Pub Date : 2025-09-09DOI: 10.1016/j.invent.2025.100871
Arcadia K. Lee, Brandon Wong, Elizabeth J. Krumrei-Mancuso
Interpersonal religious/spiritual (R/S) conflicts are relatively common and have serious mental health implications. Recent theories suggest that intellectual humility might mitigate R/S conflict and ameliorate negative outcomes. This paper delineates the development and implementation of Grounded to Grow, an asynchronous online intervention designed to help individuals navigate R/S conflicts and to minimize associated psychological distress. This paper outlines the theoretical framework used to create the intervention, describes the intervention, and highlights the planned methods for examining the effectiveness of the intervention. Grounded to Grow is appropriate for religious, spiritual, non-religious, and non-spiritual individuals. This secular, yet spiritually-sensitive approach to addressing R/S conflicts offers inclusive and personalized support, with the potential to enhance well-being across psychological, social, and spiritual domains.
{"title":"The development of an online intellectual humility intervention for religious or spiritual conflict","authors":"Arcadia K. Lee, Brandon Wong, Elizabeth J. Krumrei-Mancuso","doi":"10.1016/j.invent.2025.100871","DOIUrl":"10.1016/j.invent.2025.100871","url":null,"abstract":"<div><div>Interpersonal religious/spiritual (R/S) conflicts are relatively common and have serious mental health implications. Recent theories suggest that intellectual humility might mitigate R/S conflict and ameliorate negative outcomes. This paper delineates the development and implementation of <em>Grounded to Grow</em>, an asynchronous online intervention designed to help individuals navigate R/S conflicts and to minimize associated psychological distress. This paper outlines the theoretical framework used to create the intervention, describes the intervention, and highlights the planned methods for examining the effectiveness of the intervention. <em>Grounded to Grow</em> is appropriate for religious, spiritual, non-religious, and non-spiritual individuals. This secular, yet spiritually-sensitive approach to addressing R/S conflicts offers inclusive and personalized support, with the potential to enhance well-being across psychological, social, and spiritual domains.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"42 ","pages":"Article 100871"},"PeriodicalIF":4.1,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-28DOI: 10.1016/j.invent.2025.100869
Gwendolyn Wälchli , Laura Luisa Bielinski , Oliver Thomas Bur , Tobias Krieger , Jan Philipp Klein , Thomas Berger
Background
Treatment expectations are known to influence therapy outcomes, but their role in internet-based interventions (IBIs) for depression remains unclear. While previous research has primarily focused on expectations as a pre-treatment predictor (PTP), emerging evidence suggests that early process predictors (EPPs), including evolving expectations during treatment, may provide more relevant insights into therapeutic outcomes.
Objective
This secondary analysis of a factorial trial (Bur et al., 2022) investigates the role of treatment expectations as both a pre-treatment predictor and early process predictor in an internet-based intervention for mild to moderate depression. It also explores the temporal relationship between expectations and depressive symptoms, assessing whether earlier expectations predict later symptom severity and whether depressive symptoms influence subsequent expectations.
Methods
Treatment expectancy was measured using the Credibility and Expectancy Questionnaire (CEQ-8; Devilly & Borkovec, 2000; German version: Walach et al. 2008) at baseline (T0), two weeks (T1), and four weeks (T2), while depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9; Kroenke et al., 2001) at the same time points as well as post-treatment (T3). To analyze the relationship between treatment expectations (CEQ-8) and depressive symptoms (PHQ-9 post-treatment), simple regression models were conducted while controlling for baseline PHQ-9 scores. Multiple regression analyses were then used to examine whether CEQ-8 predicted PHQ-9 or vice versa. In addition, as a sensitivity analysis, a cross-lagged panel model (CLPM) was estimated to account for the repeated-measures structure of the data.
Results
Baseline treatment expectations did not significantly predict depressive symptoms at post-treatment. However, expectations measured at two weeks (T1) and four weeks (T2) significantly predicted depressive symptoms at T3. The results of the multiple regression analyses indicate that treatment expectations can predict changes in depressive symptoms, whereas the reverse relationship was not observed. The CLPM yielded results that were consistent with the regression analyses, supporting the robustness of the findings.
Conclusions
Treatment expectations evolve throughout therapy and appear to function as an independent predictor of symptom improvement rather than merely reflecting symptom severity. Monitoring and addressing patient expectations early in treatment may enhance intervention outcomes. These findings support the inclusion of expectation-based strategies in IBIs to optimize engagement and effectiveness.
