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Artificial intelligence as a virtual coach in a cognitive behavioural intervention for perfectionism in young people: A randomised feasibility trial 人工智能作为年轻人完美主义认知行为干预的虚拟教练:一项随机可行性试验。
IF 3.6 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-12-01 DOI: 10.1016/j.invent.2024.100795
Catherine Johnson , Sarah J. Egan , Per Carlbring , Roz Shafran , Tracey D. Wade

Background

We examined the feasibility and outcomes of Artificial Intelligence (AI) as a virtual coach in guided self-help (GSH-AI) compared to pure self-help (PSH).

Method

Participants (N = 85 undergraduate university students; M age = 20.65 years [SD = 2.38]; 84 % female) were randomised to PSH (N = 42) or GSH-AI (N = 43). The intervention was a brief 11-module online cognitive behaviour therapy for perfectionism intervention completed over 4-weeks. GSH-AI participants were given suggested questions to ask AI for guidance in completing the intervention. Data were collected at baseline, 4- and 8-weeks post-randomisation.

Results

Engagement was good, only one person in each group did not use any modules; module completion was equivalent across conditions (6.67, SD = 3.22 and 6.18, SD = 3.42 respectively). Between baseline and post-intervention people in the GSH-AI condition showed an almost 3.5 times increase in preferring support to be received from AI versus other modes of support. Only 52 % and 22 % of participants completed 4- and 8-week post-randomisation surveys, with no differences in psychological outcomes between the PSH and GSH-AI groups. Main effects of time indicated moderate to large within-group effect size improvements for disordered eating, stress, anxiety, and perfectionism.

Conclusions

Qualitative feedback indicated that AI was initially acceptable as a guide and became even more acceptable after it had been experienced. Fully powered trials are required to determine the impact of AI guidance on outcomes, and whether type of AI platform (customised versus generic) and type of mental health disorder interact with its effects.
背景:与纯自助(PSH)相比,我们研究了人工智能(AI)作为引导自助(GSH-AI)虚拟教练的可行性和结果。方法:被试(N = 85名本科生;M年龄= 20.65岁[SD = 2.38];84%女性)随机分为PSH组(N = 42)或GSH-AI组(N = 43)。干预是一个简短的11个模块的在线认知行为治疗,用于完美主义干预,完成时间为4周。向GSH-AI参与者提出建议问题,以要求AI指导完成干预。在基线、随机化后4周和8周收集数据。结果:参与程度良好,每组仅有1人未使用任何模块;不同条件下模块完成度相等(分别为6.67,SD = 3.22和6.18,SD = 3.42)。在基线和干预后之间,GSH-AI患者倾向于从AI获得的支持比其他模式的支持增加了近3.5倍。只有52%和22%的参与者完成了随机化后4周和8周的调查,PSH组和GSH-AI组之间的心理结果没有差异。时间的主要作用表明,对饮食失调、压力、焦虑和完美主义的组内效应有中等到较大的改善。结论:定性反馈表明,玩家最初可以接受AI作为一种指南,并且在体验之后会变得更容易接受。需要进行充分的试验,以确定人工智能指导对结果的影响,以及人工智能平台的类型(定制的还是通用的)和精神健康障碍的类型是否与其效果相互作用。
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引用次数: 0
Assessing the feasibility, acceptability, and preliminary efficacy of the ‘TraumaRelief’ app for PTSD symptom management in Turkey: Study protocol for a pilot randomized controlled trial 评估 "TraumaRelief "应用程序在土耳其用于创伤后应激障碍症状管理的可行性、可接受性和初步疗效:随机对照试验研究方案
IF 3.6 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-11-23 DOI: 10.1016/j.invent.2024.100793
Hasan Arslan, A. Esin Yilmaz
The rate of exposure to traumatic events is high globally, and post-traumatic stress disorder (PTSD) is one of the most serious consequences. It was reported that approximately 14 million people were affected by earthquakes in Turkey in February 2023. Cognitive Behavioral Therapy (CBT) is a therapeutic approach to treating PTSD and has a proven efficacy. However, access to face-to-face therapies such as CBT is limited and there is a high dropout rate. Technology-based interventions can offer new solutions to make CBT more accessible and integrated into daily life. In this study, we will develop an application called TraumaRelief, which aims to relieve PTSD symptoms. We will test the feasibility, acceptability, and efficacy of this application through a pilot randomized controlled study conducted in Turkey, with 105 participants aged between 18 and 65 years who have experienced a traumatic event. Participants will be randomly assigned to the Application Plus Online Therapist Support Group (AT + OT Group), Application Only Group (Group A), and Waitlist Control Group (WLC Group). This study aims to evaluate symptoms of PTSD, depression, and anxiety, as well as their effects on quality of life. In addition, the feasibility and acceptability of the study; the attrition, consent, recruitment, and adherence rate to the application; fidelity of intervention delivery; system usability score; preferred and least preferred module components; app utilization frequency; and likelihood to recommend the application will be examined. Application efficacy will be monitored with follow-ups at one and three months. The results could provide important information on the integration of technology-based treatments with psychotherapy. In addition, it could allow the evaluation of potential mobile applications in the field of psychotherapy and represents an important step in the development and evaluation of a customized mobile application for a society with unique cultural and social dynamics, such as Turkey. It could also be an important resource for increasing the capacity to cope with the effects of traumatic events that have occurred in Turkey or future events.

