The Role of Emotion Regulation and Self-Efficacy in an Internet Intervention for Grief: A Mediation Analysis. (Preprint)

2021 ◽  
Author(s):  
Jeannette Brodbeck ◽  
Thomas Berger ◽  
Nicola Biesold ◽  
Franziska Rockstroh ◽  
Stefanie J. Schmidt ◽  
...  
Keyword(s):  
Emotion Regulation ◽  
Self Efficacy ◽  
Controlled Trial ◽  
Relative Strength ◽  
Brief Symptom Inventory ◽  
Internet Intervention ◽  
Prolonged Grief ◽  
Internet Interventions ◽  
Path Models ◽  
Psychopathology Symptoms

BACKGROUND Internet interventions for mental disorders and psychological problems such as prolonged grief have established their efficacy. However, less is known about how internet interventions work and through which mechanisms they are linked to the outcomes. OBJECTIVE As a first step in identifying mechanisms of change, this study examined emotion regulation and loss-related coping self-efficacy as putative mediators in a randomised controlled trial of a guided internet intervention for prolonged grief symptoms after spousal bereavement or separation/divorce. METHODS The sample consisted of older adults who reported prolonged grief or adaptation problems after bereavement or separation/divorce and sought help from a guided internet intervention. They were recruited mainly via newspaper articles. Outcome variables were grief symptoms assessed with the Texas Revised Inventory of Grief and psychopathology symptoms assessed with the Brief Symptom Inventory. Six module-related items assessed loss-focused emotion regulation and loss-related coping-self-efficacy. Path models with the simultaneous inclusion of emotion regulation and self-efficacy investigated the specificity and relative strength of these variables as parallel mediators. RESULTS A total of 100 participants who took part in the guided internet intervention. Average age was 51 years; 80% were separated/divorced, 69% were female and 76% were of Swiss origin. The internet intervention increased emotion-regulation skills (b = .34; P = .001) and loss-related self-efficacy (b = .30; P = .002) which both correlated with improvements in grief and psychopathology symptoms. Path models including both putative mediators simultaneously indicated that emotion regulation was directly associated with improvements in grief symptoms (b = .40; P = <.001) but not psychopathology symptoms (b = .01; P = .638). Loss-related self-efficacy was directly related to improvements in psychopathology symptoms (b = .28; P = .017) but not grief symptoms (b = .16; P = .186). The path from the intervention to the improvement in grief remained significant (b = .25; P = .007) in contrast to the path from the intervention to improvements in psychopathology (b = .13; P = .179). CONCLUSIONS Emotion regulation and loss-related coping self-efficacy are promising therapeutic targets for optimizing internet interventions for grief. Emotion regulation appears to be more important for enabling grief processing whereas loss-related coping self-efficacy might be more relevant for improving psychopathology in general. Emotion regulation and coping self-efficacy should be further examined as transdiagnostic or disorder-specific putative mediators in internet interventions for other disorders. CLINICALTRIAL ClinicalTrials.gov NCT02900534; https://clinicaltrials.gov/ct2/show/NCT02900534. INTERNATIONAL REGISTERED REPORT RR2-doi:10.1186/s13063-016-1759-5

scholarly journals A Group-Based Online Intervention to Prevent Postpartum Depression (Sunnyside): Feasibility Randomized Controlled Trial

10.2196/10778 ◽  
2019 ◽  
Vol 6 (5) ◽  
pp. e10778
Author(s):  
Jennifer Duffecy ◽  
Rebecca Grekin ◽  
Hannah Hinkel ◽  
Nicholas Gallivan ◽  
Graham Nelson ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Postpartum Depression ◽  
Peer Support ◽  
Controlled Trial ◽  
Internet Intervention ◽  
Health Questionnaire ◽  
Randomized Controlled ◽  
Internet Interventions ◽  
Patient Health ◽  
Internet Support

