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Biswal B, Bora S, Anand R, Bhatia U, Fernandes A, Joshi M, Nadkarni A. A systematic review of interventions to enhance initiation of and adherence to treatment for alcohol use disorders. Drug Alcohol Depend 2024; 263:112429. [PMID: 39232484 DOI: 10.1016/j.drugalcdep.2024.112429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2024] [Revised: 08/24/2024] [Accepted: 08/24/2024] [Indexed: 09/06/2024]
Abstract
BACKGROUND Alcohol use disorders (AUDs) contribute significantly to the global disease burden in terms of morbidity and mortality. While effective treatment options exist, engagement with care remains a challenge, impacting treatment outcomes and resource allocation, particularly in resource-constrained settings. In this review, we aim to systematically examine and synthesize the evidence on interventions targeting initiation of and adherence to treatment for AUDs. METHODS A search was conducted on six electronic databases (MEDLINE, PsycINFO, Embase, Global Health, CINAHL and CENTRAL) using search terms under the following concepts: alcohol use disorders, initiation/adherence, treatments, and controlled trial study design. Due to the heterogeneity in intervention content and outcomes among the included studies, a narrative synthesis was conducted. Risk of bias was assessed using the Joanna Briggs Institute (JBI) critical appraisal tools. RESULTS The search yielded 32 distinct studies testing eleven categories of interventions. 23 out of 32 studies reported effectiveness of interventions in improving at least one initiation or adherence outcome, with 11 studies reporting an improvement in at least one outcome related to drinking, and four studies reporting improvements in at least one measure of well-being or disability. Community Reinforcement Approach and Family Training (CRAFT) emerged as a prominent approach for treatment initiation, contingency management for adherence, and motivational interviewing (MI) for both treatment initiation and adherence. CONCLUSION Integrating initiation and adherence interventions into AUD treatment services holds immense potential for optimizing client outcomes and fostering overall well-being. However, generalizability of these strategies remains uncertain owing to the lack of studies conducted in low- and middle-income countries. Addressing this gap is crucial for enhancing global access to effective treatments for AUDs.
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Affiliation(s)
| | - Shruti Bora
- Addictions and related-Research Group, Sangath, Goa, India
| | - Radhika Anand
- Addictions and related-Research Group, Sangath, Goa, India
| | - Urvita Bhatia
- Addictions and related-Research Group, Sangath, Goa, India
| | | | - Manjita Joshi
- Addictions and related-Research Group, Sangath, Goa, India
| | - Abhijit Nadkarni
- Addictions and related-Research Group, Sangath, Goa, India; Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK.
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Sriati A, Kurniawan K, Senjaya S, Khoirunnisa K, Muslim RNI, Putri AM, Aghnia N. The Effectiveness of Digital-Based Psychotherapy in Overcoming Psychological Problems in College Students During the COVID-19 Pandemic: A Scoping Review. J Holist Nurs 2024; 42:S26-S39. [PMID: 37097892 PMCID: PMC10130939 DOI: 10.1177/08980101231162990] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
Abstract
Purpose: This review aims to determine the effectiveness of the application of digital-based psychotherapy in overcoming the psychological problems of college students during the COVID-19 pandemic. Methods: Several databases consisting of EBSCO-Host CINAHL, PubMed, Scopus, Sage Journal, and Taylor and Francis were used in the search process and resulted in experimental studies focusing on the effectiveness of the application of digital-based psychotherapy during the COVID-19 pandemic timeline (2019-2022). Descriptive and exploratory analyses were performed based on the data set from the study. Results: A total of 12 articles were included in the review. The digital psychotherapy interventions found are diverse including websites, smartphone applications, and video conferencing with the types of therapies provided in the form of, Cognitive Therapy, Cognitive-Behavioral Therapy, Psychodynamic Therapy, and Mindfulness Therapy. Each intervention has a diverse duration and frequency adjusting to the type of therapy given. Digital psychotherapeutic interventions are effective in reducing mental health problems among college students during the COVID-19 pandemic. Conclusions: The use of digital psychotherapy can be used as a prevention and support service for students who experience psychological problems during the COVID-19 pandemic. The combination of the use of digital media with video conferencing can be considered to increase the effectiveness of this service. Nurses need to understand how the procedure for implementing digital-based psychotherapy is to improve the quality of mental care services as an effort to prevent and support students. More research is needed to find out the effectiveness of the use of digital psychotherapy services and how they impact the psychological well-being of students holistically.
