.edu. · The University of Texas Southwestern Medical Center at Dallas. · Perelman School of Medicine at the University of Pennsylvania, West Chester University. · Perelman School of Medicine at the University of Pennsylvania. · Perelman School of Medicine at the University of Pennsylvania, University of Pittsburgh Medical Center. ·Behav Ther · Pubmed #24680227.

ABSTRACT: As with other interventions for major depressive disorder (MDD), cognitive therapy (CT) results in treatment failure for about half of all participants. In 2007, Coffman and colleagues in Seattle studied this topic by identifying a group of patients who demonstrated an extremely poor response to CT (i.e., posttreatment BDI score≥31). They called these patients "extreme nonresponders" (ENR) and described the pretreatment characteristics that predicted response status. In the current study, we attempt a replication of the Seattle study with a larger sample of adults with recurrent MDD (N=473) who received a 16-20 session (12-14week) course of CT. The rate of ENR in this large sample was only 6.3% (30/473), compared to 22.2% (10/45) in the Seattle sample. Four pretreatment measures of symptom severity and functioning differed significantly among ENR and non-ENR participants. In each case, higher symptoms or poorer functioning were associated with ENR status. However, the combination of these factors in a regression model did not predict actual ENR status with the high degree of sensitivity or specificity observed in the Seattle study. These findings suggest that extreme nonresponse to CT is not as common as previously described and, although poor outcomes are associated with pretreatment clinical status, it is difficult to predict posttreatment symptom severity with a high degree of accuracy across different research samples.

22 Article The associations among improvement and alliance expectations, alliance during treatment, and treatment outcome for major depressive disorder. 2014

Barber, Jacques P / Zilcha-Mano, Sigal / Gallop, Robert / Barrett, Marna / McCarthy, Kevin S / Dinger, Ulrike. ·a Derner Institute , Adelphi University , Garden City , NY , USA. ·Psychother Res · Pubmed #24392793.

ABSTRACT: OBJECTIVE: To examine the associations between treatment/outcome expectations, alliance before and during treatment, and the impact of alliance on symptomatic improvement. METHODS: One hundred and fifty-three depressed patients randomized to dynamic supportive-expressive psychotherapy (SET), antidepressant medication (ADM) or placebo (PBO) + clinical management completed ratings of treatment expectations, therapeutic alliance (CALPAS, WAI-S), and depressive symptoms (HAM-D). RESULTS: Pretreatment expectations of the therapeutic alliance were significantly related to alliance later in therapy but did not differ across treatments and did not predict outcome. Alliance development over time differed between treatments; it increased more in SET than in PBO. After controlling for prior symptom improvement, early alliance predicted subsequent depression change. CONCLUSIONS: Expectations of alliance and of treatment outcome/improvement, measured prior to treatment onset, predicted subsequent alliance.

23 Article Psychotherapy credibility ratings: patient predictors of credibility and the relation of credibility to therapy outcome. 2014

Mooney, Tessa Katherine / Gibbons, Mary Beth Connolly / Gallop, Robert / Mack, Rachel A / Crits-Christoph, Paul. ·a University of Pennsylvania Medical Center, Center for Psychotherapy Research, Psychiatry , Philadelphia , PA , USA. ·Psychother Res · Pubmed #24219179.

ABSTRACT: OBJECTIVE: The current investigation examined the relation between credibility ratings for adult psychotherapies and a variety of patient factors as well as the relation between credibility ratings and subsequent symptom change. METHOD: A pooled study database that included studies evaluating the efficacy of cognitive and psychodynamic therapies for a variety of disorders was used. For all studies, a three-item credibility scale was administered at session 2. Patient variables at baseline were used to predict early treatment credibility. RESULTS: Early symptom improvement, age, education, and expectation of improvement were all significantly predictive of credibility scores at session 2. In one combined multiple regression model controlling for treatment, study, and early symptom change, age, education, and expectation of improvement remained significantly predictive of credibility scores. Credibility was predictive of subsequent symptom change even when controlling for age, education, expectation of improvement, and early symptom improvement. CONCLUSIONS: These findings suggest that age and education, in addition to expectations of improvement and the amount of early symptom improvement, may influence the patient's perceptions of the credibility of a treatment rationale early in the treatment process and that credibility ratings predict subsequent symptom change.

