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Cognitive therapy, Depressive disorder, Heart diseases, Patient compliance, Psychometrics, Questionnaires.


National Institute of Mental Health. National Heart, Lung, and Blood Institute.


The final publication is available at Springer via doi:10.1007/s10608-016-9797-6


The Techniques for Overcoming Depression (TOD) questionnaire assesses the frequency with which patients being treated for depression use cognitive-behavioral techniques in daily life. This study examined its latent structure, reliability and concurrent validity in depressed cardiac patients. The TOD was administered at the initial and final treatment sessions in three trials of cognitive behavior therapy (CBT) (n = 260) for depression in cardiac patients. Mokken scaling was used to determine its dimensionality. The TOD is unidimensional in depressed cardiac patients, both at the initial evaluation (H = .46) and the end of treatment (H = .47). It is sensitive to change and the total score correlates with therapist ratings of the patient’s socialization to CBT (r = .40, p < .05), homework adherence (r = .36, p < .05), and use of cognitive-behavioral techniques (r = .51, p < .01). TOD scores were associated with post-treatment depression scores in two of the trials (p < .01 in both analyses). The TOD is a unidimensional, reliable, valid, and clinically informative measure of self-reported use of cognitive-behavioral techniques for overcoming depression in cardiac patients. Studies of the TOD in other depressed patient populations are needed.




Freedland KE, Lemos M, Doyle F, Steinmeyer BC, Csik I, Carney RM. The Techniques for Overcoming Depression Questionnaire: Mokken Scale Analysis, Reliability, and Concurrent Validity in Depressed Cardiac Patients. Cognitive Therapy and Research. 2017;41(1):117-129.

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Available for download on Tuesday, August 22, 2017

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