Dysfunctional attitudes scale perfectionism: A predictor and partial mediator of acute treatment outcome among clinically depressed adolescents

Rachel H. Jacobs; Susan G. Silva; Mark A. Reinecke; John F. Curry; Golda S. Ginsburg; Christopher J. Kratochvil; John S. March

doi:10.1080/15374410903259031

Dysfunctional attitudes scale perfectionism: A predictor and partial mediator of acute treatment outcome among clinically depressed adolescents

Rachel H. Jacobs, Susan G. Silva, Mark A. Reinecke, John F. Curry, Golda S. Ginsburg, Christopher J. Kratochvil, John S. March

Psychiatry and Behavioral Sciences

Research output: Contribution to journal › Article › peer-review

57 Scopus citations

Abstract

The effect of perfectionism on acute treatment outcomes was explored in a randomized controlled trial of 439 clinically depressed adolescents (12-17 years of age) enrolled in the Treatment for Adolescents with Depression Study (TADS) who received cognitive behavior therapy (CBT), fluoxetine, a combination of CBT and FLX, or pill placebo. Measures included the Children's Depression Rating Scale-Revised, the Suicidal Ideation Questionnaire-Grades 7-9, and the perfectionism subscale from the Dysfunctional Attitudes Scale (DAS). Predictor results indicate that adolescents with higher versus lower DAS perfectionism scores at baseline, regardless of treatment, continued to demonstrate elevated depression scores across the acute treatment period. In the case of suicidality, DAS perfectionism impeded improvement. Treatment outcomes were partially mediated by the change in DAS perfectionism across the 12-week period.

Original language	English (US)
Pages (from-to)	803-813
Number of pages	11
Journal	Journal of Clinical Child and Adolescent Psychology
Volume	38
Issue number	6
DOIs	https://doi.org/10.1080/15374410903259031
State	Published - 2009

Funding

The Treatment for Adolescents with Depression Study (TADS) is supported by contract N01 MH80008 from the National Institute of Mental Health (NIMH) to Duke University Medical Center (John S. March, Principal Investigator). Preparation of this manuscript was supported by NIMH fellowship F31 MH075308 to Rachel H. Jacobs. Portions of this work were presented at the World Congress of Behavioural and Cognitive Therapies, 2007, the meeting of the Association for Behavior and Cognitive Therapies, 2006, and the American Psychological Association, 2006. TADS is coordinated by the Department of Psychiatry and Behavioral Sciences and the Duke Clinical Research Institute at Duke University Medical Center in collaboration with NIMH, Rockville, Maryland. The Coordinating Center principal collaborators are John March, Susan Silva, Stephen Petrycki, John Curry, Karen Wells, John Fairbank, Barbara Burns, Marisa Domino, and Steven McNulty. The NIMH principal collaborators are Benedetto Vitiello and Joanne Severe. Principal Investigators and Co-investigators from the clinical sites are as follows: Carolinas Medical Center: Charles Casat, Jeanette Kolker, Karyn Riedal, Marguerita Goldman; Case Western Reserve University: Norah Feeny, Robert Findling, Sheridan Stull, Felipe Amunategui; Children’s Hospital of Philadelphia: Elizabeth Weller, Michele Robins, Ronald Weller, Naushad Jessani; Columbia University: Bruce Waslick, Michael Sweeney, Rachel Kandel, Dena Schoenholz; Johns Hopkins University: John Walkup, Golda Ginsburg, Elizabeth Kastelic, Hyung Koo; University of Nebraska: Christopher Kratochvil, Diane May, Randy LaGrone, Martin Harrington; New York University: Anne Marie Albano, Glenn Hirsch, Tracey Knibbs, Emlyn Capili; University of Chicago/Northwestern University: Mark Reinecke, Bennett Leventhal, Catherine Nageotte, Gregory Rogers; Cincinnati Children’s Hospital Medical Center: Sanjeev Pathak, Jennifer Wells, Sarah Arszman, Arman Danielyan; University of Oregon: Anne Simons, Paul Rohde, James Grimm, Lananh Nguyen; University of Texas Southwestern: Graham Emslie, Beth Kennard, Carroll Hughes, Maryse Ruberu; Wayne State University: David Rosenberg, Nili Benazon, Michael Butkus, Marla Bartoi. Greg Clarke (Kaiser Permanente) and David Brent (University of Pittsburgh) are consultants; James Rochon (Duke University Medical Center) is statistical consultant. Disclosure: Susan Silva is a consultant with Pfizer. Christopher Kratochvil receives research support from McNeil, Abbott, Shire, Eli Lilly, and Cephalon, and is a consultant for Abbott, Eli Lilly, Pfizer, Cephalon, AstraZeneca, Organon, and Shire, and is on the Speaker’s Bureau of Eli Lilly. Golda Ginsburg received research support from Pfizer. John March is a consultant or scientific advisor to Pfizer, Lilly, Wyeth, GSK, Jazz, and MedAvante and holds stock in MedAvante; he receives research support from Lilly and study drug for an NIMH-funded study from Lilly and Pfizer. The other authors have no financial relationships to disclose.