Clinical Trial Registration

ClinicalTrials.gov Identifier NCT06288594. Unique Protocol ID: DEU-PSI-HA-001.
全球遭受创伤事件的比例很高,而创伤后应激障碍(PTSD)是最严重的后果之一。据报道,2023 年 2 月,土耳其约有 1400 万人受到地震影响。认知行为疗法(CBT)是治疗创伤后应激障碍的一种治疗方法,其疗效已得到证实。然而,获得 CBT 等面对面疗法的机会有限,而且辍学率很高。基于技术的干预措施可以提供新的解决方案,使 CBT 更容易获得并融入日常生活。在这项研究中,我们将开发一款名为 TraumaRelief 的应用程序,旨在缓解创伤后应激障碍症状。我们将在土耳其开展一项试验性随机对照研究,对该应用程序的可行性、可接受性和疗效进行测试,研究对象为 105 名年龄在 18 岁至 65 岁之间、经历过创伤事件的参与者。参与者将被随机分配到应用加在线治疗师支持组(AT + OT 组)、仅应用组(A 组)和候补对照组(WLC 组)。本研究旨在评估创伤后应激障碍、抑郁和焦虑症状及其对生活质量的影响。此外,还将考察研究的可行性和可接受性;应用程序的流失率、同意率、招募率和坚持率;干预实施的忠实度;系统可用性评分;首选和最不首选的模块组件;应用程序的使用频率;以及推荐应用程序的可能性。将在一个月和三个月时进行随访,监测应用程序的功效。研究结果将为技术治疗与心理治疗的整合提供重要信息。此外,它还能对心理治疗领域潜在的移动应用程序进行评估,是为土耳其这样一个具有独特文化和社会动态的社会开发和评估定制移动应用程序的重要一步。它还可以成为一种重要资源,提高人们应对土耳其已发生的创伤事件或未来事件影响的能力。临床试验注册ClinicalTrials.gov Identifier NCT06288594。唯一协议 ID:DEU-PSI-HA-001。
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引用次数: 0
Implementation trial II: Clinical outcomes and acceptability of an internet-delivered intervention for anxiety and depression delivered as part of routine care for university students in Australia 实施试验 II:作为澳大利亚大学生常规护理的一部分,通过互联网提供焦虑和抑郁干预的临床结果和可接受性
IF 3.6 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-11-21 DOI: 10.1016/j.invent.2024.100789
Blake F. Dear , Andreea I. Heriseanu , Bareena Johnson , Letitia Norton , Helen Nguyen , Ali Richards , Sheldon Pace , Nickolai Titov

Background

University students report high levels of psychological distress, which is a contributor to poorer academic, social and health outcomes. There is increasing interest in the use of internet-delivered psychological treatments in student counselling services as a strategy improving access to psychological care at scale. However, to date, few large-scale prospective effectiveness trials of internet-delivered psychological treatment have been conducted in “real world” settings with university student populations.

Aim

To investigate the effectiveness and acceptability of a brief transdiagnostic internet-delivered cognitive behavioural therapy (iCBT) intervention for anxiety and depression when delivered as part of routine care by the counselling service of an Australian university.

Design

A large, prospective, single-group Phase IV clinical trial.

