Competitive Memory Training (COMET) voor een negatief zelfbeeld als aanvullende behandeling bij depressieve patiënten; een pilotstudie
Dth 07/2010; 30(2):94-112. DOI: 10.1007/BF03096226
Low self-esteem seems to be an important factor in the development of and relapse in depressive disorders. To date, little specific interventions that aim at improving low self-esteem have been described or researched. Competitive Memory Training (COMET) for low self-esteem is based on insights and findings from experimental psychology. In addition to studies into other populations, the present study is a pilot study investigating the effect of COMET in depressed patients with low self-esteem in a routine mental health setting in addition to regular treatment. During COMET + regular treatment, self-esteem and autonomy increased significantly and in a large degree, while depressive symptoms decreased to a similar extent. These effects occurred in a roughly similar degree in patients with different depression diagnoses. Post hoc, a convenience comparison group of patients who had only had regular treatment for their depression was added to the study. Compared to the control group, self-esteem and autonomy of the patients in the COMET + regular treatment condition improved significantly and largely. Also, a significant decrease in depressive symptoms was found. COMET for low self-esteem seems to be an effective intervention for depressed patients with low self-esteem. Shortcomings and clinical implications of this study are discussed.
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ABSTRACT: Prevention of depression and anxiety disorders is widely acknowledged as an important health care investment. However, existing preventive interventions have only shown modest effects. In order to improve the efficacy of prevention of depression and anxiety disorders, a number of authors have suggested that it is promising to focus on selective prevention programs that are offered to individuals scoring high on clearly established risk factors, whereby the preventive intervention then specifically targets these risk variables. This review presents repetitive negative thinking (worry and rumination) as a promising target for the prevention of depression and anxiety disorders.
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ABSTRACT: Although rumination is an important mediator of depressive symptoms, there is insufficient proof that an intervention that specifically targets rumination ameliorates the clinical condition of, depressed patients. This study investigates whether a time-limited cognitive behavioral intervention (Competitive Memory Training, or COMET for depressive rumination) is an effective treatment for depression and rumination. This intervention was tested in older adult depressed outpatients. A total of 93 patients (aged ≥ 65 years with major depression and suffering from rumination) were treated in small groups according to the COMET protocol in addition to their regular treatment. Patients were randomized to two treatment conditions: 7 weeks of COMET + treatment-as-usual (TAU) versus TAU only. COMET + TAU showed a significant improvement in depression and rumination compared with TAU alone. This study shows that the transdiagnostic COMET protocol for depressive rumination might also be successful in treating depression and rumination in older adults.
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