24 Article Prevention of depression in at-risk adolescents: longer-term effects. 2013

Beardslee, William R / Brent, David A / Weersing, V Robin / Clarke, Gregory N / Porta, Giovanna / Hollon, Steven D / Gladstone, Tracy R G / Gallop, Robert / Lynch, Frances L / Iyengar, Satish / DeBar, Lynn / Garber, Judy. ·Department of Psychiatry, Boston Children's Hospital, Boston, Massachusetts2Judge Baker Children's Center, Boston, Massachusetts. ·JAMA Psychiatry · Pubmed #24005242.

ABSTRACT: IMPORTANCE: Adolescent offspring of depressed parents are at high risk for experiencing depressive disorders themselves. OBJECTIVE: To determine whether the positive effects of a group cognitive-behavioral prevention (CBP) program extended to longer-term (multiyear) follow-up. DESIGN: A 4-site randomized clinical trial with 33 months of follow-up was conducted. Recruitment of participants was from August 2003 through February 2006. SETTING: The study settings included a health maintenance organization, university medical centers, and a community mental health center. PARTICIPANTS: Three hundred sixteen adolescent (aged 13-17 years) offspring of parents with current and/or prior depressive disorders; adolescents had histories of depression, current elevated depressive symptoms, or both but did not currently meet criteria for a depressive disorder. INTERVENTIONS: The CBP program consisted of 8 weekly 90-minute group sessions followed by 6 monthly continuation sessions. Adolescents were randomly assigned to either the CBP program or usual care (UC). MAIN OUTCOMES AND MEASURES: The primary outcome was a probable or definite episode of depression (Depression Symptom Rating score ≥4) for at least 2 weeks through the month 33 follow-up evaluation. RESULTS: Over the 33-month follow-up period, youths in the CBP condition had significantly fewer onsets of depressive episodes compared with those in UC. Parental depression at baseline significantly moderated the intervention effect. When parents were not depressed at intake, CBP was superior to UC (number needed to treat, 6), whereas when parents were actively depressed at baseline, average onset rates between CBP and UC were not significantly different. A 3-way interaction among intervention, baseline parental depression, and site indicated that the impact of parental depression on intervention effectiveness varied across sites. CONCLUSIONS AND RELEVANCE: The CBP program showed significant sustained effects compared with UC in preventing the onset of depressive episodes in at-risk youth over a nearly 3-year period. Important next steps will be to strengthen the CBP intervention to further enhance its preventive effects, improve intervention outcomes when parents are currently depressed, and conduct larger implementation trials to test the broader public health impact of the CBP program for preventing depression in youth. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00073671.

25 Article Differential change in specific depressive symptoms during antidepressant medication or cognitive therapy. 2013

Fournier, Jay C / DeRubeis, Robert J / Hollon, Steven D / Gallop, Robert / Shelton, Richard C / Amsterdam, Jay D. ·Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara Street, Pittsburgh, PA 15213, USA. fournierjc@upmc.edu ·Behav Res Ther · Pubmed #23644038.

ABSTRACT: Cognitive therapy and antidepressant medications are effective treatments for depression, but little is known about their relative efficacy in reducing individual depressive symptoms. Using data from a recent clinical trial comparing cognitive therapy, antidepressant medication, and placebo in the treatment of moderate-to-severe depression, we examined whether there was a relative advantage of any treatment in reducing the severity of specific depressive symptom clusters. The sample consisted of 231 depressed outpatients randomly assigned to: cognitive therapy for 16 weeks (n = 58); paroxetine treatment for 16 weeks (n = 116); or pill placebo for 8 weeks (n = 57). Differential change in five subsets of depressive symptoms was examined: mood, cognitive/suicide, anxiety, typical-vegetative, and atypical-vegetative symptoms. Medication led to a greater reduction in cognitive/suicide symptoms relative to placebo by 4 weeks, and both active treatments reduced these symptoms more than did placebo by 8 weeks. Cognitive therapy reduced the atypical-vegetative symptoms more than placebo by 8 weeks and more than medications throughout the trial. These findings suggest that medications and cognitive therapy led to different patterns of response to specific symptoms of depression and that the general efficacy of these two well-validated treatments may be driven in large part by changes in cognitive or atypical-vegetative symptoms.

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