Looking beyond depression: A meta-analysis of the effect of behavioral activation on depression, anxiety, and activation

2019 ◽  
Author(s):  
Aliza Stein ◽  
Emily Carl ◽  
Eirini Karyotaki ◽  
Pim Cuijpers ◽  
Jasper A. J. Smits
Keyword(s):  
Active Control ◽  
Behavioral Activation ◽  
Psychological Intervention ◽  
Meta Analysis ◽  
Cost Effective ◽  
Effect Sizes ◽  
Depression Symptom ◽  
Post Intervention ◽  
Random Effects Models ◽  
Subgroup Analyses

Background: Depression is a prevalent and impairing condition. Behavioral Activation (BA) is a parsimonious, cost-effective, and easily disseminated psychological intervention for depression. The present meta-analysis expanded on existing literature supporting the efficacy of BA for depression by examining the effects of BA on additional relevant outcomes for patients with depression, namely the reduction in anxiety symptoms and increase in activation. Methods: Randomized controlled trials of BA for depression compared to active and inactive control were identified via systematic review. Effect sizes using Hedges’s g were calculated for each outcome compared to both active and inactive control using random effects models. Subgroup analyses were used to examine the inclusion of a discussion of values as a moderator of depression symptom outcome in BA. Results: Twenty-eight studies were included. Meta-analyses of symptom change between groups from baseline-to-post intervention indicated that BA outperformed inactive control for depression (g = 0.83), anxiety (g = 0.37), and activation (g = 0.64). Effect sizes did not differ significantly from active control for depression (g = 0.15), anxiety (g = 0.03), activation (g = 0.04), or for subgroup analyses. Study quality was generally low, and evidence of publication bias was present. Conclusions: Results support the efficacy of BA relative to inactive control for reducing symptoms of depression and anxiety in addition to increasing activation. BA did not differ from active control on these outcomes. These findings support the use of BA for the treatment of depression, yet call for continued high quality evaluations of BA for depression.

Looking beyond depression: a meta-analysis of the effect of behavioral activation on depression, anxiety, and activation

2020 ◽  
pp. 1-14
Author(s):  
Aliza T. Stein ◽  
Emily Carl ◽  
Pim Cuijpers ◽  
Eirini Karyotaki ◽  
Jasper A. J. Smits
Keyword(s):  
Behavioral Activation ◽  
Psychological Intervention ◽  
Meta Analysis ◽  
Cost Effective ◽  
Depression Symptom ◽  
Post Intervention ◽  
Random Effects Models ◽  
The Difference ◽  
Symptom Outcome ◽  
Meta Analyses

Abstract Background Depression is a prevalent and impairing condition. Behavioral activation (BA) is a parsimonious, cost-effective, and easily disseminated psychological intervention for depression. The current meta-analysis expands on the existing literature supporting the efficacy of BA for depression by examining the effects of BA on additional relevant outcomes for patients with depression, namely the reduction in anxiety symptoms and increase in activation. Methods Randomized controlled trials of BA for depression compared to active and inactive control were identified via a systematic review. Effect sizes using Hedges's g were calculated for each outcome compared to both active and inactive control using random effects models. Subgroup analyses were used to examine the inclusion of a discussion of values as a moderator of depression symptom outcome in BA. Results Twenty-eight studies were included. Meta-analyses of symptom change between groups from baseline-to-post intervention indicated that BA outperformed inactive control conditions for improvements in depression (g = 0.83), anxiety (g = 0.37), and activation (g = 0.64). The difference between BA and active control conditions was not significant for improvements in depression (g = 0.15), anxiety (g = 0.03), and activation (g = 0.04). There was no evidence for a discussion of values augmenting BA efficacy. Study quality was generally low, and there was evidence of publication bias. Conclusions In addition to improving depression, BA shows efficacy for reducing symptoms of anxiety and increasing activation. BA may not offer better outcomes relative to other active interventions. There is room for improvement in the quality of research in this area.

scholarly journals Internet-based treatment of gambling problems: A systematic review and meta-analysis of randomized controlled trials