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Claggett J, Petter S, Joshi A, Ponzio T, Kirkendall E. An Infrastructure Framework for Remote Patient Monitoring Interventions and Research. J Med Internet Res 2024; 26:e51234. [PMID: 38815263 PMCID: PMC11176884 DOI: 10.2196/51234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 10/12/2023] [Accepted: 04/09/2024] [Indexed: 06/01/2024] Open
Abstract
Remote patient monitoring (RPM) enables clinicians to maintain and adjust their patients' plan of care by using remotely gathered data, such as vital signs, to proactively make medical decisions about a patient's care. RPM interventions have been touted as a means to improve patient care and well-being while reducing costs and resource needs within the health care ecosystem. However, multiple interworking components must be successfully implemented for an RPM intervention to yield the desired outcomes, and the design and key driver of each component can vary depending on the medical context. This viewpoint and perspective paper presents a 4-component RPM infrastructure framework based on a synthesis of existing literature and practice related to RPM. Specifically, these components are identified and considered: (1) data collection, (2) data transmission and storage, (3) data analysis, and (4) information presentation. Interaction points to consider between components include transmission, interoperability, accessibility, workflow integration, and transparency. Within each of the 4 components, questions affecting research and practice emerge that can affect the outcomes of RPM interventions. This framework provides a holistic perspective of the technologies involved in RPM interventions and how these core elements interact to provide an appropriate infrastructure for deploying RPM in health systems. Further, it provides a common vocabulary to compare and contrast RPM solutions across health contexts and may stimulate new research and intervention opportunities.
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Affiliation(s)
- Jennifer Claggett
- School of Business, Wake Forest University, Winston-Salem, NC, United States
- Center for Healthcare Innovation, School of Medicine, Wake Forest University, Winston-Salem, NC, United States
| | - Stacie Petter
- School of Business, Wake Forest University, Winston-Salem, NC, United States
| | - Amol Joshi
- School of Business, Wake Forest University, Winston-Salem, NC, United States
- Center for Healthcare Innovation, School of Medicine, Wake Forest University, Winston-Salem, NC, United States
| | - Todd Ponzio
- Health Science Center, University of Tennessee, Memphis, TN, United States
| | - Eric Kirkendall
- Center for Healthcare Innovation, School of Medicine, Wake Forest University, Winston-Salem, NC, United States
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Kötting L, Anand-Kumar V, Keller FM, Henschel NT, Lippke S. Effective Communication Supported by an App for Pregnant Women: Quantitative Longitudinal Study. JMIR Hum Factors 2024; 11:e48218. [PMID: 38669073 PMCID: PMC11087862 DOI: 10.2196/48218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 01/31/2024] [Accepted: 02/20/2024] [Indexed: 04/30/2024] Open
Abstract
BACKGROUND In the medical field of obstetrics, communication plays a crucial role, and pregnant women, in particular, can benefit from interventions improving their self-reported communication behavior. Effective communication behavior can be understood as the correct transmission of information without misunderstanding, confusion, or losses. Although effective communication can be trained by patient education, there is limited research testing this systematically with an app-based digital intervention. Thus, little is known about the success of such a digital intervention in the form of a web-app, potential behavioral barriers for engagement, as well as the processes by which such a web-app might improve self-reported communication behavior. OBJECTIVE This study fills this research gap by applying a web-app aiming at improving pregnant women's communication behavior in clinical care. The goals of this study were to (1) uncover the potential risk factors for early dropout from the web-app and (2) investigate the social-cognitive factors that predict self-reported communication behavior after having used the web-app. METHODS In this study, 1187 pregnant women were recruited. They all started to use a theory-based web-app focusing on intention, planning, self-efficacy, and outcome expectancy to improve communication behavior. Mechanisms of behavior change as a result of exposure to the web-app were explored using stepwise regression and path analysis. Moreover, determinants of dropout were tested using logistic regression. RESULTS We found that dropout was associated with younger age (P=.014). Mechanisms of behavior change were consistent with the predictions of the health action process approach. The stepwise regression analysis revealed that action planning was the best predictor for successful behavioral change over the course of the app-based digital intervention (β=.331; P<.001). The path analyses proved that self-efficacy beliefs affected the intention to communicate effectively, which in turn, elicited action planning and thereby improved communication behavior (β=.017; comparative fit index=0.994; Tucker-Lewis index=0.971; root mean square error of approximation=0.055). CONCLUSIONS Our findings can guide the development and improvement of apps addressing communication behavior in the following ways in obstetric care. First, such tools would enable action planning to improve communication behavior, as action planning is the key predictor of behavior change. Second, younger women need more attention to keep them from dropping out. However, future research should build upon the gained insights by conducting similar internet interventions in related fields of clinical care. The focus should be on processes of behavior change and strategies to minimize dropout rates, as well as replicating the findings with patient safety measures. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT03855735; https://classic.clinicaltrials.gov/ct2/show/NCT03855735.
