The role of idioms in reducing depression in university students: a study on group cognitive behavioral therapy

Abstract Purpose To evaluate the effectiveness of Culturally Adapted Cognitive-Behavioral Therapy (CA-CBT) compared to standard CBT in alleviating depression in college students. Methods A randomized trial was conducted on college students with mild to moderate depression. The CA-CBT group (21 stude...

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Main Authors: Chenchen Lin, Mingyu Hu, Jingren Xu, Ruilu Yang, Haoran Yu, Hua Yang, Ning Zhang
Format: Article
Language:English
Published: BMC 2025-06-01
Series:BMC Psychology
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Online Access:https://doi.org/10.1186/s40359-025-02924-5
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author Chenchen Lin
Mingyu Hu
Jingren Xu
Ruilu Yang
Haoran Yu
Hua Yang
Ning Zhang
author_facet Chenchen Lin
Mingyu Hu
Jingren Xu
Ruilu Yang
Haoran Yu
Hua Yang
Ning Zhang
author_sort Chenchen Lin
collection DOAJ
description Abstract Purpose To evaluate the effectiveness of Culturally Adapted Cognitive-Behavioral Therapy (CA-CBT) compared to standard CBT in alleviating depression in college students. Methods A randomized trial was conducted on college students with mild to moderate depression. The CA-CBT group (21 students) received a group CA-CBT intervention incorporating idioms, while the standard CBT group (20 students) received a standard group-based CBT intervention. Both group interventions were conducted once a week, with each session lasting one and a half hours, for a total duration of eight weeks. Eighteen students from the standard CBT group and 12 from the CA-CBT group completed the trial. Depressive symptoms, cognitive distortions, emotional regulation, and CBT understanding were assessed at baseline, week five, post-treatment, and three months after post-treatment using validated scales. Data were analyzed using repeated measures ANOVA, t-tests, and chi-square tests via SPSS 26.0. Results The repeated measures ANOVA results for the pre-treatment and post-treatment showed a significant interaction effect of time and intervention and a significant main effect of time for the sleep disturbance factor of the Hamilton Depression Rating Scale. However, only the main effect of time was significant for all other variables. T-tests indicated that the CA-CBT group had significantly lower Hamilton scores at follow-up compared to the standard CBT group. Meanwhile, the standard CBT group had significantly better CBT understanding post-treatment. Except for the above two items, no other significant difference were found by T-test. Conclusions Compared with standard CBT, the CA-CBT group that incorporates idioms is beneficial for college students with depressive symptoms to continue to achieve relief for a certain period of time after the end of treatment. Specifically, this relief may be reflected in the improvement of sleep problems. However, CA-CBT did not better improve participants’ emotion regulation, understanding of cognitive behavioral therapy, or reduction of cognitive distortions.At the same time, the CA-CBT group did not perform better than the standard CBT group in terms of dropout rate, treatment satisfaction, recommendation, and re-use rate. Trial registration The trial was registered on the Chinese Clinical Trial Registry (No. ChiCTR2300074752|| http://www.chictr.org.cn/ ) on August 15, 2023.
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spelling doaj-art-36de2ac0deb5491f81a24c0cf7fea3af2025-08-20T02:05:42ZengBMCBMC Psychology2050-72832025-06-0113111510.1186/s40359-025-02924-5The role of idioms in reducing depression in university students: a study on group cognitive behavioral therapyChenchen Lin0Mingyu Hu1Jingren Xu2Ruilu Yang3Haoran Yu4Hua Yang5Ning Zhang6School of Psychology, Nanjing Normal UniversityMedical Psychology Department, Affiliated Brain Hospital of Nanjing Medical UniversityMedical Psychology Department, Affiliated Brain Hospital of Nanjing Medical UniversityMedical Psychology Department, Affiliated Brain Hospital of Nanjing Medical UniversityMedical Psychology Department, Affiliated Brain Hospital of Nanjing Medical UniversityMedical Psychology Department, Affiliated Brain Hospital of Nanjing Medical UniversityMedical Psychology Department, Affiliated Brain Hospital of Nanjing Medical UniversityAbstract Purpose To evaluate the effectiveness of Culturally Adapted Cognitive-Behavioral Therapy (CA-CBT) compared to standard CBT in alleviating depression in college students. Methods A randomized trial was conducted on college students with mild to moderate depression. The CA-CBT group (21 students) received a group CA-CBT intervention incorporating idioms, while the standard CBT group (20 students) received a standard group-based CBT intervention. Both group interventions were conducted once a week, with each session lasting one and a half hours, for a total duration of eight weeks. Eighteen students from the standard CBT group and 12 from the CA-CBT group completed the trial. Depressive symptoms, cognitive distortions, emotional regulation, and CBT understanding were assessed at baseline, week five, post-treatment, and three months after post-treatment using validated scales. Data were analyzed using repeated measures ANOVA, t-tests, and chi-square tests via SPSS 26.0. Results The repeated measures ANOVA results for the pre-treatment and post-treatment showed a significant interaction effect of time and intervention and a significant main effect of time for the sleep disturbance factor of the Hamilton Depression Rating Scale. However, only the main effect of time was significant for all other variables. T-tests indicated that the CA-CBT group had significantly lower Hamilton scores at follow-up compared to the standard CBT group. Meanwhile, the standard CBT group had significantly better CBT understanding post-treatment. Except for the above two items, no other significant difference were found by T-test. Conclusions Compared with standard CBT, the CA-CBT group that incorporates idioms is beneficial for college students with depressive symptoms to continue to achieve relief for a certain period of time after the end of treatment. Specifically, this relief may be reflected in the improvement of sleep problems. However, CA-CBT did not better improve participants’ emotion regulation, understanding of cognitive behavioral therapy, or reduction of cognitive distortions.At the same time, the CA-CBT group did not perform better than the standard CBT group in terms of dropout rate, treatment satisfaction, recommendation, and re-use rate. Trial registration The trial was registered on the Chinese Clinical Trial Registry (No. ChiCTR2300074752|| http://www.chictr.org.cn/ ) on August 15, 2023.https://doi.org/10.1186/s40359-025-02924-5Cognitive Behavioral TherapyIdiomsGroup therapyCultural adaptationDepressive symptom
spellingShingle Chenchen Lin
Mingyu Hu
Jingren Xu
Ruilu Yang
Haoran Yu
Hua Yang
Ning Zhang
The role of idioms in reducing depression in university students: a study on group cognitive behavioral therapy
BMC Psychology
Cognitive Behavioral Therapy
Idioms
Group therapy
Cultural adaptation
Depressive symptom
title The role of idioms in reducing depression in university students: a study on group cognitive behavioral therapy
title_full The role of idioms in reducing depression in university students: a study on group cognitive behavioral therapy
title_fullStr The role of idioms in reducing depression in university students: a study on group cognitive behavioral therapy
title_full_unstemmed The role of idioms in reducing depression in university students: a study on group cognitive behavioral therapy
title_short The role of idioms in reducing depression in university students: a study on group cognitive behavioral therapy
title_sort role of idioms in reducing depression in university students a study on group cognitive behavioral therapy
topic Cognitive Behavioral Therapy
Idioms
Group therapy
Cultural adaptation
Depressive symptom
url https://doi.org/10.1186/s40359-025-02924-5
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