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

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

Research output: Contribution to journalArticlepeer-review


ABSTRACT 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)
Pages (from-to)258-266
Number of pages9
JournalPsychotherapy Research
Issue number2
StatePublished - Feb 2021

Bibliographical note

Funding Information:
Research reported in this publication was supported by Award Number K23MH090216 from the National Institute of Mental Health of the National Institutes of Health and Award Number UL1TR000114 from the National Center for Advancing Translational Sciences of the National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the National Center for Research Resources. Study data were collected and managed using REDCap electronic data capture tools hosted at the University of Minnesota.

Publisher Copyright:
© 2020 Society for Psychotherapy Research.

Copyright 2021 Elsevier B.V., All rights reserved.


  • attachment
  • depression
  • dysfunctional attitudes
  • interpersonal psychotherapy
  • Attitude
  • Fluoxetine
  • Humans
  • Interpersonal Psychotherapy
  • Psychotherapy
  • Treatment Outcome
  • Anxiety Disorders
  • Adolescent
  • Anxiety
  • Child
  • Interpersonal Relations

PubMed: MeSH publication types

  • Randomized Controlled Trial
  • Journal Article
  • Research Support, N.I.H., Extramural


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