Background Postpartum depression (PPD) has a 20% 3-month prevalence rate. The consequences of PPD are significant for the mother, infant, and the family. There is a need for preventive interventions for PPD, which are effective and accessible; however, many barriers exist for women who attempt to access perinatal depression prevention programs. Internet interventions for the treatment and prevention of depression are widely accepted as efficacious and may overcome some of the issues pertaining to access to treatment barriers perinatal women face. However, internet interventions offered without any human support tend to have low adherence but positive outcomes for those who do complete treatment. Internet support groups often have high levels of adherence but minimal data supporting efficacy as a treatment for depression. Taken together, these findings suggest that combining the treatment components of individual interventions with the support provided by an internet support group might create an intervention with the scalability and cost-effectiveness of an individual intervention and the better outcomes typically found in supported interventions. Objectives This study aimed to describe the development of a cognitive behavioral therapy (CBT) internet intervention with peer support to prevent PPD and examine preliminary depression and site usage outcomes. Methods User-centered design groups were used to develop the internet intervention. Once the intervention was developed, women who were 20 to 28 weeks pregnant with symptoms of depression (Patient Health Questionnaire-8 scores of 5-14) but who had no major depression diagnosis were enrolled in a randomized controlled trial (RCT) to compare 8 weeks of a CBT-based internet intervention with peer support to an individual internet intervention designed to prevent PPD. Assessments took place at baseline, 4 weeks, 8 weeks (end of treatment), and then 4 weeks and 6 weeks postpartum. Results A total of 25 women were randomized. Of these, 24 women completed the RCT. Patient Health Questionnaire-9 scores at 6 weeks postpartum remained below the clinical threshold for referral for treatment in both groups, with depression measures showing a decrease in symptoms from baseline to postpartum. At 6 weeks postpartum, only 4% (1/24) met the criteria for PPD. There was no difference between groups in adherence to the intervention, with an average of 14.55 log-ins over the course of treatment. Conclusions Results suggest women were responsive to both peer support and individual internet interventions to prevent PPD and that peer support may be a useful feature to keep participants adherent. Trial Registration ClinicalTrials.gov NCT02121015; https://clinicaltrials.gov/ct2/show/NCT02121015 (archived by WebCite at http://www.webcitation.org/765a7qBKy)

scholarly journals The Role of Emotion Regulation and Loss-Related Coping Self-Efficacy in an Internet Intervention for Grief: A Mediation Analysis. (Preprint)

10.2196/27707 ◽  
2021 ◽  
Author(s):  
Jeannette Brodbeck ◽  
Thomas Berger ◽  
Nicola Biesold ◽  
Franziska Rockstroh ◽  
Stefanie J. Schmidt ◽  
...  
Keyword(s):  
Emotion Regulation ◽  
Mediation Analysis ◽  
Self Efficacy ◽  
Internet Intervention

scholarly journals Does providing a brief internet intervention for hazardous alcohol use to people seeking online help for depression reduce both alcohol use and depression symptoms among participants with these co-occurring disorders? Study protocol for a randomised controlled trial

BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e022412 ◽  
Author(s):  
John A Cunningham ◽  
Christian S Hendershot ◽  
Frances Kay-Lambkin ◽  
Clayton Neighbors ◽  
Kathleen M Griffiths ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Alcohol Consumption ◽  
Alcohol Use ◽  
Controlled Trial ◽  
Internet Intervention ◽  
Depression Symptoms ◽  
Hazardous Alcohol Use ◽  
Internet Interventions ◽  
Hazardous Alcohol ◽  
Hazardous Alcohol Consumption

