Psychology Theses and Dissertations
Permanent URI for this collectionhttp://hdl.handle.net/1903/2801
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Item Evaluating the Efficacy of Behavioral Activation Among Spanish-Speaking Latinos(2014) Collado, Anahi; Lejuez, Carl W; MacPherson, Laura; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Major depressive disorder (MDD) is highly prevalent among U.S. Spanish-speaking Latinos. Although MDD is very treatable, the lack of empirically-supported treatments precludes this population's access to quality mental health care. Following the promising results of a small open-label pilot study in which we tested the efficacy of Behavioral Activation Treatment for Depression (BATD) in a sample Latinos with Spanish-speaking preference, we conducted a randomized control trial (RCT; N = 46) that compared BATD (N = 23) to supportive counseling (N = 23) across various domains, including depression, BATD proposed mechanisms (activity level and environmental reward), and non-specific psychotherapy factors. Results indicated that relative to SC, BATD led to greater decreases in depressive symptoms over time (p = 0.04) and greater MDD remission at the end of treatment and at the one-month follow-up (p = 0.01). Activity level (p = 0.01) and environmental reward (p = 0.05) showed greater increases over time among participants who received BATD compared to SC. Further, proposed BATD mechanisms of change did not correspond over time with depressive symptomatology. Treatment adherence, therapeutic alliance, and treatment satisfaction did not differ between the groups (ps > 0.17). The one-month follow-up suggested sustained clinical gains across therapies. The current study adds to a limited treatment research literature and suggests that BATD, a time-limited and straightforward intervention, is efficacious in reducing depression and increasing activity level and environmental reward in this important, yet underserved population of the U.S. The current study sets the stage for a larger RCT to examine BATD against an empirically-supported treatment, with additional moderators of treatment and mechanisms of change.Item BRIEF BEHAVIORAL ACTIVATION TREATMENT FOR DEPRESSION IN SPANISH-SPEAKING LATINOS: ACCEPTABILITY AND PRELIMINARY EVALUATION(2012) Collado-Rodriguez, Anahi D.; MacPherson, Laura; Lejuez, Carl W; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Although depression is highly treatable, disparities in mental health treatment in the US have prevented Latinos who lack English language proficiency from accessing efficacious interventions. Reasons cited for these disparities include language barriers, high cost of services, lack of culturally sensitive treatments, and stigma toward mental health treatment. A direct Spanish translation of the Brief Behavioral Activation Treatment for Depression (BATD) may be well-equipped to address the existing barriers through its focus on individual and cultural values, its efficiency and straight-forward nature, itsfocus on developing existing and new strengths, and conceptualization of depression as a consequence of clients' environments and not of cognitive processes, which may serve to decrease stigma associated with care. Using this translation, the current study sought to establish preliminary efficacy and acceptability of BATD in a group of depressed Spanish-speaking Latinos (N=10) . Results showed that over time there was a significant decrease in self-reported depression and a significant increase in activation as indicated by multiple self-report measures. Further, increases in activation corresponded to decreases in depression. Sustained clinical gains through a one-month follow-up were observed. Taken together, these results provide preliminary support for BATD as an efficacious treatment for depression. Consideration of the results combined with interview-based feedback obtained from participants provide several domains for modification of this treatment for future studies, and suggest that the next logical step is to include a treatment control group and a larger sample size in future investigations.