| This study examines the extent that cognitive, behavioral, and dysfunctional behavioral factors predict depressive relapse following response to cognitive behavior therapy (CBT). One hundred and thirty-seven depressed outpatients received 16 weeks of CBT treatment and were followed for two years posttreatment. All participants were evaluated during the acute treatment phase and every six months during the naturalistic follow-up phase. This study examined the unique relapse risk associated with cognitive and behavioral variables among subjects who recovered at the end of acute treatment. Specifically, the predictive power of dysfunctional attitudes, behavioral activation, and stable dysfunctional behavioral repertoires were examined with regard to depressive relapse during the 2-year follow-up. Results showed that subjects who were engaged in low levels of behavioral activation at posttreatment had a greater likelihood of subsequent relapse. Dimensions of dysfunctional behavioral repertoires were also associated with depression relapse. Specifically, subjects with aggressive behavior were more likely to experience relapse. In contrast, subjects with dependent behavior experienced longer relapse-free periods. Contrary to the prevailing cognitive explanation, dysfunctional attitudes were not predictive of subsequent depressive relapse. These results add to a growing literature questioning the utility of the cognitive theory of depression and reiterate the importance of behavioral factors in the return of depressive symptoms. |