众所周知，治疗预期会影响治疗结果，但其在基于互联网的抑郁症干预（IBIs）中的作用尚不清楚。虽然以前的研究主要集中在期望作为治疗前预测因子（PTP），但新出现的证据表明，早期过程预测因子（EPPs），包括治疗过程中不断变化的期望，可能为治疗结果提供更相关的见解。目的：对一项析因试验（Bur et al., 2022）进行二次分析，探讨治疗预期在轻度至中度抑郁症基于互联网的干预中作为治疗前预测因子和早期过程预测因子的作用。它还探讨了期望与抑郁症状之间的时间关系，评估早期期望是否预测后来的症状严重程度，以及抑郁症状是否影响后来的期望。方法采用可信度和期望问卷（CEQ-8; Devilly &; Borkovec, 2000；德文版本：Walach et al. 2008）在基线（T0）、两周（T1）和四周（T2）测量治疗期望，同时在同一时间点和治疗后（T3）使用患者健康问卷-9 （PHQ-9; Kroenke et al., 2001）评估抑郁症状。为了分析治疗预期（CEQ-8）与治疗后抑郁症状（PHQ-9）之间的关系，在控制基线PHQ-9评分的情况下，采用简单回归模型。然后使用多元回归分析来检验CEQ-8是否预测PHQ-9，反之亦然。此外，作为敏感性分析，估计了一个交叉滞后面板模型（CLPM）来解释数据的重复测量结构。结果基线治疗预期对治疗后抑郁症状无显著预测作用。然而，在两周（T1）和四周（T2）测量的期望显著预测T3时的抑郁症状。多元回归分析结果表明，治疗预期可以预测抑郁症状的变化，而没有观察到相反的关系。CLPM得出的结果与回归分析一致，支持研究结果的稳健性。结论治疗预期在整个治疗过程中不断发展，似乎是症状改善的独立预测因子，而不仅仅是反映症状严重程度。在治疗早期监测和解决患者的期望可能会提高干预效果。这些发现支持将基于期望的策略纳入ibi以优化参与和有效性。
{"title":"Treatment expectations and depressive symptoms in an internet-based intervention for depression. A secondary analysis","authors":"Gwendolyn Wälchli , Laura Luisa Bielinski , Oliver Thomas Bur , Tobias Krieger , Jan Philipp Klein , Thomas Berger","doi":"10.1016/j.invent.2025.100869","DOIUrl":"10.1016/j.invent.2025.100869","url":null,"abstract":"<div><h3>Background</h3><div>Treatment expectations are known to influence therapy outcomes, but their role in internet-based interventions (IBIs) for depression remains unclear. While previous research has primarily focused on expectations as a <em>pre-treatment predictor</em> (PTP), emerging evidence suggests that <em>early process predictors</em> (EPPs), including evolving expectations during treatment, may provide more relevant insights into therapeutic outcomes.</div></div><div><h3>Objective</h3><div>This secondary analysis of a factorial trial (Bur et al., 2022) investigates the role of treatment expectations as both a <em>pre-treatment predictor</em> and <em>early process predictor</em> in an internet-based intervention for mild to moderate depression. It also explores the temporal relationship between expectations and depressive symptoms, assessing whether earlier expectations predict later symptom severity and whether depressive symptoms influence subsequent expectations.</div></div><div><h3>Methods</h3><div>Treatment expectancy was measured using the Credibility and Expectancy Questionnaire (CEQ-8; Devilly & Borkovec, 2000; German version: Walach et al. 2008) at baseline (T0), two weeks (T1), and four weeks (T2), while depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9; Kroenke et al., 2001) at the same time points as well as post-treatment (T3). To analyze the relationship between treatment expectations (CEQ-8) and depressive symptoms (PHQ-9 post-treatment), simple regression models were conducted while controlling for baseline PHQ-9 scores. Multiple regression analyses were then used to examine whether CEQ-8 predicted PHQ-9 or vice versa. In addition, as a sensitivity analysis, a cross-lagged panel model (CLPM) was estimated to account for the repeated-measures structure of the data.</div></div><div><h3>Results</h3><div>Baseline treatment expectations did not significantly predict depressive symptoms at post-treatment. However, expectations measured at two weeks (T1) and four weeks (T2) significantly predicted depressive symptoms at T3. The results of the multiple regression analyses indicate that treatment expectations can predict changes in depressive symptoms, whereas the reverse relationship was not observed. The CLPM yielded results that were consistent with the regression analyses, supporting the robustness of the findings.</div></div><div><h3>Conclusions</h3><div>Treatment expectations evolve throughout therapy and appear to function as an independent predictor of symptom improvement rather than merely reflecting symptom severity. Monitoring and addressing patient expectations early in treatment may enhance intervention outcomes. These findings support the inclusion of expectation-based strategies in IBIs to optimize engagement and effectiveness.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"42 ","pages":"Article 100869"},"PeriodicalIF":4.1,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144922573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-12DOI: 10.1016/j.invent.2025.100868
Laurianne Bastien , Sohyun Cho , Julia Petrovic , Bassam Khoury , Elana Bloom , Nancy Heath
University students are reporting high levels of stress that interfere with their academic performance and daily functioning. In response, higher education institutions have increasingly implemented digital, self-guided stress management resources to provide students with accessible mental health support. While these interventions show promise for improving student wellness, there is a significant gap in our understanding of how students use the strategies taught as part of these resources. This systematic review therefore examined if and how adherence (i.e., strategy use) has been measured in the context of digital self-guided stress management interventions, as well as its associations with stress and other wellness outcomes. Of the 40 studies that met eligibility criteria for the present review, 33 