2021 ◽  
Author(s):  
Dominic Sagoe ◽  
Mark. D. Griffiths ◽  
Eilin Kristine Erevik ◽  
Turid Høyland ◽  
Tony Leino ◽  
...  
Keyword(s):  
Random Effects ◽  
Meta Analysis ◽  
Effect Sizes ◽  
Control Group ◽  
Gambling Problems ◽  
Random Effects Models ◽  
Subgroup Analyses ◽  
Gambling Frequency ◽  
Therapist Support

AbstractBackground and aimsThe effect of internet-based psychological treatment for gambling problems has not been previously investigated by meta-analysis. The present study is therefore a quantitative synthesis of studies on the effects of internet-based treatment for gambling problems. Given that effects may vary according to the presence of therapist support and control conditions, it was presumed that subgroup analyses would elucidate such effects.MethodsA systematic search with no time constraints was conducted in PsycINFO, MEDLINE, Web of Science, and the Cochrane Library. Two authors independently extracted data using a predefined form, including study quality assessment based on the Cochrane risk of bias tool. Effect sizes were calculated using random-effects models. Heterogeneity was indexed by Cochran’s Q and the I2 statistics. Publication bias was investigated using trim and fill.ResultsThirteen studies were included in the analysis. Random effects models at post-treatment showed significant effects for general gambling symptoms (g = 0.73; 95% CI = 0.43–1.03), gambling frequency (g = 0.29; 95% CI = 0.14–0.45), and amount of money lost gambling (g = 0.19; 95% CI = 0.11–0.27). The corresponding findings at follow-up were g = 1.20 (95% CI = 0.79–1.61), g = 0.36 (95% CI = 0.12–0.60), and g = 0.20 (95% CI = 0.12–0.29) respectively. Subgroup analyses showed that for general gambling symptoms, studies with therapist support yield larger effects than studies without, both post-treatment and at follow-up. Additionally, on general gambling symptoms and gambling frequency, there were lower effect sizes for studies with a control group compared to studies without a control group at follow-up. Studies with higher baseline severity of gambling problems were associated with larger effect sizes at both posttreatment and follow-up than studies with more lenient inclusion criteria concerning gambling problems.Discussion and conclusionsInternet-based treatment has the potential to reach a large proportion of persons with gambling problems. Results of the meta-analysis suggest that such treatments hold promise as an effective approach. Future studies are encouraged to examine moderators of treatment outcomes, validate treatment effects cross-culturally, and investigate the effects of novel developments such as ecological momentary interventions.

Set-shifting ability across the spectrum of eating disorders and in overweight and obesity: a systematic review and meta-analysis

2014 ◽  
Vol 44 (16) ◽  
pp. 3365-3385 ◽  
Author(s):  
M. Wu ◽  
T. Brockmeyer ◽  
M. Hartmann ◽  
M. Skunde ◽  
W. Herzog ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Web Of Science ◽  
Meta Analysis ◽  
Strong Support ◽  
Overweight And Obesity ◽  
Effect Sizes ◽  
Set Shifting ◽  
Random Effects Models ◽  
Underlying Factor ◽  
Subgroup Analyses

Background.In this meta-analysis we review the findings from neuropsychological studies on set-shifting in people with eating disorders (EDs) or overweight/obesity.Method.Four databases (PubMed, PsycINFO, PSYNDEX and Web of Science) were searched for eligible studies. Effect sizes (ESs) were pooled using random-effects models. Moderator analyses were conducted for ED and overweight/obese subgroups, adult/adolescent samples and measures of set-shifting.Results.Sixty-four studies with a total of 1825 ED patients [1394 anorexia nervosa (AN), 376 bulimia nervosa (BN) and 55 binge eating disorder (BED)] and 10 studies with a total of 449 overweight/obese individuals were included. The meta-analysis revealed a small to medium ES for inefficient set-shifting across all three ED diagnoses (Hedges’ g = –0.45). Subgroup analyses yielded small to medium ESs for each ED subtype (g = –0.44 for AN, –0.53 for BED, –0.50 for BN), which did not differ significantly. There was a medium ES for restricting type AN (ANR; g = –0.51) but no significant ES for binge/purge type AN (AN/BP; g = –0.18). A medium ES was found across obesity studies (g = –0.61). The ES across overweight studies was not significant (g = –0.07). Adult samples did not differ from adolescent samples in either ED or overweight/obesity studies. The different set-shifting measures were associated with largely varying ESs.Conclusions.The meta-analysis provides strong support that inefficient set-shifting is a salient neuropsychological phenomenon across ED subtypes and obesity, but is less prominent in AN/BP and overweight. Compulsivity seems to be a common underlying factor supporting a dimensional and transdiagnostic conceptualization of EDs and obesity.

