Effectiveness of group cognitive behaviour therapy and contribution of positive automatic thoughts in treating depression
Depression represents a mental health disorder that has significant repercussions into the lives of its sufferers. The disorder has been the subject of intense scrutiny both worldwide as well as in Malaysia. Efforts are constantly being made to better understand the underlying mechanisms of de...
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| Format: | Thesis |
| Language: | English |
| Published: |
2016
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| Subjects: | |
| Online Access: | http://psasir.upm.edu.my/id/eprint/67112/1/FPSK%28p%29%202016%2030%20IR.pdf |
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| Summary: | Depression represents a mental health disorder that has significant repercussions into
the lives of its sufferers. The disorder has been the subject of intense scrutiny both
worldwide as well as in Malaysia. Efforts are constantly being made to better
understand the underlying mechanisms of depression, as well as determining the
effectiveness of treatment methods available.
Thus the major aims of this thesis are: a) To examine the psychometric properties and
factor structure of the Bahasa Malaysia version of the Positive Automatic Thought
Questionnaire (ATQ-P-BM), b) To determine the effectiveness of Group Cognitive
Behaviour Therapy (GCBT) in the treatment of depression and finally, c) To examine
the cognitive mechanism of change in GCBT for depression as well as the contributions
of positive automatic thoughts (PAT).
In Study 1, a cross-sectional study was used to examine the psychometric properties
and factor structures of the ATQ-P-BM. For Study 2 and 3, a randomized, double blind
placebo controlled study design was used.
Study 1 incorporated both a general population (N=343) and clinical population, whilst
Study 2 and 3 only examined the clinical population (N=171). For Study 2 and 3,
participants were randomly allocated to the GCBT+TAU, Relaxation+TAU and TAU
only group using a random number generator. Participants and clinical psychologists
were blinded to the nature of the study. The GCBT+TAU and Relaxation+TAU
received eight sessions of GCBT and relaxation training respectively, whilst the TAU
only group received treatment as usual (i.e. pharmacotherapy). Trained clinical
psychologists administered interventions (GCBT and Relaxation training). For this study, negative life events, positive as well as negative automatic thoughts,
depressive symptoms, dysfunctional attitudes and cohesion was measured. Further to
that, effect sizes as well as reliably and clinically significant change was determined.
Results from Study 1 shows that the ATQ-P-BM endorsed a 5-factor structure model
(CMIN/df = 3.58, GFI=0.88, NFI=0.92, CFI = 0.94, RMSEA = 0.07), as well as good
psychometric properties (Study 1). In Study 2, results show that GCBT+TAU was able
to elicit statistically as well as reliable and clinically significant reductions to
depression symptoms. The study also showed that the GCBT+TAU obtained good
effect sizes (ηpartial
2=.58) for treatment, greater than that observed in Relaxation+TAU
(ηpartial
2=.23) and TAU only treatment group (ηpartial
2=.006). In Study 3, data from a
Malaysian populace showed support for a causal mediation model for depression. PAT
were found to act as both a mediator and moderator in cognitive models for depression,
thus acting as a buffer for the onset of depression.
This thesis provided evidence for the application of ATQ-P-BM as a measure of PAT
in Malaysia. Results also show that the application of GCBT+TAU is an effective
treatment for depression. Analysis of the mechanism of change provided insights into
the cognitive changes that occur. Further to that, analysis also provided new insights
into PAT regarding its contribution towards treatment and cognitive mechanism of
change in GCBT for depression. |
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