Gamified Mobile Computerized Cognitive Behavioral Therapy for Japanese University Students With Depressive Symptoms: Protocol for a Randomized Controlled Trial

Background Evidence shows that computerized self-help interventions are effective for reducing symptoms of depression. One such intervention, SPARX, is a gamified mobile computerized cognitive behavioral therapy (cCBT) developed for adolescents in New Zealand, which was shown to be as effective as usual care for young people with mild-to-moderate symptoms of depression. However, gamified cCBT has not yet been tested in Japan. Objective This trial is designed to investigate whether a Japanese-adapted version of SPARX improves depressive symptoms in Japanese university students with mild-to-moderate depressive symptoms. Methods In this 7-week, multicenter, stratified, parallel-group, superiority randomized trial, participants will be allocated to either a treatment condition (SPARX) or a wait-list control condition. SPARX is a fully automated program, which will be delivered to the mobile phone or tablet device of the participants. SPARX is designed as an interactive fantasy game to guide the user through seven modules that teach key CBT strategies. All participants will be recruited from universities via advertisements on online bulletin boards, the campus newspaper, and posters. Participants in the treatment condition will use the SPARX program weekly. The primary outcome is the reduction of depressive symptoms (using Patient Health Questionnaires-9) measured at baseline and weekly: once after the 7-week intervention and once at a 1-month follow-up. Secondary outcomes include satisfaction with the program and satisfaction with life, measured by the Satisfaction With Life Scale; positive and negative moods, measured by the Profile of Mood States Second Edition; social functioning, measured by the EuroQol Instrument; rumination, measured by the Ruminative Responses Scale; and coping, measured by the Brief Coping Orientation to Problem Experienced Inventory. Results This study received funding from The Research Institute of Personalized Health Sciences, Health Sciences University of Hokkaido, and obtained institutional review board approval in September 2019. Data collection began in April 2019. Conclusions Results of this trial may provide further evidence for the efficacy of gamified cCBT for the treatment of depression and, specifically, provide support for using SPARX with Japanese university students. Trial Registration Japan Primary Registries Network UMIN000034354; https://tinyurl.com/uu7xd77 International Registered Report Identifier (IRRID) DERR1-10.2196/15164

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A Randomized Controlled Trial of Cognitive Behavioral Therapy vs Mindfulness-Based Intervention to Reduce Depressive Symptoms in University Students I

The Proceedings of the Annual Convention of the Japanese Psychological Association ◽

10.4992/pacjpa.84.0_pd-028 ◽

2020 ◽

Vol 84 (0) ◽

pp. PD-028-PD-028

Author(s):

Hikari Takashina ◽

Ayaka Higuchi ◽

Yuki Mizusaki ◽

Yukiko Yamaguchi ◽

Yumi Kaneyama ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Depressive Symptoms ◽

Cognitive Behavioral Therapy ◽

University Students ◽

Behavioral Therapy ◽

Controlled Trial ◽

Cognitive Behavioral ◽

Randomized Controlled

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Adding cognitive behavioral therapy to treatment plans reduces depressive symptoms among adolescents

PsycEXTRA Dataset ◽

10.1037/e556142006-014 ◽

2006 ◽

Keyword(s):

Depressive Symptoms ◽

Cognitive Behavioral Therapy ◽

Behavioral Therapy ◽

Cognitive Behavioral ◽

Treatment Plans

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Cognitive Behavioral Therapy, Ketamine, and Combination Treatment for Depression: Impressions of Credibility in Participants with Self-Reported Depressive Symptoms

Journal of Psychoactive Drugs ◽

10.1080/02791072.2021.1912863 ◽

2021 ◽

pp. 1-11

Author(s):

Mitch Earleywine ◽

Brianna R. Altman ◽

Joseph De Leo

Keyword(s):

Depressive Symptoms ◽

Cognitive Behavioral Therapy ◽

Combination Treatment ◽

Behavioral Therapy ◽

Cognitive Behavioral

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The impact of depressive symptoms on response to integrated cognitive behavioral therapy for substance use disorders and intimate partner violence

Advances in Dual Diagnosis ◽

10.1108/add-09-2020-0020 ◽

2021 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Lourah M. Kelly ◽

Cory A. Crane ◽

Kristyn Zajac ◽

Caroline J. Easton

Keyword(s):

