Date of Award
2024
Document Type
Dissertation
Degree Name
Doctor of Psychology (PsyD)
Department
Psychology
First Advisor
Ki Eun Shin, Ph.D.
Second Advisor
Marc Diener, Ph.D.
Third Advisor
Eva Feindler, Ph.D.
Abstract
Sudden gains, or rapid symptom reductions between two consecutive sessions, have been shown to predict better psychotherapy outcomes, especially for depression (e.g., Shalom & Aderka, 2020). However, several gaps remain in the existing literature on sudden gains, including underrepresentation of naturalistic studies and the circularity critique that it is tautological to examine symptom reduction during treatment as a predictor for overall pre to post-treatment symptom improvements. Furthermore, little is known about whether and which extra-therapeutic factors, or factors that exist within a client’s life outside treatment, are associated with sudden gains. To address these gaps, the current study examined the impact of reversed and unreversed sudden gains on treatment outcomes and the association between social conflicts experienced during treatment period and sudden gains, using records review data from a naturalistic sample of 233 depressed adult clients at a university-based psychology training clinic. To address the circularity critique, clients with sudden gains were compared to those with gradual gains, or symptom reductions across multiple sessions that are of a similar magnitude to sudden gains. Results showed that clients with unreversed sudden gains experienced significantly greater pre- to post-treatment reductions in depression symptoms than those with reverse sudden gains or gradual gains. However, there were no group differences on treatment outcomes based on quality of life. The degree of social conflicts during the treatment period were not significantly associated with sudden gains. The present findings inform more nuanced understanding of the sudden gains effects and provide implications for how the phenomenon can be leveraged to optimize treatment length and outcomes.
Recommended Citation
DeAngelis, Blaine M.A., M.S., "The Shape of Depressive Symptom Change: Comparing Sudden and Gradual Gains in Routine Practice" (2024). Selected Full Text Dissertations, 2011-. 82.
https://digitalcommons.liu.edu/post_fultext_dis/82