measured adherence (82.5 %). Specifically, nine studies measured frequency (27.2 %), eight measured completion rates (24.2 %), two measured duration (6.1 %), 12 used a combination of these approaches (36.4 %), and two (6.1 %) did not specify which approach was used. Surprisingly, although the majority of studies collected data on adherence, the associations between adherence and stress or other wellness outcomes were scarcely examined. Across studies, adherence was measured using digital analytics and/or self-report; however, barriers were identified in using these methods, including technological issues and challenges in measurement accuracy. Quality assessments revealed a moderate risk of bias. Future research should explore different approaches to enhance adherence measurement accuracy and further examine the link between adherence and wellness outcomes to determine the optimal dose of strategy use for enhancing wellness among university students.
{"title":"How do we know that they actually use it? Exploring measures of adherence to stress management strategies in university students: A systematic review","authors":"Laurianne Bastien , Sohyun Cho , Julia Petrovic , Bassam Khoury , Elana Bloom , Nancy Heath","doi":"10.1016/j.invent.2025.100868","DOIUrl":"10.1016/j.invent.2025.100868","url":null,"abstract":"<div><div>University students are reporting high levels of stress that interfere with their academic performance and daily functioning. In response, higher education institutions have increasingly implemented digital, self-guided stress management resources to provide students with accessible mental health support. While these interventions show promise for improving student wellness, there is a significant gap in our understanding of how students use the strategies taught as part of these resources. This systematic review therefore examined if and how adherence (i.e., strategy use) has been measured in the context of digital self-guided stress management interventions, as well as its associations with stress and other wellness outcomes. Of the 40 studies that met eligibility criteria for the present review, 33 measured adherence (82.5 %). Specifically, nine studies measured frequency (27.2 %), eight measured completion rates (24.2 %), two measured duration (6.1 %), 12 used a combination of these approaches (36.4 %), and two (6.1 %) did not specify which approach was used. Surprisingly, although the majority of studies collected data on adherence, the associations between adherence and stress or other wellness outcomes were scarcely examined. Across studies, adherence was measured using digital analytics and/or self-report; however, barriers were identified in using these methods, including technological issues and challenges in measurement accuracy. Quality assessments revealed a moderate risk of bias. Future research should explore different approaches to enhance adherence measurement accuracy and further examine the link between adherence and wellness outcomes to determine the optimal dose of strategy use for enhancing wellness among university students.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"41 ","pages":"Article 100868"},"PeriodicalIF":4.1,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144858470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-10DOI: 10.1016/j.invent.2025.100866
Madelyne A. Bisby , Noni Jervis , Alana Fisher , Amelia J. Scott , Nickolai Titov , Blake F. Dear
Psychological treatments for perinatal depression and anxiety are effective when delivered in-person or remotely. However, new and expectant mothers face considerable barriers to receiving mental health care, especially on an ongoing basis or when delivered in-person. Very brief digital treatments may be able to support women during this time using less time than existing treatments. The current study reports the development and initial evaluation of a therapist-guided digital ultra-brief treatment for perinatal depression or anxiety. The treatment included one online lesson, supporting resources (e.g., practice exercises), and an optional consultation (telephone or secure messaging) with a clinical psychologist. We examined acceptability, satisfaction, and preliminary efficacy in a single-group trial of women with perinatal depression or anxiety symptoms (N = 47). This was accompanied by focus groups of women with lived experience (N = 9) and semi-structured feedback interviews with treatment participants (N = 7). The treatment was feasible to deliver and associated with high completion (90 %) and satisfaction (85 %) rates. Most participants (61 %) completed the treatment without therapist guidance. At 5-weeks post-baseline, participants reported significant reductions in depression (d = 0.79) and anxiety (d = 0.44), noting that the sample reported mild baseline symptom severity. Several areas of improvement to treatment content, delivery, and look and feel were identified. The study supports ultra-brief digital treatments as an acceptable and potentially efficacious way to support women with perinatal depression or anxiety symptoms.
