Self-Criticism and Dependency in Depressed Patients Treated with Cognitive Therapy or Pharmacotherapy

The current study aimed to assess the role of self-criticism and dependency in response to cognitive therapy (CT) or pharmacotherapy (PT). It was hypothesized that (a) self-criticism would moderate treatment outcome to CT and PT, and (b) the degree of change in self-criticism and the relationship of this change to treatment response would be greater for patients treated with CT than for patients treated with PT. A sample of outpatients with unipolar major depression received either CT (n = 51) or PT (n = 58). Neither pretreatment self-criticism and dependency scores nor self-criticism and dependency change scores were found to predict response to PT. Treatment response to CT, however, was associated with pretreatment self-criticism scores and pre- and post-self-criticism change scores. Although highly self-critical patients were more likely to have a poor response to CT, the degree to which self-criticism was successfully reduced in treatment was shown to be the best predictor of treatment response to CT.