Examining the Theoretical Framework of Behavioral Activation for Major Depressive Disorder: Smartphone-Based Ecological Momentary Assessment Study
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Otros documentos de la autoría: Van Genugten, Claire Rosalie; Schuurmans, Josien; Hoogendoorn, Adriaan Willem; Araya, Ricardo; Andersson, Gerhard; Baños, Rosa Maria; Botella, Cristina; Cerga Pashoja, Arlinda; Cieslak, Roman; Ebert, David Daniel; García-Palacios, Azucena; Hazo, Jean-Baptiste; Herrero, Rocío; holtzmann, jerome; Kemmeren, Lise; Kleiboer, Annet; Krieger, Tobias; Smoktunowicz, Ewelina; Titzler, Ingrid; Topooco, Naira; Urech, Antoine; Smit, Johannes H; Riper, Heleen
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Título
Examining the Theoretical Framework of Behavioral Activation for Major Depressive Disorder: Smartphone-Based Ecological Momentary Assessment StudyAutoría
Fecha de publicación
2021-11-01Editor
JMIR PublicationsISSN
2368-7959Cita bibliográfica
van Genugten CR, Schuurmans J, Hoogendoorn AW, Araya R, Andersson G, Baños R, Botella C, Cerga Pashoja A, Cieslak R, Ebert DD, García-Palacios A, Hazo J, Herrero R, Holtzmann J, Kemmeren L, Kleiboer A, Krieger T, Smoktunowicz E, Titzler I, Topooco N, Urech A, Smit JH, Riper H Examining the Theoretical Framework of Behavioral Activation for Major Depressive Disorder: Smartphone-Based Ecological Momentary Assessment Study JMIR Ment Health 2021;8(12):e32007Tipo de documento
info:eu-repo/semantics/articleVersión
info:eu-repo/semantics/publishedVersionPalabras clave / Materias
Resumen
Background: Behavioral activation (BA), either as a stand-alone treatment or as part of cognitive behavioral therapy, has been
shown to be effective for treating depression. The theoretical underpinnings of BA derive ... [+]
Background: Behavioral activation (BA), either as a stand-alone treatment or as part of cognitive behavioral therapy, has been
shown to be effective for treating depression. The theoretical underpinnings of BA derive from Lewinsohn et al’s theory of
depression. The central premise of BA is that having patients engage in more pleasant activities leads to them experiencing more
pleasure and elevates their mood, which, in turn, leads to further (behavioral) activation. However, there is a dearth of empirical
evidence about the theoretical framework of BA.
Objective: This study aims to examine the assumed (temporal) associations of the 3 constructs in the theoretical framework of
BA.
Methods: Data were collected as part of the “European Comparative Effectiveness Research on Internet-based Depression
Treatment versus treatment-as-usual” trial among patients who were randomly assigned to receive blended cognitive behavioral
therapy (bCBT). As part of bCBT, patients completed weekly assessments of their level of engagement in pleasant activities, the
pleasure they experienced as a result of these activities, and their mood over the course of the treatment using a smartphone-based
ecological momentary assessment (EMA) application. Longitudinal cross-lagged and cross-sectional associations of 240 patients
were examined using random intercept cross-lagged panel models.
Results: The analyses did not reveal any statistically significant cross-lagged coefficients (all P>.05). Statistically significant
cross-sectional positive associations between activities, pleasure, and mood levels were identified. Moreover, the levels of
engagement in activities, pleasure, and mood slightly increased over the duration of the treatment. In addition, mood seemed to
carry over, over time, while both levels of engagement in activities and pleasurable experiences did not.
Conclusions: The results were partially in accordance with the theoretical framework of BA, insofar as the analyses revealed
cross-sectional relationships between levels of engagement in activities, pleasurable experiences deriving from these activities,
and enhanced mood. However, given that no statistically significant temporal relationships were revealed, no conclusions could
be drawn about potential causality. A shorter measurement interval (eg, daily rather than weekly EMA reports) might be more
attuned to detecting potential underlying temporal pathways. Future research should use an EMA methodology to further investigate
temporal associations, based on theory and how treatments are presented to patients.
Trial Registration: ClinicalTrials.gov, NCT02542891, https://clinicaltrials.gov/ct2/show/NCT02542891; German Clinical
Trials Register, DRKS00006866, https://tinyurl.com/ybja3xz7; Netherlands Trials Register, NTR4962,
https://www.trialregister.nl/trial/4838; ClinicalTrials.Gov, NCT02389660, https://clinicaltrials.gov/ct2/show/NCT02389660;
ClinicalTrials.gov, NCT02361684, https://clinicaltrials.gov/ct2/show/NCT02361684; ClinicalTrials.gov, NCT02449447,
https://clinicaltrials.gov/ct2/show/NCT02449447; ClinicalTrials.gov, NCT02410616,
https://clinicaltrials.gov/ct2/show/NCT02410616; ISRCTN registry, ISRCTN12388725, https://www.isrctn.com/ISRCTN12388725 [-]
Publicado en
JMIR Ment Health 2021;8(12):e32007Datos relacionados
https://jmir.org/api/download?alt_name=mental_v8i12e32007_app1.doc&filename=9038d6dffe740ab5ca99654e785cfdfa.docEntidad financiadora
European Commission
Código del proyecto o subvención
info:eu-repo/grantAgreement/EC/H2020/603098-2
Título del proyecto o subvención
The European Comparative Effectiveness Research on Internet-based Depression Treatment versus treatment-as-usual (E-COMPARED)
Derechos de acceso
info:eu-repo/semantics/openAccess
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Excepto si se señala otra cosa, la licencia del ítem se describe como: ©Claire Rosalie van Genugten, Josien Schuurmans, Adriaan W Hoogendoorn, Ricardo Araya, Gerhard Andersson, Rosa Baños,
Cristina Botella, Arlinda Cerga Pashoja, Roman Cieslak, David Daniel Ebert, Azucena García-Palacios, Jean-Baptiste Hazo,
Rocío Herrero, Jérôme Holtzmann, Lise Kemmeren, Annet Kleiboer, Tobias Krieger, Ewelina Smoktunowicz, Ingrid Titzler,
Naira Topooco, Antoine Urech, Johannes H Smit, Heleen Riper. Originally published in JMIR Mental Health
(https://mental.jmir.org), 06.12.2021. This is an open-access article distributed under the terms of the Creative Commons Attribution
License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any
medium, provided the original work, first published in JMIR Mental Health, is properly cited. The complete bibliographic
information, a link to the original publication on https://mental.jmir.org/, as well as this copyright and license information must
be included.