Intimate Partner Violence ◽

Substance Use ◽

Depressive Symptoms ◽

Cognitive Behavioral Therapy ◽

Treatment Response ◽

Partner Violence ◽

Behavioral Therapy ◽

Intimate Partner ◽

Cognitive Behavioral ◽

Content Type

Purpose Past studies demonstrated the efficacy of integrated cognitive-behavioral therapy (CBT) for substance use disorder (SUD) and intimate partner violence (IPV) as well as high rates of depressive symptoms in this population. However, little is known about how depressive symptoms impact treatment outcomes. The authors hypothesized that integrated CBT, but not standard drug counseling (DC), would buffer the negative effects of depressive symptoms on treatment response. Design/methodology/approach A secondary analysis of a randomized trial compared men assigned to 12 weeks of integrated CBT for SUD and IPV (n = 29) to those in DC (n = 34). Findings Most (60%) of the sample reported any depressive symptoms. Controlling for baseline IPV, reporting any depressive symptoms was associated with more positive cocaine screens during treatment. Among men with depressive symptoms, integrated CBT but not DC was associated with fewer positive cocaine screens. Controlling for baseline alcohol variables, integrated CBT and depressive symptoms were each associated with less aggression outside of intimate relationships (family, strangers, etc.) during treatment. For men without depressive symptoms, integrated CBT was associated with less non-IPV aggression compared to DC. Effects were not significant for other substances, IPV, or at follow-up. Research limitations/implications This study found some evidence for differential response to CBT by depressive symptoms on cocaine and aggression at end of treatment, which did not persist three months later. Future studies should explore mechanisms of integrated CBT for SUD and IPV, including mood regulation, on depressive symptoms in real-world samples. Practical implications Integrated CBT buffered depressive symptoms’ impact on cocaine use, yet only improved non-IPV aggression in men without depressive symptoms. Originality/value Although integrated CBT’s efficacy for improving SUD and IPV has been established, moderators of treatment response have not been investigated.

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Blended Care-Cognitive Behavioral Therapy for Depression and Anxiety in Real-World Settings: Pragmatic Retrospective Study (Preprint)

10.2196/preprints.18723 ◽

2020 ◽

Author(s):

Anita Lungu ◽

Janie Jihee Jun ◽

Okhtay Azarmanesh ◽

Yan Leykin ◽

Connie E-Jean Chen

Keyword(s):

Cognitive Behavioral Therapy ◽

Real World ◽

Behavioral Therapy ◽

Anxiety Symptoms ◽

Cognitive Behavioral ◽

Depression And Anxiety ◽

Symptoms Of Depression ◽

Care Intervention ◽

Blended Care ◽

Over Time

BACKGROUND The past few decades saw considerable advances in research and dissemination of evidence-based psychotherapies, yet available treatment resources are not able to meet the high need for care for individuals suffering from depression or anxiety. Blended care psychotherapy, which combines the strengths of therapist-led and internet interventions, can narrow this gap and be clinically effective and efficient, but has rarely been evaluated outside of controlled research settings. OBJECTIVE This study evaluated the effectiveness of a blended care intervention (video-based cognitive behavior therapy and internet intervention) under real-world conditions. METHODS This is a pragmatic retrospective cohort analysis of 385 participants with clinical range depression and/or anxiety symptoms at baseline, measured using Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7), who enrolled in blended care psychotherapy treatment. Participants resided in the United States and had access to the blended care intervention as a mental health benefit offered through their employers. Levels of depression and anxiety were tracked throughout treatment. Hierarchical linear modeling was used to examine the change in symptoms over time. The effects of age, gender, and providers on participants’ symptom change trajectories were also evaluated. Paired sample t-tests were also conducted, and rates of positive clinical change and clinically significant improvement were calculated. RESULTS The average depression and anxiety symptoms at 6 weeks after the start of treatment were 5.94 and 6.57, respectively. There were significant linear effects of time on both symptoms of depression and anxiety (β=–.49, <i>P</i><.001 and β=–.64, <i>P</i><.001). The quadratic effect was also significant for both symptoms of depression and anxiety (β=.04, P<.001 for both), suggesting a decelerated decrease in symptoms over time. Approximately 73% (n=283) of all 385 participants demonstrated reliable improvement, and 83% (n=319) recovered on either the PHQ-9 or GAD-7 measures. Large effect sizes were observed on both symptoms of depression (Cohen d=1.08) and of anxiety (d=1.33). CONCLUSIONS Video blended care cognitive behavioral therapy interventions can be effective and efficient in treating symptoms of depression and anxiety in real-world conditions. Future research should investigate the differential and interactive contribution of the therapist-led and digital components of care to patient outcomes to optimize care.