IntroductionHazardous alcohol consumption is common among people experiencing depression, often acting to exacerbate depressive symptoms. While many people with these co-occurring disorders do not seek face-to-face treatment, they do seek help online. There are effective internet interventions that target hazardous alcohol consumption or depression separately but none that combine these online interventions without the involvement of a therapist. In order to realise the potential of internet interventions, we need to develop an evidence base supporting the efficacy of internet interventions for co-occurring depression and hazardous alcohol use without any therapist involvement. This study aims to evaluate the effects on drinking, and on depressive symptoms, of combining an internet intervention targeting hazardous alcohol consumption with one for depression.Methods and analysisA double blinded, parallel group randomised controlled trial will be used. Participants with current depression who also drink in a hazardous fashion (n=986) will be recruited for a study to ‘help improve an online intervention for depression’. Participants will be randomised either to receive an established online intervention for depression (MoodGYM) or to receive MoodGYM plus a brief internet intervention for hazardous alcohol consumption (Check Your Drinking; CYD). Participants will be contacted 3 and 6 months after receiving the interventions to assess changes in drinking and depression symptoms. It is predicted that participants receiving the CYD intervention in addition to MoodGYM will report greater postintervention reductions in alcohol consumption and depressive symptoms compared with those who received MoodGYM only. Hypothesised mediation and moderation effects will also be investigated. Using an intention-to-treat basis for the analyses, the hypotheses will be tested using a generalised linear hypothesis framework, and longitudinal analyses will use either generalised linear mixed modelling or generalised estimating equation approach where appropriate.Ethics and disseminationThis research comprises the crucial first steps in developing lower-cost and efficacious internet interventions for people suffering from depression who also drink in a hazardous fashion—promoting the widespread availability of care for those in need. This study has been approved by the standing ethics review committee of the Centre for Addiction and Mental Health, and findings will be disseminated in the form of at least one peer-reviewed article and presentations at conferences.Trial registration numberNCT03421080; Pre-results.

scholarly journals Resource-Based Internet Intervention (Med-Stress) to Improve Well-Being Among Medical Professionals: Randomized Controlled Trial (Preprint)

2020 ◽  
Author(s):  
Ewelina Smoktunowicz ◽  
Magdalena Lesnierowska ◽  
Per Carlbring ◽  
Gerhard Andersson ◽  
Roman Cieslak
Keyword(s):  
Social Support ◽  
Job Stress ◽  
Work Engagement ◽  
Self Efficacy ◽  
Controlled Trial ◽  
Well Being ◽  
Internet Intervention ◽  
Medical Professionals ◽  
Active Comparator ◽  
Cultivation Process

BACKGROUND Medical professionals are exposed to multiple and often excessive demands in their work environment. Low-intensity internet interventions allow them to benefit from psychological support even when institutional help is not available. Focusing on enhancing psychological resources—self-efficacy and perceived social support—makes an intervention relevant for various occupations within the medical profession. Previously, these resources were found to operate both individually or sequentially with self-efficacy either preceding social support (cultivation process) or following it (enabling process). OBJECTIVE The objective of this randomized controlled trial is to compare the efficacy of 4 variants of Med-Stress, a self-guided internet intervention that aims to improve the multifaceted well-being of medical professionals. METHODS This study was conducted before the COVID-19 pandemic. Participants (N=1240) were recruited mainly via media campaigns and social media targeted ads. They were assigned to 1 of the following 4 groups: experimental condition reflecting the cultivation process, experimental condition reflecting the enabling process, active comparator enhancing only self-efficacy, and active comparator enhancing only perceived social support. Outcomes included 5 facets of well-being: job stress, job burnout, work engagement, depression, and job-related traumatic stress. Measurements were taken on the web at baseline (time 1), immediately after intervention (time 2), and at a 6-month follow-up (time 3). To analyze the data, linear mixed effects models were used on the intention-to-treat sample. The trial was partially blinded as the information about the duration of the trial, which was different for experimental and control conditions, was public. RESULTS At time 2, job stress was lower in the condition reflecting the cultivation process than in the one enhancing social support only (<i>d</i>=−0.21), and at time 3, participants in that experimental condition reported the lowest job stress when compared with all 3 remaining study groups (<i>ds</i> between −0.24 and −0.41). For job-related traumatic stress, we found a significant difference between study groups only at time 3: stress was lower in the experimental condition in which self-efficacy was enhanced first than in the active comparator enhancing solely social support (<i>d</i>=−0.24). The same result was found for work engagement (<i>d</i>=−0.20), which means that it was lower in exactly the same condition that was found beneficial for stress relief. There were no differences between study conditions for burnout and depression neither at time 2 nor at time 3. There was a high dropout in the study (1023/1240, 82.50% at posttest), reflecting the pragmatic nature of this trial. CONCLUSIONS The Med-Stress internet intervention improves some components of well-being—most notably job stress—when activities are completed in a specific sequence. The decrease in work engagement could support the notion of dark side of this phenomenon, but further research is needed. CLINICALTRIAL ClinicalTrials.gov NCT03475290; https://clinicaltrials.gov/ct2/show/NCT03475290 INTERNATIONAL REGISTERED REPORT RR2-10.1186/s13063-019-3401-9