scholarly journals Secondary Effects of Body Dissatisfaction Interventions on Adolescent Depressive Symptoms: A Meta-Analysis

2021 ◽  
Author(s):  
Isaac Ahuvia ◽  
Laura Jans ◽  
Jessica L. Schleider
Keyword(s):  
Body Dissatisfaction ◽  
Meta Analysis ◽  
Significant Risk ◽  
Effect Sizes ◽  
Secondary Outcome ◽  
Future Research ◽  
Depression Symptoms ◽  
Depression Symptom ◽  
Secondary Effects ◽  
Post Intervention

Objective: Depression is a leading cause of disability among adolescents, yet existing treatments are variably effective, suggesting needs to identify novel intervention targets. Body dissatisfaction (BD) may be a promising, but understudied, target: BD is common among adolescents; prospectively associated with future depression; and modifiable through intervention. BD interventions are typically evaluated in terms of impacts on eating disorders, but many trials also measure depression-related secondary outcomes. However, BD intervention effects on depression have not been systematically examined. We therefore conducted a meta-analysis to estimate secondary effects of BD interventions on depression symptoms and related outcomes in adolescents (ages 12-19). Method: Our systematic review included RCTs published between January 2006-December 2020. Across-group effect sizes were analyzed using robust variance estimation. Pre-registered methods, data, and analytic code are available at https://osf.io/734n8/. Results: The meta-analysis included thirteen RCTs, 50 effect sizes, and 6,962 participants. BD interventions led to significant post-intervention reductions in depression-related outcomes versus control conditions (g = -.19 at post-intervention, 95% CI -.07, -.31, p = .005). No evidence emerged for moderators of this meta-analytic effect. Discussion: Overall, BD-focused interventions significantly reduced adolescent depression, with mean post-intervention effect sizes comparable to those observed for interventions targeting depression explicitly. Results are bolstered by pre-registered methods and robustness checks. Limitations include a lack of data on participants’ sexual and gender identities and a significant risk of bias in the underlying literature. Future research on BD interventions should measure depression symptom severity as a secondary outcome.

Effectiveness of psychological interventions to improve emotion regulation in youth - a meta-analysis

2019 ◽  
Author(s):  
Bettina Moltrecht ◽  
Jessica Deighton ◽  
Praveetha Patalay ◽  
Julian Childs
Keyword(s):  
Emotion Regulation ◽  
Emotion Dysregulation ◽  
Psychological Intervention ◽  
Meta Analysis ◽  
Age Groups ◽  
Effect Sizes ◽  
What Works ◽  
Large Heterogeneity ◽  
Larger Sample

Background: Research investigating the role of emotion regulation (ER) in the development and treatment of psychopathology has increased in recent years. Evidence suggests that an increased focus on ER in treatment can improve existing interventions. Most ER research has neglected young people, therefore the present meta-analysis summarizes the evidence for existing psychosocial intervention and their effectiveness to improve ER in youth. Methods: A systematic review and meta-analysis was conducted according to the PRISMA guidelines. Twenty-one randomized-control-trials (RCTs) assessed changes in ER following a psychological intervention in youth exhibiting various psychopathological symptoms.Results: We found moderate effect sizes for current interventions to decrease emotion dysregulation in youth (g=-.46) and small effect sizes to improve emotion regulation (g=0.36). Significant differences between studies including intervention components, ER measures and populations studied resulted in large heterogeneity. Conclusion: This is the first meta-analysis that summarizes the effectiveness for existing interventions to improve ER in youth. The results suggest that interventions can enhance ER in youth, and that these improvements correlate with improvements in psychopathology. More RCTs including larger sample sizes, different age groups and psychopathologies are needed to increase our understanding of what works for who and when.

