Internet Interventions-The Application of Information Technology in Mental and Behavioural Health最新文献_第7页

ISRII 2025: Advancing equity in digital interventions across the lifespan - an introduction to this year's conference in San Diego, CA — August 4–7, 2025 ISRII 2025：在整个生命周期中推进数字干预的公平性——介绍今年在加州圣地亚哥举行的会议（2025年8月4日至7日）

IF 4.1 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Internet Interventions-The Application of Information Technology in Mental and Behavioural Health

Pub Date : 2025-05-23 DOI: 10.1016/j.invent.2025.100836

Anna-Carlotta Zarski

引用次数: 0

Symptom heterogeneity in students with mild to severe depression symptomatology and their differential symptom-specific changes during an internet-based, guided cognitive behavioural therapy intervention 在基于互联网的认知行为治疗干预中，轻至重度抑郁症学生症状的异质性及其差异症状特异性变化

IF 3.6 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Internet Interventions-The Application of Information Technology in Mental and Behavioural Health

Pub Date : 2025-05-16 DOI: 10.1016/j.invent.2025.100834

Lynn Boschloo , Jasmijn Wijnands , Nadia Garnefski , Vivian Kraaij , Petra Hurks , Danielle Remmerswaal , Reinout W. Wiers , Sascha Struijs , Elske Salemink

Background

Students often report depression and stress symptomatology but may differ in their symptoms and their symptom-specific changes during interventions. This study adopted a symptom-specific approach and examined 1) individual symptoms in students experiencing mild to severe depression symptomatology and 2) changes in individual symptoms during a guided, internet-based intervention. We zoomed in on how these (changes in) symptoms were related to each other and to (changes in) overall quality of life.

Methods

This study included 1816 students with mild to severe baseline depression symptomatology, of which 412 activated their account for an eight-week, guided, internet-based Cognitive Behavioural Therapy intervention (Moodpep) and completed the post-treatment assessment. Depression symptomatology was assessed with the Patient Health Questionnaire, stress symptomatology with the Perceived Stress Scale and overall quality of life with a single item from the Mental Health Quality of Life questionnaire. Network estimations were conducted to examine the interrelations of (changes in) symptoms.

Results

Mean scores of baseline symptoms differed substantially, and network estimations showed multiple positive connections across symptoms and negative connections of symptoms with overall quality of life. During the intervention, all symptoms reduced significantly, although with differential magnitude, and network estimations showed that changes in symptoms were differentially related to other changes in symptoms and changes in overall quality of life.

Conclusions

Our findings highlight the importance of considering individual symptoms and their interrelations as a more complete and nuanced measure for 1) the heterogeneity of baseline symptomatology and 2) the heterogeneity of changes in symptomatology during an intervention.

背景：学生经常报告抑郁和压力症状，但在干预期间，他们的症状和症状特异性变化可能有所不同。本研究采用了一种症状特异性方法，并检查了1)经历轻度至重度抑郁症状的学生的个体症状，以及2)在指导的、基于互联网的干预过程中个体症状的变化。我们放大了这些症状（变化）是如何相互关联的，以及如何与整体生活质量（变化）相关的。方法本研究纳入了1816名有轻度至重度基线抑郁症状的学生，其中412人激活了他们的账户，进行了为期8周的基于网络的认知行为治疗干预（Moodpep），并完成了治疗后评估。抑郁症状用患者健康问卷进行评估，压力症状用感知压力量表进行评估，整体生活质量用心理健康生活质量问卷中的单项进行评估。进行网络估计以检查症状（变化）的相互关系。结果基线症状的平均得分存在显著差异，网络估计显示症状与整体生活质量之间存在多重正相关和负相关。在干预期间，所有症状都显著减轻，尽管程度不同，网络估计显示症状的变化与其他症状的变化和整体生活质量的变化存在差异。结论：我们的研究结果强调了考虑个体症状及其相互关系的重要性，作为1)基线症状的异质性和2)干预期间症状变化的异质性的更完整和细致的衡量标准。

