OBJECTIVES This study examined whether 'personality vulnerability' (i.e., self-critical perfectionism or dependency) predicts the trajectory of change, as well as variability and instability (i.e., entropy) of symptoms, during cognitive behaviour therapy (CBT) for depression. DESIGN Study participants were outpatients (N = 312) experiencing a primary mood disorder. Participants received CBT for depression group sessions over 15 weeks. Self-report measures of self-critical perfectionism, dependency, and depression were collected longitudinally. METHODS A latent growth mixture modelling (LGMM) statistical approach was used to evaluate the presence of latent classes of individuals based on their longitudinal pattern of symptom change during CBT and to evaluate whether baseline self-critical perfectionism or dependency predicts class membership. A Latent Acceleration Score (LAS) model evaluated whether perfectionism or dependency led to variability in depression symptom change (e.g., velocity) by considering changes in velocity (e.g., acceleration and/or deceleration). RESULTS LGMM indicated the presence of two latent classes that represent symptom improvement (N = 239) or minimal symptom improvement over time (N = 73). Elevated baseline self-critical perfectionism, but not dependency, predicted a greater likelihood of membership in the class of participants who demonstrated minimal symptom improvement over time. The second analysis examined whether baseline self-critical perfectionism also predicts depression symptom variability and instability. The LAS perfectionism model demonstrated that perfectionism accelerates depression symptom change during the first seven sessions of treatment, then has a decelerating effect on depression symptom change. CONCLUSIONS Results indicated that higher baseline self-critical perfectionism predicted higher variability and instability in depression symptoms and variability in acceleration and deceleration, over the course of treatment.

中文翻译：

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抑郁症认知行为治疗期间的自我批评完美主义、依赖和熵。

目的 本研究检验了在抑郁症的认知行为治疗 (CBT) 期间，“人格脆弱性”（即自我批评的完美主义或依赖）是否可以预测变化的轨迹，以及症状的可变性和不稳定性（即熵）。设计 研究参与者是患有原发性情绪障碍的门诊患者 (N = 312)。参与者在 15 周内接受 CBT 进行抑郁症小组会议。纵向收集自我批评完美主义、依赖和抑郁的自我报告测量。方法 潜在增长混合模型 (LGMM) 统计方法用于根据 CBT 期间症状变化的纵向模式评估个体潜在类别的存在，并评估基线自我批评完美主义或依赖是否预测类别成员资格。潜在加速评分 (LAS) 模型通过考虑速度的变化（例如，加速和/或减速）来评估完美主义或依赖是否导致抑郁症状变化（例如，速度）的可变性。结果 LGMM 表明存在两个潜在类别，代表症状改善 (N = 239) 或随时间的最小症状改善 (N = 73)。提升基线自我批评完美主义，但不依赖，预测随着时间的推移表现出最小症状改善的参与者类别的成员资格的可能性更大。第二项分析检查了基线自我批评完美主义是否也可以预测抑郁症状的变异性和不稳定性。LAS完美主义模型表明，完美主义在前七次治疗期间加速了抑郁症状的变化，然后对抑郁症状的变化产生了减速作用。结论 结果表明，在治疗过程中，较高的基线自我批评完美主义预示着抑郁症状的变异性和不稳定性以及加速和减速的变异性较高。LAS完美主义模型表明，完美主义在前七次治疗期间加速了抑郁症状的变化，然后对抑郁症状的变化产生了减速作用。结论 结果表明，在治疗过程中，较高的基线自我批评完美主义预示着抑郁症状的变异性和不稳定性以及加速和减速的变异性较高。LAS完美主义模型表明，完美主义在前七次治疗期间加速了抑郁症状的变化，然后对抑郁症状的变化产生了减速作用。结论 结果表明，在治疗过程中，较高的基线自我批评完美主义预示着抑郁症状的变异性和不稳定性以及加速和减速的变异性较高。