A Systematic Review and Meta-Analysis of the Relation Between Engagement and Achievement in Early Childhood Research

2021 ◽  
pp. 027112142110327
Author(s):  
Esther R. Lindström ◽  
Jason C. Chow ◽  
Kathleen N. Zimmerman ◽  
Hongyang Zhao ◽  
Elise Settanni ◽  
...  
Keyword(s):  
Early Childhood ◽  
Academic Engagement ◽  
Literature Search ◽  
Meta Analysis ◽  
Effect Sizes ◽  
Data Sets ◽  
Systematic Literature Search ◽  
Random Effects Models ◽  
Unique Data ◽  
Early Childhood Research

Engagement in early childhood has been linked with later achievement, but the relation between these variables and how they are measured in early childhood requires examination. We estimated the overall association between academic engagement and achievement in children prior to kindergarten entry. Our systematic literature search yielded 13,521 reports for structured eligibility screening; from this pool of studies, we identified 21 unique data sets, with 199 effect sizes for analysis. We coded eligible studies, extracted effect sizes, accounted for effect size dependency, and used random-effects models to synthesize findings. The overall correlation between academic engagement and achievement was r = .24 (range: −.08 to −.71), and moderator analyses did not significantly predict the relation between the two constructs. This study aligns with previous research on this topic and examines issues related to these measures, their constraints, and applications as they pertain to early childhood research.

scholarly journals Effects of Psychological Interventions on the Prevention of Sports Injuries: A Meta-analysis

2020 ◽  
Vol 8 (8) ◽  
pp. 232596712092832
Author(s):  
Shanshan Li ◽  
Qianjin Wu ◽  
Zichao Chen
Keyword(s):  
Sports Injuries ◽  
Meta Analysis ◽  
Significant Risk ◽  
Effect Sizes ◽  
Psychological Interventions ◽  
Random Effects Model ◽  
Level Of Evidence ◽  
Randomized Controlled ◽  
Subgroup Analyses ◽  
Substantial Heterogeneity

Background: Studies have shown that preventive psychological interventions can reduce the occurrence of sports injuries. Purpose: To systematically evaluate the published literature on the effects of psychological interventions on rates of sports injuries and propose a set of psychological interventions to reduce such injuries. Study Design: Systematic review; Level of evidence, 1. Methods: A total of 11 randomized controlled trials and intervention control trials involving 1287 participants were included. A random-effects model was used to analyze the data. Pooled results were expressed as effect sizes and 95% CIs. Bias and heterogeneity among the studies were assessed, and sensitivity and subgroup analyses were performed. Results: Meta-analysis suggested that preventive psychological interventions effectively prevented the occurrence of sports injuries (effect size = –0.55; P < .001), although the studies showed substantial heterogeneity ( I 2 = 94.2%; P < .001), which could not be attributed to specific variables. Nevertheless, sensitivity analysis suggested that overall results were reliable. No significant risk of publication bias was found. Conclusion: Preventive psychological interventions moderately reduced the risk of sports injuries. Risk screening also significantly reduced the risk of sports injuries. These interventions should focus on cognitive behavior and be administered in 1 to 6 sessions over 7 to 12 weeks for 60 minutes per session.

Action observation therapy for improving arm function, walking ability, and daily activity performance after stroke: a systematic review and meta-analysis

2019 ◽  
Vol 33 (8) ◽  
pp. 1277-1285 ◽  
Author(s):  
Tzu-Hsuan Peng ◽  
Jun-Ding Zhu ◽  
Chih-Chi Chen ◽  
Ruei-Yi Tai ◽  
Chia-Yi Lee ◽  
...  
Keyword(s):  
Effect Size ◽  
Action Observation ◽  
Meta Analysis ◽  
Effect Sizes ◽  
Gait Velocity ◽  
Walking Ability ◽  
Stroke Patients ◽  
Large Effect Size ◽  
Subgroup Analyses ◽  
Activity Performance

