Marcus Huibers

Marcus Huibers
Utrecht University | UU · Division of Clinical and Health Psychology

PhD

About

212
Publications
128,273
Reads
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8,530
Citations
Introduction
Marcus J.H. Huibers is Professor of Clinical Psychology at Utrecht University, Adjunct Professor at the University of Pennsylvania and a psychotherapist at the NPI Center for Personality Disorders. His research focuses on depression, suicidality and personality disorders, using randomized trials to investigate the effectiveness of psychotherapy, predictors of response and mechanisms of change, and experimental studies that isolate therapeutic procedures, to advance personalized psychotherapy.
Additional affiliations
May 2012 - present
Vrije Universiteit Amsterdam
Position
  • Professor (Full)
July 2003 - present
Maastricht University
Position
  • Professor (Full)

Publications

Publications (212)
Article
Background Childhood trauma is a common and potent risk factor for developing major depressive disorder in adulthood, associated with earlier onset, more chronic or recurrent symptoms, and greater probability of having comorbidities. Some studies indicate that evidence-based pharmacotherapies and psychotherapies for adult depression might be less e...
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Objective: Psychotherapies for depression are similarly effective, but the processes through which these therapies work have not been identified. We focus on psychological process changes during therapy as predictors of long-term depression outcome in treatment responders. Method: Secondary analysis of a randomized trial comparing cognitive ther...
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Childhood maltreatment may play an important role in the transition from suicidal ideation to suicidal behavior. Recently, research has begun evaluating the association between childhood maltreatment and involuntary and distressing intrusions about one's own suicide, also called suicidal intrusions. This cross‐sectional, multicenter study aimed to...
Article
Background Recently, we showed that twice weekly sessions of cognitive-behavioral therapy (CBT) and interpersonal psychotherapy (IPT) for depression lead to better and faster treatment outcomes compared to once weekly sessions (Bruijniks et al., 2020). The present study investigated which pathways of change may account for the effects of different...
Article
The probationer–probation officer working alliance plays an important role in the outcome of probation supervision. This study explored the development of the working alliance between probationers and probation officers in the Netherlands, from the perspective of both probationers and probation officers. More specifically, we explored the significa...
Article
Objective: The Personalized Advantage Index (PAI) is a method to guide treatment selection by investigating which of two or more treatments is optimal for a given individual. Recently, it was shown that, on average, twice-weekly sessions of psychotherapy for depression lead to better outcomes compared to once-weekly sessions. The present study app...
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Depressie op latere leeftijd hangt samen met meer ziekte, sterfte en risico op comorbide stoornissen, maar wordt niet altijd effectief behandeld. Gedragsactivatie is een laagdrempelige, eenvoudig uit te voeren en effectieve psychologische behandeling voor depressie. Om de effectiviteit en toegankelijkheid van de psychische zorg voor depressieve oud...
Article
Background The present study investigated the specific and temporal role of putative mechanisms of change in cognitive-behavioral therapy (CBT) and interpersonal psychotherapy (IPT) for major depressive disorder (MDD). Method 200 patients were randomized to CBT weekly, CBT twice weekly, IPT weekly or IPT twice weekly. Outcome and putative mechanis...
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Cognitive behavior therapy (CBT) is an umbrella term that refers to psychological therapies founded on the premise that (a) cognitive and behavioral processes are implicated in the development and maintenance of psychopathology, and (b) those processes are likely to be present during the session and require the therapist to tailor the intervention...
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Background Clinical guidelines suggest that psychological interventions specifically aimed at reducing suicidality may be beneficial. We examined the impact of two depression treatments, cognitive therapy (CT) and interpersonal psychotherapy (IPT) on suicidal ideation (SI) and explored the temporal associations between depression and SI over the co...
Article
Objective: Patient choice is recognized as a factor that influences clinical outcomes and treatment evaluation in mental health care. However, research on how having a choice affects patients with depression has been rare. This Dutch study examined whether patients randomly selected to choose between two types of depression psychotherapy benefited...
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Objective: Patient choice is recognized as a factor that influences clinical outcomes and treatment evaluation in mental health care. However, research on how having a choice affects patients with depression has been rare. This Dutch study examined whether patients randomly selected to choose between two types of depression psychotherapy benefited...
Article
Samenvatting Doel Onderzoeken of het verhogen van de sessiefrequentie de effecten van psychotherapie voor depressie vergroot. Opzet Prospectief gerandomiseerd onderzoek. Methode Dit onderzoek, de FreqMech-studie is een multicentrische Nederlandse studie waarin 200 patiënten met de diagnose ‘depressieve stoornis’ willekeurig werden toegewezen aan ee...
