Emily Bralee, Mohammod Mostazir, Fiona C Warren, Alexandra Newbold, Claire Hulme, Timothy Cranston, Benjamin Aas, Holly Bear, Cristina Botella, Felix Burkhardt, Thomas Ehring, Mina Fazel, Johnny R J Fontaine, Mads Frost, Azucena Garcia-Palacios, Ellen Greimel, Christiane Hößle, Arpine Hovasapian, Veerle E I Huyghe, Nanna Iversen, Kostas Karpouzis, Johanna Löchner, Guadalupe Molinari, Reinhard Pekrun, Belinda Platt, Tabea Rosenkranz, Klaus R Scherer, Katja Schlegel, Bjorn W Schuller, Gerd Schulte-Korne, Carlos Suso-Ribera, Varinka Voigt, Maria Voss, Edward R Watkins
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Self-help included coping strategies for moment-by-moment use (Tools) and self-learning/planning exercises (Challenges). On the primary outcome (depression, Patient Health Questionnaire-9 [PHQ-9]) at 3-months follow-up (primary endpoint), only the CBT app outperformed self-monitoring. In this secondary analysis, only data from participants who used the CBT or self-monitoring apps at least once were analyzed to test what app use predicted change in depression from baseline to 3 months.</p><p><strong>Results: </strong>Of the original 1,262 participants (79% female), 558 were included (CBT, baseline, n = 273, PHQ-9: M = 7.48, SD = 3.9; 3 months, N = 163, PHQ-9: M = 8.83, SD = 4.92; self-monitoring, baseline, n = 285, PHQ-9: M = 7.45, SD = 4.26; 3 months, N = 183, PHQ-9: M = 7.48, SD = 3.9). Neither total app use, self-monitoring, nor use of Tools predicted change in depression (all ps > .05). Frequency of use of Challenges predicted lower depression symptoms and caseness at 3 months (β = -0.28, 95% CI [-0.53, -0.03], p = .029). Specifically, the use of behavioral activation challenges mediated the effects of the CBT app on depression over 3 months (β = -0.59, 95% CI [-1.13, -0.05], p = .03).</p><p><strong>Conclusions: </strong>Brief psychoeducation about behavioral activation principles in an app may protect young people from depression over 3 months, even when only used once. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":15447,"journal":{"name":"Journal of consulting and clinical psychology","volume":"93 4","pages":"293-306"},"PeriodicalIF":4.5000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Brief use of behavioral activation features predicts benefits of self-help app on depression symptoms: Secondary analysis of a selective prevention trial in young people.\",\"authors\":\"Emily Bralee, Mohammod Mostazir, Fiona C Warren, Alexandra Newbold, Claire Hulme, Timothy Cranston, Benjamin Aas, Holly Bear, Cristina Botella, Felix Burkhardt, Thomas Ehring, Mina Fazel, Johnny R J Fontaine, Mads Frost, Azucena Garcia-Palacios, Ellen Greimel, Christiane Hößle, Arpine Hovasapian, Veerle E I Huyghe, Nanna Iversen, Kostas Karpouzis, Johanna Löchner, Guadalupe Molinari, Reinhard Pekrun, Belinda Platt, Tabea Rosenkranz, Klaus R Scherer, Katja Schlegel, Bjorn W Schuller, Gerd Schulte-Korne, Carlos Suso-Ribera, Varinka Voigt, Maria Voss, Edward R Watkins\",\"doi\":\"10.1037/ccp0000917\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To explore which cognitive behavioral therapy (CBT) self-help app usage predicted depression during a selective prevention trial.</p><p><strong>Method: </strong>A recent controlled trial (ECoWeB-PREVENT) randomized young people aged 16-22, at increased risk for depression because of elevated worry/rumination, negative appraisals, and/or rejection sensitivity but without past or current history of major depression, to apps that provided self-monitoring, self-monitoring plus CBT self-help, or self-monitoring plus emotional competency self-help. Self-help included coping strategies for moment-by-moment use (Tools) and self-learning/planning exercises (Challenges). On the primary outcome (depression, Patient Health Questionnaire-9 [PHQ-9]) at 3-months follow-up (primary endpoint), only the CBT app outperformed self-monitoring. In this secondary analysis, only data from participants who used the CBT or self-monitoring apps at least once were analyzed to test what app use predicted change in depression from baseline to 3 months.</p><p><strong>Results: </strong>Of the original 1,262 participants (79% female), 558 were included (CBT, baseline, n = 273, PHQ-9: M = 7.48, SD = 3.9; 3 months, N = 163, PHQ-9: M = 8.83, SD = 4.92; self-monitoring, baseline, n = 285, PHQ-9: M = 7.45, SD = 4.26; 3 months, N = 183, PHQ-9: M = 7.48, SD = 3.9). Neither total app use, self-monitoring, nor use of Tools predicted change in depression (all ps > .05). Frequency of use of Challenges predicted lower depression symptoms and caseness at 3 months (β = -0.28, 95% CI [-0.53, -0.03], p = .029). Specifically, the use of behavioral activation challenges mediated the effects of the CBT app on depression over 3 months (β = -0.59, 95% CI [-1.13, -0.05], p = .03).</p><p><strong>Conclusions: </strong>Brief psychoeducation about behavioral activation principles in an app may protect young people from depression over 3 months, even when only used once. 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引用次数: 0
