International Journal of Cognitive Therapy
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Background: Evidence has converged to suggest that cognitive processing and content covary with depression severity, whereas indices of cognitive structure exhibit greater stability and promise as markers of vulnerability for depression. The objective of the current study was to investigate the temporal dynamics and causal role of cognitive structure and processing in treatment for depression. Method: A total of 104 patients with major depressive disorder were randomized to receive cognitive behavioral therapy (CBT; n = 54) or pharmacotherapy (n = 50). Patients completed the Hamilton Depression Rating Scale (HAM-D), Beck Depression Inventory-II (BDI-II), Psychological Distance Scaling Task (PDST), Redundancy Card-Sorting Task (RCST), and Self-Referent Encoding Task (SRET) before, during, and after treatment. Results: Most cognitive indices exhibited change over treatment to a similar degree across both treatments. Evidence for the mediating role of cognition was limited, and not specific to CBT. Discussion: Results suggest that both cognitive structure and processing may be amenable to change, by both CBT and pharmacotherapy. The role of cognitive structure in the course of depression may require qualification.