Change in dysfunctional attitudes and attachment in interpersonal psychotherapy for depressed adolescents

Yuan Zhou, Jessica Arend, Laura Mufson, Meredith Gunlicks-Stoessel

Research output: Contribution to journalArticlepeer-review


This study examined changes in depressed adolescents’ reports of dysfunctional attitudes while receiving interpersonal psychotherapy (IPT-A) and the relationship between the change in dysfunctional attitudes and change in attachment anxiety and avoidance with IPT-A. Forty adolescents (age 12–17) participated in a 16-week randomized clinical trial of 4 adaptive treatment strategies that began with IPT-A and augmented treatment for insufficient responders by adding additional IPT-A sessions or the antidepressant medication, fluoxetine. Measures of attachment anxiety and avoidance (Experience in Close Relationships Scale—Revised [ECR-R]), dysfunctional attitudes (Dysfunctional Attitudes Scale [DAS]), and depression (Children’s Depression Rating Scale—Revised [CDRS-R]) were administered at baseline and weeks 4, 8, 12, and 16. Adolescents demonstrated a significant decrease in dysfunctional attitudes (DAS) over the course of treatment. Reductions in dysfunctional attitudes (DAS) were also significantly associated with reductions in attachment anxiety and avoidance (ECR-R), controlling for depression (CDRS-R). Our results suggest that change in adolescents’ attachment anxiety and avoidance may be an important mechanism of change in adolescents’ dysfunctional thinking patterns.

Original languageEnglish (US)
JournalPsychotherapy Research
StateAccepted/In press - 2020


  • attachment
  • depression
  • dysfunctional attitudes
  • interpersonal psychotherapy

PubMed: MeSH publication types

  • Journal Article

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