ASJC Scopus subject areas

Clinical Psychology
Developmental and Educational Psychology

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10.1080/15374410903259031

Cite this

Jacobs, R. H., Silva, S. G., Reinecke, M. A., Curry, J. F., Ginsburg, G. S., Kratochvil, C. J., & March, J. S. (2009). Dysfunctional attitudes scale perfectionism: A predictor and partial mediator of acute treatment outcome among clinically depressed adolescents. Journal of Clinical Child and Adolescent Psychology, 38(6), 803-813. https://doi.org/10.1080/15374410903259031

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title = "Dysfunctional attitudes scale perfectionism: A predictor and partial mediator of acute treatment outcome among clinically depressed adolescents",

abstract = "The effect of perfectionism on acute treatment outcomes was explored in a randomized controlled trial of 439 clinically depressed adolescents (12-17 years of age) enrolled in the Treatment for Adolescents with Depression Study (TADS) who received cognitive behavior therapy (CBT), fluoxetine, a combination of CBT and FLX, or pill placebo. Measures included the Children's Depression Rating Scale-Revised, the Suicidal Ideation Questionnaire-Grades 7-9, and the perfectionism subscale from the Dysfunctional Attitudes Scale (DAS). Predictor results indicate that adolescents with higher versus lower DAS perfectionism scores at baseline, regardless of treatment, continued to demonstrate elevated depression scores across the acute treatment period. In the case of suicidality, DAS perfectionism impeded improvement. Treatment outcomes were partially mediated by the change in DAS perfectionism across the 12-week period.",

author = "Jacobs, {Rachel H.} and Silva, {Susan G.} and Reinecke, {Mark A.} and Curry, {John F.} and Ginsburg, {Golda S.} and Kratochvil, {Christopher J.} and March, {John S.}",

note = "Funding Information: The Treatment for Adolescents with Depression Study (TADS) is supported by contract N01 MH80008 from the National Institute of Mental Health (NIMH) to Duke University Medical Center (John S. March, Principal Investigator). Preparation of this manuscript was supported by NIMH fellowship F31 MH075308 to Rachel H. Jacobs. Portions of this work were presented at the World Congress of Behavioural and Cognitive Therapies, 2007, the meeting of the Association for Behavior and Cognitive Therapies, 2006, and the American Psychological Association, 2006. TADS is coordinated by the Department of Psychiatry and Behavioral Sciences and the Duke Clinical Research Institute at Duke University Medical Center in collaboration with NIMH, Rockville, Maryland. The Coordinating Center principal collaborators are John March, Susan Silva, Stephen Petrycki, John Curry, Karen Wells, John Fairbank, Barbara Burns, Marisa Domino, and Steven McNulty. The NIMH principal collaborators are Benedetto Vitiello and Joanne Severe. Principal Investigators and Co-investigators from the clinical sites are as follows: Carolinas Medical Center: Charles Casat, Jeanette Kolker, Karyn Riedal, Marguerita Goldman; Case Western Reserve University: Norah Feeny, Robert Findling, Sheridan Stull, Felipe Amunategui; Children{\textquoteright}s Hospital of Philadelphia: Elizabeth Weller, Michele Robins, Ronald Weller, Naushad Jessani; Columbia University: Bruce Waslick, Michael Sweeney, Rachel Kandel, Dena Schoenholz; Johns Hopkins University: John Walkup, Golda Ginsburg, Elizabeth Kastelic, Hyung Koo; University of Nebraska: Christopher Kratochvil, Diane May, Randy LaGrone, Martin Harrington; New York University: Anne Marie Albano, Glenn Hirsch, Tracey Knibbs, Emlyn Capili; University of Chicago/Northwestern University: Mark Reinecke, Bennett Leventhal, Catherine Nageotte, Gregory Rogers; Cincinnati Children{\textquoteright}s Hospital Medical Center: Sanjeev Pathak, Jennifer Wells, Sarah Arszman, Arman Danielyan; University of Oregon: Anne Simons, Paul Rohde, James Grimm, Lananh Nguyen; University of Texas Southwestern: Graham Emslie, Beth Kennard, Carroll Hughes, Maryse Ruberu; Wayne State University: David Rosenberg, Nili Benazon, Michael Butkus, Marla Bartoi. Greg Clarke (Kaiser Permanente) and David Brent (University of Pittsburgh) are consultants; James Rochon (Duke University Medical Center) is statistical consultant. Funding Information: Disclosure: Susan Silva is a consultant with Pfizer. Christopher Kratochvil receives research support from McNeil, Abbott, Shire, Eli Lilly, and Cephalon, and is a consultant for Abbott, Eli Lilly, Pfizer, Cephalon, AstraZeneca, Organon, and Shire, and is on the Speaker{\textquoteright}s Bureau of Eli Lilly. Golda Ginsburg received research support from Pfizer. John March is a consultant or scientific advisor to Pfizer, Lilly, Wyeth, GSK, Jazz, and MedAvante and holds stock in MedAvante; he receives research support from Lilly and study drug for an NIMH-funded study from Lilly and Pfizer. The other authors have no financial relationships to disclose.",

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Dysfunctional attitudes scale perfectionism: A predictor and partial mediator of acute treatment outcome among clinically depressed adolescents

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