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- Ebert, D. D., et al.
(författare)
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Does Internet-based guided-self-help for depression cause harm? An individual participant data meta-analysis on deterioration rates and its moderators in randomized controlled trials
- 2016
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Ingår i: Psychological Medicine. - : Cambridge University Press. - 0033-2917 .- 1469-8978. ; 46:13, s. 2679-2693
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Forskningsöversikt (refereegranskat)abstract
- Almost nothing is known about the potential negative effects of Internet-based psychological treatments for depression. This study aims at investigating deterioration and its moderators within randomized trials on Internet-based guided self-help for adult depression, using an individual patient data meta-analyses (IPDMA) approach.Studies were identified through systematic searches (PubMed, PsycINFO, EMBASE, Cochrane Library). Deterioration in participants was defined as a significant symptom increase according to the reliable change index (i.e. 7.68 points in the CES-D; 7.63 points in the BDI). Two-step IPDMA procedures, with a random-effects model were used to pool data.A total of 18 studies (21 comparisons, 2079 participants) contributed data to the analysis. The risk for a reliable deterioration from baseline to post-treatment was significantly lower in the intervention v. control conditions (3.36 v. 7.60; relative risk 0.47, 95% confidence interval 0.29–0.75). Education moderated effects on deterioration, with patients with low education displaying a higher risk for deterioration than patients with higher education. Deterioration rates for patients with low education did not differ statistically significantly between intervention and control groups. The benefit–risk ratio for patients with low education indicated that 9.38 patients achieve a treatment response for each patient experiencing a symptom deterioration.Internet-based guided self-help is associated with a mean reduced risk for a symptom deterioration compared to controls. Treatment and symptom progress of patients with low education should be closely monitored, as some patients might face an increased risk for symptom deterioration. Future studies should examine predictors of deterioration in patients with low education.
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| 2. |
- Forsell, E., et al.
(författare)
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Overcoming procrastination : One-year follow-up and predictors of change in a randomized controlled trial of Internet-based cognitive behavior therapy
- 2016
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Konferensbidrag (refereegranskat)abstract
- Procrastination; the purposeful delay of an intended course of action is, for many, a persistent behavior associated with reduced mood, increased stress, and poorer performance. 20 % of adults and 50 % of students experience significant difficulties with procrastination. Internet- based cognitive behavior therapy (ICBT) shows promise for several conditions, but has never been applied to procrastination. The current study examined the efficacy of ICBT for procrastination at post treatment and one-year follow-up, and investigated predictors of change.Method: Participants (N = 150) were randomized to 10 weeks of either guided self-help, unguided self-help, or wait-list control (receiving unguided self-help after the first treatment period). Outcome measures were the Pure Procrastination Scale (PPS), the Irrational Procrastination Scale (IPS), the Susceptibility to Temptation Scale, the Montgomery Åsberg Depression Rating Scale, the Generalized Anxiety Disorder Assessment, and the Quality of Life Inventory. Intention-to-treat was used for all statistical analyses, with mixed-effects models to assess the effect of time and group.Results: Moderate to large effect sizes were obtained post treatment comparing guided and unguided self-help with wait-list control, the PPS, Cohen’s d = 0.70, 95% confidence interval (CI) [0.29, 1.10], and d = 0.50, 95% CI [0.10, 0.90], and the IPS, d = 0.81 95% CI [0.40, 1.22], and d = 0.69 95% CI [0.29, 1.09]. Clinically significant change was achieved among 31.3–40.0% for guided self-help and 24.0–36.0% for unguided self-help. Neither treatment condition was superior on any outcome measure, Fs (98, 65.17-72.55) < 1.70, p > .19. One-year follow-up data has been collected and the results will be available at the time of the conference, including predictors of change.Conclusion: ICBT could be useful for self-reported problems of procrastination, with results at one-year follow-up and predictors of change revealing the long-term benefit and variables associated with successful treatment outcome.
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| 3. |
- Rozental, Alexander, et al.
(författare)
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Overcoming procrastination : One-year follow-up and predictors of change in a randomized controlled trial of Internet-based cognitive behavior therapy
- 2016
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Konferensbidrag (refereegranskat)abstract
- Aim: Procrastination refers to the purposeful delay of an intended course of action and can become a persistent behavioral pattern associated with reduced mood, increased stress, and poorer performance. One-fifth of the adult population and half of the student population experience significant difficulties due to procrastination, but has received little attention in clinical research. Meanwhile, Internet-based cognitive behavior therapy (ICBT) has been found promising for several conditions, but has not yet been used in relation to procrastination. The current study thus aimed to examine the efficacy of ICBT for procrastination at post treatment and one-year follow-up, as well as to investigate predictors of change.Method: Participants (N = 150) were randomized to a ten-week treatment programme; guided self-help, unguided self-help, and wait-list control (receiving unguided self-help after the first treatment period). Outcome measures were administered at screening, post treatment, one-year follow-up, or weekly, consisting of the Pure Procrastination Scale (PPS), the Irrational Procrastination Scale (IPS), the Susceptibility to Temptation Scale, the Montgomery Åsberg Depression Rating Scale, the Generalized Anxiety Disorder Assessment, and the Quality of Life Inventory. Intention-to-treat was used for all statistical analyses, with mixed-effects models to assess the effect of time and group.Results: Moderate to large effect sizes were obtained at post treatment comparing guided and unguided self-help with wait-list control, the PPS, Cohen’s d = 0.70, 95% confidence interval (CI) [0.29, 1.10], and d = 0.50, 95% CI [0.10, 0.90], and the IPS, d = 0.81 95% CI [0.40, 1.22], and d = 0.69 95% CI [0.29, 1.09]. Clinically significant change was achieved among 31.3–40.0% for guided self-help, compared with 24.0–36.0% for unguided self-help. Neither of the treatment conditions was found to be superior on any of the outcome measures, Fs (98, 65.17-72.55) < 1.70, p > .19. One-year follow-up data has just been collected and the results of will be available at the time of the conference, including predictors of change.Conclusion: ICBT could be useful for managing self-reported problems of procrastination, with results at one-year follow-up and predictors of change revealing the long-term benefit and possible variables responsible for a successful treatment outcome.
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