Inter-Session Emotional and Cognitive Suppression as a Mechanism of Change in CBT for Depression

Major depressive disorder (MDD) is one of the most prevalent mental health disorders worldwide. First line treatment for MDD involves psychotherapy and pharmacotherapy. While cognitive-behavioural therapy (CBT) is studied extensively as a treatment for MDD, it is not effective for all patients. Research has increasingly focused on studying mechanisms of change in CBT to increase effectiveness and support personalisation of treatment. The present study examines emotional and cognitive suppression as a potential mechanism of change in a sample of 140 adults (M = 40.7 years) diagnosed with depression undergoing CBT. A longitudinal, multilevel modelling approach was used with repeated measures within individuals. Psychotherapy outcome was measured with a well-being scale as a proxy for depression severity. A significant negative between-patient (γ01 = -0.41, p < .001) and within-patient effect (γ10 = -0.22, p < .001) were found, showing that overall lower levels of suppression as well...Show moreMajor depressive disorder (MDD) is one of the most prevalent mental health disorders worldwide. First line treatment for MDD involves psychotherapy and pharmacotherapy. While cognitive-behavioural therapy (CBT) is studied extensively as a treatment for MDD, it is not effective for all patients. Research has increasingly focused on studying mechanisms of change in CBT to increase effectiveness and support personalisation of treatment. The present study examines emotional and cognitive suppression as a potential mechanism of change in a sample of 140 adults (M = 40.7 years) diagnosed with depression undergoing CBT. A longitudinal, multilevel modelling approach was used with repeated measures within individuals. Psychotherapy outcome was measured with a well-being scale as a proxy for depression severity. A significant negative between-patient (γ01 = -0.41, p < .001) and within-patient effect (γ10 = -0.22, p < .001) were found, showing that overall lower levels of suppression as well as lower suppression levels over time were related to better psychotherapy outcome. The findings suggest that CBT may need to be tailored based on individual suppression levels and suppression could be an indicator of psychotherapy outcome. Assessing suppression levels could support personalised strategies and interventions to increase CBT effectiveness. Future research should aim to replicate the current findings and examine interventions to reduce suppression during treatment.Show less

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Inter-Session Emotional and Cognitive Suppression as a Mechanism of Change in CBT for Depression