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引用次数: 0

Predicting the strength of next-day negative emotion states in body dysmorphic disorder using passive smartphone data: An intensive longitudinal assessment study 使用被动智能手机数据预测身体畸形障碍患者第二天消极情绪状态的强度：一项密集的纵向评估研究

IF 3.6 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Internet Interventions-The Application of Information Technology in Mental and Behavioural Health

Pub Date : 2025-05-15 DOI: 10.1016/j.invent.2025.100833

Hilary Weingarden , Xiang Meng , Michael Armey , Jukka-Pekka Onnela , Adam Jaroszewski , Caroline H. Armstrong , Sabine Wilhelm

Body dysmorphic disorder (BDD) is a debilitating and common psychiatric illness associated with high rates of suicide and substance use disorders. Negative emotions – particularly shame and anxiety – are elevated in BDD and correlate with suicide risk and substance use. It is critical to have reliable and valid tools to assess negative emotions in BDD. Retrospective self-reports are subject to recall biases, average one's experiences over broad time frames, and are burdensome to complete. Alternatively, sensor-based digital phenotyping has potential to yield low-burden emotion assessment within acute time frames. This study aimed to use smartphone sensor data (GPS, accelerometer, collected over 3 months) to predict next-day peak shame, anxiety, and general negative emotion states (collected via 28 days of ecological momentary assessment) in 83 adults with BDD. We tested cumulative link mixed models [CLMM]) and random forest [RF] models. RFs outperformed CLMMs across prediction performance metrics and had overall prediction accuracies (i.e., proportion of predicted scores that exactly matched actual scores, out of total predictions) of 42.1–50.0 %, versus 10.9–20.2 % for CLMMs. Binary predictive performance at high levels of negative emotion was moderate. Developing unobtrusive methods for predicting shame, anxiety, and general negative emotion states over acute time frames using smartphone sensor data can enable just-in-time intervention opportunities, as a future step to reduce risk for suicide and substance use in BDD. Models might be strengthened with larger samples, data collected over longer time frames, and incorporation of wearable-based physiological data.

Trial Registration: ClinicalTrials.gov Identifier: NCT04254575.

身体畸形障碍（BDD）是一种衰弱和常见的精神疾病，与高自杀率和物质使用障碍有关。负面情绪——尤其是羞耻感和焦虑——在BDD中会升高，并与自杀风险和药物使用有关。拥有可靠和有效的工具来评估BDD中的负面情绪是至关重要的。回顾性自我报告会受到回忆偏差的影响，在较长的时间框架内平均一个人的经历，而且完成起来很麻烦。另外，基于传感器的数字表型有可能在急性时间框架内产生低负担的情绪评估。本研究旨在使用智能手机传感器数据（GPS、加速度计，收集超过3个月）来预测83名BDD成人第二天的羞耻感、焦虑和一般负面情绪状态（通过28天的生态瞬时评估收集）。我们测试了累积链接混合模型（CLMM）和随机森林模型（RF）。RFs在预测性能指标上优于clmm，并且具有42.1 - 50.0%的总体预测准确性（即，预测分数与实际分数完全匹配的比例，在总预测中），而clmm为10.9 - 20.2%。高水平负性情绪的二元预测表现是中等的。开发一种不引人注意的方法，利用智能手机传感器数据在急性时间框架内预测羞耻、焦虑和一般负面情绪状态，可以提供及时干预的机会，作为降低BDD患者自杀和药物使用风险的未来一步。通过更大的样本、更长的时间框架内收集的数据，以及结合基于可穿戴设备的生理数据，模型可能会得到加强。试验注册：ClinicalTrials.gov标识符：NCT04254575。

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引用次数: 0

Digital interventions for supporting alcohol abstinence in aftercare – a systematic review 支持戒酒后护理的数字干预——系统综述

IF 3.6 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Internet Interventions-The Application of Information Technology in Mental and Behavioural Health

Pub Date : 2025-05-15 DOI: 10.1016/j.invent.2025.100832

Luana Lenzi , Aaliya Ibrahim , David Brough , Alexander Thompson

Background and aims

Alcohol Use Disorders (AUD) are associated with numerous negative health and societal consequences. Relapse is common among individuals with AUD following discharge from treatment programs, often due to a lack of continuing care and barriers to accessing in-person interventions. Digital interventions may have the potential to overcome these barriers. This systematic review aims to assess the efficacy of digital interventions in supporting abstinence following AUD treatment.

