Therapist Guided Activity Practice for Depressive Symptoms in University Students: A Randomized Controlled Trial

2019 ◽  
Author(s):  
Aliza Stein ◽  
Jason Shumake ◽  
Christopher G Beevers ◽  
Jasper A. J. Smits
Keyword(s):  
Depressive Symptoms ◽  
Behavioral Activation ◽  
Controlled Trial ◽  
Treatment Strategies ◽  
Self Report ◽  
Single Session ◽  
Guided Practice ◽  
Practice Condition ◽  
Positive Effect ◽  
Target Activity

Behavioral activation (BA) interventions are efficacious for depression, yet a substantial minority of patients do not respond to treatment. Strategies that facilitate activity outside of session may improve BA treatment outcomes. The objective of the current study was to examine whether briefly practicing a target activity (guided practice) during a modified single session of BA resulted in higher homework completion compared to activity planning alone (control). Participants (n=100) were college students with depressive symptoms. All participants selected an activity to monitor for 7 days with a goal of completing the activity 5 times. Self-report questionnaires were completed at baseline and 7-days later. Contrary to our hypothesis, participants assigned to the guided practice condition did not evidence a greater improvement in self-efficacy for completing the targeted activity relative to the control condition. However, there was a positive effect of guided practice on activity completion. Participants assigned to the guided practice condition evidenced a higher rate of activity completion relative to those assigned to the control condition. These results support the utility of guided practice as a strategy for improving homework compliance in BA.

scholarly journals Antianhedonic Effect of Repeated Ketamine Infusions in Patients With Treatment Resistant Depression

2021 ◽  
Vol 12 ◽  
Author(s):  
Alina Wilkowska ◽  
Mariusz Stanisław Wiglusz ◽  
Maria Gałuszko-Wegielnik ◽  
Adam Włodarczyk ◽  
Wiesław Jerzy Cubała
Keyword(s):  
Depressive Symptoms ◽  
Depressive Episode ◽  
Controlled Trial ◽  
Self Report ◽  
Treatment Resistant Depression ◽  
Treatment Resistant ◽  
Antidepressive Effect ◽  
Resistant Depression ◽  
Depression Symptomatology

Anhedonia constitutes one of the main symptoms of depressive episode. It correlates with suicidality and significantly effects the quality of patient's lives. Available treatments are not sufficient against this group of symptoms. Ketamine is a novel, rapid acting strategy for treatment resistant depression. Here we report the change in symptoms of anhedonia measured by Snaith-Hamilton Pleasure Scale as an effect of eight ketamine infusions as an add-on treatment in 42 patients with treatment resistant depression. We also determined the effect of this change on the severity of depressive symptoms measured by Inventory for Depression Symptomatology-Self Report 30-Item (IDS-SR 30). We have observed statistically significant decrease in the level of anhedonia during ketamine treatment. After adjusting for potential confounders we have found that significant reduction in Snaith-Hamilton Pleasure Scale (SHAPS) after each infusion and 1 week post treatment was observed only among patients who did not use benzodiazepines. The reduction in symptoms of anhedonia mediates the antidepressive effect of ketamine. The results need replication in a larger randomized placebo controlled trial.

scholarly journals Single-Session Interventions for Adolescent Depression in the Context of COVID-19: A Nationwide Randomized-Controlled Trial

2021 ◽  
Author(s):  
Jessica L. Schleider ◽  
Michael C Mullarkey ◽  
Kathryn Fox ◽  
Mallory Dobias ◽  
Akash Shroff ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Adolescent Depression ◽  
Behavioral Activation ◽  
Controlled Trial ◽  
High Stress ◽  
Single Session ◽  
Post Intervention ◽  
Personal Traits ◽  
Randomized Controlled ◽  
Increasing Risk

The COVID-19 pandemic caused financial hardship, social isolation, and distress, increasing risk for adolescent depression. Even before the pandemic, <50% of youth with depression accessed care, and not all benefited from existing treatments. Accordingly, this randomized-controlled trial tested online single-session interventions (SSIs) during COVID-19 in adolescents with elevated depression (N=2,452, ages 13-16). Adolescents recruited via social media were randomized to 1 of 3 SSIs: a behavioral activation SSI, an SSI teaching that personal traits are malleable, or a supportive control. We tested each SSI’s effects on post-intervention (hopelessness, agency) and 3-month outcomes (depression, hopelessness, agency, generalized anxiety, COVID-related trauma). Compared to the control, both active SSIs reduced 3-month depressive symptoms; decreased post-intervention and 3-month hopelessness; and increased post-intervention agency. Several differences between active SSIs emerged. Results confirm the effectiveness of two free-of-charge, online SSIs for adolescents with elevated depression, even in the high-stress context of COVID-19.

