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Cogn Ther Res (2013) 37:368379
DOI 10.1007/s10608-012-9458-3
ORIGINAL ARTICLE
Motivation and Changes in Depression
David Burns Henny Westra Mickey Trockel
Aaron Fisher
Published online: 22 April 2012 Springer Science+Business Media, LLC 2012
Abstract This study evaluated the capacity of the Willingness Scale (WS) to predict changes in depression over the course of a brief inpatient admission. Two cohorts (N = 160) of adult inpatients completed the Willingness Scale along with a measure of depression following admission. Depression severity was assessed approximately 4 days later, prior to discharge. Data were evaluated using structural equation modeling. Higher WS scores predicted greater reductions in depression in both cohorts, and the magnitude of this effect was large. The ts of the models were outstanding, with no signicant differences in any parameter estimates across the two cohorts. The WS predicts changes in depression, even within a brief inpatient admission where the treatment is predominantly biological. These results replicate results of previous studies in outpatient populations where CBT was the primary treatment and suggest motivational factors may play an important role in causation and recovery from depression.
Keywords Motivation Willingness Depression
Inpatients Structural equation modeling
Introduction
Despite high levels of disability associated with mental health problems such as depression (Judd et al. 2000), non-adherence with recommended treatment procedures is a formidable problem in multiple settings and populations. For example, in their analysis of over 740,000 new prescriptions for Selective Serotonin Reuptake Inhibitors (SSRIs), Eaddy and Regan (as cited in Keene 2005) reported that nearly 50 % of patients failed to adhere for a minimum of 60 days and a mere 28 % were compliant at 6 months. In fact, poor adherence with treatment regimens is the primary cause for readmission and relapse in a number of psychological disorders, including bipolar mood disorder (Svarstad et al. 2001) and schizophrenia (Weiden et al. 2004).
Psychotherapy homework (HW) assignments are frequently recommended across various types of psychotherapy (Kazantzis and Ronan 2006) and are widely hypothesized to be essential to the efcacy of empirically supported treatments such as Cognitive Behavioral Therapy (CBT; Kazantzis et al. 2005). Nonetheless, HW non-adherence is a commonly acknowledged problem limiting the efcacy of treatment (for a review see Kazantzis et al. 2000). For example, Helbig and Fehm (2004) surveyed practicing...