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Background <p>Sudden gains are associated with better acute and follow-up outcomes in cognitive-behavioral therapy (CBT) for mood and anxiety disorders.</p> Methods <p>Using the group CBT for seasonal affective disorder (CBT-SAD) condition (<i>n</i> = 88) from a parent randomized clinical trial, this study examines whether sudden gains can be detected in CBT-SAD and whether they relate to outcome at post-treatment and at follow-ups one and two winters later. Applying Kelly et al.’s (Behav Res Ther 43(6):703–714, 2005. <a href="https://doi.org/10.1016/j.brat.2004.06.002">https://doi.org/10.1016/j.brat.2004.06.002</a>) criteria to week-to-week symptom changes [i.e., scores on the Structured Interview Guide for the Hamilton Rating Scale for Depression—Seasonal Affective Disorder Version (SIGH-SAD)] with SIGH-SAD score drop ≥ 6, 44.3% (39/88) of CBT-SAD participants had a sudden gain.</p> Results <p>Most sudden gains (25/39, 64.1%) occurred between pre-treatment and Week 3. Sudden gainers had lower depression severity on the Beck Depression Inventory-Second Edition (BDI-II) and a greater likelihood of remission (BDI-II ≤ 8) at both winter follow-ups than non-gainers. Sudden gain groups did not differ on post-treatment depression outcomes. Relative to non-gainers, sudden gainers showed greater improvement in seasonal beliefs, CBT-SAD’s potential mechanism, during CBT-SAD, with more flexible seasonal beliefs than non-gainers at post-treatment. Membership in a particular CBT-SAD group was not related to the effect of sudden gains on treatment outcome.</p>

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Sudden Gains in Cognitive-Behavioral Therapy for Seasonal Affective Disorder

  • 期刊论文

  • 发表日期：

    2025年5月5日

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  • Raquel Castillo Cruz,
  • Kelly J. Rohan

摘要

Background

Sudden gains are associated with better acute and follow-up outcomes in cognitive-behavioral therapy (CBT) for mood and anxiety disorders.

Methods

Using the group CBT for seasonal affective disorder (CBT-SAD) condition (n = 88) from a parent randomized clinical trial, this study examines whether sudden gains can be detected in CBT-SAD and whether they relate to outcome at post-treatment and at follow-ups one and two winters later. Applying Kelly et al.’s (Behav Res Ther 43(6):703–714, 2005. https://doi.org/10.1016/j.brat.2004.06.002) criteria to week-to-week symptom changes [i.e., scores on the Structured Interview Guide for the Hamilton Rating Scale for Depression—Seasonal Affective Disorder Version (SIGH-SAD)] with SIGH-SAD score drop ≥ 6, 44.3% (39/88) of CBT-SAD participants had a sudden gain.

Results

Most sudden gains (25/39, 64.1%) occurred between pre-treatment and Week 3. Sudden gainers had lower depression severity on the Beck Depression Inventory-Second Edition (BDI-II) and a greater likelihood of remission (BDI-II ≤ 8) at both winter follow-ups than non-gainers. Sudden gain groups did not differ on post-treatment depression outcomes. Relative to non-gainers, sudden gainers showed greater improvement in seasonal beliefs, CBT-SAD’s potential mechanism, during CBT-SAD, with more flexible seasonal beliefs than non-gainers at post-treatment. Membership in a particular CBT-SAD group was not related to the effect of sudden gains on treatment outcome.