scholarly journals Treating Insomnia with High Risk of Depression Using Therapist-Guided Digital Cognitive, Behavioral, and Circadian Rhythm Support Interventions to Prevent Worsening of Depressive Symptoms: A Randomized Controlled Trial

2021 ◽  
pp. 1-12
Author(s):  
Jeanne Leerssen ◽  
Oti Lakbila-Kamal ◽  
Laura M.S. Dekkers ◽  
Savannah L.C. Ikelaar ◽  
Anne C.W. Albers ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Circadian Rhythm ◽  
Depressive Symptoms ◽  
High Risk ◽  
Depressive Symptomatology ◽  
Controlled Trial ◽  
Self Report ◽  
Cognitive Behavioral ◽  
Randomized Controlled ◽  
Increased Risk

<b><i>Introduction:</i></b> The global disease burden of major depressive disorder urgently requires prevention in high-risk individuals, such as recently discovered insomnia subtypes. Previous studies targeting insomnia with fully automated eHealth interventions to prevent depression are inconclusive: dropout was high and likely biased, and depressive symptoms in untreated participants on average improved rather than worsened. <b><i>Objective:</i></b> This randomized controlled trial aimed to efficiently prevent the worsening of depressive symptoms by selecting insomnia subtypes at high risk of depression for internet-based circadian rhythm support (CRS), cognitive behavioral therapy for insomnia (CBT-I), or their combination (CBT-I+CRS), with online therapist guidance to promote adherence. <b><i>Methods:</i></b> Participants with an insomnia disorder subtype conveying an increased risk of depression (<i>n</i> = 132) were randomized to no treatment (NT), CRS, CBT-I, or CBT-I+CRS. The Inventory of Depressive Symptomatology – Self Report (IDS-SR) was self-administered at baseline and at four follow-ups spanning 1 year. <b><i>Results:</i></b> Without treatment, depressive symptoms indeed worsened (<i>d</i> = 0.28, <i>p</i> = 0.041) in high-risk insomnia, but not in a reference group with low-risk insomnia. Therapist-guided CBT-I and CBT-I+CRS reduced IDS-SR ratings across all follow-up assessments (respectively, <i>d</i> = –0.80, <i>p</i> = 0.001; <i>d</i> = –0.95, <i>p</i> &#x3c; 0.001). Only CBT-I+CRS reduced the 1-year incidence of clinically meaningful worsening (<i>p</i> = 0.002). Dropout during therapist-guided interventions was very low (8%) compared to previous automated interventions (57–62%). <b><i>Conclusions:</i></b> The findings tentatively suggest that the efficiency of population-wide preventive strategies could benefit from the possibility to select insomnia subtypes at high risk of developing depression for therapist-guided digital CBT-I+CRS. This treatment may provide effective long-term prevention of worsening of depressive symptoms. <b><i>Trial registration:</i></b> the Netherlands Trial Register (NL7359).

Efficacy of an online intervention for treatment of depressive disorders: a three-arm randomized controlled trial comparing guided and unguided self-help with waitlist control (Preprint)

2021 ◽  
Author(s):  
Krämer Rico
Keyword(s):  
Depressive Symptoms ◽  
Depressive Disorders ◽  
Depressive Symptomatology ◽  
Controlled Trial ◽  
Intervention Group ◽  
Online Intervention ◽  
Self Report ◽  
Secondary Outcome ◽  
Control Group

BACKGROUND Digital health applications are efficacious treatment options for mild-to-moderate depressive disorders. However, the extent to which psychological guidance increases the efficacy of these applications is controversial. OBJECTIVE We evaluated the efficacy of the online intervention “Selfapy” for unipolar depression. We also investigated differences between a psychotherapist-guided vs. unguided version compared with those from a control group. METHODS A cohort of 401 participants with mild-to-severe depressive disorders were assigned randomly to either participate in a guided version of Selfapy (involving weekly telephone calls of 25-min duration), an unguided version of Selfapy, or to the waiting list (control group). Selfapy is a cognitive behavioral therapy-based intervention for depressive disorders of duration 12 weeks. Symptom assessment was undertaken at T1 (before study entrance), T2 (after 6 weeks), T3 (post-treatment, after 12 weeks), and T4 (follow-up, after 6 months). The main outcome was reduction in depressive symptoms in the Beck Depression Inventory (BDI-II) from T1 to T3. Secondary-outcome parameters were the Quick Inventory of Depressive Symptomatology – Self Report (QIDS-SR 16) and Beck Anxiety Inventory (BAI). RESULTS A total of 297 out of 401 participants (74.06%) completed the post-measurement at T3. In the primary analysis, both intervention groups showed a significantly higher reduction in depressive symptoms (BDI-II) from T1 to T3 compared with that in the control group, with high within-effect sizes (guided: d = 1.46; unguided d = 1.36). No significant differences were found for guided vs. unguided treatment groups. The response rate (BDI-II) for intention-to-treat data in the guided version was 46.4%, 40.0% for the unguided version, and 2.0% in the control group. After 6 months (T4), treatment effects could been maintained for both intervention groups (BDI-II) without differences between either intervention group. CONCLUSIONS Conclusions: Selfapy can help to reduce depressive symptoms in guided or unguided version. Follow-up data suggest that these effects could be maintained. The guided version was not superior to the unguided version. CLINICALTRIAL Trial Registration: Current Controlled Trial DRKS00017191 Date of registration: 14 May 2019 INTERNATIONAL REGISTERED REPORT RR2-https://doi.org/10.1186/s13063-021-05218-4