Method

Students engaging with the university counselling service between 2018 and 2023 (N = 845; 8.5% of those presenting to the service) were given the option to receive the intervention based on their clinical needs and preferences. Students completed standardised measures of depression and anxiety severity at pre-treatment, each week of the intervention, and post-treatment. A subsample (n = 426) also completed the measures at 3-month follow-up.

Results

Over a 5-year period, 700 students participated in the intervention and 489 provided data at post-treatment. Significant reductions in depression symptoms (% reduction = 27%, Hedges' g = 0.35) and anxiety (% reduction = 37%, Hedges' g = 0.61) were observed, alongside high levels of satisfaction (>70%) and adherence (68%). Over 50% of students had clinically significant improvements in symptom severity, and symptom deterioration was observed in <15% of students.

Conclusion

The results of the current trial provide support for the effectiveness and acceptability of internet-delivered psychological interventions provided as part of routine care to university students with symptoms of anxiety and depression.
背景大学生的心理困扰程度很高,这也是学业、社交和健康状况较差的一个原因。越来越多的人开始关注在学生咨询服务中使用互联网提供的心理治疗方法,并将其作为一种改善心理治疗可及性的策略。目的 研究澳大利亚一所大学的心理咨询服务机构在常规治疗中使用简短的跨诊断网络认知行为疗法(iCBT)干预焦虑和抑郁的有效性和可接受性。设计一项大型、前瞻性、单组IV期临床试验。方法2018年至2023年期间参与大学咨询服务的学生(N = 845;占服务对象的8.5%)可根据其临床需求和偏好选择接受干预。学生们在治疗前、干预期间的每周和治疗后完成了抑郁和焦虑严重程度的标准化测量。结果在 5 年的时间里,共有 700 名学生参与了干预,其中 489 人提供了治疗后的数据。抑郁症状(减少率 = 27%,赫奇斯 g = 0.35)和焦虑症状(减少率 = 37%,赫奇斯 g = 0.61)显著减少,同时满意度(70%)和坚持率(68%)也很高。50%以上的学生症状严重程度有了明显改善,15%的学生症状恶化。
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引用次数: 0
Implementation trial I: Clinical outcomes and acceptability of an internet-delivered intervention for anxiety and depression delivered as part of routine care for university students in New Zealand 实施试验 I:作为新西兰大学生常规护理的一部分,通过互联网提供焦虑和抑郁干预的临床结果和可接受性
IF 3.6 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-11-21 DOI: 10.1016/j.invent.2024.100791
Blake F. Dear , Andreea I. Heriseanu , Bareena Johnson , David Sander , Kimberly Farmer , Nickolai Titov

Background

Psychological distress is highly prevalent among university students and can contribute to poor academic performance and drop-out. Help-seeking has increased in recent years, contributing to growing interest in employing internet-delivered psychological treatments to support the mental health of university students. However, few large-scale “real-world” effectiveness trials have been conducted in routine care settings for this population.

Aim

The aim of the current study was to examine the acceptability and effectiveness of a brief, five-week internet-delivered cognitive behavioural therapy (iCBT) intervention for anxiety and depression when delivered as part of routine care by a university counselling service in New Zealand.

Design

A large, prospective, single-group Phase IV clinical trial.

Method

Students (N = 1044) engaging with the university counselling service between 2018 and 2023 were provided the option to receive the intervention based on their needs and preferences. Students completed standardised measures of depression and anxiety severity at pre-treatment, each week of the intervention, and post-treatment. A subsample (n = 405) also completed these at 3-month follow-up.

Results

Over a 5-year period, 839 students participated in the intervention. Significant reductions in symptoms of depression (% reduction = 35%, Hedges' g = 0.56) and anxiety (% reduction = 36%, Hedges' g = 0.73) were observed, alongside high levels of satisfaction (> 60%). Symptom deterioration was observed in <10% of students.