摘要
目的：在一项选择性预防试验中，探讨认知行为疗法（CBT）自助应用程序的使用对抑郁症的预测作用。方法：最近的一项对照试验（ecoweb - prevention）将年龄在16-22岁、因焦虑/沉思、负面评价和/或拒绝敏感性升高而患抑郁症风险增加但过去或现在没有严重抑郁症病史的年轻人随机分配到提供自我监控、自我监控加CBT自助或自我监控加情绪能力自助的应用程序中。自助包括随时使用的应对策略（工具）和自我学习/计划练习（挑战）。在3个月随访（主要终点）的主要结局（抑郁，患者健康问卷-9 [PHQ-9]）上，只有CBT应用程序优于自我监测。在这一次要分析中，只分析了至少使用过一次CBT或自我监控应用程序的参与者的数据，以测试哪些应用程序的使用可以预测抑郁从基线到3个月的变化。结果：在最初的1262名参与者中（79%为女性），558人被纳入(CBT，基线，n = 273, PHQ-9: M = 7.48, SD = 3.9；3个月，N = 163, PHQ-9: M = 8.83, SD = 4.92；自我监测，基线，n = 285, PHQ-9: M = 7.45, SD = 4.26；3个月，N = 183, PHQ-9: M = 7.48, SD = 3.9)。应用程序的总使用、自我监控和工具的使用都不能预测抑郁症的变化（均为0.05）。使用挑战的频率预测3个月时抑郁症状和发病率降低（β = -0.28, 95% CI [-0.53, -0.03], p = 0.029）。具体而言，行为激活挑战的使用介导了CBT应用程序在3个月内对抑郁症的影响（β = -0.59, 95% CI [-1.13, -0.05], p = .03）。结论：在应用程序中对行为激活原理进行简短的心理教育，即使只使用一次，也可以在3个月内保护年轻人免受抑郁症的困扰。（PsycInfo Database Record (c) 2025 APA，版权所有）。
Brief use of behavioral activation features predicts benefits of self-help app on depression symptoms: Secondary analysis of a selective prevention trial in young people.
Objective: To explore which cognitive behavioral therapy (CBT) self-help app usage predicted depression during a selective prevention trial.
Method: A recent controlled trial (ECoWeB-PREVENT) randomized young people aged 16-22, at increased risk for depression because of elevated worry/rumination, negative appraisals, and/or rejection sensitivity but without past or current history of major depression, to apps that provided self-monitoring, self-monitoring plus CBT self-help, or self-monitoring plus emotional competency self-help. Self-help included coping strategies for moment-by-moment use (Tools) and self-learning/planning exercises (Challenges). On the primary outcome (depression, Patient Health Questionnaire-9 [PHQ-9]) at 3-months follow-up (primary endpoint), only the CBT app outperformed self-monitoring. In this secondary analysis, only data from participants who used the CBT or self-monitoring apps at least once were analyzed to test what app use predicted change in depression from baseline to 3 months.
Results: Of the original 1,262 participants (79% female), 558 were included (CBT, baseline, n = 273, PHQ-9: M = 7.48, SD = 3.9; 3 months, N = 163, PHQ-9: M = 8.83, SD = 4.92; self-monitoring, baseline, n = 285, PHQ-9: M = 7.45, SD = 4.26; 3 months, N = 183, PHQ-9: M = 7.48, SD = 3.9). Neither total app use, self-monitoring, nor use of Tools predicted change in depression (all ps > .05). Frequency of use of Challenges predicted lower depression symptoms and caseness at 3 months (β = -0.28, 95% CI [-0.53, -0.03], p = .029). Specifically, the use of behavioral activation challenges mediated the effects of the CBT app on depression over 3 months (β = -0.59, 95% CI [-1.13, -0.05], p = .03).
Conclusions: Brief psychoeducation about behavioral activation principles in an app may protect young people from depression over 3 months, even when only used once. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
期刊介绍：
The Journal of Consulting and Clinical Psychology® (JCCP) publishes original contributions on the following topics: the development, validity, and use of techniques of diagnosis and treatment of disordered behaviorstudies of a variety of populations that have clinical interest, including but not limited to medical patients, ethnic minorities, persons with serious mental illness, and community samplesstudies that have a cross-cultural or demographic focus and are of interest for treating behavior disordersstudies of personality and of its assessment and development where these have a clear bearing on problems of clinical dysfunction and treatmentstudies of gender, ethnicity, or sexual orientation that have a clear bearing on diagnosis, assessment, and treatmentstudies of psychosocial aspects of health behaviors. Studies that focus on populations that fall anywhere within the lifespan are considered. JCCP welcomes submissions on treatment and prevention in all areas of clinical and clinical–health psychology and especially on topics that appeal to a broad clinical–scientist and practitioner audience. JCCP encourages the submission of theory–based interventions, studies that investigate mechanisms of change, and studies of the effectiveness of treatments in real-world settings. JCCP recommends that authors of clinical trials pre-register their studies with an appropriate clinical trial registry (e.g., ClinicalTrials.gov, ClinicalTrialsRegister.eu) though both registered and unregistered trials will continue to be considered at this time.
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