The Mediating Role of Pleasant Activities in Cognitive Behavioral Therapy for Depressed Adolescents

Document Type : Original Article

Authors

1 Department of Psychology, Faculty of Educational Sciences and Psychology, Shahid Chamran University, Ahvaz, Iran

2 Department of Psychology, Faculty of Educational Sciences and Psychology, University of Isfahan, Isfahan, Iran

3 Department of Psychology, Faculty of Literature and Humanities, Salman Farsi University of Kazerun, Kazerun, Iran

Abstract

Introduction: The purpose of this study was to investigate the effectiveness of cognitive-behavioral therapy in the depression of adolescents by an increase in pleasurable activities as a mediation.
Method: The statistical population included all adolescent girls (ages14to17) in Isfahan. In the form of an empirical study with a control and an experimental group and by evaluation of pre-test and post-test, 60girls which had been diagnosed with depression were selected and randomly assigned into two groups. Subjects, using Beck Depression Inventory (BDI-II) and Pleasant Events Schedule (PES).Data were analyzed for mediation analysis by R software and ANCOVA by SPSS-24.
Results: Findings show that cognitive-behavioral therapy is effective in increasing pleasurable activities (path coefficient: 0.19). The increase of pleasurable activities is effective in reducing depression (path coefficient: 0.35) and the cognitive-behavioral therapy by the mediation of pleasurable activities (path coefficient: 0.28) is effective. The entire effect of cognitive-behavioral therapy was on depression (β=0.28). Actually, 22%direct and 0.06%indirect effects was applied through the effect of pleasurable activities on depression.
Conclusion: Mediation analysis showed that pleasant events can play a mediating role in the relationship between depression and cognitive-behavioral therapy and can be used in short-term treatments.