Conclusion

The current results provide further support for the provision of internet-delivered psychological interventions as routine care to university students with symptoms of anxiety and depression.
背景心理困扰在大学生中非常普遍,可导致学习成绩差和辍学。近年来,大学生寻求帮助的人数不断增加,这促使人们越来越关注采用互联网提供的心理治疗方法来帮助大学生获得心理健康。本研究的目的是考察新西兰一所大学的咨询服务机构在提供常规服务时,采用为期五周的简短网络认知行为疗法(iCBT)干预焦虑症和抑郁症的可接受性和有效性。方法在2018年至2023年期间接受大学咨询服务的学生(N = 1044)可根据自己的需求和偏好选择接受干预。学生在治疗前、干预期间的每周和治疗后完成了抑郁和焦虑严重程度的标准化测量。结果在 5 年的时间里,共有 839 名学生参与了干预。抑郁症状明显减轻(减轻率 = 35%,赫奇斯 g = 0.56),焦虑症状明显减轻(减轻率 = 36%,赫奇斯 g = 0.73),满意度也很高(60%)。结论目前的研究结果进一步支持将互联网提供的心理干预作为对有焦虑和抑郁症状的大学生的常规护理。
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引用次数: 0
Promoting safer gambling through social norms and goal setting: A qualitative process analysis of participants' experiences in the EROGamb 2.0 feasibility trial 通过社会规范和目标设定促进更安全的赌博:EROGamb2.0可行性试验参与者经验的定性过程分析
IF 3.6 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-11-20 DOI: 10.1016/j.invent.2024.100790
Reece Bush-Evans , Emily Arden-Close , Sarah Thomas , John McAlaney , Ruijie Wang , Elvira Bolat , Sarah Hodge , Abigail Hamson-Ford , Keith Phalp
Gambling, though a popular social activity, can lead to addiction and cause significant harm. This study aimed to explore the experiences of 36 low-to-moderate risk gamblers (PGSI score 0–7; 31 male, 5 female; 10 per each intervention arm, 6 per control group) in the ‘EROGamb 2.0’ feasibility trial (n = 168). The trial used social norm messages and goal setting feedback to promote safer gambling behaviour. Participants took part in semi-structured interviews via telephone or audio calls using Zoom or Wire, a secure messaging app. The interviews were analysed using Framework Analysis. Most participants found the interventions interesting and useful, though some reported no change in their gambling behaviour. Motivations for joining the trial included interest in the topic, altruism, and financial incentives. Participants appreciated the study's clear information, efficient processes, and helpful notifications, despite some technical issues. Reactions to social norm messages were mixed, with some expressing scepticism about the statistics. However, the goal setting intervention was well-received, with participants valuing the clarity and usefulness of the information. External factors, such as promotional offers from gambling companies, influenced gambling behaviour. The findings support the feasibility and acceptability of social norm and goal setting interventions to reduce gambling behaviour, highlighting the need for personalised approaches in future research.
赌博虽然是一种广受欢迎的社交活动,但却可能导致成瘾并造成重大伤害。本研究旨在探讨 "EROGAMB 2.0 "可行性试验(n = 168)中 36 名中低度风险赌徒(PGSI 分数 0-7;31 名男性,5 名女性;每个干预组 10 人,每个对照组 6 人)的经历。该试验利用社会规范信息和目标设定反馈来促进更安全的赌博行为。参与者通过电话或使用 Zoom 或安全信息应用程序 Wire 进行音频通话,参加了半结构化访谈。访谈采用框架分析法进行分析。大多数参与者认为干预措施既有趣又有用,但也有一些人表示他们的赌博行为没有改变。参加试验的动机包括对主题的兴趣、利他主义和经济激励。尽管存在一些技术问题,但参与者对研究的清晰信息、高效流程和有用通知表示赞赏。参与者对社会规范信息的反应不一,有些人对统计数据表示怀疑。不过,目标设定干预措施受到了欢迎,参与者对信息的清晰度和实用性给予了高度评价。赌博公司的促销活动等外部因素影响了赌博行为。研究结果支持社会规范和目标设定干预措施在减少赌博行为方面的可行性和可接受性,强调了在未来研究中采用个性化方法的必要性。
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引用次数: 0
Developing a coaching manual to provide human support for the Mothers and Babies Online (eMB) perinatal mental health intervention 编写辅导手册,为母婴在线(eMB)围产期心理健康干预提供人力支持
IF 3.6 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-11-17 DOI: 10.1016/j.invent.2024.100792
Lara Baez , Jaime Hamil , Elaine McBride , Katherine A. Czech , Bayley J. Taple , Adriana Santillano , Mingjing Huang , Alinne Z. Barrera , S. Darius Tandon

