Effects of a depression-focused internet intervention in slot machine gamblers: A randomized controlled trial

Bücker, Lara; Bierbrodt, Julia; Hand, Iver; Wittekind, Charlotte E.; Moritz, Steffen

doi:10.1371/journal.pone.0198859

Cited by 43 publications

(60 citation statements)

References 77 publications

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“…Sample sizes ranged from 27 to 1013, resulting in a total of 2901 across all studies. Except for one study [20], all other studies included more women than men, and the mean age ranged from 32 to 48.…”

Section: Discussionmentioning

confidence: 99%

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Effectiveness of a tailored, integrative Internet intervention (deprexis) for depression: Updated meta-analysis

et al. 2020

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Digitally delivered interventions for depression vary in many aspects, including their therapeutic orientation, depth of content, interactivity, individual tailoring, inclusion of multimedia, cost, and effectiveness. However, their effectiveness is rarely examined in intervention-specific meta-analyses. An earlier meta-analysis of eight randomized controlled trials (RCT) demonstrated the effectiveness of a tailored, integrative digital intervention (deprexis), which is delivered via the Internet. This updated meta-analysis of twelve deprexis-specific RCT with a total of N = 2901 participants confirmed the effectiveness of deprexis for depression reduction at post-intervention (g = 0.51, 95% CI: 0.40-0.62, I 2 = 26%). Results were analogous when study quality, screening and randomization procedure were taken into account. Clinician guidance, developer-involvement, setting (community vs. clinical), and initial symptom severity did not have statistically significant effects on the effect size, and there was no evidence of publication bias. Thus, these findings demonstrate that deprexis can facilitate clinically relevant reduction of depressive symptoms over 8-12 weeks across a broad range of initial symptom severity, and that the intervention can be combined with other forms of depression treatment. There is now a need to study the intervention's implementation in routine care settings as well as its long-term effectiveness and cost-effectiveness in diverse cultural and linguistic settings.Funding: Funding Statement: Gaia AG, Hamburg, provided support in the form of salaries for authors [B.M. and O.B.], but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the Despite such encouraging findings, caution is warranted for several reasons, and sweeping conclusions suggesting that all Internet interventions for depression are effective would be misguided. Of note, meta-analytic evidence showing that such interventions are effective on average does not mean that these interventions are all equally effective or, indeed, that any one intervention is effective at all. Internet interventions for depression differ substantially in their accessibility, therapeutic orientation, depth of content, interactivity, individual tailoring, inclusion of multimedia, self-monitoring tools, homework assignments, and cost [4]. Worryingly, many such interventions for depression are not evidence-based because they are never evaluated in randomized clinical trials (RCTs); this was the case for 20 out of 32 identified programs in a recent review [4].Given this substantial heterogeneity among Internet interventions for depression, one might expect that they also differ in terms of their effectiveness, although head-to-head trials are rare. In one large trial that included two Internet interventions for depression (Beating the Blues and MoodGYM), neither of them was effective when added to primary care in the United Kingdom [5]. A recent meta-analysis of self-guided depressio...

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Section: Discussionmentioning

confidence: 99%

“…Screening agreement rate between the authors BM and OB was 100%. After excluding records because they were not RCTs, 12 studies were included in the meta-analysis[8][9][10][18][19][20][21][22][23][24][25][26].…”

mentioning

confidence: 99%

Effectiveness of a tailored, integrative Internet intervention (deprexis) for depression: Updated meta-analysis

et al. 2020

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“…135 1) the certainty that the patient's efforts are being recorded and visualized by the therapist, 2) the technology is well-accepted by the patient, showing positive expectations and high satisfaction, and 3) it has the possibility of increasing the commitment to the scheduled SC tasks (before) and ERP components (after). The reported positive expectations and high satisfaction scores by the patients coincide with previous studies showing that ICT treatments are well-accepted [10,359,360], also in pathological gambling studies [398,400]. Specifically, LBT has been well-assessed in a previous pilot study with another pathology (see section 5.1) obtaining promising preliminary results.…”

Section: Discussionsupporting

confidence: 82%

“…The first promising technology was virtual reality (VR), which emerged as an effective tool for psychological disorders, reporting efficacy in the treatment of GD and the ERP component [396,397]. Furthermore, media development has led to the use of the Internet to deliver CBT, obtaining very adequate results by RCT [398][399][400][401], systematic review or meta-analysis [391,402] in which the efficacy of these self-guided treatments has been confirmed in many countries. The implementation of Information and Communication Technologies (ICT) for psychological intervention has been empirically tested.…”