{"title":"Development and initial evaluation of an ultra-brief digital treatment for perinatal depression and anxiety symptoms","authors":"Madelyne A. Bisby , Noni Jervis , Alana Fisher , Amelia J. Scott , Nickolai Titov , Blake F. Dear","doi":"10.1016/j.invent.2025.100866","DOIUrl":"10.1016/j.invent.2025.100866","url":null,"abstract":"<div><div>Psychological treatments for perinatal depression and anxiety are effective when delivered in-person or remotely. However, new and expectant mothers face considerable barriers to receiving mental health care, especially on an ongoing basis or when delivered in-person. Very brief digital treatments may be able to support women during this time using less time than existing treatments. The current study reports the development and initial evaluation of a therapist-guided digital ultra-brief treatment for perinatal depression or anxiety. The treatment included one online lesson, supporting resources (e.g., practice exercises), and an optional consultation (telephone or secure messaging) with a clinical psychologist. We examined acceptability, satisfaction, and preliminary efficacy in a single-group trial of women with perinatal depression or anxiety symptoms (<em>N</em> = 47). This was accompanied by focus groups of women with lived experience (<em>N</em> = 9) and semi-structured feedback interviews with treatment participants (<em>N</em> = 7). The treatment was feasible to deliver and associated with high completion (90 %) and satisfaction (85 %) rates. Most participants (61 %) completed the treatment without therapist guidance. At 5-weeks post-baseline, participants reported significant reductions in depression (<em>d</em> = 0.79) and anxiety (<em>d</em> = 0.44), noting that the sample reported mild baseline symptom severity. Several areas of improvement to treatment content, delivery, and look and feel were identified. The study supports ultra-brief digital treatments as an acceptable and potentially efficacious way to support women with perinatal depression or anxiety symptoms.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"42 ","pages":"Article 100866"},"PeriodicalIF":4.1,"publicationDate":"2025-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144908154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-09eCollection Date: 2025-09-01DOI: 10.1016/j.invent.2025.100865
Lauren G Staples, Blake F Dear, Olav Nielssen, Nickolai Titov
Background: People who are socioeconomically disadvantaged have higher rates of mental disorder and are more likely to face barriers to evidence-based psychological services. Barriers include the cost of treatment, limited availability of local services, and the burden of psychosocial difficulties. Psychological treatment delivered via the internet can overcome some of these barriers.
Methods: This study was a retrospective analysis of data collected from 21,561 patients accessing online psychological assessment and treatment. Residential postcodes were used to assign patients to a socioeconomic group (low, mid, or high SES), based on the Index of Economic Resources published by the Australian Bureau of Statistics.
Results: The low SES group comprised 34.1 % of the sample and the mid SES group comprised 35.7 %. A perceived lack of local or affordable mental health services was the main reason given for accessing online mental health assessment and treatment. There were small but significant demographic differences between groups at assessment, and baseline symptoms of depression and anxiety were slightly higher for the low and mid SES groups. Despite these differences, there were no group differences in treatment outcomes. All groups showed large symptom reductions on measures of depression (PHQ-9) and anxiety (GAD-7), with Cohen's d effect sizes between 1.36 and 1.47. Reliable deterioration rates were low, and satisfaction rates were high.
Conclusion: This study shows that people residing in low socioeconomic areas engage with and benefit from digital mental health services. Results suggest that scalable digital psychological services can improve the equity of access to mental health care.