Background

Depression that occurs in pregnancy or postpartum (perinatal depression) impacts 1 in 5 mothers, yet access to effective and high-quality preventative interventions remains elusive for most. Digital interventions are a promising solution to this treatment gap because of the ubiquity of mobile devices and internet access. The Mothers and Babies Online Course (eMB) is an online adaptation of Mothers and Babies, an evidence-based preventative program for postpartum depression. Preliminary studies of eMB point to its potential efficacy, but low engagement with eMB was a major limitation. Leveraging home visitors as coaches to guide clients through eMB may be a way to increase uptake and engagement, and ultimately improve outcomes when implemented in home visiting programs.

Objective

The aim of this study was to implement user-centered design methods to develop a coaching manual for home visitors to implement eMB.

Methods

10 parents and 10 home visitors were interviewed individually. Measures included a “think aloud” activity and a semi-structured interview focused on gaining insight into parent and home visitor needs and preferences regarding eMB coaching in the context of home visiting. Thematic analysis was used to derive themes and sub-themes from interview transcripts.

Results

Parents were enthusiastic about eMB, but noted barriers including limited time and forgetfulness. Parents also thought that their home visitor would be the ideal eMB coach because of the existing close relationship. Home visitors shared that eMB would fit seamlessly into their home visiting workflow. They also thought that home visitors could address challenges that parents encounter in using eMB and leverage their relationship with parents to crystalize learning. Home visitors also noted that a coaching manual would be a key part of successful eMB implementation. Thus, valuable insights from parents and home visitors were used to create a coaching manual.

Conclusions

Parents and home visitors were both enthusiastic about eMB with adjunctive coaching, and home visitors agreed that a coaching manual would be vital in guiding them to help parents through eMB. Results highlight the importance of engaging end-users in all aspects of online intervention design, including the coaching manual. The effectiveness of the intervention and utility of the coaching protocol will be evaluated in a future pilot trial.
背景孕期或产后抑郁症(围产期抑郁症)影响着五分之一的母亲,但大多数人仍然无法获得有效和高质量的预防性干预措施。由于移动设备和互联网无处不在,数字干预是解决这一治疗缺口的可行方案。母亲与婴儿在线课程(eMB)是对《母亲与婴儿》的在线改编,《母亲与婴儿》是一项针对产后抑郁症的循证预防计划。对 eMB 的初步研究显示了其潜在的功效,但 eMB 的低参与度是其主要局限。本研究的目的是采用以用户为中心的设计方法,为家庭访视者开发一本实施电子母婴教育的辅导手册。方法:对 10 位家长和 10 位家庭访视者进行了单独访谈。访谈措施包括 "大声想一想 "活动和半结构式访谈,重点是深入了解家长和家访者在家访中对电子母婴辅导的需求和偏好。采用主题分析法从访谈记录中得出主题和次主题。结果家长们对电子教具充满热情,但也指出了一些障碍,包括时间有限和健忘。家长们还认为,由于已有的密切关系,他们的家庭访视者将是理想的电子教具指导者。家访者认为,电子教具可以完美地融入他们的家访工作流程。他们还认为,家访人员可以解决家长在使用电子教具时遇到的难题,并利用他们与家长的关系来促进学习。家访者还指出,辅导手册将是成功实施电子教 育管理的关键部分。结论 家长和家庭访视者都热衷于使用辅助辅导的电子教具,家庭访视者也认为辅导手册对于指导他们帮助家长完成电子教具至关重要。研究结果凸显了让最终用户参与在线干预设计(包括辅导手册)各个方面的重要性。干预的有效性和指导方案的实用性将在未来的试点试验中进行评估。
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引用次数: 0
Effectiveness of a guided multicomponent internet and mobile gratitude training program - A pragmatic randomized controlled trial 指导性多成分互联网和移动感恩培训计划的效果--实用随机对照试验
IF 3.6 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-11-12 DOI: 10.1016/j.invent.2024.100787
Dirk Lehr , Henning Freund , Bernhard Sieland , Lina Kalon , Matthias Berking , Heleen Riper , David Daniel Ebert

Objective

To investigate the effectiveness of a guided, internet- and smartphone-based gratitude intervention on the transdiagnostic risk-factor ‘repetitive negative thinking’. The multicomponent intervention integrates a variety of gratitude exercises, targeting the cognitive, emotional and behavioural facets of gratitude.

