Article

Treating Major Depression by Creating Positive Expectations for the Future: A Pilot Study for the Effectiveness of Future‐Directed Therapy (FDT) on Symptom Severity and Quality of Life

Cedars-Sinai Medical Center, Los Angeles, CA, USA.
CNS Neuroscience & Therapeutics (Impact Factor: 3.93). 03/2011; 18(2):102-9. DOI: 10.1111/j.1755-5949.2011.00235.x
Source: PubMed

ABSTRACT

This nonrandomized pilot study assesses the efficacy of a new future-oriented form of therapy, known as future-directed therapy (FDT), as a treatment for patients with Major Depressive Disorder (MDD) in a naturalistic hospital-based outpatient psychiatry clinic. The study measured symptom severity of depression and anxiety, in addition to quality of life pre- and posttreatment.
The study examined a new manualized treatment designed to help people anticipate a more positive future. The intervention consists of twenty 90-min group sessions administered twice a week over 10 weeks. The intervention was compared to depressed patients in the same clinic who enrolled in traditional cognitive-based group psychotherapy. Sixteen patients with MDD completed the FDT intervention as part of their outpatient treatment for depression. Seventeen patients with MDD participated in treatment as usual (TAU) cognitive-based group therapy. The Quick Inventory of Depressive Symptoms, the Beck Anxiety Inventory, and the Quality-of-Life Enjoyment and Satisfaction Questionnaire short form, self-report instruments were administered prior to and immediately after the completion of therapy.
Patients treated with FDT demonstrated significant improvements in depression (P = 0.001), anxiety (P = 0.021) and quality of life (P = 0.035), and also reported high satisfaction with the therapy. Compared to the TAU group, patients treated with FDT showed greater improvements in depressive symptoms (P = 0.049).
FDT may have the potential of becoming an additional treatment option for patients with MDD.

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Available from: Jennice S Vilhauer
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    • "In terms of cortisol, we propose that profiling TP and baseline cortisol could provide scientist-practitioners with a method of assessing the efficacy of TP-based treatment approaches (Boniwell, 2005; Boniwell & Osin, 2015; Boniwell, Osin, & Sircova, 2014; Kazakina, 2015; Melges, 1982; Rappaport, 1990; Sword et al., 2014, 2015; van Beek, Kerkhof, & Beekman, 2009; Vilhauer et al., 2012 Zimbardo et al., 2012). Indeed, analogous treatment modalities, like Mindfulness-Based Interventions (MBIs), help normalize cortisol concentrations across veterans and nurses affected by PTSD symptoms (Bergen-Cico, Possemato, & Pigeon, 2014; Kim et al., 2013). "
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    ABSTRACT: Perceptions of past, present, and future events may be related to stress pathophysiology. We assessed whether Time Perspective (TP) is associated with cortisol dynamics among healthy adults (N = 61, Ages = 18-35, M = 22.9, SD = 4.1) exposed to the Trier Social Stress Test (TSST). TP was measured according to two profiles: maladaptive Deviation from Balanced TP (DBTP) and adaptive Deviation from Negative TP (DNTP). Eight salivary cortisol samples were analyzed using area under the curve with respect to ground (AUCg) and to increase (AUCi). Statistic analyses involved partial correlations controlling for depressive symptoms. Results for both sexes showed that higher DBTP scores were associated with lower cortisol AUCg scores, while higher DNTP scores were associated with higher cortisol AUCg scores. These novel findings suggest that maladaptive TP profiles influence hypocortisolism, whereas adaptive TP profiles influence hypercortisolism. Thus, TP profiles may impact conditions characterized by altered cortisol concentrations.
    Full-text · Article · Sep 2015 · Biological psychology
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    • "The results showed that the guided intervention was more effective than unguided, self-helped ones, or control group in symptom improvement and quality of life (Berger, Hammerli, Gubser, Andersson, & Caspar, 2011; Cook et al., 2012; Johansson et al., 2012; Vilhauer et al., 2012). Exercise was one of the treatments that may have some benefit on the quality of life (Schuch, Vasconcelos- Moreno, & Fleck, 2011). "
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    ABSTRACT: Objective/Background To investigate the efficacy and feasibility of the Quality of Life Enhancement Programme (QOLEP) for individuals with mood disorder. Methods Twenty-one individuals with mood disorder were recruited from psychiatric rehabilitation centres in Taipei City and were randomly assigned to either the treatment group (N = 11) or the control group (N = 10). The treatment group received an 8-week QOLEP. The control group received only "phone contact", which included support for everyday situations pertaining to daily life and emotions. The primary outcome measure was evaluating improvements in quality of life using the World Health Organization Quality of Life-BREF-Taiwan version questionnaire. The feasibility of the intervention was assessed by the recruitment rate, dropout rate of the participants, and by its content and delivery. The content and delivery were assessed by the group satisfaction questionnaire. The mixed-effects linear model was applied to analyze the efficacy of QOLEP. Results The individuals who participated in the eight-session QOLEP showed significant improvement in their level of depression compared with the control group [pre vs. post, treatment group: 25.8 (19.2) vs. 17.8 (13.1); control group: 13.3 (17.3) vs. 13.3 (14.4)]. The criteria of feasibility were met in this study. Most of the participants were satisfied with engaging in the QOLEP activities within a supportive environment. Conclusion The participants who received the 8-week QOLEP demonstrated significant improvement in the level of depression. Studies with a sample size of at least 104 participants are recommended in the future. Copyright © 2015, Hong Kong Occupational Therapy Association. Published by Elsevier (Singapore) Pte Ltd. All rights reserved.
    Full-text · Article · May 2015 · Hong Kong Journal of Occupational Therapy
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    • "No obstante, en ambos casos se ha apuntado a centrar la orientación temporal hacia el futuro. Si bien esta orientación es saludable y positiva (Vilhauer et al., 2012) una orientación excesiva en esta dirección tiene menores indicadores de salud que un equilibrio entre la orientación al futuro y una actitud positiva del pasado y espacio para momentos hedonistas en el presente (Oyanadel & Buela-Casal, 2011; Zimbardo & Boyd, 2009). "
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    ABSTRACT: La teoría de la perspectiva del tiempo de Zimbardo (1999) plantea una clasificación de las dimensiones de la orientación temporal, medidas con el Zimbardo Time Perspective Inventory (ZTPI), la cual propone, por una parte, que si se tiene una actitud positiva y moderada hacia el pasado, el presente y el futuro, se puede desarrollar mayor bienestar y buena salud tanto mental como física, mientras que actitudes negativas o extremas reflejarían pautas de vida poco saludables. El principal objetivo de esta investigación es evaluar el efecto de una intervención grupal breve para la modificación del perfil temporal. Para este fin, se realizó un estudio cuasiexperimental con grupo control en una muestra de 28 estudiantes universitarios; 14 de ellos formaron el grupo experimental y 14 formaron el grupo control. Los resultados muestran que la intervención realizada al grupo experimental modificó la orientación temporal de los participantes hacia un perfil equilibrado. Para terminar, se concluye que, con una intervención breve y grupal que potencie un pasado positivo y un futuro y un presente más saludables, es posible lograr un perfil equilibrado. Posteriores estudios podrían evaluar el impacto de la modificación del perfil temporal en población clínica.
    Full-text · Article · Mar 2014
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Questions & Answers about this publication