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Affiliation(s)
- Lukas Kötting
- Psychology and Methods, School of Business, Social & Decision Sciences, Constructor University Bremen gGmbH, Bremen, Germany
| | - Vinayak Anand-Kumar
- Psychology and Methods, School of Business, Social & Decision Sciences, Constructor University Bremen gGmbH, Bremen, Germany
| | | | - Nils Tobias Henschel
- Psychology and Methods, School of Business, Social & Decision Sciences, Constructor University Bremen gGmbH, Bremen, Germany
| | - Sonia Lippke
- Psychology and Methods, School of Business, Social & Decision Sciences, Constructor University Bremen gGmbH, Bremen, Germany
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Gao L, Keller FM, Becker P, Dahmen A, Lippke S. Predictors of Dropout Among Psychosomatic Rehabilitation Patients During the COVID-19 Pandemic: Secondary Analysis of a Longitudinal Study of Digital Training. J Med Internet Res 2023; 25:e43584. [PMID: 37903289 PMCID: PMC10683786 DOI: 10.2196/43584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 09/29/2023] [Accepted: 10/11/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND High dropout rates are a common problem reported in web-based studies. Understanding which risk factors interrelate with dropping out from the studies provides the option to prevent dropout by tailoring effective strategies. OBJECTIVE This study aims to contribute an understanding of the predictors of web-based study dropout among psychosomatic rehabilitation patients. We investigated whether sociodemographics, voluntary interventions, physical and mental health, digital use for health and rehabilitation, and COVID-19 pandemic-related variables determine study dropout. METHODS Patients (N=2155) recruited from 4 psychosomatic rehabilitation clinics in Germany filled in a web-based questionnaire at T1, which was before their rehabilitation stay. Approximately half of the patients (1082/2155, 50.21%) dropped out at T2, which was after the rehabilitation stay, before and during which 3 voluntary digital trainings were provided to them. According to the number of trainings that the patients participated in, they were categorized into a comparison group or 1 of 3 intervention groups. Chi-square tests were performed to examine the differences between dropout patients and retained patients in terms of sociodemographic variables and to compare the dropout rate differences between the comparison and intervention groups. Logistic regression analyses were used to assess what factors were related to study dropout. RESULTS The comparison group had the highest dropout rate of 68.4% (173/253) compared with the intervention groups' dropout rates of 47.98% (749/1561), 50% (96/192), and 42.9% (64/149). Patients with a diagnosis of combined anxiety and depressive disorder had the highest dropout rate of 64% (47/74). Younger patients (those aged <50 y) and patients who were less educated were more likely to drop out of the study. Patients who used health-related apps and the internet less were more likely to drop out of the study. Patients who remained in their jobs and patients who were infected by COVID-19 were more likely to drop out of the study. CONCLUSIONS This study investigated the predictors of dropout in web-based studies. Different factors such as patient sociodemographics, physical and mental health, digital use, COVID-19 pandemic correlates, and study design can correlate with the dropout rate. For web-based studies with a focus on mental health, it is suggested to consider these possible dropout predictors and take appropriate steps to help patients with a high risk of dropping out overcome difficulties in completing the study.