Methods

We searched the databases Embase, Medline, and APA PsycInfo for randomized controlled trials (RCTs) that evaluated digital interventions designed to support alcohol-dependent individuals to maintain abstinence after discharge from treatment programs. Studies in which participants were not abstinent at the time of randomization were excluded.

Results

Eleven studies were identified, with interventions including text messages, smartphones apps, wireless breathalysers, telephone-based support, and e-books. Four studies (2 using apps and 2 using supportive text messages) reported statistically significant results in prolonging abstinence. However, one intervention using a cue exposure therapy (CET) app found increased relapse rates in all groups. The risk of bias across studies ranged from moderate to high.

Conclusion

There is insufficient evidence to support the efficacy of digital interventions in maintaining abstinence after AUD treatment discharge. While digital interventions may improve the accessibility and uptake of aftercare services to prevent relapse, further research is needed.

背景和目的酒精使用障碍（AUD）与许多负面的健康和社会后果有关。AUD患者在治疗方案出院后复发是常见的，通常是由于缺乏持续的护理和获得亲自干预的障碍。数字干预措施可能有潜力克服这些障碍。本系统综述旨在评估数字干预在AUD治疗后支持戒断的有效性。方法：我们检索了Embase、Medline和APA PsycInfo数据库，以获取随机对照试验（rct），这些试验评估了旨在支持酒精依赖个体在治疗方案出院后保持戒断的数字干预措施。参与者在随机化时不禁欲的研究被排除在外。结果通过短信、智能手机应用、无线酒精测试仪、基于电话的支持和电子书等干预措施，确定了11项研究。四项研究（两项使用应用程序，两项使用支持性短信）报告了在延长禁欲方面的统计显著结果。然而，一项使用提示暴露疗法（CET）应用程序的干预发现，所有组的复发率都增加了。各研究的偏倚风险从中等到高不等。结论支持数字化干预在AUD治疗出院后维持戒断的有效性的证据不足。虽然数字干预可能会改善获得和接受善后服务以防止复发，但还需要进一步的研究。

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引用次数: 0

Dropout and completion in iCBT for university students: Insights from a thematic analysis 大学生iCBT的辍学和完成：专题分析的见解

IF 3.6 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Internet Interventions-The Application of Information Technology in Mental and Behavioural Health

Pub Date : 2025-05-14 DOI: 10.1016/j.invent.2025.100831

Jurrijn A. Koelen , Lisa de Koning , Matilda K. Nottage , Anke M. Klein , Claudia M. van der Heijde , Peter Vonk , Reinout W. Wiers

Online cognitive behavioral therapy (iCBT) is a promising treatment for depression and anxiety among university students but faces high dropout rates. Understanding the reasons behind dropout or completion can help improve the implementation of iCBT in educational settings. Semi-structured phone interviews were conducted with 32 students who dropped out early (n = 9), midway (n = 12), or completed (n = 11) guided or unguided iCBT in the context of a randomized controlled trial. Data were analyzed using Braun and Clarke's (2012) thematic analysis. Common themes among dropouts included personal factors (like competing priorities), perceived difficulty or redundancy of the intervention, and lack of human interaction. Early dropouts uniquely cited disbelief in the intervention's efficacy and preference for other mental health support. Midway dropouts mentioned issues with the interactivity, feedback, content, perceived effectiveness, and lack of personalization. Completers had positive initial impressions, valued the online format, found the exercises and guidance helpful, and felt cared for. The themes identified among participants who dropped out from or completed the iCBT intervention provide valuable insights into factors which may be of importance for retention. Implications regarding setting expectations, participant selection, interactive functionalities, personalized feedback, and the role of therapist guidance are discussed.