scholarly journals REMOTION Blended Transdiagnostic Intervention for Symptom Reduction and Improvement of Emotion Regulation in an Outpatient Psychotherapeutic Setting: Protocol for a Pilot Randomized Controlled Trial (Preprint)

2020 ◽  
Author(s):  
Laura Luisa Bielinski ◽  
Tobias Krieger ◽  
Franz Moggi ◽  
Leonie Trimpop ◽  
Ulrike Willutzki ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Emotion Regulation ◽  
Controlled Trial ◽  
Intervention Group ◽  
Well Being ◽  
Brief Symptom Inventory ◽  
Randomized Controlled ◽  
Blended Treatment ◽  
Internet Based Intervention ◽  
Pilot Randomized Controlled Trial

BACKGROUND Emotion regulation has been identified as an important transdiagnostic factor relevant to the treatment of mental health disorders. Many empirically validated psychotherapeutic treatments incorporate elements targeting emotion regulation. Most of these treatment approaches are conceptualized as standard face-to-face treatments not as blended treatments, which include an internet-based intervention. OBJECTIVE The aim of this study is to examine, for the first time, a new internet-based intervention—REMOTION—that will be provided transdiagnostically, as an add-on to psychotherapy, to provide a blended treatment format. METHODS A total of 70 participants will be assigned (1:1 allocation ratio) to either the intervention group (REMOTION + psychotherapy) or the treatment-as-usual group that receives psychotherapy alone. To maximize external validity, a typical outpatient treatment sample of patients diagnosed with a range of disorders such as depression, anxiety disorders, and adjustment disorder will be recruited from a university outpatient clinic. Patients with bipolar disorder, psychotic disorders, or acute suicidality will be excluded from the study. The feasibility and potential effectiveness of the intervention will be examined by assessing data at baseline, 6 weeks (post), and 12 weeks (follow-up). The primary outcome is general symptom severity, assessed with the Brief Symptom Inventory. Secondary outcomes are emotion regulation, depressive symptoms, anxiety symptoms, health related quality of life, well-being, and a variety of feasibility parameters. Quantitative data will be analyzed on an intention-to-treat basis. RESULTS Participant recruitment and data collection started in February 2020, and as of November 2020, are ongoing. Results for the study are expected in 2022. CONCLUSIONS This pilot randomized controlled trial will inform future studies using transdiagnostic blended treatment. CLINICALTRIAL ClinicalTrials.gov NCT04262726; http://clinicaltrials.gov/ct2/show/NCT04262726 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/20936

scholarly journals Resource-Based Internet Intervention (Med-Stress) to Improve Well-Being Among Medical Professionals: Randomized Controlled Trial

10.2196/21445 ◽  
2021 ◽  
Vol 23 (1) ◽  
pp. e21445
Author(s):  
Ewelina Smoktunowicz ◽  
Magdalena Lesnierowska ◽  
Per Carlbring ◽  
Gerhard Andersson ◽  
Roman Cieslak
Keyword(s):  
Social Support ◽  
Job Stress ◽  
Work Engagement ◽  
Self Efficacy ◽  
Controlled Trial ◽  
Well Being ◽  
Internet Intervention ◽  
Medical Professionals ◽  
Active Comparator ◽  
Cultivation Process