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Affiliation(s)
- Lingling Gao
- Health Psychology and Behavioural Medicine, Constructor University Bremen, Bremen, Germany
| | - Franziska Maria Keller
- Health Psychology and Behavioural Medicine, Constructor University Bremen, Bremen, Germany
| | | | - Alina Dahmen
- Health Psychology and Behavioural Medicine, Constructor University Bremen, Bremen, Germany
- Klinikum Wolfsburg, Wolfsburg, Germany
| | - Sonia Lippke
- Health Psychology and Behavioural Medicine, Constructor University Bremen, Bremen, Germany
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López-Del-Hoyo Y, Fernández-Martínez S, Pérez-Aranda A, Barceló-Soler A, Bani M, Russo S, Urcola-Pardo F, Strepparava MG, García-Campayo J. Effects of eHealth interventions on stress reduction and mental health promotion in healthcare professionals: A systematic review. J Clin Nurs 2023; 32:5514-5533. [PMID: 36703266 DOI: 10.1111/jocn.16634] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/12/2022] [Accepted: 01/04/2023] [Indexed: 01/28/2023]
Abstract
AIMS To evaluate the effectiveness of eHealth interventions to reduce stress and promote mental health in healthcare professionals, and to compare the efficacy of different types of programs (guided vs. self-guided; 'third-wave' psychotherapies vs. other types). BACKGROUND Healthcare workers present high levels of stress, which constitutes a risk factor for developing mental health problems such as depression and anxiety. eHealth interventions have been designed to reduce these professional's stress considering that the characteristics of this delivery method make it a cost-effective and very appealing alternative because of its fast and easy access. DESIGN A systematic review of quantitative studies. METHODS A comprehensive database search for quantitative studies was conducted in PubMed, EMBASE and Cochrane (until 1 April 2022). The systematic review was conducted in accordance with the PRISMA and SWiM reporting guidelines. The quality of the studies was assessed using the National Heart, Lung and Blood Institute tools. RESULTS The abstracts of 6349 articles were assessed and 60 underwent in-depth review, with 27 fulfilling the inclusion criteria. The interventions were classified according to their format (self-guided vs. guided) and contents ('third-wave' psychotherapies vs. others). Twenty-two interventions emerged, 13 of which produced significant posttreatment reductions in stress levels of health professionals (9 self-guided, 8 'third wave' psychotherapies). Significant effects in improving depressive symptomatology, anxiety, burnout, resilience and mindfulness, amongst others, were also found. CONCLUSION The evidence gathered in this review highlights the heterogeneity of the eHealth interventions that have been studied; self-guided and 'third-wave' psychotherapy programs are the most common, often with promising results, although the methodological shortcomings of most studies hinder the extraction of sound conclusions. PROTOCOL REGISTRATION PROSPERO CRD42022310199. No Patient or Public Contribution.
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Affiliation(s)
- Yolanda López-Del-Hoyo
- Institute of Health Research of Aragon (IIS Aragón), Miguel Servet University Hospital, Zaragoza, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS) RD21/0016/0005, Zaragoza, Spain
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
| | - Selene Fernández-Martínez
- Institute of Health Research of Aragon (IIS Aragón), Miguel Servet University Hospital, Zaragoza, Spain
| | - Adrián Pérez-Aranda
- Institute of Health Research of Aragon (IIS Aragón), Miguel Servet University Hospital, Zaragoza, Spain
- Department of Basic, Developmental and Educational Psychology, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain
| | - Alberto Barceló-Soler
- Institute of Health Research of Aragon (IIS Aragón), Miguel Servet University Hospital, Zaragoza, Spain
- Navarra Medical Research Institute (IdiSNA), Pamplona, Spain
| | - Marco Bani
- School of Medicine and Surgery, University of Milano - Bicocca, Monza, Italy
| | - Selena Russo
- School of Medicine and Surgery, University of Milano - Bicocca, Monza, Italy
| | - Fernando Urcola-Pardo
- Department of Physiatry and Nursing, University of Zaragoza, Zaragoza, Spain
- Research Group Water and Environmental Health (B43_20R), University Institute of Research in Environmental Science of Aragon, University of Zaragoza, Zaragoza, Spain
| | - Maria Grazia Strepparava
- School of Medicine and Surgery, University of Milano - Bicocca, Monza, Italy
- Clinical Unit "Psicologia Clinica", Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - Javier García-Campayo
- Institute of Health Research of Aragon (IIS Aragón), Miguel Servet University Hospital, Zaragoza, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS) RD21/0016/0005, Zaragoza, Spain
- Psychiatry Department, Faculty of Medicine, University of Zaragoza, Zaragoza, Spain