在线认知行为疗法（iCBT）是一种很有前途的治疗大学生抑郁和焦虑的方法，但面临着高辍学率。了解辍学或结业背后的原因有助于改善iCBT在教育环境中的实施。在随机对照试验的背景下，对32名早期（n = 9）、中途（n = 12）或完成（n = 11）引导或非引导iCBT的学生进行了半结构化的电话访谈。数据分析采用Braun和Clarke（2012）的主题分析。辍学者的共同主题包括个人因素（如竞争优先级），干预的感知困难或冗余，以及缺乏人际互动。早期辍学者唯一的理由是不相信干预的有效性，并倾向于其他心理健康支持。中途辍学者提到了交互性、反馈、内容、感知有效性和缺乏个性化等问题。完成者有积极的最初印象，重视在线形式，发现练习和指导很有帮助，并感到被关心。在退出或完成iCBT干预的参与者中确定的主题为可能对保留重要的因素提供了有价值的见解。讨论了关于设定期望、参与者选择、互动功能、个性化反馈和治疗师指导作用的含义。

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引用次数: 0

Stepped care and digital intervention service model design in the multidisciplinary sleep service 多学科睡眠服务中的阶梯式护理和数字化干预服务模式设计

IF 3.6 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Internet Interventions-The Application of Information Technology in Mental and Behavioural Health

Pub Date : 2025-04-19 DOI: 10.1016/j.invent.2025.100830

Sara Winter , Sara Crocker , Tricia Rolls , Deanne Curtin , Jessica Haratsis , Irene Szollosi

In order to ensure access to insomnia treatment in our public health environment of increasing patient acuity, increasing demand and health care costs, we need to innovate and implement systematised models of care to achieve better outcomes and efficiencies.

The design of a new Stepped Care treatment model in the multidisciplinary sleep disorders service with consumer and stakeholder engagement is described. Patients, their referrers and staff were surveyed to explore their views and preferences towards Stepped Care, including digital transformation. A consensus group workshop using the Nominal Group Technique was undertaken with the multidisciplinary team to develop the model of care.

The team endorsed a hierarchy of treatment steps beginning with digital intervention, group and trainee interventions as first line, escalating to more intensive 1:1 ‘upstream’ for higher acuity presentations. Referrer surveys highlighted the need for education in primary care settings about the availability of evidence-based internet treatment options. While few patients were aware of the availability of digital insomnia intervention, they were largely supportive of digital transformation. Barriers and risks to the Stepped Care approach were identified which informed the refinement of the treatment pathway.

Stepped Care treatment models offer adaptability and flexibility, allowing for adjustments in interventions based on patients' response to treatment, and preventing unnecessary escalation of care while reducing costs and improving efficiencies.

为了确保在我们的公共卫生环境中获得失眠治疗，患者的视力越来越敏锐，需求越来越大，医疗成本也越来越高，我们需要创新和实施系统化的护理模式，以实现更好的结果和效率。在多学科睡眠障碍服务与消费者和利益相关者参与的一个新的台阶护理治疗模式的设计被描述。对患者、他们的转诊医生和工作人员进行了调查，以探讨他们对阶梯式护理的看法和偏好，包括数字化转型。与多学科团队一起进行了使用名义小组技术的共识小组研讨会，以开发护理模式。团队认可了治疗步骤的层次结构，从数字干预开始，小组和实习生干预作为一线，逐步升级到更密集的1:1“上游”，以获得更高的视力表现。转诊者调查突出表明，需要在初级保健机构开展教育，让人们了解基于证据的互联网治疗方案的可用性。虽然很少有患者意识到数字化失眠干预的可用性，但他们在很大程度上支持数字化转型。确定了阶梯式护理方法的障碍和风险，从而为改进治疗途径提供了信息。阶梯式护理治疗模式具有适应性和灵活性，允许根据患者对治疗的反应调整干预措施，并在降低成本和提高效率的同时防止不必要的护理升级。

