Clinical psychology
Query
"mechanisms of relapse prevention in cognitive behavioral therapy for major depressive disorder"
Representative hypothesis
Patients who show greater within-session reductions in negative self-referential processing during the middle phase of CBT (sessions 6–10) will exhibit lower depressive symptom relapse rates at 12-month follow-up, independent of post-treatment symptom severity.
Suggested design
n=120 adults with recurrent MDD entering 16-session CBT. Self-referential processing measured weekly via Self-Referent Encoding Task. Outcome: time to relapse over 12 months. Cox regression controlling for baseline severity, medication, and prior episodes.
Commentary
Targets a within-treatment mechanism rather than treatment-versus-control. The Self-Referent Encoding Task is well-validated. Risk: the proposed mediator is correlated with symptom change, so causal claims require careful temporal modeling.
