@article{90fb67c1bdba4ea5a09ea0b61030d544,
title = "The Role of Dyadic Discord in Outcomes in Acute Phase Cognitive Therapy for Adults With Recurrent Major Depressive Disorder",
abstract = "Major depressive disorder (MDD) and relationship discord between cohabiting partners frequently co-occur, with bidirectional effects established. As relationship quality influences understanding and treatment of MDD, the current analyses clarified the relations of pretreatment dyadic discord with outcomes during and at the end of acute phase cognitive therapy (CT) for adults with recurrent MDD. Married or cohabiting patients (n = 219) completed the Dyadic Adjustment Scale (DYS) before and after a 16–20 session, 12–14 week CT protocol. Lower levels of dyadic adjustment indicated higher levels of dyadic discord. Response to CT was defined as the absence of a major depressive episode and ≤ 12 on the 17-item Hamilton Rating Scale for Depression. Pretreatment dyadic discord, whether defined as a continuous or categorical variable (using DYS cutoff score of 97), was not associated with treatment completion or response but was positively associated with levels of depressive symptoms at the end of acute phase CT. Furthermore, CT was associated with declines in dyadic discord, with 23.3% of initially discordant couples moving to nondiscordant status at the end of CT. Depressive symptoms did not significantly mediate changes in dyadic discord. Finally, pre- (but not mid-) treatment dyadic discord was associated with subsequent changes in depressive symptoms, suggesting limited mediation. These findings replicate prior research indicating that individual CT is associated with reductions in depressive symptoms and dyadic discord while clarifying that lower pre-treatment dyadic discord may predict initial improvement in depressive symptoms.",
keywords = "cognitive therapy, couples, depression, dyadic discord, marital satisfaction",
author = "Trombello, {Joseph M.} and Vittengl, {Jeffrey R.} and Denton, {Wayne H.} and Abu Minhajuddin and Thase, {Michael E.} and Jarrett, {Robin B.}",
note = "Funding Information: This report was supported by Grants Number K24 MH001571, R01 MH58397, R01 MH69619 (Robin B. Jarrett, Ph.D.) and R01 MH58356 and R01 MH69618 (Michael E. Thase, M.D.) from the National Institute of Mental Health (NIMH). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIMH. This work has not been previously published or presented elsewhere. We appreciate the careful review by the trial{\textquoteright}s Data Safety and Monitoring Board. We are indebted to our patients, research teams, and our colleagues at The University of Texas Southwestern Medical Center, the University of Pittsburgh (where Dr. Thase accrued patients), and the University of Pennsylvania (Dr. Thase{\textquoteright}s current affiliation). We appreciate the participation of colleagues, previously named, and study participants. We are grateful to Carol Tamminga, M.D., Lou and Ellen McGinley Distinguished Chair in Psychiatric Research and Communities Foundation of Texas Chair in Brain Sciences and the University of Texas Southwestern Medical Center Department of Psychiatry for support of research. Funding Information: This report was supported by Grants Number K24 MH001571, R01 MH58397, R01 MH69619 (Robin B. Jarrett, Ph.D.) and R01 MH58356 and R01 MH69618 (Michael E. Thase, M.D.) from the National Institute of Mental Health (NIMH). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIMH. This work has not been previously published or presented elsewhere. We appreciate the careful review by the trial's Data Safety and Monitoring Board. We are indebted to our patients, research teams, and our colleagues at The University of Texas Southwestern Medical Center, the University of Pittsburgh (where Dr. Thase accrued patients), and the University of Pennsylvania (Dr. Thase's current affiliation). We appreciate the participation of colleagues, previously named, and study participants. We are grateful to Carol Tamminga, M.D., Lou and Ellen McGinley Distinguished Chair in Psychiatric Research and Communities Foundation of Texas Chair in Brain Sciences and the University of Texas Southwestern Medical Center Department of Psychiatry for support of research. Publisher Copyright: {\textcopyright} 2019",
year = "2019",
month = jul,
doi = "10.1016/j.beth.2018.11.006",
language = "English (US)",
volume = "50",
pages = "778--790",
journal = "Behavior Therapy",
issn = "0005-7894",
publisher = "Elsevier Inc.",
number = "4",
}