A Study Of Correlation Of Locus Of Control To Cognitive-Behavioral Therapy In 60 Inpatients With Major Depression

Objective: It was to explore the possibility for the correlation of locus of control to cognitive-behavioral therapy (CBT) in 60 inpatients with major depression, by comparing locus of control with outcome of CBT, the compliance with homework assignments during the course of CBT, and by tracking whether CBT would result in change of locus of control. The aim of this study was to provide some data in selecting the measures of intervention for patients with major depression.Methods: Among 120 inpatients aged from 18 to 55 meeting criteria of DSM-IV for major depression, 60 were selected to receive integral intervention including drug and CBT(experimental group), as the rest matched with sex, age, education, the first episode or recurrent, psychiatric family history received single drug therapy (control group). HAMD. CRS, IPCS were administered to two groups at the end of screening day, 4 week and 8 week. At the same time the compliance of homework in experimental group was graded from 0 to 5.Results: 1. The depressive symptoms were decreased significantly in both of groups, but more significant in experimental group than that in control group (P<0.001). Also more significant for both of groups in patients whose Intemality scores above the mean than those below the mean (Pe=0.003, Pc=0.001). 2. The change of locus of control in experimental group was significant, including higher Intemality (P<0.001), and lower Powerful Others (P=0.014) and Chance (P<0.001). In control group, the change of Intemality and Chance were not significant, but Powerful Others was increased (P=0.010).In experimental group, for the patients whose lnternality scores above the mean, there was an insignificant variance in lnternality scores after 8 weeks treatment. 3. In both groups, there was correlation between locus of control and pre- and post-treatment depression level, lnternality related with depression level negatively, while Powerful Others and chance positively. 4. There was no significant correlation between homework compliance (HC) assessed by therapist and locus of control, but positive correlation was found between HC assessed by therapist and patients' education level. HC evaluated by patients themselves positively related with lnternality, negatively with Powerful Others. 5. Pre-treatment depression level and pre-treatment lnternality scores were better predictors for post-treatment depression level, whose standardized regression coefficients were significant in the level of a =0.01.Conclusions: 1. The efficacy of integral intervention including drug and CBT for major depression was higher than that of single drug therapy. 2. CBT could lead to change of locus of control, including higher Internalit). lower Powerful Others and Chance. But for patients whose lnternality scores above the mean, CBT could not increase lnternality scores significantly. 3. There was correlation between locus of control and outcome of treatment. Higher lnternality was helpful for improvement of depressive symptoms, while higher Powerful Others and Chance hindered. 4, lnternality was not significantly related with HC assessed by therapist, but significantly with HC evaluated by patients themselves, which may be contributed from patients' education level. 5. Pre-treatment depression level and pre-treatment lnternality scores were better predictors to outcome of integral therapy.