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引用次数: 0

The promise and challenges of computer mouse trajectories in DMHIs – A feasibility study on pre-treatment dropout predictions 计算机鼠标轨迹在 DMHIs 中的前景与挑战--关于治疗前辍学预测的可行性研究

IF 3.6 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Internet Interventions-The Application of Information Technology in Mental and Behavioural Health

Pub Date : 2025-04-09 DOI: 10.1016/j.invent.2025.100828

Kirsten Zantvoort , Jennifer J. Matthiesen , Pontus Bjurner , Marie Bendix , Ulf Brefeld , Burkhardt Funk , Viktor Kaldo

With the impetus of Digital Mental Health Interventions (DMHIs), complex data can be leveraged to improve and personalize mental health care. However, most approaches rely on a very limited number of often costly features. Computer mouse trajectories can be unobtrusively and cost-efficiently gathered and seamlessly integrated into current baseline processes. Empirical evidence suggests that mouse movements hold information on user motivation and attention, both valuable aspects otherwise difficult to measure at scale. Further, mouse trajectories can already be collected on pre-treatment questionnaires, making them a promising candidate for early predictions informing treatment allocation. Therefore, this paper discusses how to collect and process mouse trajectory data on questionnaires in DMHIs. Covering different complexity levels, we combine hand-crafted features with non-sequential machine learning models, as well as spatiotemporal raw mouse data with state-of-the-art sequential neural networks. The data processing pipeline for the latter includes task-specific pre-processing to convert the variable length trajectories into a single prediction per user. As a feasibility study, we collected mouse trajectory data from 183 patients filling out a pre-intervention depression questionnaire. While the hand-crafted features slightly improve baseline predictions, the spatiotemporal models underperform. However, considering our small data set size, we propose more research to investigate the potential value of this novel and promising data type and provide the necessary steps and open-source code to do so.

在数字精神卫生干预（DMHIs）的推动下，可以利用复杂的数据来改善和个性化精神卫生保健。然而，大多数方法依赖于数量非常有限且通常代价高昂的特性。计算机鼠标轨迹可以不显眼地、低成本地收集，并无缝地集成到当前的基线过程中。经验证据表明，鼠标移动包含用户动机和注意力的信息，这两个有价值的方面很难大规模测量。此外，小鼠轨迹已经可以在治疗前问卷中收集到，这使它们成为早期预测治疗分配的有希望的候选者。因此，本文讨论了如何收集和处理DMHIs问卷中的鼠标轨迹数据。为了覆盖不同的复杂程度，我们将手工制作的特征与非顺序机器学习模型相结合，并将时空原始鼠标数据与最先进的顺序神经网络相结合。后者的数据处理管道包括特定于任务的预处理，以将可变长度的轨迹转换为每个用户的单个预测。作为一项可行性研究，我们收集了183名患者的小鼠轨迹数据，这些患者填写了干预前抑郁症问卷。虽然手工制作的特征略微改善了基线预测，但时空模型表现不佳。然而，考虑到我们的数据集规模很小，我们建议进行更多的研究，以调查这种新颖而有前途的数据类型的潜在价值，并提供必要的步骤和开源代码。

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引用次数: 0

Sexual trauma and interest in mobile health among women with mental illness in Ghana 加纳精神疾病妇女的性创伤和对流动保健的兴趣

IF 3.6 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Internet Interventions-The Application of Information Technology in Mental and Behavioural Health

Pub Date : 2025-04-09 DOI: 10.1016/j.invent.2025.100829

Dror Ben-Zeev , Joel Agorinya , Alexa Beaulieu , Emmanuel Quame Sottie , Anna Larsen , Dzifa Abra Attah , Michele Bedard-Gilligan , Sammy Ohene , Pamela Y. Collins , Kristen P. Lindgren , Angela Ofori-Atta , Debra Kaysen , Kwadwo Obeng

