Technology-Assisted, Group-Based CBT for Rural Adults’ Depression: Open Pilot Trial Results

2021 ◽  
pp. 104973152110448
Author(s):  
Addie Weaver ◽  
Anao Zhang ◽  
Caroline Landry ◽  
Jessica Hahn ◽  
Lynne McQuown ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Rural Areas ◽  
Behavioral Therapy ◽  
Pilot Trial ◽  
Treatment Access ◽  
Eta Squared ◽  
Pre Treatment ◽  
Open Pilot ◽  
Rural Adults

Purpose: This pilot study assesses the association of Raising Our Spirits Together (ROST), a technology-assisted, group-based cognitive behavioral therapy for depression, with rural adults’ depressive symptoms and anxiety. Method: Nine adults from rural Michigan participated in an open pilot of ROST. Clergy facilitated pilot groups. The pilot began in February 2020 in-person. Due to COVID-19, the pilot was completed virtually. Results: Mean depressive symptom scores, based on the PHQ-9, significantly decreased from pre-treatment ( M = 14.4) to post-treatment ( M = 6.33; t (8) = 6.79; P < .001). Symptom reduction was maintained at 3-month follow-up ( M = 8.00), with a significant pattern of difference in depressive symptoms over time (F(2) = 17.7; P < .001; eta-squared = .689). Similar patterns occurred for anxiety based on the GAD-7. Participants attended an average of 7.33 of 8 sessions. Fidelity ratings were excellent. Discussion: ROST is a potentially feasible intervention for rural adults’ depressive symptoms. ROST offers a promising model for increasing treatment access and building capacity in rural areas.

Assessment of incident frailty hazard associated with depressive symptoms in a Taiwanese longitudinal study

2021 ◽  
pp. 1-10
Author(s):  
Che-Chia Chang ◽  
Chi-Shin Wu ◽  
Han-Yun Tseng ◽  
Chun-Yi Lee ◽  
I-Chien Wu ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Longitudinal Study ◽  
Rural Areas ◽  
Healthy Aging ◽  
Asian Population ◽  
Epidemiological Studies ◽  
Frailty Status ◽  
Health Need ◽  
The Impact

ABSTRACT Objectives: To estimate the risks of depressive symptoms for developing frailty, accounting for baseline robust or pre-frailty status. Design: An incident cohort study design. Setting: Community dwellers aged 55 years and above from urban and rural areas in seven regions in Taiwan. Participants: A total of 2,717 participants from the Healthy Aging Longitudinal Study in Taiwan (HALST) were included. Subjects with frailty at baseline were excluded. The average follow-up period was 5.9 years. Measurements: Depressive symptoms were measured by the 20-item Center for Epidemiological Studies Depression (CES-D) Scale. Frailty was assessed using the Fried frailty measurement. Participants were stratified by baseline robust or pre-frailty status to reduce the confounding effects of the shared criteria between depressive symptoms and frailty. Overall and stratified survival analyses were conducted to assess risks of developing frailty as a result of baseline depressive symptoms. Results: One hundred individuals (3.7%) had depressive symptoms at baseline. Twenty-seven individuals (27.0%) with depressive symptoms developed frailty, whereas only 305 out of the 2,617 participants (11.7%) without depressive symptoms developed frailty during the follow-up period. After adjusting for covariates, depressive symptoms were associated with a 2.6-fold (95% CI 1.6, 4.2) increased hazard of incident frailty. The patterns of increased hazard were also observed when further stratified by baseline robust or pre-frailty status. Conclusions: Depressive symptoms increased the risk of developing frailty among the older Asian population. The impact of late-life depressive symptoms on physical health was notable. These findings also replicated results from Western populations. Future policies on geriatric public health need to focus more on treatment and intervention against geriatric depressive symptoms to prevent incident frailty among older population.

scholarly journals Response trajectories of gambling severity after cognitive behavioral therapy in young-adult pathological gamblers

2020 ◽  
Vol 9 (1) ◽  
pp. 140-152
Author(s):  
Roser Granero ◽  
Susana Valero-Solis ◽  
Fernando Fernández-Aranda ◽  
Mónica Gómez-Peña ◽  
Laura Moragas ◽  
...  
Keyword(s):  
Young Adult ◽  
Cognitive Behavioral Therapy ◽  
Emotional Regulation ◽  
Latent Class ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Therapeutic Outcomes ◽  
Gambling Severity ◽  
Pre Treatment