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Background Previous research suggests a relationship between measurement frequency of selfreported depressive symptoms and change in depressive symptom scores for the Beck Depression Inventory II (BDI-II). The goal of the current study was to investigate the differential effects of weekly and monthly completion of the BDI-II and Quick Inventory of...
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Background Several evidence-based psychotherapeutic treatment options are available for depression, but the treatment results could be improved. The D*Phase study directly compares short-term psychodynamic supportive psychotherapy (SPSP) and cognitive behavioural therapy (CBT) for Major Depressive Disorder (MDD). The objectives are 1. to investigat...
Article
Background Internet cognitive behavioural therapy (iCBT) is a viable delivery format of CBT for depression. However, iCBT programmes include training in a wide array of cognitive and behavioural skills via different delivery methods, and it remains unclear which of these components are more efficacious and for whom. Methods We did a systematic revi...
Article
The responsivity principle is a vital element in the risk-need-responsivity model. The working alliance is a good illustration of the intention of this responsivity principle. In this study, we examine the influence of the working alliance (WAMCI) between 199 offenders and probation officers on recidivism. Data for this longitudinal study originate...
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Background: The frequency and clinical impact of Sudden Gains —large symptom improvements during a single between-session interval—in psychotherapy for depression have been well established. However, there have been relatively few efforts to identify the processes that lead to sudden gains. Aim: To explore therapy processes associated with sudden g...
Article
Background Research on which therapy processes are crucial for whom is necessary to optimize treatment outcomes for major depressive disorder (MDD) but may be impeded by a lack of variation in therapy quality and because of individual differences in therapy response. The present study used a dataset with large variation in therapy quality to invest...
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Importance Personalized treatment choices would increase the effectiveness of internet-based cognitive behavioral therapy (iCBT) for depression to the extent that patients differ in interventions that better suit them. Objective To provide personalized estimates of short-term and long-term relative efficacy of guided and unguided iCBT for depressi...
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In this conceptual paper, we outline the many challenges on the road to personalized psychotherapy, using the example of cognitive behavior therapy (CBT) for depression. To optimize psychotherapy for the individual patient, we need to find out how therapy works (identification of mechanisms of change) and for whom it works (identification of modera...
Preprint
Background: Previous research suggests a relationship between measurement frequency of self-reported depressive symptoms and change in depressive symptom scores for the Beck Depression Inventory II (BDI-II). The goal of the current study was to investigate the differential effects of weekly and monthly completion of the BDI-II and Quick Inventory o...
Preprint
Objectives: Sudden gains were first identified in cognitive therapy (CT) for depression to characterize large and stable improvements. They have subsequently been studied in at least 50 studies across a range of disorders and treatments. There is evidence that sudden gains are reliably associated with positive treatment outcomes. Nonetheless, simul...
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Background Only about half of all patients with anxiety disorders or major depression respond to cognitive behaviour therapy (CBT), even though this is an evidence-based treatment. Personalized treatment offers an approach to increase the number of patients who respond to therapy. The aim of this study was to examine predictors and moderators of (d...
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Objective: Optimizing treatment selection may improve treatment outcomes in depression. A promising approach is the Personalized Advantage Index (PAI), which predicts the optimal treatment for a given individual. To determine the generalizability of the PAI, models needs to be externally validated, which has rarely been done. Method: PAI models wer...
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Introduction: Behavioural activation is an effective treatment for depression, but little is known about its working mechanisms. Theoretically, its effect is thought to rely on an interplay between activation and environmental reward. Objective: The present systematic review examines the mediators of behavioural activation for depression. Metho...
Article
Background Insight into patient characteristics that predict response to treatment for major depressive disorder (MDD) may help to personalize treatment and improve outcomes. One mechanism that has been linked to the success of treatment for MDD is brain-derived neurotropic factor (BDNF). BDNF is implicated in learning and memory and may play a rol...
Article
Although the association between working alliance and outcome is a consistent finding in voluntary psychotherapy research, there is a lack of knowledge of the significance of this concept in mandated treatment. This study examined the relationship between the offender-rated working alliance and recidivism in a sample of 199 offenders mandated to co...
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Background: Many persons with autism spectrum disorder (ASD) are treated in long-term specialised care. In this population, suicidal behaviour troubles patients, families, and specialists in the field because it is difficult to treat. At present, there is no documented effective therapy for suicidal behaviour in ASD (Autism Research 7:507-521, 201...