Sexual violence against vulnerable populations is common worldwide. Many survivors of sexual assault experience long-term mental health difficulties. This study evaluated sexual violence exposure among women with mental illness in Ghana and examined their readiness to engage in mobile health interventions. We surveyed 200 women receiving inpatient or outpatient treatment at a large psychiatric hospital. Survey results indicated that 41.0 % reported having experienced sexual violence in the past. Over two-thirds of respondents had a high probability of PTSD (68.4 %) and these proportions were higher among those who experienced sexual violence (77.5 %). The majority were interested in mobile health resources that could provide them with support (73.2 %). Respondents' top topics of interest were information about managing stress and improving mood. The skill they were most interested in was relaxation. Video and audio content were rated as preferred intervention modalities. Most of the sample reported owning a mobile phone (86.4 %), with most being smartphones (76.1 %). Almost all respondents reported having access to electricity (99.5 %), a majority had a data plan (86.2 %), and all reported daily mobile phone use (100.0 %). Our findings suggest that there are significant unmet mental health needs among female survivors of sexual violence who are already receiving care in Ghana; most female survivors of sexual assault are open to using mobile health interventions; and most women with mental illness have access to the resources necessary for deployment of mobile interventions in their communities. Smartphone applications that leverage video and audio content may be particularly suitable for this context.

针对弱势群体的性暴力在全世界都很常见。许多性侵犯的幸存者经历了长期的精神健康问题。这项研究评估了加纳患有精神疾病的妇女遭受性暴力的情况，并检查了她们参与流动保健干预的情况。我们调查了在一家大型精神病院接受住院或门诊治疗的200名妇女。调查结果显示，41.0%的人报告过去曾遭受过性暴力。超过三分之二的受访者患PTSD的概率很高（68.4%），而在经历过性暴力的人中，这一比例更高（77.5%）。大多数人对可以为他们提供支持的移动卫生资源感兴趣（73.2%）。受访者最感兴趣的话题是有关管理压力和改善情绪的信息。他们最感兴趣的技能是放松。视频和音频内容被评为首选干预方式。大多数受访者表示拥有一部手机（86.4%），其中大部分是智能手机（76.1%）。几乎所有受访者都报告有电可用（99.5%），大多数受访者有数据计划（86.2%），所有受访者都报告每天使用移动电话（100.0%）。我们的研究结果表明，在加纳已经接受治疗的性暴力女性幸存者中，存在大量未满足的心理健康需求；大多数性侵犯的女性幸存者愿意使用流动保健干预措施；而且，大多数患有精神疾病的妇女能够获得在其社区部署流动干预措施所需的资源。利用视频和音频内容的智能手机应用程序可能特别适合这种情况。

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引用次数: 0

Impact of the best possible self intervention on affective well-being in early adolescence: A randomized controlled online trial 最佳自我干预对青少年早期情感幸福感的影响：一项随机对照在线试验

IF 3.6 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Internet Interventions-The Application of Information Technology in Mental and Behavioural Health

Pub Date : 2025-04-08 DOI: 10.1016/j.invent.2025.100827

Stefanie Bartha, Silke Schmidt, Samuel Tomczyk

The Best Possible Self intervention (BPS) has demonstrated efficacy in promoting well-being in various populations, yet its impact in adolescence is under-researched. Our study investigated the feasibility and efficacy of the BPS in early adolescence (11–15 years) to promote positive affect and reduce negative affect. We conducted a randomized controlled online trial (N = 200, M_age = 14.01 years, SD = 1.19, 78.5 % female). Participants were assigned to the BPS group (n = 59), a writing control group (n = 68), or a non-writing control group (n = 73). Affect (PANAS-C-SF) was measured immediately before and after the intervention. The BPS demonstrated feasibility in our sample and significantly increased positive affect post-intervention compared to both control groups, suggesting a mood-boosting effect. The BPS did not significantly reduce negative affect post-intervention relative to the control groups. Our findings provide initial evidence that the BPS is a feasible and effective intervention for enhancing positive affect in early adolescence. Future research should explore its long-term effects, repeated administration, and potential for implementation in group settings to maximize its impact.