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Litvin S, Saunders R, Jefferies P, Seely H, Pössel P, Lüttke S. The Impact of a Gamified Mobile Mental Health App (eQuoo) on Resilience and Mental Health in a Student Population: Large-Scale Randomized Controlled Trial. JMIR Ment Health 2023; 10:e47285. [PMID: 37477955 PMCID: PMC10403802 DOI: 10.2196/47285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 06/02/2023] [Accepted: 06/20/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND With many digital mental health interventions failing to engage clients for enough time to demonstrate substantive changes to their well-being and with only 2% of all digital solutions on app stores having undergone randomized controlled trials, the rising demand for mental health prevention and early intervention care is not being met. Young adults in particular struggle to find digital well-being apps that suit their needs. OBJECTIVE This study explored the effects of eQuoo, an evidence-based mental health game that teaches psychological skills through gamification, on resilience, depression, anxiety, and attrition in a student population. METHODS In total, 1165 students from 180 universities in the United Kingdom participated in a 5-week, 3-armed randomized controlled trial. Participants were randomly allocated into 1 of 3 groups: eQuoo users, users of a treatment-as-usual evidence-based cognitive behavioral health app called Sanvello, and a no-intervention waitlist. The Rugged Resilience Scale, Generalized Anxiety Disorder-7, and Patient Health Questionnaire-8 were administered to all participants at baseline and every 7 days until completion. RESULTS A repeated measures-ANOVA revealed statistically significant increases in resilience scores in the test group (P<.001) compared with both control groups (Sanvello: P=.10 and waitlist: P=.82) over 5 weeks. The app also significantly decreased anxiety and depression scores (both P<.001). With 64.5% (251/389) adherence, the eQuoo group retained 42% more participants than the control groups. CONCLUSIONS Digital health interventions such as eQuoo are effective, scalable, and low-cost solutions for supporting young adults and are available on all leading mobile platforms. Further investigation could clarify the extent to which specific elements of the eQuoo app (including gamification) led to better outcomes. TRIAL REGISTRATION German Clinical Trials Register (DRKS) DRKS00027638; https://drks.de/search/en/trial/DRKS00027638.
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Affiliation(s)
- Silja Litvin
- Department Psychologie, Ludwig-Maximilians-Universität, München, Germany
| | - Rob Saunders
- Division of Psychology and Language Sciences, Clinical Education and Health Psychology, University College London, London, United Kingdom
| | - Philip Jefferies
- Resilience Research Centre, Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Hayley Seely
- Department of Counseling and Human Development, College of Education and Human Development, University of Louisville, Kentucky, KY, United States
| | - Patrick Pössel
- Department of Counseling and Human Development, College of Education and Human Development, University of Louisville, Kentucky, KY, United States
| | - Stefan Lüttke
- Department für Klinische Psychologie und Psychotherapie, Institute für Psychologie, Universität Greifswald, Greifswald, Germany
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Barceló-Soler A, Morillo-Sarto H, Fernández-Martínez S, Monreal-Bartolomé A, Chambel MJ, Gardiner P, López-del-Hoyo Y, García-Campayo J, Pérez-Aranda A. A Systematic Review of the Adherence to Home-Practice Meditation Exercises in Patients with Chronic Pain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4438. [PMID: 36901448 PMCID: PMC10001876 DOI: 10.3390/ijerph20054438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 02/28/2023] [Accepted: 03/01/2023] [Indexed: 06/18/2023]
Abstract
Mindfulness-, compassion-, and acceptance-based (i.e., "third wave") psychotherapies are effective for treating chronic pain conditions. Many of these programs require that patients engage in the systematic home practice of meditation experiences so they can develop meditation skills. This systematic review aimed at evaluating the frequency, duration, and effects of home practice in patients with chronic pain undergoing a "third wave" psychotherapy. A comprehensive database search for quantitative studies was conducted in PubMed, Embase, and Web of Sciences Core Collection; 31 studies fulfilled the inclusion criteria. The reviewed studies tended to indicate a pattern of moderately frequent practice (around four days/week), with very high variability in terms of time invested; most studies observed significant associations between the amount of practice and positive health outcomes. Mindfulness-Based Stress Reduction and Mindfulness-Based Cognitive Therapy were the most common interventions and presented low levels of adherence to home practice (39.6% of the recommended time). Some studies were conducted on samples of adolescents, who practiced very few minutes, and a few tested eHealth interventions with heterogeneous adherence levels. In conclusion, some adaptations may be required so that patients with chronic pain can engage more easily and, thus, effectively in home meditation practices.
