Adaptive actions and treatment outcomes in transdiagnostic internet-delivered cognitive behaviour therapy for chronic health conditions

IF 4.1 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Internet Interventions-The Application of Information Technology in Mental and Behavioural Health Pub Date : 2026-06-01 Epub Date: 2026-03-09 DOI:10.1016/j.invent.2026.100930

Heather D. Hadjistavropoulos , Vanessa Peynenburg , Aaron E. Philipp-Muller , Auguste Nomeikaite , Nickolai Titov , Blake F. Dear , Lauren Staples

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Abstract

Transdiagnostic internet-delivered cognitive behavioural therapy (ICBT) has demonstrated effectiveness for improving a range of outcomes for individuals living with diverse chronic health conditions. However, the behavioural processes that contribute to these outcomes remain unclear. This study examined whether participation in a 5-lesson transdiagnostic ICBT program for chronic health conditions was associated with changes in adaptive actions (i.e., Healthy Thinking, Meaningful Activities, Goals and Plans, Healthy Habits, and Social Connections) and whether these changes were maintained at follow-up. We also explored whether changes in adaptive actions were associated with changes on measures of depression, anxiety, pain intensity, and pain interference. Adults (N = 121) received a transdiagnostic ICBT program for chronic health conditions in a routine online care setting. Adaptive actions were assessed with the Things You Do Questionnaire–15 Item (TYDQ–15). GEE analyses indicated that the TYDQ–15 total and domain scores improved significantly from pre- to post-treatment and were maintained at follow-up. Effect sizes were small to moderate. Hierarchical linear regression models indicated a significant association between adaptive behaviours and clinical outcomes on the PHQ-9, GAD-7, and BPI-Interference. The findings highlight the potential value of encouraging adaptive actions early in treatment and underscore the need for further research to identify actions that may contribute to improvements in depression, anxiety, and related outcomes.

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跨诊断互联网认知行为治疗慢性疾病的适应性行为和治疗效果

互联网提供的跨诊断认知行为疗法（ICBT）在改善各种慢性疾病患者的一系列结果方面已被证明是有效的。然而，导致这些结果的行为过程仍不清楚。本研究调查了参与5课慢性健康状况的ICBT跨诊断项目是否与适应性行为（即健康思维、有意义的活动、目标和计划、健康习惯和社会关系）的变化有关，以及这些变化是否在随访中保持不变。我们还探讨了适应性行为的变化是否与抑郁、焦虑、疼痛强度和疼痛干扰的测量变化有关。成人（N = 121）在常规在线护理环境中接受慢性健康状况的ICBT项目。采用“你所做的事情”问卷第15项（TYDQ-15）对适应性行为进行评估。GEE分析表明，TYDQ-15总分和结构域评分从治疗前到治疗后显著提高，并在随访中保持不变。效应量从小到中等。层次线性回归模型显示，适应行为与临床结果在PHQ-9、GAD-7和bpi -干扰之间存在显著关联。研究结果强调了在治疗早期鼓励适应性行动的潜在价值，并强调了进一步研究的必要性，以确定可能有助于改善抑郁、焦虑和相关结果的行动。

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来源期刊

Internet Interventions-The Application of Information Technology in Mental and Behavioural Health Medicine-Health Informatics

CiteScore

6.50

自引率

9.30%

发文量

审稿时长

6 weeks

期刊介绍： Official Journal of the European Society for Research on Internet Interventions (ESRII) and the International Society for Research on Internet Interventions (ISRII). The aim of Internet Interventions is to publish scientific, peer-reviewed, high-impact research on Internet interventions and related areas. Internet Interventions welcomes papers on the following subjects: • Intervention studies targeting the promotion of mental health and featuring the Internet and/or technologies using the Internet as an underlying technology, e.g. computers, smartphone devices, tablets, sensors • Implementation and dissemination of Internet interventions • Integration of Internet interventions into existing systems of care • Descriptions of development and deployment infrastructures • Internet intervention methodology and theory papers • Internet-based epidemiology • Descriptions of new Internet-based technologies and experiments with clinical applications • Economics of internet interventions (cost-effectiveness) • Health care policy and Internet interventions • The role of culture in Internet intervention • Internet psychometrics • Ethical issues pertaining to Internet interventions and measurements • Human-computer interaction and usability research with clinical implications • Systematic reviews and meta-analysis on Internet interventions