最佳自我干预（Best Possible Self intervention， BPS）在促进不同人群的幸福感方面已被证明有效，但其对青少年的影响尚未得到充分研究。本研究探讨了青少年早期（11-15岁）BPS在促进积极情绪和减少消极情绪方面的可行性和有效性。我们进行了一项随机对照在线试验（N = 200，年龄= 14.01,SD = 1.19，女性占78.5%）。参与者被分为BPS组（n = 59）、写作控制组（n = 68）和非写作控制组（n = 73）。在干预前后立即测量影响（PANAS-C-SF）。BPS在我们的样本中证明了可行性，并且与两个对照组相比，干预后显著增加了积极影响，表明有促进情绪的作用。与对照组相比，BPS并没有显著减少干预后的负面影响。我们的研究结果提供了初步的证据，证明BPS是一种可行和有效的干预措施，可以增强青少年早期的积极影响。未来的研究应探索其长期效果、重复管理和在群体环境中实施的潜力，以最大限度地发挥其影响。

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引用次数: 0

The role of self-efficacy in internet-based interventions for mental health: A systematic review and meta-analysis 自我效能感在基于网络的心理健康干预中的作用：系统回顾和荟萃分析

IF 3.6 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Internet Interventions-The Application of Information Technology in Mental and Behavioural Health

Pub Date : 2025-04-05 DOI: 10.1016/j.invent.2025.100821

Solveig Behr , Laura Martinez Garcia , Julia Lucas , Esther Kohlhase , Marie Puetz , Johanna Boettcher , Carmen Schaeuffele , Christine Knaevelsrud

Introduction

Internet-based interventions (IBI) increase access to evidence-based treatments for mental disorders, but knowledge of their mechanisms of change is limited. Self-efficacy, a key factor in psychotherapy, is especially relevant in IBI due to its self-help focus. We investigated self-efficacy and related constructs as outcomes, predictors/moderators, and mediators in randomized controlled trials.

Methods

A systematic search was conducted across PsycINFO, PubMed, CINAHL, and Web of Science. Two reviewers selected studies, extracted data, and assessed bias. Effects were quantified using random effect models and supplemented by narrative syntheses and box score visualizations.

Results

70 studies (N = 17,407 participants) were included. IBI showed moderate effects on self-efficacy in within (d = 0.47) and between (d = 0.46) comparisons, with guided interventions having the largest effect (d = 0.66). Findings on self-efficacy as a predictor/moderator were mixed, though some studies suggested individuals with lower self-efficacy benefit more. Self-efficacy emerged as a mediator through which IBI affected treatment outcomes.

Conclusion

Self-efficacy appears influential in IBI efficacy and may itself be a valuable treatment target. However, mixed results and methodological limitations in mediator studies highlight the need for further research, particularly on long-term effects.

导言基于互联网的干预（IBI）增加了精神障碍循证治疗的可及性，但对其改变机制的了解却很有限。自我效能感是心理治疗中的一个关键因素，由于其自助性，它与 IBI 尤为相关。我们调查了随机对照试验中作为结果、预测因子/调节因子和中介因子的自我效能和相关构建。两名审稿人选择研究、提取数据并评估偏倚。采用随机效应模型对效果进行量化，并辅以叙述性综述和盒式评分可视化。结果共纳入 70 项研究（N = 17,407 名参与者）。在内部（d = 0.47）和之间（d = 0.46）比较中，综合干预对自我效能感的影响适中，其中引导式干预的影响最大（d = 0.66）。关于自我效能感作为预测因素/调节因素的研究结果不一，但一些研究表明，自我效能感较低的人受益更多。结论：自我效能感似乎对 IBI 的疗效有影响，其本身也可能是一个有价值的治疗目标。然而，中介研究的结果参差不齐且存在方法上的局限性，这凸显了进一步研究的必要性，尤其是对长期效果的研究。

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引用次数: 0