scholarly journals Analysis of the Components of a Cognitive-Behavioral Intervention for the prevention of Depression Administered via Conference Call to Nonprofessional Caregivers: A Randomized Controlled Trial

2020 ◽  
Vol 17 (6) ◽  
pp. 2067 ◽  
Author(s):  
Fernando L. Vázquez ◽  
Lara López ◽  
Ángela J. Torres ◽  
Patricia Otero ◽  
Vanessa Blanco ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Behavioral Activation ◽  
Preventive Intervention ◽  
Controlled Trial ◽  
Informal Caregivers ◽  
Cognitive Behavioral ◽  
Control Group ◽  
Number Needed To Treat ◽  
Conference Call ◽  
Randomized Controlled

Effective and accessible interventions for indicated prevention of depression are necessary and lacking, especially for informal caregivers. Although telephone-based interventions could increase the accessibility for caregivers, randomized controlled trials are scarce, with no examination of prevention to date. Moreover, the efficacy of specific therapeutic components in preventive cognitive-behavioral programs is unknown. The main objective of this study was to evaluate the efficacy of a telephone-administered psychological preventive intervention in informal caregivers with high depressive symptoms. A total of 219 caregivers were randomized to a cognitive-behavioral conference call intervention (CBCC, n = 69), a behavioral-activation conference call intervention (BACC, n = 70), or a usual care control group (CG, n = 80). Both interventions consisted of five 90-minute group sessions. At the post-intervention, incidence of depression was lower in CBCC and BACC compared to CG (1.5% and 1.4% vs. 8.8%). Relative risk was 0.17 for the CBCC and 0.16 for the BACC, and the number-needed-to-treat was 14 in both groups. Depressive symptoms were significantly lower in BACC and BACC groups compared to CG (d = 1.16 and 1.29), with no significant differences between CBCC and BACC groups. The conference call intervention was effective in preventing depression and the behavioral-activation component (BACC) was comparable to the CBCC intervention.

scholarly journals Mechanisms of rumination change in adolescent depression (RuMeChange): study protocol for a randomised controlled trial of rumination-focused cognitive behavioural therapy to reduce ruminative habit and risk of depressive relapse in high-ruminating adolescents

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Henrietta Roberts ◽  
Rachel H. Jacobs ◽  
Katie L. Bessette ◽  
Sheila E. Crowell ◽  
Mindy Westlund-Schreiner ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Controlled Trial ◽  
Inferior Frontal Gyrus ◽  
Preventive Therapy ◽  
Self Report ◽  
Phase Iii ◽  
Feasibility Trial ◽  
Response Scale ◽  
Post Intervention ◽  
Depressive Rumination

Abstract Background Adolescent-onset depression often results in a chronic and recurrent course, and is associated with worse outcomes relative to adult-onset depression. Targeting habitual depressive rumination, a specific known risk factor for relapse, may improve clinical outcomes for adolescents who have experienced a depressive episode. Randomized controlled trials (RCTs) thus far have demonstrated that rumination-focused cognitive behavioral therapy (RFCBT) reduces depressive symptoms and relapse rates in patients with residual depression and adolescents and young adults with elevated rumination. This was also observed in a pilot RCT of adolescents at risk for depressive relapse. Rumination can be measured at the self-report, behavioral, and neural levels- using patterns of connectivity between the Default Mode Network (DMN) and Cognitive Control Network (CCN). Disrupted connectivity is a putative important mechanism for understanding reduced rumination via RFCBT. A feasibility trial in adolescents found that reductions in connectivity between DMN and CCN regions following RFCBT were correlated with change in rumination and depressive symptoms. Method This is a phase III two-arm, two-stage, RCT of depression prevention. The trial tests whether RFCBT reduces identified risk factors for depressive relapse (rumination, patterns of neural connectivity, and depressive symptoms) in adolescents with partially or fully remitted depression and elevated rumination. In the first stage, RFCBT is compared to treatment as usual within the community. In the second stage, the comparator condition is relaxation therapy. Primary outcomes will be (a) reductions in depressive rumination, assessed using the Rumination Response Scale, and (b) reductions in resting state functional magnetic resonance imaging connectivity of DMN (posterior cingulate cortex) to CCN (inferior frontal gyrus), at 16 weeks post-randomization. Secondary outcomes include change in symptoms of depression following treatment, recurrence of depression over 12 months post-intervention period, and whether engagement with therapy homework (as a dose measure) is related to changes in the primary outcomes. Discussion RFCBT will be evaluated as a putative preventive therapy to reduce the risk of depressive relapse in adolescents, and influence the identified self-report, behavioral, and neural mechanisms of change. Understanding mechanisms that underlie change in rumination is necessary to improve and further disseminate preventive interventions. Trial registration ClinicalTrials.gov Identifier: NCT03859297, registered 01 March 2019.

