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Attributional Intervention for Depression in Two People with Multiple Sclerosis (MS): Single Case Design

Published online by Cambridge University Press:  15 October 2010

Helen Wain
Surrey Community Health, Haslemere, UK
Ian I. Kneebone*
Surrey Community Health, Haslemere, UK and University of Surrey, Guildford, UK
Mark Cropley
University of Surrey, Guildford, UK
Reprint requests to Ian I. Kneebone, Surrey Community Health, Haslemere and District Community Hospital, Church Lane, Haslemere, Surrey GU27 2BJ, UK. E-mail: An extended version is also available online in the table of contents for this issue:


Background: Depression is common in those with MS. The hopelessness theory of depression, emphasizing the role of attributional style, is supported in this population. Cognitive behaviour therapy (CBT) that can affect attributional style can reduce depression in people who have MS. Aims: The present study aimed to consider whether changing attributional style would reduce depression in two people with MS, thereby supporting the importance of this component of CBT with this population. Method: Two female participants with MS were offered a 5-session intervention designed to alter attributional style. The study followed an ABA design. Attributional style and depressive symptoms were the principal measures considered. Negative life events and MS related stresses were also monitored. Results: The intervention appeared effective for one of the participants, with predicted changes in attributional style and sizeable reductions in depressive symptoms from pre- to post-treatment that were sustained at 3-month follow-up. Improvement was still evident at 6 months, although with some reduction of effect. The intervention was less successful for the other participant who declined further treatment after three sessions. Conclusions: Some support for the hopelessness theory of depression was found, indicating its relevance to CBT interventions for those who have MS and depression.

Brief Clinical Report
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2010

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Abramson, L. Y., Metalsky, G. I. and Alloy, L. (1989). Hopelessness depression: a theory based sub-type of depression. Psychological Review, 96, 358372.CrossRefGoogle Scholar
DeRubeis, R. J. and Hollon, S. D. (1995). Explanatory style in the treatment of depression. In Buchanan, G. and Seligman, M. E. P. (Eds.), Explanatory Style. Hillsdale, NJ: Erlbaum.Google Scholar
Forsterling, F. (1985). Attributional retraining: a review. Psychological Bulletin, 98, 495512.CrossRefGoogle ScholarPubMed
Green-Emrich, A. and Altmaier, E. M. (1991). Attribution retraining as a structured group counselling intervention. Journal of Counselling and Development, 69, 351355.CrossRefGoogle Scholar
Kneebone, I. I. and Dunmore, E. (2004). Attributional style and symptoms of depression in persons with multiple sclerosis. International Journal of Behavioral Medicine, 11, 110.CrossRefGoogle ScholarPubMed
Mohr, D. C., Likosky, W., Bertagnolli, A., Goodkin, D. E., Van Der Wende, J., Dwyer, P. and Dick, L. P. (2000). Telephone-administered cognitive behavioural therapy for the treatment of depressive symptoms in multiple sclerosis. Journal of Consulting and Clinical Psychology, 68, 356361.CrossRefGoogle ScholarPubMed
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