Background Medical professionals are exposed to multiple and often excessive demands in their work environment. Low-intensity internet interventions allow them to benefit from psychological support even when institutional help is not available. Focusing on enhancing psychological resources—self-efficacy and perceived social support—makes an intervention relevant for various occupations within the medical profession. Previously, these resources were found to operate both individually or sequentially with self-efficacy either preceding social support (cultivation process) or following it (enabling process). Objective The objective of this randomized controlled trial is to compare the efficacy of 4 variants of Med-Stress, a self-guided internet intervention that aims to improve the multifaceted well-being of medical professionals. Methods This study was conducted before the COVID-19 pandemic. Participants (N=1240) were recruited mainly via media campaigns and social media targeted ads. They were assigned to 1 of the following 4 groups: experimental condition reflecting the cultivation process, experimental condition reflecting the enabling process, active comparator enhancing only self-efficacy, and active comparator enhancing only perceived social support. Outcomes included 5 facets of well-being: job stress, job burnout, work engagement, depression, and job-related traumatic stress. Measurements were taken on the web at baseline (time 1), immediately after intervention (time 2), and at a 6-month follow-up (time 3). To analyze the data, linear mixed effects models were used on the intention-to-treat sample. The trial was partially blinded as the information about the duration of the trial, which was different for experimental and control conditions, was public. Results At time 2, job stress was lower in the condition reflecting the cultivation process than in the one enhancing social support only (d=−0.21), and at time 3, participants in that experimental condition reported the lowest job stress when compared with all 3 remaining study groups (ds between −0.24 and −0.41). For job-related traumatic stress, we found a significant difference between study groups only at time 3: stress was lower in the experimental condition in which self-efficacy was enhanced first than in the active comparator enhancing solely social support (d=−0.24). The same result was found for work engagement (d=−0.20), which means that it was lower in exactly the same condition that was found beneficial for stress relief. There were no differences between study conditions for burnout and depression neither at time 2 nor at time 3. There was a high dropout in the study (1023/1240, 82.50% at posttest), reflecting the pragmatic nature of this trial. Conclusions The Med-Stress internet intervention improves some components of well-being—most notably job stress—when activities are completed in a specific sequence. The decrease in work engagement could support the notion of dark side of this phenomenon, but further research is needed. Trial Registration ClinicalTrials.gov NCT03475290; https://clinicaltrials.gov/ct2/show/NCT03475290 International Registered Report Identifier (IRRID) RR2-10.1186/s13063-019-3401-9

scholarly journals A Group-Based Online Intervention to Prevent Postpartum Depression (Sunnyside): Feasibility Randomized Controlled Trial (Preprint)

2018 ◽  
Author(s):  
Jennifer Duffecy ◽  
Rebecca Grekin ◽  
Hannah Hinkel ◽  
Nicholas Gallivan ◽  
Graham Nelson ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Postpartum Depression ◽  
Peer Support ◽  
Controlled Trial ◽  
Internet Intervention ◽  
Health Questionnaire ◽  
Randomized Controlled ◽  
Internet Interventions ◽  
Patient Health ◽  
Internet Support

BACKGROUND Postpartum depression (PPD) has a 20% 3-month prevalence rate. The consequences of PPD are significant for the mother, infant, and the family. There is a need for preventive interventions for PPD, which are effective and accessible; however, many barriers exist for women who attempt to access perinatal depression prevention programs. Internet interventions for the treatment and prevention of depression are widely accepted as efficacious and may overcome some of the issues pertaining to access to treatment barriers perinatal women face. However, internet interventions offered without any human support tend to have low adherence but positive outcomes for those who do complete treatment. Internet support groups often have high levels of adherence but minimal data supporting efficacy as a treatment for depression. Taken together, these findings suggest that combining the treatment components of individual interventions with the support provided by an internet support group might create an intervention with the scalability and cost-effectiveness of an individual intervention and the better outcomes typically found in supported interventions. OBJECTIVES This study aimed to describe the development of a cognitive behavioral therapy (CBT) internet intervention with peer support to prevent PPD and examine preliminary depression and site usage outcomes. METHODS User-centered design groups were used to develop the internet intervention. Once the intervention was developed, women who were 20 to 28 weeks pregnant with symptoms of depression (Patient Health Questionnaire-8 scores of 5-14) but who had no major depression diagnosis were enrolled in a randomized controlled trial (RCT) to compare 8 weeks of a CBT-based internet intervention with peer support to an individual internet intervention designed to prevent PPD. Assessments took place at baseline, 4 weeks, 8 weeks (end of treatment), and then 4 weeks and 6 weeks postpartum. RESULTS A total of 25 women were randomized. Of these, 24 women completed the RCT. Patient Health Questionnaire-9 scores at 6 weeks postpartum remained below the clinical threshold for referral for treatment in both groups, with depression measures showing a decrease in symptoms from baseline to postpartum. At 6 weeks postpartum, only 4% (1/24) met the criteria for PPD. There was no difference between groups in adherence to the intervention, with an average of 14.55 log-ins over the course of treatment. CONCLUSIONS Results suggest women were responsive to both peer support and individual internet interventions to prevent PPD and that peer support may be a useful feature to keep participants adherent. CLINICALTRIAL ClinicalTrials.gov NCT02121015; https://clinicaltrials.gov/ct2/show/NCT02121015 (archived by WebCite at http://www.webcitation.org/765a7qBKy)