Article
Objective: Although the effectiveness of interpersonal psychotherapy (IPT) and cognitive therapy (CT) for major depression has been established, little is known about how and for whom they work and how they compare in the long term. The latter is especially relevant for IPT because research on its long-term effects has been limited. This overview...
Article
Background It is unclear what session frequency is most effective in cognitive–behavioural therapy (CBT) and interpersonal psychotherapy (IPT) for depression. Aims Compare the effects of once weekly and twice weekly sessions of CBT and IPT for depression. Method We conducted a multicentre randomised trial from November 2014 through December 2017....
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Background Optimizing treatment selection is a way to enhance treatment success in major depressive disorder (MDD). In clinical practice, treatment selection heavily depends on clinical judgment. However, research has consistently shown that statistical prediction is as accurate - or more accurate - than predictions based on clinical judgment. In t...
Article
Veel mensen met een depressieve stoornis hebben last van repetitieve, oncontroleerbare en indringende suïcidale beelden en gedachten. Deze zogenaamde ‘suïcidale intrusies’ kunnen mogelijk een aanknopingspunt zijn voor versterking van suïcidale ideatie en suïcidaal gedrag. Verschillende experimentele studies hebben aangetoond dat oogbewegingen tijde...
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Background Psychotherapies for depression are equally effective on average, but individual responses vary widely. Outcomes can be improved by optimizing treatment selection using multivariate prediction models. A promising approach is the Personalized Advantage Index (PAI) that predicts the optimal treatment for a given individual and the magnitude...
Article
The body of evidence that the working alliance is associated with positive outcomes for mandated clients is growing. The aim of this research was to investigate the influence of several characteristics of probation officers (POs) and offenders on the course of the working alliance during probation supervision. This study examined the patterns on th...
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Hoewel de effectiviteit van cognitieve therapie (CT) en interpersoonlijke psychotherapie (IPT) voor depressie overtuigend is aangetoond, is er weinig bekend over hoe, hoelang, en voor wie ze werken. In dit artikel wordt een overzicht gegeven van resultaten van een grote gerandomiseerde behandelstudie naar de (differentiële) effecten en werkingsmech...
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Using data from 202 patients with depression, the authors conducted a psychometric evaluation of the Dutch translation of the Competencies of Cognitive Therapy Scale-Self-Report and an initial psychometric evaluation of the newly developed Interpersonal Psychotherapy Skills Scale-Self-Report.
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Background: Suicide is a major public health problem, and it remains unclear which processes link suicidal ideation and plans to the act of suicide. Growing evidence shows that the majority of suicidal patients diagnosed with major depression or bipolar disorder report repetitive suicide-related images and thoughts (suicidal intrusions).Various stu...
Article
Psychotherapies may work through techniques that are specific to each therapy or through factors that all therapies have in common. Proponents of the common factors model often point to meta-analyses of comparative outcome studies that show all therapies have comparable effects. However, not all meta-analyses support the common factors model; the i...
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Insight into how cognitive behavioral therapy (CBT) works is urgently needed to improve depressive outcome. First, we discuss the role of learning in CBT for depression by reviewing evidence for learning processes involved in the development and maintenance of depression. Second, we investigate the role of learning capacity as a moderator by review...
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1 Background Major depressive disorder (MDD) has a highly recurrent nature. After successful treatment, it is important to identify individuals who are at risk of an unfavorable long‐term course. Despite extensive research, there is no consensus yet on the clinically relevant predictors of long‐term outcome in MDD, and no prediction models are impl...
Article
Experimental studies that manipulate treatment procedures to investigate their direct effects on treatment processes and outcomes are necessary to find out the effective elements and improve the effects of cognitive behavioral therapy (CBT) for depression. The present study randomized mildly to severely depressed participants into a procedure focus...
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Samenvatting Om een optimale afname in depressieve symptomen te bewerkstelligen is een goede therapeutische relatie van belang. Er wordt verwacht dat het vroeg meten van de kwaliteit van deze relatie tijdens behandeling de behandeluitkomst krachtiger kan voorspellen. Ook wordt verwacht dat waargenomen therapeutkenmerken gerelateerd zijn aan hoe de...
Article
Background: Although the effectiveness of cognitive therapy (ct) and interpersonal psychotherapy (ipt) for depression has been well established, little is known about how, how long and for whom they work. AIM: To summarize findings from a large rct to the (differential) effects and mechanisms of change of ct/ipt for depression. METHOD: 182 adult d...