Abstract Background and aims The significant increase in the prevalence of gambling disorder (GD) among young adults in recent years has attracted interest in determining therapeutic efficiency in this sector of the population. The aim of this work was to estimate the response trajectories of gambling severity during the six-month follow-up after a cognitive behavioral therapy (CBT) program in young adult patients and to identify the main variables associated with each trajectory. Methods The sample included n = 192 patients, aged 19–35 years old, seeking treatment for GD. Response trajectories were identified through latent class growth analysis. Results Three trajectories emerged: T1 (n = 118, 61.5%), composed of patients with severe GD at pre-treatment and good evolution to recovery; T2 (n = 62, 32.3%), with patients with moderate-high GD affectation at baseline and good evolution to recovery; and T3 (n = 12, 6.3%), with participants with severe baseline GD severity and poor evolution after CBT (Abbott, 2019). The highest risk of poor therapeutic outcomes was related to lower social index positions, high emotional distress, high scores in harm avoidance and low scores in self-directedness. Discussion and conclusions Differences in the response trajectories at short-term follow-up after CBT reveal heterogeneity in the samples including young and young-adult GD patients. Patients' phenotype at baseline should be considered when developing efficient, person-centered intervention programs, which should comprise strategies aimed at increasing emotional regulation capacities, self-esteem and self-efficacy, with the aim of avoiding relapses in the medium-long term after therapy.

scholarly journals Cognitive behavioral therapy for insomnia among young adults who are actively drinking: a randomized pilot trial

SLEEP ◽  
2020 ◽  
Author(s):  
Mary Beth Miller ◽  
Chelsea B Deroche ◽  
Lindsey K Freeman ◽  
Chan Jeong Park ◽  
Nicole A Hall ◽  
...  
Keyword(s):  
Young Adults ◽  
Alcohol Use ◽  
Cognitive Behavioral Therapy ◽  
Binge Drinking ◽  
Behavioral Therapy ◽  
Pilot Trial ◽  
Cognitive Behavioral ◽  
Wrist Actigraphy ◽  
Insomnia Severity

Abstract Study Objectives More than half of young adults at risk for alcohol-related harm report symptoms of insomnia. Insomnia symptoms, in turn, have been associated with alcohol-related problems. Yet one of the first-line treatments for insomnia (Cognitive Behavioral Therapy for Insomnia or CBT-I) has not been tested among individuals who are actively drinking. This study tested (1) the feasibility and short-term efficacy of CBT-I among binge-drinking young adults with insomnia and (2) improvement in insomnia as a predictor of improvement in alcohol use outcomes. Methods Young adults (ages 18–30 years, 75% female, 73% college students) who met criteria for Insomnia Disorder and reported 1+ binge drinking episode (4/5+ drinks for women/men) in the past month were randomly assigned to 5 weekly sessions of CBT-I (n = 28) or single-session sleep hygiene (SH, n = 28). All participants wore wrist actigraphy and completed daily sleep surveys for 7+ days at baseline, posttreatment, and 1-month follow-up. Results Of those randomized, 43 (77%) completed posttreatment (19 CBT-I, 24 SH) and 48 (86%) completed 1-month follow-up (23 CBT-I, 25 SH). CBT-I participants reported greater posttreatment decreases in insomnia severity than those in SH (56% vs. 32% reduction in symptoms). CBT-I did not have a direct effect on alcohol use outcomes; however, mediation models indicated that CBT-I influenced change in alcohol-related consequences indirectly through its influence on posttreatment insomnia severity. Conclusions CBT-I is a viable intervention among individuals who are actively drinking. Research examining improvement in insomnia as a mechanism for improvement in alcohol-related consequences is warranted. Trial Registration U.S. National Library of Medicine, https://clinicaltrials.gov/ct2/show/NCT03627832, registration #NCT03627832

scholarly journals Mindfulness-based cognitive therapy and cognitive behavioral therapy for chronic pain in multiple sclerosis: a randomized controlled trial protocol

