"Research growing out of practice"
best describes the way Dr. James P. McCullough, Jr., Emeritus Professor of Psychology of Virginia Commonwealth University, has conducted his over 45-year university career. During the mid-1970s, Dr. McCullough began working with chronically depressed outpatients. At that time, chronic depression was considered to be a Personality Disorder and was not considered to be responsive to either medication or psychotherapy. Dr. McCullough developed the therapy model, Cognitive Behavioral Analysis System of Psychotherapy (CBASP), while working with chronically depressed patients. He investigated the treatment efficacy of CBASP using single-case design methodology and published the first CBASP articles in 1980 and 1984. With the publication of DSM-III in 1980, the American Psychiatric Association removed one form of chronic depression from its Personality Disorder status as it defined Dysthymia as an Axis I Psychological Disorder; however, chronic depression remained a “specifier” of Major Depression (in DSM-III-R, 1987; DSM-IV, 1994; DSM-IV-TR, 2000) until 2013 (in DSM-5).
In 1980, in addition to developing a psychotherapy method to treat chronic depression, Dr. McCullough began a series of diagnostic investigations prospectively studying untreated chronically depressed community adults for extended periods of time. The aim of this research was to determine if the disorder would remit spontaneously over time. There were few spontaneous remissions (13%), and of those who did remit, over half relapsed within two years. The majority of the subjects reported an onset which began during adolescence. In his sample, chronic depression appeared to be a disorder of adolescence as well as a lifetime problem that doesn’t improve spontaneously. His diagnostic investigations continue to the present time. Work with his colleague at Stony Brook University, Professor D.N. Klein, contributed to the emergence of the first independent diagnostic category for chronic depression that appeared in DSM-5 (2013); namely, Persistent Depressive Disorder (PDD). PDD is no longer considered to be a “specifier” for Major Depression.
In the late 1980s, Dr. McCullough served as a Field Trial Site Coordinator studying Dysthymia, Major Depression, and two minor depressions in the American Psychiatric Association’s DSM-III-R revision project. He has also participated as a Principal Investigator in three national, multi-site clinical trials involving 2166 chronically depressed outpatients. One study (Keller et al., 2000) utilized CBASP alone and in combination with medication and compared both groups to a medication only group. Patients who completed the study and who received combination treatment obtained the highest response rates (85%) ever reported in a chronic depression study.
Dr. McCullough has written six books and published approximately 100 scientific papers. Three books were published in 2000, 2001, and 2003, all by Guilford Press; a 2006 text was published by Springer Press and his fifth book was published in 2015 by Routledge Press. The 2015 text summarizes the latest CBASP research and describes the CBASP model in detail. CBASP has also achieved empirically validated treatment status in the United States and Europe following a number of clinical trials conducted in the U.S. and abroad. Its international impact was realized over two decades ago through the formation of the European CBASP Network, an international CBASP Convention held bi-annually in Germany. The Convention regularly attracts several hundred clinicians and scholars from all over the world who attend its seminars, lectures and workshops. More recently, the International CBASP Society was founded in the United States. Its mission is to disseminate the impact of CBASP in the United States and abroad, to facilitate the training of CBASP practitioners, and to facilitate the treatment of and research with Persistent Depressive Disorder (chronic depression). Dr. McCullough’s sixth book, his memoir, was published in 2019 with Dorrance Publishing Company: Swimming Upstream: A Story about Becoming Human.