{"title":"Do people residing in low socioeconomic areas engage with and benefit from digital mental health services?","authors":"Lauren G Staples, Blake F Dear, Olav Nielssen, Nickolai Titov","doi":"10.1016/j.invent.2025.100865","DOIUrl":"10.1016/j.invent.2025.100865","url":null,"abstract":"<p><strong>Background: </strong>People who are socioeconomically disadvantaged have higher rates of mental disorder and are more likely to face barriers to evidence-based psychological services. Barriers include the cost of treatment, limited availability of local services, and the burden of psychosocial difficulties. Psychological treatment delivered via the internet can overcome some of these barriers.</p><p><strong>Methods: </strong>This study was a retrospective analysis of data collected from 21,561 patients accessing online psychological assessment and treatment. Residential postcodes were used to assign patients to a socioeconomic group (low, mid, or high SES), based on the Index of Economic Resources published by the Australian Bureau of Statistics.</p><p><strong>Results: </strong>The low SES group comprised 34.1 % of the sample and the mid SES group comprised 35.7 %. A perceived lack of local or affordable mental health services was the main reason given for accessing online mental health assessment and treatment. There were small but significant demographic differences between groups at assessment, and baseline symptoms of depression and anxiety were slightly higher for the low and mid SES groups. Despite these differences, there were no group differences in treatment outcomes. All groups showed large symptom reductions on measures of depression (PHQ-9) and anxiety (GAD-7), with Cohen's d effect sizes between 1.36 and 1.47. Reliable deterioration rates were low, and satisfaction rates were high.</p><p><strong>Conclusion: </strong>This study shows that people residing in low socioeconomic areas engage with and benefit from digital mental health services. Results suggest that scalable digital psychological services can improve the equity of access to mental health care.</p>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"41 ","pages":"100865"},"PeriodicalIF":4.1,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12357260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144876031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-08DOI: 10.1016/j.invent.2025.100867
Anna Baumeister , Lea Schuurmans , Steffen Moritz
Background and aim
Anxiety disorders are the most common psychiatric condition, yet few patients receive adequate treatment, primarily due to high barriers to treatment (e.g., long waiting times, fear of stigmatization). Internet-based cognitive behavioral therapy (iCBT) programs have emerged as a promising approach to addressing this treatment gap, demonstrating effectiveness across various anxiety disorders. However, only a few studies have specifically addressed unguided iCBT. This trial investigated a six-week transdiagnostic unguided iCBT intervention designed to reduce anxiety and related symptoms.
Methods
Randomized to an intervention group and a waitlist control group with care as usual, 318 participants were included in the analyses, which used ANCOVAs to assess changes in symptom severity of anxiety (primary) and related secondary outcomes (stress, depression and anxiety, quality of life, self-esteem).
Results
Significant post-intervention reductions in anxiety, stress, and depression were found in the intervention group compared to controls at small to medium effect sizes (|Hedges's g| = 0.27–0.35). Concurrent ongoing psychotherapy negatively modified the treatment effect.
Conclusion
The iCBT program proved effective overall in reducing anxiety and anxiety-related symptoms compared to care as usual. However, the program did not appear to have an add-on effect for individuals who were simultaneously receiving conventional psychotherapy. Further research is needed to investigate the effects in this subgroup in more detail.
{"title":"Anxiety unplugged: Effectiveness of an unguided, transdiagnostic, web-based intervention for anxiety disorders—A randomized controlled trial","authors":"Anna Baumeister , Lea Schuurmans , Steffen Moritz","doi":"10.1016/j.invent.2025.100867","DOIUrl":"10.1016/j.invent.2025.100867","url":null,"abstract":"<div><h3>Background and aim</h3><div>Anxiety disorders are the most common psychiatric condition, yet few patients receive adequate treatment, primarily due to high barriers to treatment (e.g., long waiting times, fear of stigmatization). Internet-based cognitive behavioral therapy (iCBT) programs have emerged as a promising approach to addressing this treatment gap, demonstrating effectiveness across various anxiety disorders. However, only a few studies have specifically addressed unguided iCBT. This trial investigated a six-week transdiagnostic unguided iCBT intervention designed to reduce anxiety and related symptoms.</div></div><div><h3>Methods</h3><div>Randomized to an intervention group and a waitlist control group with care as usual, 318 participants were included in the analyses, which used ANCOVAs to assess changes in symptom severity of anxiety (primary) and related secondary outcomes (stress, depression and anxiety, quality of life, self-esteem).</div></div><div><h3>Results</h3><div>Significant post-intervention reductions in anxiety, stress, and depression were found in the intervention group compared to controls at small to medium effect sizes (|Hedges's <em>g</em>| = 0.27–0.35). Concurrent ongoing psychotherapy negatively modified the treatment effect.</div></div><div><h3>Conclusion</h3><div>The iCBT program proved effective overall in reducing anxiety and anxiety-related symptoms compared to care as usual. However, the program did not appear to have an add-on effect for individuals who were simultaneously receiving conventional psychotherapy. Further research is needed to investigate the effects in this subgroup in more detail.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"41 ","pages":"Article 100867"},"PeriodicalIF":4.1,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144830580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Perinatal depression is a predominant and serious condition that adversely affects prenatal and postpartum women and their children. Prenatal depression is a notable predictor of postpartum depression, highlighting the need for mental health care during pregnancy. Therefore, we developed an innovative smartphone application based on interpersonal psychotherapy (IPT) to improve depressive symptoms in women in the perinatal period (i.e., from pregnancy through the first year postpartum). Here, we present a randomized controlled trial (RCT) protocol to investigate the potential of this intervention for prenatal women.
