Cognitive Behavioral Therapy versus Short Psychodynamic Supportive Psychotherapy in the outpatient treatment of depression: a randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>Previous research has shown that Short Psychodynamic Supportive Psychotherapy (SPSP) is an effective alternative to pharmacotherapy and combined treatment (SPSP and pharmacotherapy) in the treatment of depressed outpatients. The question remains, however, how Short Psychodynamic Supportive Psychotherapy compares with other established psychotherapy methods. The present study compares Short Psychodynamic Supportive Psychotherapy to the evidence-based Cognitive Behavioral Therapy in terms of acceptability, feasibility, and efficacy in the outpatient treatment of depression. Moreover, this study aims to identify clinical predictors that can distinguish patients who may benefit from either of these treatments in particular. This article outlines the study protocol. The results of the study, which is being currently carried out, will be presented as soon as they are available.</p> <p>Methods/Design</p> <p>Adult outpatients with a main diagnosis of major depressive disorder or depressive disorder not otherwise specified according to DSM-IV criteria and mild to severe depressive symptoms (<it>Hamilton Depression Rating Scale </it>score ≥ 14) are randomly allocated to Short Psychodynamic Supportive Psychotherapy or Cognitive Behavioral Therapy. Both treatments are individual psychotherapies consisting of 16 sessions within 22 weeks. Assessments take place at baseline (week 0), during the treatment period (week 5 and 10) and at treatment termination (week 22). In addition, a follow-up assessment takes place one year after treatment start (week 52). Primary outcome measures are the number of patients refusing treatment (acceptability); the number of patients terminating treatment prematurely (feasibility); and the severity of depressive symptoms (efficacy) according to an independent rater, the clinician and the patient. Secondary outcome measures include general psychopathology, general psychotherapy outcome, pain, health-related quality of life, and cost-effectiveness. Clinical predictors of treatment outcome include demographic variables, psychiatric symptoms, cognitive and psychological patient characteristics and the quality of the therapeutic relationship.</p> <p>Discussion</p> <p>This study evaluates Short Psychodynamic Supportive Psychotherapy as a treatment for depressed outpatients by comparing it to the established evidence-based treatment Cognitive Behavioral Therapy. Specific strengths of this study include its strong external validity and the clinical relevance of its research aims. Limitations of the study are discussed.</p> <p>Trial registration</p> <p>Current Controlled Trails ISRCTN31263312</p

On the acquisition of classifiers in 5 – 6 year-old Deaf children

Posterpresentatie op Conferentie. Introduction: Classifiers are handshapes (sometimes combined with a specific orientation) that, when combined with the other parameters of movement and location form a ‘verb of motion or location’. There is a limited body of research available on the acquisition of classifiers by children. The available studies have focused on deaf children of deaf (DOD) parents, who are native signers. Results show that classifiers emerge at 3 years and approach an adult like level at the age of 9 (Beal Alvarez & Easterbrooks, 2013). This small study was set out to investigate the production of classifiers in DOH children who acquire Sign Language of the Netherlands. Our expectation was that DOH children produce classifiers, but fail to use them correctly in all instances due to lack of pragmatic control (Slobin et al., 2003). Method: Four children (two girls, two boys) were recruited at a school for the Deaf in The Netherlands (5;10 – 6;8 years). All children were deaf or severely hearing-impaired from birth. Children used (sign supported) Dutch at home and sign language at school and had approximately three years of exposure to sign language. Narratives (Frog-story) were recorded. The recordings were transcribed and analyzed using ELAN-software. Analysis focused on type of classifier (entity and handling) and accuracy in production. Results: The children produced 22 classifiers in total, 20 entity classifiers and 2 handling classifiers. Ten percent of the entity classifiers was incorrect; the handshape to express the entity did not match the handshape frequently selected for that entity. Conclusion: DOH children produce classifiers after three years of exposure to sign language. Errors in classifier production involved errors in handshape selection. This compares to type of errors frequently found for DOD children. Results will be discussed in relation to the iconic and gestural properties of classifiers (Cormier et al., 2012). References: Beal-Alvarez, J.S. & Easterbrooks, S.R. (2013). Increasing children’s ASL classifier production: A multicomponent intervention. American Annals of the Deaf, 158, 311 – 333. Cormier, K., Quinto-Pozos, D., Sevcikova, Z., Schembri, A. (2012). Lexicalisation and de-lexicalisation processes in sign languages: Comparing depicting constructions and viewpoint gestures. Language & Communication, 32, 329 – 348. Slobin, D., Hoiting, N., Kuntze, K., Lindert, R., Weinberg, A. Pyers, J., Anthony, M., Biederman, Y., Thumann, H. (2003). A cognitive/functional perspective on the acquisition of ‘classifiers’. In: Emmorey, K. (Ed.). Perspectives on classifier constructions in sign languages. Lawrence Erlbaum Associates, Mahwah, NJ. Pp 297 – 310