OBJECTIVE Despite the importance for understanding mechanisms of change, little is known about the order of change in daily life emotions, cognitions, and behaviors during treatment of depression. This study examined the within-person temporal order of emotional, cognitive, and behavioral improvements using ecological momentary assessment data. METHOD Thirty-two individuals with diagnosed depression completed ecological momentary assessment questions on emotions (sad mood, happy mood), behaviors (social interaction, number of activities), and cognitive variables (worrying, negative self-thoughts) 5 times a day during a 4-month period in which they underwent psychotherapy for depression. Nonparametric change-point analyses were used to determine the timing of gains (i.e., improvements in the mean of each variable) for each individual. We then established whether the first (i.e., earliest) gains in emotions preceded, followed, or occurred in the same week as cognitive and behavioral gains for each individual. RESULTS Contrary to our hypotheses, first gains in behaviors did not precede first emotional gains (3 times, 8%) more often than they followed them (26 times, 70%). Cognitive gains often occurred in the same week as first emotional gains (43 times, 58%) and less often preceded (13 times, 18%) or followed emotional gains (18 times, 24%). CONCLUSION The first improvements in behaviors did not tend to precede the first improvements in emotions likely because fewer behavioral gains were found. The finding that cognitive variables tend to improve around the same time as sad mood may explain why many studies failed to find that cognitive change predicts later change in depressive symptoms. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

中文翻译：

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抑郁症治疗期间日常生活中情绪、认知和行为增益的时间顺序。


目的 尽管理解变化机制很重要，但人们对抑郁症治疗期间日常生活情绪、认知和行为的变化顺序知之甚少。这项研究使用生态瞬时评估数据检查了人内情绪、认知和行为改善的时间顺序。方法 32 名确诊抑郁症患者每天完成 5 次关于情绪（悲伤情绪、快乐情绪）、行为（社交互动、活动数量）和认知变量（担忧、消极自我想法）的生态瞬时评估问题。他们接受抑郁症心理治疗的 4 个月期间。非参数变化点分析用于确定每个个体的增益时间（即每个变量平均值的提高）。然后，我们确定每个人的第一次（即最早的）情绪增益是否在认知和行为增益之前、之后或在同一周内发生。结果与我们的假设相反，行为上的首次收获并不先于情感上的首次收获（3 倍，8%），而不是随后的情绪收获（26 倍，70%）。认知增益通常与首次情绪增益发生在同一周（43 次，58%），但较少发生在情绪增益之前（13 次，18%）或之后（18 次，24%）。结论 行为的首次改善往往不会先于情绪的首次改善，这可能是因为发现的行为收益较少。认知变量往往与悲伤情绪大约同时改善，这一发现可能解释了为什么许多研究未能发现认知变化可以预测抑郁症状的后续变化。 （PsycInfo 数据库记录 (c) 2024 APA，保留所有权利）。