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Cognitive behavioral therapy improves diverse profiles of depressive symptoms in Parkinson's disease

International Journal of Geriatric Psychiatry ◽

10.1002/gps.5077 ◽

2019 ◽

Vol 34 (5) ◽

pp. 722-729 ◽

Cited By ~ 6

Author(s):

Roseanne D. Dobkin ◽

Sarah L. Mann ◽

Alejandro Interian ◽

Michael A. Gara ◽

Matthew Menza

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Depressive Symptoms ◽

Cognitive Behavioral Therapy ◽

Behavioral Therapy ◽

Cognitive Behavioral

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Application of Cognitive-behavioral Therapy in a Case of Obsessive-compulsive Disorder

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.1067 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S644-S644

Author(s):

L. Rodríguez Andrés ◽

A. Rodriguez Campos ◽

I. Sevillano Benito ◽

H. De la Red Gallego ◽

C. Noval Canga ◽

...

Keyword(s):

Depressive Symptoms ◽

Cognitive Behavioral Therapy ◽

Obsessive Compulsive Disorder ◽

Behavioral Therapy ◽

Psychiatric Inpatient ◽

Normal Function ◽

Cognitive Behavioral ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Competing Interest

We present the case report of a 46-year-old woman who experienced obsessive-compulsive symptoms for over twenty years, with multiple relapses, severe depressive symptoms and many hospitalizations in the psychiatric Inpatient Unit. Treatment with different SSRIs, tricyclic antidepressants, atypical antipsychotics and even electroconvulsive therapy were administered with poor results.After her last hospitalization a Cognitive-Behavioral Therapy, including exposure and response prevention and cognitive therapy, is initiated combined with medication, improving depressive symptoms, the ritual behaviors and levels of anxiety.Modern treatments for Obsessive-Compulsive Disorder (OCD) have radically changed how the disorder is viewed. While in the past OCD was regarded as chronic and untreatable, a diagnosis of OCD may now be regarded with hope. Cognitive and behavior therapy and antidepressant medications are currently used to treat the disorder. They can be used to control the symptoms and enable people with OCD to restore normal function in their lives.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Does Homework “Matter” in Cognitive Behavioral Therapy for Adolescent Depression?

Journal of Cognitive Psychotherapy ◽

10.1891/0889-8391.26.4.390 ◽

2012 ◽

Vol 26 (4) ◽

pp. 390-404 ◽

Cited By ~ 15

Author(s):

Anne D. Simons ◽

C. Nathan Marti ◽

Paul Rohde ◽

Cara C. Lewis ◽

John Curry ◽

...

Keyword(s):

Depressive Symptoms ◽

Cognitive Behavioral Therapy ◽

Clinical Improvement ◽

Adolescent Depression ◽

Behavioral Therapy ◽

Antidepressant Medication ◽

Self Report ◽

Cognitive Behavioral ◽

Homework Completion ◽

Over Time

Objective: Examine the degree to which homework completion is associated with various indices of clinical improvement in adolescents with depression treated with cognitive behavioral therapy (CBT) either as a monotherapy and in combination with antidepressant medication. Method: This study used data from the Treatment of Adolescents with Depression Study (TADS), which compared the efficacy of CBT, fluoxetine (FLX), the combination of CBT and FLX (COMB), and a pill placebo (PBO; TADS Team, 2003, 2004, 2005). Current analyses included only TADS participants in the CBT (n = 111) or COMB (n = 107) conditions. Analyses focused on the relations between partial and full homework completion and a dichotomized measure of clinical response, evaluator and self-report ratings of depressive symptoms, hopelessness, and suicidality. Results: Homework completion significantly predicted clinical improvement, decrease in self-reported hopelessness, suicidality, and depression—but not in evaluator-rated depressive symptoms—in adolescents treated with CBT only. These relationships were almost completely absent in the COMB condition. The only significant COMB finding was that partially completed homework was related to decrease in hopelessness over time. Conclusions: These findings suggest that the ability of therapists and clients to collaboratively develop and complete between-session assignments is associated with response to CBT, self-report of severity of depressive symptoms, hopelessness, and suicidality and may be integral to optimizing the effects of CBT when delivered as a monotherapy.

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