Method

Two hundred adults with pronounced repetitive negative thinking were recruited from the general population. Participants were randomly assigned to either a four-session guided gratitude intervention (n = 100) or waiting list (n = 100). The primary outcome was repetitive negative thinking three months after randomization, with exploratory assessments at six weeks and six months, the latter just for participants in the intervention group.

Results

Following the intention-to-treat principle, by analyses of covariance (ANCOVA), the gratitude intervention group exhibited significantly lower levels of repetitive negative thinking than controls at three months, with d = 0.66, 95 % CI [0.37, 0.94] maintained at six-month follow-up. Significant and meaningful beneficial effects were observed in symptoms of depression (d = 0.42) and generalized anxiety (d = 0.38). These effects were notably stronger in intervention completers who finished at least three sessions.

Conclusions

Results suggest that a multicomponent gratitude intervention is effective at reducing repetitive negative thinking. Multicomponent interventions may be a next step needed to fully realize the potential of gratitude interventions. Such interventions could expand the repertoire of transdiagnostic interventions, especially for repetitive negative thinking. Furthermore, due to its positive connotations, gratitude is a candidate for an indirect intervention aimed at reducing the burden of depression in the general population.

Trial registration

The study is registered in the German Clinical Trial Register (approved primary register of the WHO) as DRKS00006825. The trial protocol can be assessed at: https://www.drks.de/
目的研究基于互联网和智能手机的指导性感恩干预对跨诊断风险因素 "重复性消极思维 "的效果。方法从普通人群中招募了 200 名有明显重复性消极思维的成年人。参与者被随机分配到为期四节的引导式感恩干预(100 人)或等待名单(100 人)中。结果根据意向治疗原则,通过协方差分析(ANCOVA),感恩干预组在三个月后的重复性消极思维水平明显低于对照组,在六个月的随访中,d = 0.66,95 % CI [0.37, 0.94]保持不变。在抑郁症状(d = 0.42)和广泛焦虑症状(d = 0.38)方面,观察到了显著而有意义的有益效果。结论结果表明,多成分感恩干预能有效减少重复性消极思维。多成分干预可能是充分发挥感恩干预潜力所需的下一步。这种干预可以扩大跨诊断干预的范围,尤其是针对重复性消极思维的干预。此外,由于其积极的内涵,感恩也是旨在减轻普通人群抑郁负担的间接干预措施的候选对象。试验注册该研究已在德国临床试验注册中心(世界卫生组织批准的一级注册中心)注册,注册号为 DRKS00006825。试验方案可在以下网址进行评估: https://www.drks.de/
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引用次数: 0
Sudden gains in internet cognitive therapy for social anxiety disorder in routine clinical practice 互联网认知疗法在常规临床实践中治疗社交焦虑症的突飞猛进
IF 3.6 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-11-12 DOI: 10.1016/j.invent.2024.100788
See Heng Yim , David M. Clark , Paul M. Salkovskis , Graham R. Thew

Background

Sudden gains are large symptom improvements between consecutive therapy sessions. They have been shown to occur in randomised controlled trials of internet-delivered psychological interventions, but little is known about their occurrence when such treatments are delivered in routine clinical practice.

Objective

This study examined the occurrence of sudden gains in a therapist-guided internet-delivered Cognitive Therapy intervention for social anxiety disorder (iCT-SAD) delivered in the UK NHS talking therapies for anxiety and depression (formerly known as IAPT services). It aimed to assess whether sudden gains were associated with better therapy outcomes, and examine changes in process variables around the period of sudden gains.

Methods

The study examined sudden gains based on the Liebowitz Social Anxiety Scale. Of 193 treated patients, 146 provided sufficient data to permit analysis. Linear mixed effects models were used to examine the impact of sudden gains on clinical outcomes, and examine changes in negative social cognitions, self-focused attention, and depressed mood.

Results

Seventy sudden gains were found among 57 participants. The occurrence rate of sudden gains was 39 %. Individuals who experienced sudden gains had a larger reduction in social anxiety symptoms at end of intervention and at three-month follow-up. There was evidence of a reduction in the frequency of negative social cognitions prior to the gain, whereas changes in self-focused attention occurred simultaneously with the gain. Depressed mood did not show significant changes over these timepoints.