Trials ◽  
2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Dawn M. Ehde ◽  
Kevin N. Alschuler ◽  
Melissa A. Day ◽  
Marcia A. Ciol ◽  
Makena L. Kaylor ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Usual Care ◽  
Behavioral Therapy ◽  
Controlled Trial ◽  
Randomized Controlled ◽  
Average Pain Intensity ◽  
Average Pain ◽  
Pre Treatment ◽  
Management Approaches

Abstract Background Chronic pain is one of the most prevalent and disabling symptoms associated with multiple sclerosis (MS). Individuals with MS are interested in nonpharmacologic pain management approaches. Cognitive-behavioral therapy (CBT) is efficacious in improving MS-related pain outcomes. Mindfulness-based cognitive therapy (MBCT) is a promising, alternative approach. Little is known about moderators of these treatments’ outcomes, however. This article describes the study protocol for the first randomized controlled trial comparing MBCT, CBT, and usual care and examining treatment effect moderators in individuals with chronic pain and MS. Methods We will conduct a single-center, randomized, single blind, parallel-group trial comparing MBCT, CBT, and usual care in adults with MS and chronic pain. Both interventions will be delivered via eight group sessions using videoconferencing technology. Primary (average pain intensity) and secondary outcomes (including pain interference, depressive symptoms, fatigue, and sleep) will be assessed pre-treatment, mid-treatment, post-treatment, and at 6-month follow up. Potential treatment moderators will be assessed pre-treatment. We hypothesize that participants randomly assigned to MBCT or CBT will report significantly greater reductions in average pain intensity than participants assigned to usual care at post-treatment (primary study endpoint) and 6-month follow up. We also hypothesize that mindfulness, pain catastrophizing, and behavioral activation pre-treatment will moderate response to both active treatments, but not response to usual care. Discussion Findings will provide important new information about the efficacy and moderators of two nonpharmacologic pain management approaches delivered using technology to overcome common barriers to treatment access. The knowledge gained may lead to better patient-treatment matching and, ultimately, better pain treatment outcomes in MS. Trial registration ClinicalTrials.gov, NCT03782246. Registered on 20 December 2018.

Perfectionism in People who Stutter: Preliminary Findings Using a Modified Cognitive-Behavioral Treatment Approach

2007 ◽  
Vol 36 (1) ◽  
pp. 35-40 ◽  
Author(s):  
Barbara J. Amster ◽  
Evelyn R. Klein
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Behavioral Treatment ◽  
Treatment Approach ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Cognitive Behavioral Treatment ◽  
Trial Testing ◽  
Preliminary Research ◽  
Pre Treatment

AbstractPerfectionistic people set unrealistic goals and, when they fail to reach them, experience self-criticism and blame. Preliminary research revealed that perfectionism appears to be a characteristic of people who stutter (PWS) (Amster, 1995). The purpose of the present study was to explore perfectionism in PWS and to determine if a modified cognitive behavioral therapy approach alone and combined with Stuttering Modification could help reduce perfectionistic tendencies and stuttering behaviors. Degree of perfectionism and scores of stuttering severity were measured with eight adult PWS and compared at pre-treatment, mid-treatment, after 6-weeks of treatment, and at 15 weeks follow-up, after treatment was withdrawn. Initial open-trial testing showed promising results as perfectionism and stuttering severity were reduced and communication attitudes improved. CBT significantly reduced perfectionism by mid-point. Stuttering decreased significantly throughout all phases of the study. Possible implications are discussed.

scholarly journals Optimizing Smartphone-Delivered Cognitive Behavioral Therapy for Body Dysmorphic Disorder Using Passive Smartphone Data: Initial Insights From an Open Pilot Trial

10.2196/16350 ◽  
2020 ◽  
Vol 8 (6) ◽  
pp. e16350
Author(s):  
Hilary Weingarden ◽  
Aleksandar Matic ◽  
Roger Garriga Calleja ◽  
Jennifer L Greenberg ◽  
Oliver Harrison ◽  
...  
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Symptom Severity ◽  
Body Dysmorphic Disorder ◽  
Behavioral Therapy ◽  
Pilot Trial ◽  
Cognitive Behavioral ◽  
Sensor Data ◽  
Mobility Patterns ◽  
Insight Into ◽  
Open Pilot

