Diverging paths: Modeling the relation between adverse effects, attitudes, perceived adherence, and treatment effect in an internet-based cognitive-behavioral intervention for obsessive-compulsive disorder

IF 4.2 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy Pub Date : 2025-02-01 DOI:10.1016/j.brat.2024.104673

Anna Baumeister , Lea Schuurmans , Josephine Schultz , Johanna Schröder , Steffen Moritz , Lena Jelinek

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引用次数: 0

Abstract

Background and aim

The efficacy of internet-based interventions (IBI) for various psychiatric disorders is widely established, but little is known about the mechanisms or possible influencing factors. One of the most prominent problems in IBI is low adherence, but the relationship between adherence and level of improvement is still unclear. Patients’ attitudes and beliefs about IBI as well as the experience of adverse effects—another widely neglected topic—may also influence the effectiveness of these interventions. This secondary analysis is aimed at investigating the relationship between adverse effects, attitudes, perceived adherence (i.e., patient's impression of their compliance), and treatment effect in an IBI for obsessive-compulsive disorder (OCD).

Methods

Participants were 151 individuals with symptoms of OCD, of which 59.96% (n = 90) took part in the post-assessment. Attitudes toward IBI were assessed before they used an IBI for OCD; subjective adherence perception and experience of negative effects were assessed afterward. OCD symptom severity was evaluated at two time points, the difference score defining the treatment effect. A path analysis was conducted to test the hypothesized model. Objective and subjective adherence measures were correlated exploratively.

Results

The path analysis revealed that attitude toward IBI and adverse effects were negatively associated with adherence perception but adherence perception was not associated with the treatment effect. Objective and subjective adherence measures did not correlate.

Conclusion

The results did not support the hypothesized model. Since both attitudes toward IBI and adverse effects were negatively associated with adherence perception, managing users’ expectations clearly before using IBI might improve adherence. The role of adherence perception on the treatment effect is yet to be clarified.

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歧路：在基于互联网的强迫症认知行为干预中，不良反应、态度、感知依从性和治疗效果之间的关系建模。

背景与目的：网络干预（internet-based interventions， IBI）对多种精神疾病的疗效已被广泛证实，但其机制或可能的影响因素尚不清楚。IBI最突出的问题之一是低依从性，但依从性与改善水平之间的关系尚不清楚。患者对IBI的态度和信念以及不良反应的经历——另一个被广泛忽视的话题——也可能影响这些干预措施的有效性。这一次要分析旨在调查IBI治疗强迫症（OCD）的不良反应、态度、感知依从性（即患者对依从性的印象）和治疗效果之间的关系。方法：研究对象为151例有强迫症症状的个体，其中59.96% （n = 90）参加了后评估。在他们使用IBI治疗强迫症之前评估他们对IBI的态度；随后评估主观依从性感知和负面影响体验。在两个时间点评估强迫症症状严重程度，差异评分定义治疗效果。通过通径分析对假设模型进行检验。主观依从性指标与客观依从性指标之间存在探索性的相关性。结果：通径分析显示，对IBI的态度和不良反应与依从性知觉呈负相关，而依从性知觉与治疗效果不相关。客观依从性和主观依从性测量不相关。结论：结果不支持假设模型。由于对IBI的态度和不良反应都与依从性感知呈负相关，因此在使用IBI之前明确管理用户的期望可能会提高依从性。依从性感知对治疗效果的作用尚不明确。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Behaviour Research and Therapy PSYCHOLOGY, CLINICAL-

CiteScore

7.50

自引率

7.30%

发文量

148

期刊介绍： The major focus of Behaviour Research and Therapy is an experimental psychopathology approach to understanding emotional and behavioral disorders and their prevention and treatment, using cognitive, behavioral, and psychophysiological (including neural) methods and models. This includes laboratory-based experimental studies with healthy, at risk and subclinical individuals that inform clinical application as well as studies with clinically severe samples. The following types of submissions are encouraged: theoretical reviews of mechanisms that contribute to psychopathology and that offer new treatment targets; tests of novel, mechanistically focused psychological interventions, especially ones that include theory-driven or experimentally-derived predictors, moderators and mediators; and innovations in dissemination and implementation of evidence-based practices into clinical practice in psychology and associated fields, especially those that target underlying mechanisms or focus on novel approaches to treatment delivery. In addition to traditional psychological disorders, the scope of the journal includes behavioural medicine (e.g., chronic pain). The journal will not consider manuscripts dealing primarily with measurement, psychometric analyses, and personality assessment.