Conclusions

Approximately 2 in 5 patients experienced a sudden gain whilst accessing the iCT-SAD intervention in routine practice. They were associated with better clinical outcomes following treatment compared to those who did not experience a sudden gain.
背景突发性改善是指在连续的治疗过程中症状得到明显改善。本研究考察了英国国家医疗服务系统(NHS)焦虑症和抑郁症谈话疗法(以前称为 IAPT 服务)中由治疗师指导的网络认知疗法干预社交焦虑症(iCT-SAD)中突发性增益的发生情况。研究旨在评估突发性增益是否与更好的治疗效果相关,并检查突发性增益期前后过程变量的变化。在 193 名接受治疗的患者中,有 146 人提供了足够的数据进行分析。研究采用线性混合效应模型来考察突发性增益对临床结果的影响,并考察消极社交认知、自我关注和抑郁情绪的变化。在 57 名参与者中发现了 70 例突发性增益,突发性增益的发生率为 39%。在干预结束时和三个月的随访中,经历过突发性增益的人的社交焦虑症状有较大程度的减轻。有证据表明,在获得收益之前,负面社交认知的频率有所降低,而在获得收益的同时,自我关注也发生了变化。结论大约每5名患者中就有2名在常规治疗中接受iCT-SAD干预时经历了突发性增益。与未出现突发性增益的患者相比,这些患者在治疗后会获得更好的临床疗效。
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引用次数: 0
Psychotherapy 2.0 - Application context and effectiveness of sensor technology in psychotherapy with children and adolescents: A systematic review 心理治疗 2.0 - 传感器技术在儿童和青少年心理治疗中的应用环境和效果:系统回顾
IF 3.6 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-11-06 DOI: 10.1016/j.invent.2024.100785
Annika K. Alt , Anja Pascher , Lennart Seizer , Marlene von Fraunberg , Annette Conzelmann , Tobias J. Renner

Background

E-mental health applications have been increasingly used in the psychotherapeutic care of patients for several years. State-of-the-art sensor technology could be used to determine digital biomarkers for the diagnosis of mental disorders. Furthermore, by integrating sensors into treatment, relevant contextual information (e.g. field of gaze, stress levels) could be made transparent and improve the treatment of people with mental disorders. An overview of studies on this approach would be useful to provide information about the current status quo.

Methods

A systematic review of the use of sensor technology in psychotherapy for children and adolescents was conducted with the aim of investigating the use and effectiveness of sensory technology in psychotherapy treatment. Five databases were searched for studies ranging from 2000 to 2023. The study was registered by PROSPERO (CRD42023374219), conducted according to Cochrane recommendations and used the PRISMA reporting guideline.

Results

Of the 38.560 hits in the search, only 10 publications met the inclusion criteria, including 3 RCTs and 7 pilot studies with a total of 257 subjects. The study population consisted of children and adolescents aged 6 to 19 years with mental disorders such as OCD, anxiety disorders, PTSD, anorexia nervosa and autistic behavior. The psychotherapy methods investigated were mostly cognitive behavioral therapy (face-to-face contact) with the treatment method of exposure for various disorders. In most cases, ECG, EDA, eye-tracking and movement sensors were used to measure vital parameters. The heterogeneous studies illustrate a variety of potential useful applications of sensor technology in psychotherapy for adolescents. In some studies, the sensors are implemented in a feasible approach to treatment.

