Disorder-specific versus transdiagnostic and clinician-guided versus self-guided treatment for major depressive disorder and comorbid anxiety disorders: A randomized controlled trial

Titov, Nickolai; Dear, Blake F.; Staples, Lauren G.; Terides, Matthew D.; Karin, Eyal; Sheehan, Joanne; Johnston, Luke; Gandy, Milena; Fogliati, Vincent J.; Wootton, Bethany M.; McEvoy, Peter M.

doi:10.1016/j.janxdis.2015.08.002

Cited by 195 publications

(205 citation statements)

References 72 publications

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“…Previous examples of supported BITs have been predominantly guided by one of three models: supportive accountability (Mohr, Cuijpers, & Lehman, 2011), the Macquarie University Model (MUM; Titov et al, 2015), or the "Swedish Experience" (Andersson et al, 2008). Supportive accountability's main focus is the use of a BIT.…”

Section: Supported Bitsmentioning

confidence: 99%

Integrating Human Support Into Behavioral Intervention Technologies: The Efficiency Model of Support

Schueller¹,

Tomasino²,

Mohr³

2016

Clin Psychol Sci Pract

147

152

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A growing number of interventions use websites, mobile applications, and wearable devices to deliver and enhance mental health treatments. These technologies are used more often and are more effective when provided along with human support. Integrating human support, however, requires developed models for providing this support. This article presents the Efficiency Model of Support, a new model for understanding the provision of human support in the context of behavioral intervention technologies. The Efficiency Model of Support defines the ratio of benefit accrued from an intervention to resources devoted to it as a critical consideration in support provision. The Efficiency Model of Support serves to consolidate the current findings and guide future research and practice with regard to human support and technology.Additional Supporting Information may be found online in the supporting information tab for this article:

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Section: Supported Bitsmentioning

confidence: 99%

Integrating Human Support Into Behavioral Intervention Technologies: The Efficiency Model of Support

Schueller¹,

Tomasino²,

Mohr³

2016

Clin Psychol Sci Pract

147

152

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“…For example, the effects of some fully automated eCBT interventions are only modest, although providing clinician support may improve adherence and outcomes . Several direct comparisons between supported and fully automated eCBT interventions have yielded small or no differences, however, and some interventions failed to improve outcomes even when personal support was provided . Thus, evidence is mixed, and more research is needed to evaluate the potential of eCBT interventions for PwE.…”

Section: Introductionmentioning

confidence: 99%

Effects of an epilepsy‐specific Internet intervention (Emyna) on depression: Results of the ENCODE randomized controlled trial

et al. 2019

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Summary Objective Depression and anxiety are highly prevalent among people with epilepsy (PwE) but often remain unrecognized and treated inadequately. Effective psychosocial treatments such as cognitive behavioral therapy (CBT) are rarely available to most PwE, which is one reason electronically delivered CBT (eCBT) is regarded as promising. This study examined an eCBT intervention, termed Emyna, that was tailored to suit the needs of PwE. It includes CBT‐related content on depression, stress and anxiety, seizure triggers and auras, and lifestyle habits. The trial examined the efficacy of Emyna in reducing symptoms of depression (primary outcome) and anxiety as well as improving quality of life. Methods Participants (N = 200) with epilepsy, a diagnosis of a depressive disorder, and at least moderate depressive symptoms were randomized to Emyna or care as usual. At baseline and after 3, 6, and 9 months, participants were invited to complete online questionnaires. The primary outcome was improvement of depressive symptoms at 3 months. Results Relative to the control group, intervention group participants experienced significantly greater improvements in depression, anxiety, stress, social‐occupational impairment, and epilepsy‐related quality of life, in both intention‐to‐treat (ITT) and per‐protocol analyses. In ITT analyses, effects of medium magnitude were observed, as measured by the Patient Health Questionnaire–9 items (Cohen d = 0.54, 95% confidence interval [CI] = 0.25‐0.82, P < 0.001) and the Neurological Disorders Depression Inventory for Epilepsy (d = 0.51, 95% CI = 0.23‐0.79, P < 0.01). At 3 months, intervention group participants also reported fewer illness‐related days off work and fewer days hospitalized over the preceding months, compared to control group participants (P ≤ 0.05), whereas no such differences were present at baseline (P > 0.30). Significance These findings showed that Emyna, used adjunctively to usual care, could help improve mental health, social‐occupational functioning, and quality of life among PwE. The program provides an additional treatment option that could produce clinically relevant symptom reductions and reduce key cost drivers (ie, hospitalization rates and illness‐related inability to work).

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“…In addition, the data will also be compared to transdiagnostic protocols applied over the Internet, but without components for up-regulating PA [15, 108–112]. …”

Section: Discussionmentioning

confidence: 99%

Efficacy of a Transdiagnostic internet-based treatment for emotional disorders with a specific component to address positive affect: Study protocol for a randomized controlled trial

et al. 2017

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BackgroundEmotional disorders (ED) are among the most prevalent mental disorders. However, less than 50% of people suffering from ED receive the appropriate treatment. This situation has led to the development of new intervention proposals based on the transdiagnostic perspective, which tries to address the underlying processes common to ED. Most of these programs focus primarily on down-regulating negative affectivity, rather than increasing strengths and up-regulating positive affectivity. The data suggest the existence of disturbances in positive affectivity in these disorders, and so new interventions focusing on these problems are greatly needed. It is also essential to provide assistance to all the people in need. Information and Communication Technologies can be very useful. This study aims to evaluate the efficacy of a transdiagnostic Internet-based treatment for ED in a community sample. The protocol includes traditional CBT components, as well as a specific component to address positive affect. We intend to test this protocol, including this specific component or not, versus a waiting list control group. Moreover, we aim to test the differential effect of this specific component, and study the effectiveness (in terms of patients’ acceptance) of using a self-applied Internet-based program. This paper presents the study protocol.MethodsThe study is a randomized controlled trial. 207 participants will be randomly assigned to: a)Transdiagnostic Internet-based protocol (TIBP), b)Transdiagnostic Internet-based protocol + positive affect component (TIBP + PA), or c)a Waiting List control group (WL). Primary outcomes measures will be the BDI-II, the BAI, and the PANAS. Secondary outcomes will include diagnosis-specific measures of the principal disorder. Participants’ treatment acceptance will also be measured. Participants will be assessed at pre-, post-treatment, and 3- and 12- month follow-ups. The data will be analyzed based on the Intention-to-treat principle. Per protocol analyses will also be performed.DiscussionTo the best of our knowledge, this is the first study of a transdiagnostic Internet-based treatment for ED with a specific component to up-regulate positive affectivity. This intervention could contribute to improve the efficiency and effectiveness of current treatment programs for ED, promote the dissemination of EBTs, and help to decrease the high prevalence of ED.Trial registrationClinicalTrial.gov: NCT02578758. Registered 15 October 2015.

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Disorder-specific versus transdiagnostic and clinician-guided versus self-guided treatment for major depressive disorder and comorbid anxiety disorders: A randomized controlled trial

Cited by 195 publications

References 72 publications

Integrating Human Support Into Behavioral Intervention Technologies: The Efficiency Model of Support

Integrating Human Support Into Behavioral Intervention Technologies: The Efficiency Model of Support

Effects of an epilepsy‐specific Internet intervention (Emyna) on depression: Results of the ENCODE randomized controlled trial

Efficacy of a Transdiagnostic internet-based treatment for emotional disorders with a specific component to address positive affect: Study protocol for a randomized controlled trial

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