Section: Introductionmentioning

confidence: 99%

“…This in turn, makes these variables become crucial features in psychotherapy results [358]. Several studies have focused on the expectations and satisfaction with different ICT tools such as VR or Internet-based treatment for delivering psychological treatments [10,359,360] including gambling disorder [398,400], reporting high satisfaction with the exposure component mediated by technologies. Studying acceptability and usability of an ICT has to take into account a very specific conceptualization inside the user experience, exploring the ease of use of a product by a specific user with clearly defined context and goals with the aim of enhancing the ICT development.…”

Section: Introductionmentioning

confidence: 99%

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Analysis and Development of a Platform for Generating Context-Aware Apps for Mental Health

Tena¹

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This work gathers a research carried out on the use of context-aware technologies in their application to the field of mental health. It begins by performing a deep state of the art of mobile technologies used in psychological interventions and extracting the characteristics and disorders most discussed in the literature; It continues to propose a series of considerations to take into account in the development of this type of technologies to increase its chances of success, focusing on three areas of study: Context, Mental Health and the Technology itself; The next contribution is the process of developing a platform that allows therapists to create their own mobile applications with geolocation to customize their own intervention tools without the need for high technical knowledge, the development is based on the learning obtained in the first two contributions, it is described as an intervention example a hypothetical case of depression; Finally, the platform is validated with three patients suffering from two different disorders: Panic disorder and agoraphobia; and gambling disorder.

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A Self-Guided Internet-Based Intervention for the Reduction of Gambling Symptoms

Rolvien,

Buddeberg,

Gehlenborg

et al. 2024

JAMA Netw Open

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ImportanceMost individuals with problem gambling or gambling disorder remain untreated due to barriers to treatment. Limited research exists on alternative treatments.ObjectiveTo investigate the efficacy of a self-guided internet-based intervention for individuals with gambling problems and to identify potential outcome moderators.Design, Setting, and ParticipantsThis single-center randomized clinical trial was conducted from July 13, 2021, to December 31, 2022, at the University Medical Center Hamburg-Eppendorf. Participants were recruited across Germany for 2 assessments (before intervention [t0] and 6 weeks after intervention [t1]). Eligible participants were individuals aged 18 to 75 years with gambling problems, internet access, German proficiency, and willingness to participate in 2 online assessments.InterventionThe self-guided internet-based intervention was based on cognitive behavioral therapy, metacognitive training, acceptance and commitment therapy, and motivational interviewing.Main Outcome and MeasuresThe primary outcome was change in gambling-related thoughts and behavior as measured with the pathological gambling adaption of the Yale-Brown Obsessive-Compulsive Scale. Secondary outcomes were change in depressive symptoms, gambling severity, gambling-specific dysfunctional thoughts, attitudes toward online interventions, treatment expectations, and patient satisfaction.ResultsA total of 243 participants (154 [63.4%] male; mean [SD] age, 34.73 [10.33] years) were randomized to an intervention group (n = 119) that gained access to a self-guided internet-based intervention during 6 weeks or a wait-listed control group (n = 124). Completion at t1 was high (191 [78.6%]). Results showed a significantly greater reduction in gambling-related thoughts and behavior (mean difference, −3.35; 95% CI, −4.79 to −1.91; P &lt; .001; Cohen d = 0.59), depressive symptoms (mean difference, −1.05; 95% CI, −1.87 to −0.22; P = .01; Cohen d = 0.33), and gambling severity (mean difference, −1.46; 95% CI, −2.37 to −0.54; P = .002; Cohen d = 0.40) but not in gambling-specific dysfunctional thoughts (mean difference, −1.62; 95% CI, −3.40 to 0.15; P = .07; Cohen d = 0.23) favoring the intervention group. Individuals in the intervention group who had a positive treatment expectation and more severe gambling-specific dysfunctional thoughts and gambling symptoms benefited more on the primary outcome relative to the control group.Conclusions and RelevanceIn this randomized clinical trial, the effectiveness of a self-guided internet-based intervention for individuals with self-reported problematic gambling behavior was demonstrated when measured 6 weeks after start of the intervention. The study’s findings are particularly relevant given the increasing need for accessible and scalable solutions to address problematic gambling.Trial Registrationbfarm.de Identifier: DRKS00024840

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Effects of a depression-focused internet intervention in slot machine gamblers: A randomized controlled trial

Cited by 43 publications

References 77 publications

Effectiveness of a tailored, integrative Internet intervention (deprexis) for depression: Updated meta-analysis

Effectiveness of a tailored, integrative Internet intervention (deprexis) for depression: Updated meta-analysis

Analysis and Development of a Platform for Generating Context-Aware Apps for Mental Health

A Self-Guided Internet-Based Intervention for the Reduction of Gambling Symptoms

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