Conclusion

Sensors might enrich psychotherapy in different application contexts.
However, so far there is still a lack of further randomized controlled clinical studies that provide reliable findings on the effectiveness of sensory therapy in psychotherapy for children and adolescents. This could stimulate the embedding of such technologies into psychotherapeutic process.
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023374219, identifier [CRD42023374219].
背景几年来,电子心理健康应用越来越多地用于病人的心理治疗。最先进的传感器技术可用于确定诊断精神障碍的数字生物标记。此外,通过将传感器整合到治疗中,相关的背景信息(如注视范围、压力水平)可以变得透明,从而改善对精神障碍患者的治疗。我们对传感器技术在儿童和青少年心理治疗中的应用进行了系统综述,旨在研究感知技术在心理治疗中的应用和效果。我们在五个数据库中搜索了 2000 年至 2023 年的研究。该研究已在 PROSPERO(CRD42023374219)注册,根据 Cochrane 建议进行,并采用了 PRISMA 报告指南。结果在 38.560 次检索中,只有 10 篇出版物符合纳入标准,其中包括 3 项 RCT 和 7 项试点研究,共有 257 名受试者。研究对象包括患有强迫症、焦虑症、创伤后应激障碍、神经性厌食症和自闭症等精神障碍的 6 至 19 岁儿童和青少年。所调查的心理治疗方法主要是认知行为疗法(面对面接触),以及针对各种障碍的暴露治疗方法。在大多数情况下,使用心电图、电子数据采集、眼动跟踪和运动传感器来测量生命参数。这些不同的研究说明了传感器技术在青少年心理治疗中的各种潜在有用应用。在一些研究中,传感器被应用于可行的治疗方法中。结论在不同的应用环境中,传感器可能会丰富心理治疗的内容。然而,迄今为止,仍然缺乏进一步的随机对照临床研究,以提供关于感官疗法在儿童和青少年心理治疗中的有效性的可靠结论。这可以促进将此类技术嵌入心理治疗过程。https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023374219,标识符[CRD42023374219]。
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引用次数: 0
Change processes in cognitive therapy for social anxiety disorder: A comparison of face-to-face and internet-based treatment formats 社交焦虑症认知疗法的改变过程:面对面治疗与网络治疗形式的比较
IF 3.6 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-11-02 DOI: 10.1016/j.invent.2024.100786
Graham R. Thew , Anke Ehlers , David M. Clark

Background

Compared to efficacy research, studies investigating the processes of change in psychological therapy are rare, especially for internet-based interventions. While many online therapies are based on face-to-face therapy protocols, it is unknown whether the processes of clinical improvement differ between these treatment formats.

Objective

To examine candidate change processes in an online therapist-guided cognitive therapy intervention for social anxiety disorder (iCT-SAD), and compare the results to the corresponding face-to-face therapy (CT-SAD).

Methods

Data from a randomised controlled trial (n = 99) were analysed using Multilevel Structural Equation Models, incorporating the temporal precedence of the process variable, and disaggregating the within- and between-subject components of the predictors. These examined three candidate change processes: self-focused attention, negative social cognitions, and depressed mood. Moderated mediation models provided an additional test of the moderating effect of treatment format.

Results

Negative social cognitions and self-focused attention were supported as significant mediators of clinical improvement in both CT-SAD and iCT-SAD. Effects were of similar strength and moderated mediation was not observed. There was also evidence of cyclical relationships between social anxiety symptoms and these process variables. Depressed mood also emerged as a significant but weak mediator in CT-SAD, but not in iCT-SAD. Moderated mediation was not observed.

Conclusion

The online format of therapy showed a similar pattern of change processes to face-to-face treatment, with self-focused attention and negative social cognitions mediating clinical improvement in both treatments. Efforts to improve the efficacy and efficiency of SAD interventions by targeting these factors may therefore be equally applicable to online and face-to-face interventions.
背景与疗效研究相比,调查心理治疗变化过程的研究很少见,尤其是基于互联网的干预。目的 研究社交焦虑症在线治疗师指导的认知疗法干预(iCT-SAD)的候选变化过程,并将结果与相应的面对面疗法(CT-SAD)进行比较。方法 使用多层次结构方程模型分析随机对照试验(n = 99)的数据,将过程变量的时间优先性纳入其中,并对预测因素的受试者内和受试者间成分进行分解。这些模型考察了三个候选变化过程:自我关注、消极社会认知和抑郁情绪。结果在 CT-SAD 和 iCT-SAD 中,负性社会认知和自我关注被认为是临床改善的重要中介因素。两者的效应强度相似,且未观察到调节中介效应。还有证据表明,社交焦虑症状与这些过程变量之间存在周期性关系。在 CT-SAD 中,抑郁情绪也是一个显著但微弱的中介因素,但在 iCT-SAD 中却不是。结论:在线治疗与面对面治疗显示出相似的变化过程模式,自我关注和消极社交认知对两种治疗方法的临床改善都有中介作用。因此,针对这些因素提高SAD干预疗效和效率的努力可能同样适用于在线和面对面干预。
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引用次数: 0
期刊
Internet Interventions-The Application of Information Technology in Mental and Behavioural Health
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