Keywords

References

References
1.   Eskin M, Ertekin K, Demir H. Efficacy of a Problem-Solving Therapy for Depression and Suicide Potential in Adolescents and Young Adults. Cogn Ther Res. 2008;32(227).
2.   Dilsaver SC. An estimate of the minimum economic burden of bipolar I and II disorders in the United States. Journal of affective disorders. 2011;1(129):79-83.
3.   Gutman DA, Nemeroff CB. Stress and depression. The handbook of stress science: Biology, psychology, and health. 2001:345-57.
4.   Wilson CJ, Deane FP. Help negation and suicidal ideation: The role of depression, anxiety and hopelessness. Journal of Youth and Adolescence. 2010;39(3):291-305.
5.   Weinberger AH, Gbedemah M, Martinez AM, Nash D, Galea S, Goodwin RD. Trends in depression prevalence in the USA from 2005 to 2015: widening disparities in vulnerable groups. Psychological Medicine. 2018;48(8):1308-15.
6.   Shapero BG, Mazzone E, ulholland C. Early Onset of Depression during Childhood and Adolescence. The Massachusetts General Hospital Guide to Depression. 2018:59-70.
7.   Martin F, Oliver T. Behavioral activation for children and adolescents: a systematic review of progress and promise. European Child & Adolescent Psychiatry. 2019;28(4):427-4410.
8.   Hofmann SG, Hayes SC. Emotion in Therapy: From Science to Practice. 2014 ed. London: The Gilford Press; 2014.
9.   Tugade MM, Shiota MN, Kirby LD. Handbook of positive emotions: Guilford Publications; 2014.
10. Brown JF. The Emotion Regulation Skills System for Cognitively Challenged Clients A DBT -Informed Approach. London: The Gilford Press; 2016.
11. Lavretsky H, Sajatovic M, Reynolds CF. Late-Life Mood Disorders: Oxford University Press; 2013.
12. Jeste DV, Palmer BW. Positive Psychiatry: A Clinical Handbook. Arlington: American Psychiatric Publishing; 2015.
13. Curry J. Specific psychotherapies for childhood and adolescent depression. Biological Psychiatry. 2001;49:1091–100.
14. Beck AT, Rush AJ, Shaw BF, Emery G. Cognitive therapy of depression. New York: Guilford Press; 1979.
15. Byun TH, Swarna S, Chaliki SS, Kenneth GM, Poole KG. New Treatment Options for Depression: A Primer for Internists. The American Journal of Medicine. 2018;132(6):678-84.
16. Rush AJ, Kovacs M, Beck AT, Weissenburger J, Hollon SD. Differential effects of cognitive therapy and pharmacotherapy on depressive symptoms. Journal of Affective Disorders. 1981;3:221-9.
17. Melyani M. Mindfulness based cognitive therapy versus cognitive behavioral therapy on residual symptoms in recurrent Depression Int J Behav Sci 2013;7(2):159-66.
18. Mohammadpour Mea. The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: Treatment of Comorbid Psychopathology Accompanying a Generalized Anxiety Disorder. Int J Behav Sci. 2018;12(3):125-31.
19. Cole DA, Maxwell SE. Testing meditational models with longitudinal data: Questions and tips in the use of structural equation modeling. Journal of Abnormal Psychology. 2003;112:558 – 77.
20. Kolko DJ, Brent DA, Baugher M, Bridge J, Brimaher B. Cognitive and family therapies for adolescent depression: Treatment specificity, mediation and moderation. Journal of consulting and Clinical  Psychology. 2000;68:603-14.
21. Kraemer HC, Stice E, Kazdin A, Offord D, D. K. How do risk factors work together? Mediators, moderators, and independent, overlapping, and proxy risk factors. American journal of psychiatry. 2001;158(6):848-56.
22. oreizi h, Khalilian M. Methods of Intermediary Analysis and Its Application in Investigating Organizational Attractions as Intermediary Variables.  9th Iranian Statistician Conference; August 30 to September 1; Isfahan University2008. p. 241-30.
23. Baron RM, Kenny DA, 0022-3514/86/$00.75. The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology. 1986;51:1173–82.
24. Clarke GN, Rohde P, Lewinsohn PM, Hops H, Seeley JR. Cognitive-behavioral treatment of adolescent depression: efficacy of acute group treatment and booster sessions. J Am Acad Child Adolesc Psychiatry. 1999;38(3):272-9.
25. Veenhoven R. Hedonism and happiness. Journal of Happiness Studies. 2003;4(4):437-57.
26. Soltanizadeh M, Malekpour M, Neshatdoost H. The relationship between physical pleasure and positive negative affection in students of University of Isfahan. Journal of Psychological Studies. 2007;1(4):31-46.
27. Diener E, Sandvik E, Pavot W. Happiness is the frequency, not the intensity of positive versus negative affect. . Diener E, editor. Dordrecht: Springer; 2009.
28. Berenbaum H. Varieties of joy-related pleasurable activities and feelings. Cognition and Emotion. 2002;16(4):473-94.
29. MacPhillamy DJ, Lewinsohn PM. The pleasant events schedule: Studies on reliability, validity, and scale inter correlation. Journal of Consulting and Clinical Psychology. 1982;50:363–80.
30. Emmons RA. Personal striving, daily life events and psychological and physical well-being. . Journal of Personality. 1991;59:453-72.
31. Dadestan P. Psychopathology transition from childhood to adulthood. Tehran: Samt Publication; 2016.
32. Hops H, Lewinsohn P, MAndrews J, Seely J. Cognitive-Behavioral Group Treatment of  Adolescent Depression: Prediction of Outcome. Journal of Behavioralteraphy. 1992;23:341-54.
33. Dobson K, MohammadKhani P. Psychometric properties of the Beck Depression Inventory-II in a large sample of patients with major depressive disorder. Journal of rehabilitation in diseases and mental disorders. 2007;8(3).
34. MacPhillamy DJ, Lewinsohn PM. Depression as a function of desired and obtained pleasure. Journal of Abnormal Psychology. 1974;83:651-7.
35. Preacher KJ, Hayes AF. SPSS and SAS procedures for estimating indirect effects in simple mediation models. Behavior Research Methods, Instruments, & Computers. 2004;36(4):717–31.
36. Ezaei F, Noori A, Oreizi H. Workplace incivility and turnover intention: The Mediating Role of Organizational Justice. Knowledge and Research in Applied Psychology. 2011;46(12):40-9.
37. Kaufman NK, Rohde P, Seeley JR. Potential mediators of Cognitive Behavioral Therapy for Adolescents with Comorbid Major Depression Conduct disorder. Journal of consulting and Psychology. 2005;13:38 – 46.
38. Lewinsohn PM, Clarke GN, Hops H, Andrews J. Cognitive-behavioral treatment for depressed adolescents. Behavior Therapy. 1990;21(4):385–401.
39. Biglan A, Craker D. Effects of pleasant-activities manipulation on depression. Journal of Consulting and Clinical Psychology. 1982;50(3): 436-8.
40. Jordan DG, Winer ES, Salam T, Kilgore J. Longitudinal evaluation of anhedonia as a mediator of fear of positive evaluation and other depressive symptoms. . Journal Cognition and Emotion. 2018;32(7):1437-47.
 
 
International Journal of Behavioral Sciences
Volume 13, Issue 1
April 2019
Pages 33-39

Files

Share

How to cite

Statistics