Early Life Adversity as a Moderator of Symptom Change following Selective Serotonin Reuptake Inhibitors and Cognitive Be
- PDF / 869,728 Bytes
- 12 Pages / 595.276 x 790.866 pts Page_size
- 33 Downloads / 185 Views
ORIGINAL ARTICLE
Early Life Adversity as a Moderator of Symptom Change following Selective Serotonin Reuptake Inhibitors and Cognitive Behavioral Therapy Meredith A. Gruhn1,3 · K. Luan Phan2 · Heide Klumpp1 · Olusola Ajilore1 · Stephanie M. Gorka2 Accepted: 14 September 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Early Life Adversity (ELA) is consistently linked to chronic, treatment-resistant depression and anxiety. Selective serotonin reuptake inhibitors (SSRIs) and cognitive-behavioral therapy (CBT) represent the two first-line treatments for internalizing disorders. However, little is known about the efficacy of these therapies for individuals with ELA, particularly within heterogeneous cohorts of patients with high levels of comorbidity. Methods Treatment seeking adults with depression and/or anxiety were randomized to twelve weeks of SSRI (n = 46) or CBT (n = 50), and internalizing disorder symptoms were assessed pre- and post-treatment. Individuals with and without ELA were included. Results Both SSRI and CBT resulted in reductions in internalizing symptoms, as expected. A significant ELA by treatment type interaction for depression, but not anxiety, also emerged. Individuals with a positive history of ELA had a greater reduction in depression symptoms following SSRIs compared with CBT. In contrast, individuals with a negative history of ELA had a greater reduction in depression symptoms following CBT compared with SSRIs. Conclusions Findings suggest that SSRIs may be particularly effective for individuals with ELA and CBT may be particularly effective for individuals without ELA in reducing depression, but not anxiety, symptoms. Clinical implications and future directions are discussed. Depression and anxiety represent the most substantial mental health burdens worldwide, with over 30% of the population experiencing one or both conditions during their lifetime (Bandelow and Michaelis 2015; Vos et al. 2015). Selective serotonin reuptake inhibitors (SSRIs) and
ClinicalTrials.gov identifier: NCT01903447. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10608-020-10158-5) contains supplementary material, which is available to authorized users. * Meredith A. Gruhn [email protected]; [email protected] 1
Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
2
Department of Psychiatry and Behavioral Health, Institute for Behavioral Medicine Research, Ohio State University, Columbus, OH, USA
3
Institute for Juvenile Research #235, 1737 W. Roosevelt Road, Chicago, IL 60612, USA
cognitive behavioral therapy (CBT) represent the two gold standards of treatment for internalizing disorders and tend to work equally well for depression and anxiety; however, response rates vary between 38 and 87% (Amick et al. 2015; DeRubeis et al. 2008). While CBT requires patient-provider collaboration that works toward correcting self-reinforcing negative/anxious schemata through a repeated
Data Loading...