scholarly journals Exploring Mediators of a Guided Web-Based Self-Help Intervention for People With HIV and Depressive Symptoms: Randomized Controlled Trial

10.2196/12711 ◽  
2019 ◽  
Vol 6 (8) ◽  
pp. e12711 ◽  
Author(s):  
Sanne van Luenen ◽  
Vivian Kraaij ◽  
Philip Spinhoven ◽  
Tom F Wilderjans ◽  
Nadia Garnefski
Keyword(s):  
Randomized Controlled Trial ◽  
Depressive Symptoms ◽  
Behavioral Activation ◽  
Controlled Trial ◽  
Cognitive Behavioral ◽  
Mediation Effect ◽  
Web Based ◽  
Randomized Controlled ◽  
Self Help ◽  
The Web

Background Cognitive behavioral therapy (CBT) is frequently used to treat depressive symptoms in people living with HIV. We developed an internet-based cognitive behavioral intervention for people with HIV and depressive symptoms, which was based on an effective self-help booklet. The Web-based intervention was previously found to be effective. Objective The objective of this study was to investigate potential mediators of the Web-based intervention. Methods This study was part of a randomized controlled trial, in which the intervention was compared with an attention-only waiting list control condition. Participants were 188 (97 in intervention group and 91 in control group) people with HIV and mild to moderate depressive symptoms recruited in HIV treatment centers in the Netherlands. A total of 22 participants (22/188, 11.7%) in the study were female and 166 (166/188, 88.3%) were male. The average age of the participants was 46.30 years (SD 10.63). The intervention comprised Web-based self-help CBT for 8 weeks, 1 to 2 hours a week, including minimal telephone support from a coach. The participants received Web-based questionnaires at pretest, 3 times during the intervention/or waiting period, and post intervention. The outcome was depressive symptoms. Factors tested as potential mediators were changes in behavioral activation, relaxation, the cognitive coping strategies catastrophizing and positive refocusing, goal re-engagement, and coping self-efficacy. Results Using multilevel structural equation modeling, changes in behavioral activation (P=.006) and goal re-engagement (P=.009) were found to be significant mediators of the intervention effect. The mediation effect seemed to occur between weeks 3 and 5 for behavioral activation and weeks 1 and 3 for goal re-engagement. Using (bivariate) autoregressive latent trajectory analysis, we found a return effect (from the dependent variable to the mediator) for goal re-engagement but not for behavioral activation, which suggested that the mediation effect of changes in behavioral activation was stronger than that in goal re-engagement. Conclusions The results suggest that changes in behavioral activation and goal re-engagement may mediate the effect of the Web-based intervention for people with HIV and depressive symptoms. The results may lead to possible mechanisms of change of the intervention and improvement of therapy outcomes. Clinical Trial Netherlands Trial Register NTR5407; https://www.trialregister.nl/trial/5298

scholarly journals Effects of emotion perception training on mood in undergraduate students: randomised controlled trial

2012 ◽  
Vol 201 (1) ◽  
pp. 71-72 ◽  
Author(s):  
Ian S. Penton-Voak ◽  
Helen Bate ◽  
Glyn Lewis ◽  
Marcus R. Munafò
Keyword(s):  
Depressive Symptoms ◽  
Undergraduate Students ◽  
Controlled Trial ◽  
Negative Mood ◽  
Emotion Perception ◽  
Self Report ◽  
Control Procedure ◽  
Emotional Perception ◽  
Randomised Controlled ◽  
Perception Training

SummaryWe investigated the effects of emotion perception training on depressive symptoms and mood in young adults reporting high levels of depressive symptoms (trial registration: ISRCTN02532638). Participants were randomised to an intervention procedure designed to increase the perception of happiness over sadness in ambiguous facial expressions or a control procedure, and completed self-report measures of depressive symptoms and mood. Those in the intervention condition had lower depressive symptoms and negative mood at 2-week follow-up, but there was no statistical evidence for a difference. There was some evidence for increased positive mood. Modification of emotional perception may lead to an increase in positive affect.

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