A randomized controlled trial of Internet-delivered CBT and attention bias modification for early intervention of depression

The conceptualization and empirical knowledge base related to major depression has increased dramatically in recent years. We now have well-developed and validated models of depression from a range of theoretical perspectives. These models have significantly enhanced the development of effective treatments and preventative interventions. Although various prevention programs are available, Web-based protocols can enhance accessibility to evidence-based prevention programs. The current study involved a randomized controlled trial focused on the prevention and treatment of depression in high-risk first- and second-year undergraduate students. Three Internet-delivered preventative programs were compared: cognitive behavioral therapy (CBT; MoodGym), attentional bias modification, and an active attentional control condition. Participants (n = 350) completed symptom measurement pre- and post-intervention (6 weeks) and again at a 4-month follow-up, when they were also administered a structured diagnostic interview. Participants in the CBT condition showed more dramatic and continuous depressive symptom improvement between baseline and follow-up than did participants in the other two conditions. In addition, significantly fewer individuals in CBT condition met diagnostic criteria for major depression at follow-up than in the other conditions. These findings have important implications for future early intervention research and practice.