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Background Isolating a therapeutic procedure might be a powerful way to enhance our understanding of how cognitive behavior therapy (CBT) works. The present study explored new methods to isolate cognitive procedures and to study their direct impact on hypothesized underlying processes and CBT outcome. Method The effects of a cognitive therapy skil...
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Few studies have investigated the association between psychotherapeutic approaches and their processes in routine psychological practice. We compared cognitive therapy (CT) and behavioral activation (BA) on their effectiveness and change processes. Forty-three depressed patients participated in our trial. Scores on depression and specific and nonsp...
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Background: Although psychotherapy is an effective treatment for depression, a large number of patients still do not receive care according to the protocols that are used in clinical trials. Instead, patients often receive a modified version of the original intervention. It is not clear how and when treatment protocols are used or modified in the...
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Background Although equally efficacious in the acute phase, it is not known how cognitive therapy (CT) and interpersonal psychotherapy (IPT) for major depressive disorder (MDD) compare in the long run. This study examined the long-term outcomes of CT v. IPT for MDD. Methods One hundred thirty-four adult (18–65) depressed outpatients who were treat...
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Background Little is known about potential harmful effects as a consequence of self-guided internet-based cognitive behaviour therapy (iCBT), such as symptom deterioration rates. Thus, safety concerns remain and hamper the implementation of self-guided iCBT into clinical practice. We aimed to conduct an individual participant data (IPD) meta-analys...
Article
It is not clear whether specific target groups for psychotherapies in adult depression benefit as much from these treatments as other patients. We examined target groups that have been examined in randomized trials, including women, older adults, students, minorities, patients with general medical disorders, and specific types of depression, and we...
Article
Background and objectives The underlying mechanisms of symptom change in schema therapy (ST) for chronic major depressive disorder (cMDD) have not been studied. The aim of this study was to explore the impact of two potentially important mechanisms of symptom change, maladaptive schemas (proxied by negative idiosyncratic core-beliefs) and the thera...
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Suicide and suicidal behavior are major public health concerns, and affect 3-9% of the population worldwide. Despite increased efforts for national suicide prevention strategies, there are still few effective interventions available for reducing suicide risk. In this article, we describe various theoretical approaches for suicide ideation and behav...
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Background Depressive symptoms are common in older adults. The effectiveness of pharmacological treatments and the availability of psychological treatments in primary care are limited. A behavioural approach to depression treatment might be beneficial to many older adults but such care is still largely unavailable. Behavioural Activation (BA) proto...
Article
The present study explored the temporal relationships between change in five candidate causal mechanisms and change in depressive symptoms in a randomized comparison of individual Cognitive Therapy (CT) and Interpersonal Psychotherapy (IPT) for adult depression. Furthermore, hypotheses concerning the mediation of change in these treatments were tes...
Preprint
Suicide and suicidal behavior are major public health concerns and affect 3-9% of the population worldwide. Despite growing evidence, there are still few effective interventions available to reduce suicide risk. In this article, we describe theoretical models of suicide ideation and behavior and propose to examine the possible effectiveness of a ne...
Article
Importance: Self-guided internet-based cognitive behavioral therapy (iCBT) has the potential to increase access and availability of evidence-based therapy and reduce the cost of depression treatment. Objectives: To estimate the effect of self-guided iCBT in treating adults with depressive symptoms compared with controls and evaluate the moderati...
Article
Objective: Understanding how treatments work is a goal of psychotherapy research, however the strength of relationships between therapy processes and outcomes is inconsistent. DeRubeis, Cohen, et al. (2014) proposed that process-outcome relationships are moderated by patient characteristics. These "patient response patterns" (PRPs) indicate indivi...
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Chronic depression is one of the most challenging types of the major depressive disorders to treat, as many patients with chronic depression are resistant to several treatments, leaving clinicians with no or few treatment options available. From a public health perspective, chronic depressive disorders are also problematic because they are responsi...
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We report the current best estimate of the effects of cognitive behavior therapy (CBT) in the treatment of major depression (MDD), generalized anxiety disorder (GAD), panic disorder (PAD) and social anxiety disorder (SAD), taking into account publication bias, the quality of trials, and the influence of waiting list control groups on the outcomes....
Article
Background: The aim of this study was to investigate the effects of sad mood on default mode network (DMN) resting-state connectivity in persons with chronic major depressive disorder (cMDD). Methods: Participants with a diagnosis of cMDD (n=18) and age, gender and education level matched participants without a diagnosis of depression (n=18) und...