Background Smartphone-delivered cognitive behavioral therapy (CBT) is becoming more common, but research on the topic remains in its infancy. Little is known about how people typically engage with smartphone CBT or which engagement and mobility patterns may optimize treatment. Passive smartphone data offer a unique opportunity to gain insight into these knowledge gaps. Objective This study aimed to examine passive smartphone data across a pilot course of smartphone CBT for body dysmorphic disorder (BDD), a psychiatric illness characterized by a preoccupation with a perceived defect in physical appearance, to inform hypothesis generation and the design of subsequent, larger trials. Methods A total of 10 adults with primary diagnoses of BDD were recruited nationally and completed telehealth clinician assessments with a reliable evaluator. In a 12-week open pilot trial of smartphone CBT, we initially characterized natural patterns of engagement with the treatment and tested how engagement and mobility patterns across treatment corresponded with treatment response. Results Most participants interacted briefly and frequently with smartphone-delivered treatment. More frequent app usage (r=–0.57), as opposed to greater usage duration (r=–0.084), correlated strongly with response. GPS-detected time at home, a potential digital marker of avoidance, decreased across treatment and correlated moderately with BDD severity (r=0.49). Conclusions The sample was small in this pilot study; thus, results should be used to inform the hypotheses and design of subsequent trials. The results provide initial evidence that frequent (even if brief) practice of CBT skills may optimize response to smartphone CBT and that mobility patterns may serve as useful passive markers of symptom severity. This is one of the first studies to examine the value that passively collected sensor data may contribute to understanding and optimizing users’ response to smartphone CBT. With further validation, the results can inform how to enhance smartphone CBT design.

scholarly journals 0532 Cognitive Behavioral Therapy Delivered Via Telemedicine vs. Face-to-Face: Results from a Randomized Controlled Non-Inferiority Trial

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A203-A204
Author(s):  
J Arnedt ◽  
D Conroy ◽  
A Mooney ◽  
K DuBuc ◽  
S Balstad ◽  
...  
Keyword(s):  
Behavioral Therapy ◽  
Severity Index ◽  
Healthcare Services ◽  
Post Treatment ◽  
Self Report ◽  
Daytime Functioning ◽  
Face To Face ◽  
Randomized Controlled ◽  
Pre Treatment

Abstract Introduction Telemedicine is increasingly an option for delivery of healthcare services, but its efficacy and acceptability for delivering CBT for insomnia has not been adequately tested. In a randomized controlled non-inferiority trial, we compared face-to-face and telemedicine delivery (via the AASM SleepTM platform) of CBT for insomnia for improving sleep and daytime functioning at post-treatment and 12-week follow-up. Methods Sixty-five adults with chronic insomnia (46 women, mean age 47.2 ± 16.3 years) were recruited primarily from insomnia clinics and screened for disqualifying sleep, medical, and mental health disorders. Eligible participants were randomized to 6 sessions of CBT for insomnia delivered face-to-face (n=32) or via AASM SleepTM (n=33). Participants completed self-report measures of insomnia (Insomnia Severity Index, ISI) and daytime functioning (fatigue, depression, anxiety, and overall functioning) at pre-treatment, post-treatment, and 12-week follow-up. The ISI was the primary non-inferiority outcome. Results Telemedicine was non-inferior to face-to-face delivery of CBT for insomnia, based on a non-inferiority margin of 4 points on the ISI (β = -0.07, 95% CI -2.28 to 2.14). Compared to pre-treatment, ISI scores improved significantly at post-treatment (β = -9.02, 95% CI -10.56 to -7.47) and at 12-week follow-up (β = -9.34, 95% CI -10.89 to -7.79). Similarly, daytime functioning measures improved from pre- to post-treatment, with sustained improvements at 12-week follow-up. Scores on the fatigue scale were lower in the telemedicine group at both post-treatment (F=4.64, df=1,119, p&lt;.03) and follow-up (F=5.79, df=1,119, p&lt;.02). Conclusion Insomnia and daytime functioning improve similarly whether CBT for insomnia is delivered via telemedicine or face-to-face. Telemedicine delivery of CBT for insomnia should be implemented more systematically to improve access to this evidence-based treatment. Support American Sleep Medicine Foundation Grant # 168-SR-17 (JT Arnedt, PhD)

scholarly journals 0524 Web-Delivered CBT for Insomnia Intervention Improves Sleep Among Adults with Insomnia and Depressive Symptoms