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Affiliation(s)
- Alberto Barceló-Soler
- Institute of Health Research of Aragon (IIS), 50009 Zaragoza, Spain
- Navarra Medical Research Institute (IdiSNA), 31008 Pamplona, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), 50009 Zaragoza, Spain
| | - Héctor Morillo-Sarto
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), 50009 Zaragoza, Spain
- Department of Psychology and Sociology, University of Zaragoza, 50009 Zaragoza, Spain
| | - Selene Fernández-Martínez
- Institute of Health Research of Aragon (IIS), 50009 Zaragoza, Spain
- Department of Psychiatry, University of Zaragoza, 50009 Zaragoza, Spain
| | - Alicia Monreal-Bartolomé
- Institute of Health Research of Aragon (IIS), 50009 Zaragoza, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), 50009 Zaragoza, Spain
- Department of Psychology and Sociology, University of Zaragoza, 50009 Zaragoza, Spain
| | - Maria José Chambel
- CicPsi, Faculdade de Psicologia, Universidade de Lisboa, 1649-004 Lisbon, Portugal
| | - Paula Gardiner
- Center for Mindfulness and Compassion, Cambridge Health Alliance, Cambridge, MA 02141, USA
- Department of Family Medicine, Medical School, University of Massachusetts, Worcester, MA 01655, USA
| | - Yolanda López-del-Hoyo
- Institute of Health Research of Aragon (IIS), 50009 Zaragoza, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), 50009 Zaragoza, Spain
- Department of Psychology and Sociology, University of Zaragoza, 50009 Zaragoza, Spain
| | - Javier García-Campayo
- Institute of Health Research of Aragon (IIS), 50009 Zaragoza, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), 50009 Zaragoza, Spain
- Department of Psychiatry, University of Zaragoza, 50009 Zaragoza, Spain
| | - Adrián Pérez-Aranda
- Institute of Health Research of Aragon (IIS), 50009 Zaragoza, Spain
- Department of Basic, Developmental and Educational Psychology, 08193 Cerdanyola del Vallès, Spain
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Bernstein EE, Weingarden H, Greenberg JL, Williams J, Hoeppner SS, Snorrason I, Phillips KA, Harrison O, Wilhelm S. Credibility and expectancy of smartphone-based cognitive behavioral therapy among adults with body dysmorphic disorder. J Obsessive Compuls Relat Disord 2023; 36:100781. [PMID: 38313683 PMCID: PMC10835574 DOI: 10.1016/j.jocrd.2023.100781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Few patients receive cognitive behavioral therapy, the gold-standard for body dysmorphic disorder (CBT-BDD). Smartphones can make evidence-based interventions, like CBT-BDD, more accessible and scalable. A key question is: how do patients view it? Low credibility and expectancy would likely translate to low uptake and engagement outside of research settings, diminishing the impact. Thus, it is important to understand patients' beliefs about digital CBT-BDD. METHODS We compared credibility and expectancy in a coach-guided app-based CBT-BDD trial (N=75) to a previous in-person CBT-BDD trial (N = 55). We further examined the relationship of perceptions of digital CBT-BDD to baseline clinical and demographic factors and dropout. RESULTS Credibility did not differ between the in-person (M=19.3) and digital (M=18.3) trials, p=.24. Expectancy for improvement was moderately higher for in-person (M=58.4) than digital (M=48.3) treatment, p=.005. In the digital trial, no demographic variables were associated with credibility or expectancy. Better BDD-related insight and past non-CBT BDD therapy were associated with greater expectancy. Credibility was associated with lower likelihood of dropout. DISCUSSION Digital CBT-BDD was regarded as similarly credible to in-person CBT-BDD but with lower expectancy. Tailored expectancy-enhancing strategies could strengthen this novel approach, particularly among those with poorer insight and without prior BDD treatment.