Methods
This study is an 8-week, open-label, parallel-group, stratified block RCT. In total, 350 primiparous women were randomly assigned to the intervention group—combining the smartphone application for mental health care based on IPT and care as usual—and the control group, with only care as usual. The women assigned to the intervention were encouraged to use the application for approximately 5–10 min daily. The primary outcomes included the proportion of participants with moderate-to-high satisfaction (scoring ≥17 on the 8-item Client Satisfaction Questionnaire) and changes in depressive symptoms measured by the Patient Health Questionnaire-9 from baseline to the end of the 8-week intervention.
Discussion
To our knowledge, this RCT is the first to investigate the acceptability and efficacy of an IPT-based smartphone application for reducing depressive symptoms in prenatal women. If successful, the findings will contribute to the growing evidence supporting digital mental health interventions during pregnancy, offering a scalable and accessible solution for prenatal mental health care.
{"title":"Acceptability and efficacy of a smartphone application intervention for mental health care based on interpersonal psychotherapy for improving depression symptoms in prenatal women: Protocol for a randomized controlled trial","authors":"Yuko Toshishige , Natsumi Chatani , Shiori Kawasaki , Shinobu Goto , Yuki Yoshida , Yusaku Takahashi , Misaki Shimasaki , Takuya Okami , Gaku Sakaguchi , Toshiaki A. Furukawa , Hiroko Mizushima , Tatsuo Akechi","doi":"10.1016/j.invent.2025.100838","DOIUrl":"10.1016/j.invent.2025.100838","url":null,"abstract":"<div><h3>Background</h3><div>Perinatal depression is a predominant and serious condition that adversely affects prenatal and postpartum women and their children. Prenatal depression is a notable predictor of postpartum depression, highlighting the need for mental health care during pregnancy. Therefore, we developed an innovative smartphone application based on interpersonal psychotherapy (IPT) to improve depressive symptoms in women in the perinatal period (i.e., from pregnancy through the first year postpartum). Here, we present a randomized controlled trial (RCT) protocol to investigate the potential of this intervention for prenatal women.</div></div><div><h3>Methods</h3><div>This study is an 8-week, open-label, parallel-group, stratified block RCT. In total, 350 primiparous women were randomly assigned to the intervention group—combining the smartphone application for mental health care based on IPT and care as usual—and the control group, with only care as usual. The women assigned to the intervention were encouraged to use the application for approximately 5–10 min daily. The primary outcomes included the proportion of participants with moderate-to-high satisfaction (scoring ≥17 on the 8-item Client Satisfaction Questionnaire) and changes in depressive symptoms measured by the Patient Health Questionnaire-9 from baseline to the end of the 8-week intervention.</div></div><div><h3>Discussion</h3><div>To our knowledge, this RCT is the first to investigate the acceptability and efficacy of an IPT-based smartphone application for reducing depressive symptoms in prenatal women. If successful, the findings will contribute to the growing evidence supporting digital mental health interventions during pregnancy, offering a scalable and accessible solution for prenatal mental health care.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"41 ","pages":"Article 100838"},"PeriodicalIF":4.1,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144892900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-21DOI: 10.1016/j.invent.2025.100863
Youngjung Suh , Jinwon Yoo
Problematic Internet Usage (PIU) research has long been a topic of interest across disciplines, and numerous theoretical and empirical studies have been conducted over the past decade. This study systematically reviews the existing literature to identify key research objectives, datasets, methodologies, and applications, and to highlight important gaps and challenges. To improve understanding and detection of PIU, we designed a comprehensive machine learning pipeline that combines detailed preprocessing, feature extraction, modeling, and performance validation strategies. Systematic evaluations demonstrate that model performance is significantly improved by addressing missing values and data imbalance. In particular, we identified key predictive features such as physiological indicators, physical activity, sleep quality, and Internet usage patterns, and clearly elucidated the differences in the positive or negative impact of these key features on PIU detection at different severity levels. These results have practical implications, especially for promoting early detection and enabling tailored interventions. Ultimately, this study contributes to digital health initiatives by providing actionable insights for the development of effective Internet addiction prevention and intervention programs.