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A200-A201
Author(s):  
P J Batterham ◽  
H Christensen ◽  
F P Thorndike ◽  
L M Ritterband ◽  
R Gerwien ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Sleep Quality ◽  
Large Scale ◽  
Behavioral Therapy ◽  
Controlled Trial ◽  
Sleep Onset ◽  
Sleep Diary ◽  
Sleep Onset Latency ◽  
Sleep Diaries

Abstract Introduction Cognitive behavioral therapy for insomnia (CBT-I) is the first line recommended treatment for adults with chronic insomnia. In a prior randomized controlled trial (RCT), data showed web-delivered CBT-I (SHUTi) reduced insomnia severity as well as symptoms of depression, among adults with insomnia and elevated depressive symptoms. The present study aimed to further evaluate the effectiveness of web CBT-I to improve sleep outcomes as measured by prospectively entered sleep diaries in this same sample. Methods A large-scale RCT (N=1149) of Australian adults with insomnia and depressive symptoms compared a 9-week, web CBT-I therapeutic with an attention-matched web program at baseline, posttest and 6-, 12-, and 18-month follow-ups. Although depression outcomes have been presented previously, the online sleep-diary derived variables have not yet been presented, including sleep-onset latency (SOL), wake after sleep onset (WASO), sleep efficiency (SE), number of awakenings, sleep quality, and total sleep time (TST). Sleep diaries were entered online for 10 days at each assessment period. Results Data showed web CBT-I participants demonstrated greater reductions from baseline to posttest compared with control for the following sleep variables: SOL (LS mean difference [95% CI]=-22.3 min [-29.2, -15.3]; p&lt;.0001), WASO (-17.8 min [-23.4, -12.3]; p&lt;.0001), and number of awakenings (-0.38 [-0.68, -0.09]; p=.0113). Web CBT-I also showed greater improvements in SE (9.18% [7.25%, 11.10%]; p&lt;.0001) and sleep quality (0.41 [0.30, 0.53]; p&lt;.0001) from baseline to posttest compared with control. TST was not significantly different between groups at posttest or 6-month follow-up, although it improved over baseline at 12 (18.73 min [7.39, 30.07]; p=.0013) and 18 months (23.76 min [9.15, 38.36]; p=.0015) relative to control. All other significant sleep treatment effects were maintained in the treatment arm at 6, 12, and 18-month follow-up. Conclusion Data showed web CBT-I produced lasting improvements in sleep outcomes among adults with insomnia and elevated depressive symptoms. Support Clinical trial ACTRN12611000121965 was funded by the Australian National Health and Medical Research Council. The statistical analysis described here was funded by Pear Therapeutics, Inc and conducted by Provonix.

An Evaluation of Cognitive-Behaviour Therapy for Depression in Patients with Multiple Sclerosis

1984 ◽  
Vol 145 (4) ◽  
pp. 366-371 ◽  
Author(s):  
Nora A. Larcombe ◽  
Peter H. Wilson
Keyword(s):  
Multiple Sclerosis ◽  
Depressive Symptoms ◽  
Cognitive Behaviour Therapy ◽  
Condition Assessment ◽  
Waiting List ◽  
Behaviour Therapy ◽  
Cognitive Behavioural ◽  
Cognitive Behaviour ◽  
Pre Treatment

SummaryTwenty depressed multiple sclerotic patients were randomly allocated either to cognitive-behaviour therapy or to a waiting list control condition. Assessment of depressive symptoms was conducted at pre-treatment, post-treatment, and a four-week follow-up. In comparison to the waiting list control condition, cognitive-behaviour therapy was found to result in clinically and statistically significant improvement on most measures. Although the mechanism by which such treatment achieves its effects is unclear, these results clearly support the use of cognitive-behavioural treatments for depression in this population.

Sign in / Sign up

Export Citation Format

Share Document