Summary of the Effectiveness of Biological & Psychological Treatments of MDD & Phobias (DP IB Psychology)

Treatment & Study

Effectiveness

Biological Treatments of MDD & Phobias:

For MDD: SSRIs (paroxetine, fluoxetine and sertraline) - Kroenke et al. (2001)

For phobias: MAOI phenelzine - Liebowitz et al. (1998)

Kroenke et al (2001):

Results:  

79% of participants completed the full 9 month treatment programme

All participants improved similarly, by a mean of between 15 and 17 points on the MCSS

All of the participants saw an improvement in depressive symptoms from 74% at baseline to 32% at 3 months and 26% at 9 months

Conclusion: 

SSRIs may be an effective treatment for MDD

SSRIs appear to be similar in their effectiveness for the treatment of MDD

Liebowitz et al. (1998):

Results: 

The participants in the phenelzine treatment group had improved scores for anxiety compared to the placebo groups i.e. their social phobia had decreased over the course of the 8-week trial

There was no significant difference seen in the atenolol group when compared to the placebo group i.e. atenolol does not appear to improve social phobia

Conclusion:  Phenelzine appears to be an effective treatment for social phobia.

Psychological Treatments of MDD & Phobias:

For MDD: CBT & combination therapy (CBT & antidepressants) March et al. (2007)

• For phobias: Internet-delivered CBT - Vigerland et al.  (2013)

March et al. (2007):

Results: 

After 36 weeks of treatment 81% of the antidepressant group, 81% of the CBT group and 86% of the combined antidepressant and CBT group showed significant improvements in their symptoms

Suicidal ideation decreased in both the CBT group and the combination group but not to any great extent in the antidepressant group

Conclusion: 

Adolescents with MDD respond well to CBT and to CBT in combination with antidepressants

CBT in combination with antidepressants may enhance the safety of the medication

Overall CBT combination therapy appears to be the best course of treatment for adolescents with MDD 

Vigerland et al.  (2013)

Results:

ll of the children showed a decrease in phobia-specific symptoms (shown via reduced CSR scores) 

35% of the children no longer met the criteria for specific phobia i.e. their phobic response had been extinguished 

Both the parents and  their children reported significantly lower levels of anxiety 

The positive effects of the CBT were still present at the three-month follow-up checkpoint 

Conclusion:

Internet-delivered CBT appears to be an effective treatment for children with specific phobia.

The Role of Culture in Treatment of MDD & Phobias:

• For MDD: A review of existing therapies - Hodge & Nadir (2008)

• For phobias: Culturally-adapted CBT - Hinton et al. (2005)

Hodge & Nadir (2008):

Results:  

Two forms of therapy were identified as being more suitable to treating Muslims:

Strength-based approach as this is more congruent with Islamic ideals

CBT the underlying principles of CBT are congruent with Islamic values 

CBT, could be modified to substitute traditional self-statements with more Islamic-appropriate statements

This approach (cited in the above bullet point) has also been successful in Taoist, Christian and Muslim cultural settings 

The adaptation of CBT in order to align it with Muslim values is necessary

Conclusion:

Adaptations and modifications to existing treatments such as CBT should help to align these treatments with the client’s values and to ensure that treatment outcome is positive. 

Hinton et al. (2005):

Results:

The participants in the IT condition improved significantly in comparison to those in the DT condition 

By the second assessment, 12 of the IT patients no longer met the diagnostic criteria for PTSD  and 11 of these patients also no longer met GAD criteria

The IT patients also found that their somatic symptoms had decreased

The DT patients all met the criteria for both PTSD and GAD i.e. their symptoms remained unchanged

At the third assessment i.e. once all of the patients had experienced the culturally-adapted CBT, 10 of the DT patients no longer met the PTSD criteria and 9 of them no longer met the GAD criteria

Conclusion: 

Culturally adapted CBT focusing on PTSD and panic attacks may be effective in reducing symptoms and distress for a range of anxiety disorders

Receiving CBT as the initial treatment appears to result in the best outcomes for PTSD patients