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Pub Date : 2025-07-19DOI: 10.1016/j.invent.2025.100864
Robert Ahm , Nina Rottmann , Søren Jensen Skovbakke , Charlotte Helmark , Christina Antoinetta Vasilescu , Susanne S. Pedersen
Introduction
Ischemic heart disease (IHD) is a leading cause of mortality that is very often accompanied by comorbid anxiety and depression. The aim of this study was to develop MY-CHOICE, a guided internet-based psychological intervention for the treatment of anxiety and depression in IHD patients using patient and public involvement (PPI).
Method
We used the framework recommended by the Medical Research Counsel for developing and evaluating complex interventions to develop MY-CHOICE. Patient representatives with IHD and comorbid anxiety and/or depression (n = 5) were recruited from Odense University Hospital and invited to a series of workshops to gather their feedback on the MY-CHOICE prototype. The workshops used the MUST method for the planning, facilitation, data generation and analysis. The MoSCoW principles were used to help the patient representatives in prioritizing among their suggestions. Data were collected by means of audio recordings and observational notes.
Results
This study revealed the need for new treatment modules, including how to manage chronic pain and how to navigate the healthcare system. The patient representatives emphasized the importance of shared decision-making in customizing treatment to individual preferences and needs.
Discussion
MY-CHOICE represents a patient focused approach to improving mental health in patients with IHD. By integrating patient feedback through PPI, MY-CHOICE aims to deliver tailored psychological treatment, possibly increasing relevance and adherence.
Conclusion
This study highlights the necessity of addressing comprehensive needs in IHD patients, including chronic pain, and emphasizes the importance of using shared decision-making to optimize patient engagement and adherence to treatment.
{"title":"Development of a guided internet-based psychological intervention for patients with ischemic heart disease and comorbid anxiety and/or depression: A patient and public involvement study","authors":"Robert Ahm , Nina Rottmann , Søren Jensen Skovbakke , Charlotte Helmark , Christina Antoinetta Vasilescu , Susanne S. Pedersen","doi":"10.1016/j.invent.2025.100864","DOIUrl":"10.1016/j.invent.2025.100864","url":null,"abstract":"<div><h3>Introduction</h3><div>Ischemic heart disease (IHD) is a leading cause of mortality that is very often accompanied by comorbid anxiety and depression. The aim of this study was to develop MY-CHOICE, a guided internet-based psychological intervention for the treatment of anxiety and depression in IHD patients using patient and public involvement (PPI).</div></div><div><h3>Method</h3><div>We used the framework recommended by the Medical Research Counsel for developing and evaluating complex interventions to develop MY-CHOICE. Patient representatives with IHD and comorbid anxiety and/or depression (<em>n</em> = 5) were recruited from Odense University Hospital and invited to a series of workshops to gather their feedback on the MY-CHOICE prototype. The workshops used the MUST method for the planning, facilitation, data generation and analysis. The MoSCoW principles were used to help the patient representatives in prioritizing among their suggestions. Data were collected by means of audio recordings and observational notes.</div></div><div><h3>Results</h3><div>This study revealed the need for new treatment modules, including how to manage chronic pain and how to navigate the healthcare system. The patient representatives emphasized the importance of shared decision-making in customizing treatment to individual preferences and needs.</div></div><div><h3>Discussion</h3><div>MY-CHOICE represents a patient focused approach to improving mental health in patients with IHD. By integrating patient feedback through PPI, MY-CHOICE aims to deliver tailored psychological treatment, possibly increasing relevance and adherence.</div></div><div><h3>Conclusion</h3><div>This study highlights the necessity of addressing comprehensive needs in IHD patients, including chronic pain, and emphasizes the importance of using shared decision-making to optimize patient engagement and adherence to treatment.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"41 ","pages":"Article 100864"},"PeriodicalIF":3.6,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144679625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-11DOI: 10.1016/j.invent.2025.100860
Mathias Harrer , Clara Miguel , Lingyao Tong , Paula Kuper , Antonia A. Sprenger , Yuki Furukawa , Yingying Wang , Wouter van Ballegooijen , Marketa Ciharova , Olga M. Panagiotopoulou , Ioana Cristea , Jessica L. Hamblen , Paula P. Schnurr , Heleen Riper , Marit Sijbrandij , Eirini Karyotaki , Annemieke van Straten , Toshi A. Furukawa , Davide Papola , Stefan Leucht , Pim Cuijpers
Objectives
In this unified series of meta-analyses, we integrate the effects of digital interventions in adults with mental disorders compared to inactive controls. We cover eight indications: depressive disorder, insomnia, specific phobias, generalized anxiety, panic, social anxiety, obsessive-compulsive, and posttraumatic stress disorder.