  • Lonny Meinecke asked a question in Health Psychology:
    Are additional, similar studies planned?
    I just wanted to thank you, Dr. Vilhauer and your team for sharing this here. This paper was instrumental in aiding discovery of support for a primary aspect for my masters paper, and I am very appreciative. The role of positive anticipation seems not often approached in regard to cognitive therapies as a goal in and of itself. Neisser had discussed anticipation's effect on outcomes so prominently in 1976, and your paper and references provide such a welcome addition as applications toward relieving depressive symptoms. As you noted that the sample pool experienced some losses and was partially limited to availability, are there plans perhaps to fashion larger future random samples with this approach?
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      [Show abstract] [Hide abstract]
      ABSTRACT: This nonrandomized pilot study assesses the efficacy of a new future-oriented form of therapy, known as future-directed therapy (FDT), as a treatment for patients with Major Depressive Disorder (MDD) in a naturalistic hospital-based outpatient psychiatry clinic. The study measured symptom severity of depression and anxiety, in addition to quality of life pre- and posttreatment. The study examined a new manualized treatment designed to help people anticipate a more positive future. The intervention consists of twenty 90-min group sessions administered twice a week over 10 weeks. The intervention was compared to depressed patients in the same clinic who enrolled in traditional cognitive-based group psychotherapy. Sixteen patients with MDD completed the FDT intervention as part of their outpatient treatment for depression. Seventeen patients with MDD participated in treatment as usual (TAU) cognitive-based group therapy. The Quick Inventory of Depressive Symptoms, the Beck Anxiety Inventory, and the Quality-of-Life Enjoyment and Satisfaction Questionnaire short form, self-report instruments were administered prior to and immediately after the completion of therapy. Patients treated with FDT demonstrated significant improvements in depression (P = 0.001), anxiety (P = 0.021) and quality of life (P = 0.035), and also reported high satisfaction with the therapy. Compared to the TAU group, patients treated with FDT showed greater improvements in depressive symptoms (P = 0.049). FDT may have the potential of becoming an additional treatment option for patients with MDD.
      Full-text · Article · Mar 2011 · CNS Neuroscience & Therapeutics