Objective:This study was to investigate the effectiveness of action observation therapy on arm and hand motor function, walking ability, gait performance, and activities of daily living in stroke patients.Design:Systematic review and meta-analysis of randomized controlled trials.Data sources:Searches were completed in January 2019 from electronic databases, including PubMed, Scopus, the Cochrane Library, and OTseeker.Review methods:Two independent reviewers performed data extraction and evaluated the study quality by the PEDro scale. The pooled effect sizes on different aspects of outcome measures were calculated. Subgroup analyses were performed to examine the impact of stroke phases on treatment efficacy.Results:Included were 17 articles with 600 patients. Compared with control treatments, the action observation therapy had a moderate effect size on arm and hand motor outcomes (Hedge’s g = 0.564; P < 0.001), a moderate to large effect size on walking outcomes (Hedge’s g = 0.779; P < 0.001), a large effect size on gait velocity (Hedge’s g = 0.990; P < 0.001), and a moderate to large effect size on activities of daily function (Hedge’s g = 0. 728; P = 0.004). Based on subgroup analyses, the action observation therapy showed moderate to large effect sizes in the studies of patients with acute/subacute stroke or those with chronic stroke (Hedge’s g = 0.661 and 0.783).Conclusion:This review suggests that action observation therapy is an effective approach for stroke patients to improve arm and hand motor function, walking ability, gait velocity, and daily activity performance.

scholarly journals Web-Site-Based Tailored Advice to Promote Strength and Balance Training: An Experimental Evaluation

2009 ◽  
Vol 17 (2) ◽  
pp. 210-222 ◽  
Author(s):  
Samuel R. Nyman ◽  
Lucy Yardley
Keyword(s):  
Older People ◽  
Experimental Evaluation ◽  
Web Site ◽  
Action Plan ◽  
Meta Analysis ◽  
Balance Training ◽  
Cost Effective ◽  
Effect Sizes ◽  
Balance Problems ◽  
Tailored Advice

This study evaluated a Web site providing tailored advice to encourage older people to undertake strength and balance training (SBT). Adults age 60–88 (N = 302) were randomized to read either generic advice or advice tailored to their self-perceived balance problems and activity preferences. Between-groups differences in attitudes toward SBT after reading the advice did not quite reach significance (p = .059), but the tailored group reported higher ratings than the generic group that the advice was personally relevant (p = .017) and that the activities would be good for them (p = .047). Within-groups differences in the tailored group showed that completing an action plan increased confidence in undertaking SBT (p = .006). These findings were supported by a meta-analysis that pooled the effect sizes with those of a previous study. Thus, a tailored Web site might be a cost-effective way of encouraging some older people to undertake SBT.

scholarly journals The efficacy of psychotherapy, pharmacotherapy and their combination on functioning and quality of life in depression: a meta-analysis

2016 ◽  
Vol 47 (3) ◽  
pp. 414-425 ◽  
Author(s):  
K. Kamenov ◽  
C. Twomey ◽  
M. Cabello ◽  
A. M. Prina ◽  
J. L. Ayuso-Mateos
Keyword(s):  
Quality Of Life ◽  
Depressive Disorders ◽  
Meta Analysis ◽  
Combined Treatment ◽  
Effect Sizes ◽  
Controlled Trials ◽  
Depression Symptom ◽  
Cochrane Central Register ◽  
Central Register

BackgroundThere is growing recognition of the importance of both functioning and quality of life (QoL) outcomes in the treatment of depressive disorders, but the meta-analytic evidence is scarce. The objective of this meta-analysis of randomized controlled trials (RCTs) was to determine the absolute and relative effects of psychotherapy, pharmacotherapy and their combination on functioning and QoL in patients with depression.MethodOne hundred and fifty-three outcome trials involving 29 879 participants with depressive disorders were identified through database searches in Pubmed, PsycINFO and the Cochrane Central Register of Controlled Trials.ResultsCompared to control conditions, psychotherapy and pharmacotherapy yielded small to moderate effect sizes for functioning and QoL, ranging from g = 0.31 to g = 0.43. When compared directly, initial analysis yielded no evidence that one of them was superior. After adjusting for publication bias, psychotherapy was more efficacious than pharmacotherapy (g = 0.21) for QoL. The combination of psychotherapy and medication performed significantly better for both outcomes compared to each treatment alone yielding small effect sizes (g = 0.32 to g = 0.39). Both interventions improved depression symptom severity more than functioning and QoL.ConclusionDespite the small number of comparative trials for some of the analyses, this study reveals that combined treatment is superior, but psychotherapy and pharmacotherapy alone are also efficacious for improving functioning and QoL. The overall relatively modest effects suggest that future tailoring of therapies could be warranted to better meet the needs of individuals with functioning and QoL problems.

Sign in / Sign up

Export Citation Format

Share Document