Methods
Digital intervention trials in patients with a diagnosed mental disorder (confirmed by clinical interviews) were extracted from the Metapsy living databases for psychological treatments. Standardized meta-analyses were conducted to pool effects for each disorder, as well as separately for guided and unguided treatments. We also examined study dropout rates, conducted meta-regression analyses stratified by disorder, and identified treatments that have since become available as prescribable digital therapeutics in routine care.
Results
In total, 168 studies (22,144 patients) were included. Moderate effect sizes were observed for PTSD (g = 0.57), depression (g = 0.62), and obsessive-compulsive disorder (g = 0.68). Large effects emerged for generalized anxiety (g = 0.80), social anxiety (g = 0.84), insomnia (g = 0.94), panic disorder (g = 1.05), and specific phobias (g = 1.18). Pooled study dropout rates were generally moderate (≤20 %), but higher in intervention arms (RR = 1.13–2.66). Trials with low risk of bias and care-as-usual comparisons were limited across indications. We found 16 trials evaluating a prescribable digital therapeutic (g = 0.33–1.60).
Conclusions
Digital interventions can be effective across a wide range of diagnosed mental disorders. For some indications, more high-quality trials and comparisons against care-as-usual are needed to confirm the robustness of the effect, particularly for unguided treatments. Digital interventions are increasingly commercialized as prescribable digital therapeutics. Rising industry involvement may present both opportunities and new challenges for the field.
{"title":"Effectiveness of digital interventions for eight mental disorders: A meta-analytic synthesis","authors":"Mathias Harrer , Clara Miguel , Lingyao Tong , Paula Kuper , Antonia A. Sprenger , Yuki Furukawa , Yingying Wang , Wouter van Ballegooijen , Marketa Ciharova , Olga M. Panagiotopoulou , Ioana Cristea , Jessica L. Hamblen , Paula P. Schnurr , Heleen Riper , Marit Sijbrandij , Eirini Karyotaki , Annemieke van Straten , Toshi A. Furukawa , Davide Papola , Stefan Leucht , Pim Cuijpers","doi":"10.1016/j.invent.2025.100860","DOIUrl":"10.1016/j.invent.2025.100860","url":null,"abstract":"<div><h3>Objectives</h3><div>In this unified series of meta-analyses, we integrate the effects of digital interventions in adults with mental disorders compared to inactive controls. We cover eight indications: depressive disorder, insomnia, specific phobias, generalized anxiety, panic, social anxiety, obsessive-compulsive, and posttraumatic stress disorder.</div></div><div><h3>Methods</h3><div>Digital intervention trials in patients with a diagnosed mental disorder (confirmed by clinical interviews) were extracted from the Metapsy living databases for psychological treatments. Standardized meta-analyses were conducted to pool effects for each disorder, as well as separately for guided and unguided treatments. We also examined study dropout rates, conducted meta-regression analyses stratified by disorder, and identified treatments that have since become available as prescribable digital therapeutics in routine care.</div></div><div><h3>Results</h3><div>In total, 168 studies (22,144 patients) were included. Moderate effect sizes were observed for PTSD (<em>g</em> = 0.57), depression (<em>g</em> = 0.62), and obsessive-compulsive disorder (<em>g</em> = 0.68). Large effects emerged for generalized anxiety (<em>g</em> = 0.80), social anxiety (<em>g</em> = 0.84), insomnia (<em>g</em> = 0.94), panic disorder (<em>g</em> = 1.05), and specific phobias (<em>g</em> = 1.18). Pooled study dropout rates were generally moderate (≤20 %), but higher in intervention arms (<em>RR</em> = 1.13–2.66). Trials with low risk of bias and care-as-usual comparisons were limited across indications. We found 16 trials evaluating a prescribable digital therapeutic (<em>g</em> = 0.33–1.60).</div></div><div><h3>Conclusions</h3><div>Digital interventions can be effective across a wide range of diagnosed mental disorders. For some indications, more high-quality trials and comparisons against care-as-usual are needed to confirm the robustness of the effect, particularly for unguided treatments. Digital interventions are increasingly commercialized as prescribable digital therapeutics. Rising industry involvement may present both opportunities and new challenges for the field.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"41 ","pages":"Article 100860"},"PeriodicalIF":3.6,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144655703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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