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Affiliation(s)
| | | | | | | | | | | | - Katharine A. Phillips
- Rhode Island Hospital and Alpert Medical School of Brown University
- New York-Presbyterian Hospital and Weill Cornell Medical College
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Dahmen A, Gao L, Keller FM, Lehr D, Becker P, Lippke S. [Curriculum Hannover - Web-based vs. Analogue Psychotherapeutic aftercare after Psychosomatic Rehabilitation and vs. Care as Usual]. REHABILITATION 2022; 61:287-296. [PMID: 35995058 DOI: 10.1055/a-1872-9727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
PURPOSE In order to maintain the effect achieved in the psychosomatic rehabilitation measure, psychosomatic rehabilitation aftercare is indicated for most rehabilitation patients. Due to the low availability of aftercare therapists close to home, the use of digital offers is a possibility to enable access independent of location. The aim of the study was to evaluate the therapeutic effects of web-based aftercare in comparison to face-to-face (F2F) therapy (both on the conceptual basis of the Curriculum Hannover) in the equivalence study and to no standardized aftercare (care as usual, CAU) in the superiority study. METHODS 300 rehabilitation patients with an indication for psychosomatic aftercare were assigned to the equivalence study if an aftercare service close to home was available and then randomized to F2F or online aftercare. Without a service close to home, the participants were assigned to the superiority study and randomized to online or CAU group. The outcomes (primary: psychological and somatoform complaints, secondary: subscales of the HEALTH-49, employment prognosis, ability to work) were assessed by online questionnaires at the end of rehabilitation, 9 or 12 and 15 or 18 months after rehabilitation and evaluated with multiple imputation and intention-to-treat-analyses. For the primary outcome, a sensitivity analysis was also carried out on the basis of the completed dataset. RESULTS After excluding non-adherent participants, n=142 participants were evaluated in the equivalence study and n=111 in the superiority study. In the equivalence study, no significant differences (d=0,28 and 0,10 with ITT-analyses; d=0,09 and 0,03 with completed dataset) were found between online and F2F follow-up with regard to short-term and long-term psychological and somatoform complaints. In the superiority study, long-term psychological and somatoform complaints decrease in the online group, while in the CAU group they first decreased at T2 (d=0,56) and increased again at T3 (d=0,72). The latter finding is confirmed with the analysis of the completed dataset (d=0,12), while an increase was seen in the online group at T3 (d=0,10). CONCLUSION According to the results of the present study, web-based psychosomatic aftercare seems to have a longer-term advantage for rehabilitants without access to previous aftercare. Compared to F2F implementation, it can be considered equivalent.
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Affiliation(s)
- Alina Dahmen
- Dr. Becker Klinikgruppe, Köln.,Jacobs University Bremen.,Klinikum Wolfsburg
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Keller FM, Derksen C, Kötting L, Dahmen A, Lippke S. Distress, loneliness, and mental health during the COVID-19 pandemic: Test of the extension of the Evolutionary Theory of Loneliness. Appl Psychol Health Well Being 2022; 15:24-48. [PMID: 35266309 PMCID: PMC9111432 DOI: 10.1111/aphw.12352] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 02/12/2022] [Accepted: 02/15/2022] [Indexed: 01/18/2023]
Abstract
COVID-19 restrictions such as lockdowns or quarantines may increase the risk for social isolation and perceived loneliness. The mechanisms can be modeled by Cacioppo's Evolutionary Theory of Loneliness (ETL), which predicts that a lack of perceived social connectedness may lead, in the long-term, to mental and physical health consequences. However, the association between COVID-19 pandemic distress, mental health, and loneliness is not sufficiently understood. The present longitudinal study examined the relationship between distress and depression, and the mediating effects of anxiety and loneliness in a German rehabilitation sample (N = 403) at two timepoints (≤6 weeks pre-rehabilitation; ≥12 weeks post-rehabilitation; mean time between T1 and T2 was 52 days). Change scores between T1 and T2 were examined for the variables COVID-19 Peritraumatic Distress Index (CPDI), anxiety, loneliness, and depression. The results of the serial mediation analysis indicated that anxiety and loneliness were able to explain the relationship between distress and depression with 42% of variance in depression accounted for. Findings extend research on the relationship between COVID-19 and mental health by considering anxiety and loneliness as sustaining factors of depressive symptoms, thus, successfully applying the ETL. Results stress the necessity to consider anxiety and loneliness in the treatment or prevention of depression.
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Affiliation(s)
| | | | | | - Alina Dahmen
- Jacobs University Bremen gGmbHBremenGermany,Dr. Becker KlinikgruppeKölnGermany,Klinikum WolfsburgWolfsburgGermany
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