Improving Positive Life Event Predictions through Cognitive Behavioral Therapy

Background Depression is characterized by a tendency to overestimate the probability of negative life events and underestimate the probability of positive events. Although cognitive behavioral therapy (CBT) targets overly negative future expectations, research has yet to examine how such expectations change relative to one’s experiences. We examined the relation between predictions and event occurrence for positive and negative life events (i.e., informativeness of predictions [IoP]) among patients in CBT for depression. We examined how IoP changed over the course of CBT and whether these changes were related to CBT skill acquisition or symptom reduction. Methods At intake and posttreatment, 67 patients were asked to estimate the probability of 40 events in the following week; patients later reported whether the events occurred. Results IoP improved for positive but not negative events across treatment. IoP for positive (but not negative) events were also associated with symptoms at intake and therapist-rated CBT skills at posttreatment. However, neither positive nor negative event IoP changes were associated with symptom improvement over the course of CBT. Conclusions These findings suggest changes in the informativeness of predictions of positive life events may uniquely change and be important to the development of skills in CBT for depression.