Daniel R. Strunk

My research focuses on the relationship between cognition and abnormal emotional states, particularly the emotional states characteristic of Major Depressive Disorder. I have begun to address several questions in this domain. These include: How do treatments for depression, such as Cognitive Therapy (CT), achieve their effects? What is the role of cognitive change in these treatments? How might treatments be adapted to best suit different patients? What kinds of changes predict resistance to relapse and recurrence following treatment? I have also been addressing more basic questions, such as: what kinds of cognitive biases are evident among depressed people? Thus, my work has focused on three related areas: (1) investigations of how treatments for depression achieve their effects; (2) how treatment strategies for depression can be refined and integrated to better serve depressed patients; and (3) investigations of the nature of cognitive biases associated with depression.

In our work on the process of change in the treatment of depression, my co-authors and I provided evidence that ratings of therapist competence predict subsequent symptom change in CT (Strunk, Brotman, DeRubeis, & Hollon, 2010). When examining the role of specific therapist strategies, we found adherence to strategies targeting cognitive change most strongly predict session-to-session symptom improvements (Strunk, Brotman, & DeRubeis, 2010). Interestingly, we have also found that behavioral strategies appear to be more important when CT is provided in combination with anti-depressant medication (Strunk, Cooper, Ryan, DeRubeis, & Hollon, under review). In an examination of predictors of CT’s long-term effects, my co-authors and I found that both mastery of skills taught in CT and independent use of these skills at the end of treatment were each predictive of reduced risk for relapse following treatment (Strunk, DeRubeis, Chiu, & Alvarez, 2007). Taken together, my work in this area has highlighted the importance of competently administered cognitive and behavioral strategies for promoting acute symptom relief and patients’ mastery and use of those strategies for promoting long-term resistance to relapse and recurrence.

With regard to adapting treatments, my collaborator Jen Cheavens and I have compared two approaches to personalizing psychotherapy for depression based on patients' characteristics: a capitalization and a compensation approach. In our pilot trial, we obtained evidence to suggest that personalizing depression treatment in a way that focused on patients' relative strengths led to significantly superior clinical outcomes than a course of treatment focused on compensating for relative weaknesses (manuscript in preparation).

Finally, in my work on cognitive biases, I have published papers showing that depressive symptoms (and Major Depressive Disorder) are characterized by unrealistic pessimistic biases in several judgment tasks (Strunk, Lopez, & DeRubeis, 2006; Strunk & Adler, 2009).

Ultimately, I hope to understand the relation of cognition and emotion so as to better understand both the process by which treatments for depression achieve their effects and what treatments strategies most benefit different patients. I am also quite concerned with the need to ensure that the best available treatment options are readily available to those seeking treatment.