scholarly journals REMOTION Blended Transdiagnostic Intervention for Symptom Reduction and Improvement of Emotion Regulation in an Outpatient Psychotherapeutic Setting: Protocol for a Pilot Randomized Controlled Trial

10.2196/20936 ◽  
2020 ◽  
Vol 9 (11) ◽  
pp. e20936
Author(s):  
Laura Luisa Bielinski ◽  
Tobias Krieger ◽  
Franz Moggi ◽  
Leonie Trimpop ◽  
Ulrike Willutzki ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Emotion Regulation ◽  
Controlled Trial ◽  
Intervention Group ◽  
Well Being ◽  
Brief Symptom Inventory ◽  
Randomized Controlled ◽  
Blended Treatment ◽  
Internet Based Intervention ◽  
Pilot Randomized Controlled Trial

Background Emotion regulation has been identified as an important transdiagnostic factor relevant to the treatment of mental health disorders. Many empirically validated psychotherapeutic treatments incorporate elements targeting emotion regulation. Most of these treatment approaches are conceptualized as standard face-to-face treatments not as blended treatments, which include an internet-based intervention. Objective The aim of this study is to examine, for the first time, a new internet-based intervention—REMOTION—that will be provided transdiagnostically, as an add-on to psychotherapy, to provide a blended treatment format. Methods A total of 70 participants will be assigned (1:1 allocation ratio) to either the intervention group (REMOTION + psychotherapy) or the treatment-as-usual group that receives psychotherapy alone. To maximize external validity, a typical outpatient treatment sample of patients diagnosed with a range of disorders such as depression, anxiety disorders, and adjustment disorder will be recruited from a university outpatient clinic. Patients with bipolar disorder, psychotic disorders, or acute suicidality will be excluded from the study. The feasibility and potential effectiveness of the intervention will be examined by assessing data at baseline, 6 weeks (post), and 12 weeks (follow-up). The primary outcome is general symptom severity, assessed with the Brief Symptom Inventory. Secondary outcomes are emotion regulation, depressive symptoms, anxiety symptoms, health related quality of life, well-being, and a variety of feasibility parameters. Quantitative data will be analyzed on an intention-to-treat basis. Results Participant recruitment and data collection started in February 2020, and as of November 2020, are ongoing. Results for the study are expected in 2022. Conclusions This pilot randomized controlled trial will inform future studies using transdiagnostic blended treatment. Trial Registration ClinicalTrials.gov NCT04262726; http://clinicaltrials.gov/ct2/show/NCT04262726 International Registered Report Identifier (IRRID) DERR1-10.2196/20936

scholarly journals Prolonged Grief Disorder Among Refugees in Psychological Treatment—Association With Self-Efficacy and Emotion Regulation

2020 ◽  
Vol 11 ◽  
Author(s):  
Oriane Lacour ◽  
Naser Morina ◽  
Julia Spaaij ◽  
Angela Nickerson ◽  
Ulrich Schnyder ◽  
...  
Keyword(s):  
Emotion Regulation ◽  
Self Efficacy ◽  
Psychological Treatment ◽  
Prolonged Grief Disorder ◽  
Prolonged Grief
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