Assessing change in short-term therapy for depression using ESM

使用 ESM 评估抑郁症短期治疗的变化

基本信息

批准号：
8150365
负责人：
KARI M EDDINGTON
金额：
$ 17.26万
依托单位：
UNIVERSITY OF NORTH CAROLINA GREENSBORO
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-09-28 至 2013-11-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8150365
关键词：
Address Adult Affect Aftercare Area Behavior Behavioral Brief Psychotherapy Characteristics Chronic Cognition Complex DSM-IV Data Data Collection Depressed mood Developed Countries Development Diagnostic Effectiveness Endogenous depression Environment Etiology Face Failure Goals Health Benefit Incentives Individual Individual Differences Informal Social Control Intervention Knowledge Lead Link Major Depressive Disorder Measures Mental Depression Methodology Methods Microscopic Modality Morbidity - disease rate Motivation Nature Outcome Study Participant Patients Pattern Persons Prevention Process Psychotherapy Public Health Randomized Recording of previous events Relapse Reporting Research Research Design Research Personnel Research Project Grants Research Subjects Sampling Series Signal Transduction Structure Symptoms System Techniques Telephone Testing Therapeutic Intervention Time Treatment outcome Voice Work base depressive symptoms disability experience follow-up improved innovation meetings novel programs psychologic public health relevance response self system therapy sound theories translational approach treatment as usual

项目摘要

DESCRIPTION (provided by applicant): Outcome studies have shown that several forms of psychotherapy are effective for depression, but questions about how, why, and when these treatments work remain. The proposed study answers the call for innovative research designs that allow for more intensive, individualized data collection that can address complex questions about the dynamic nature of treatment-related change. In this R21 application, we propose a proof-of-concept study using an innovative application of experience sampling methodology (ESM) that combines the idiographic advantages of single-subject research with the statistical advantages associated with larger samples and multilevel analyses. ESM involves sampling aspects of behavior occurring in the participant's everyday environment, thereby enhancing ecological validity and reducing retrospective bias. Thirty-four adults with primary major depressive disorder will be randomly assigned to 16 weeks of either self-system therapy (SST), a new short-term, empirically-supported psychotherapy for depression that targets deficits in incentive motivation and goal pursuit, or treatment-as-usual (TAU). Participants will complete a battery of individual difference and diagnostic measures at pretreatment. One week of intensive ESM will be collected at both pre- and post-treatment, during which participants will be signaled at random times during each day to answer questions about current functioning in several domains (e.g., affect, cognition, and goal pursuit) delivered via a phone-based interactive voice response (IVR) system. Throughout the 16 weeks of treatment, participants will complete similar IVR assessments on two randomly-selected days per week. The proposed study will test three main hypotheses. (1) Patients in SST will show greater increases in engagement with promotion goals and activities as well as greater increases in goal-related daily experiences of positive affect over the course of treatment compared to patients in TAU. (2) Patients in SST will show greater decreases in engagement with prevention goals and activities as well as greater decreases in goal- related daily experiences of negative affect over the course of treatment compared to patients in TAU. (3) Within the SST condition, a history of failure to pursue or achieve promotion goals and individual differences in chronic regulatory orientation (i.e., strength of orientation toward promotion and prevention goals) will moderate the effects of SST on changes in depressive symptoms and on daily experiences of promotion goal engagement. The proposed research will have a significant impact on an important public health problem and will expand our knowledge of how psychotherapy for depression works. The data to be obtained from this study will provide a sound empirical and theoretical framework for larger-scale programmatic research on the nature of treatment-induced change processes in patients with depression. PUBLIC HEALTH RELEVANCE: Depression is a major public health concern and a leading cause of morbidity and disability in industrialized nations. The proposed project will examine how adults with clinical depression change over the course of short-term psychotherapy by assessing how they are functioning in their daily lives. This project will lead to a more comprehensive understanding of how therapy affects patients' everyday functioning, and it has direct relevance for improving treatment outcomes.

描述（由申请人提供）：结果研究表明，几种形式的心理治疗对抑郁症有效，但关于这些治疗如何、为何以及何时发挥作用的问题仍然存在。拟议的研究响应了对创新研究设计的需求，这些设计允许进行更密集、个性化的数据收集，从而解决有关治疗相关变化的动态性质的复杂问题。在此 R21 应用程序中，我们提出了一项概念验证研究，使用经验抽样方法 (ESM) 的创新应用，将单受试者研究的具体优势与较大样本和多层次分析相关的统计优势结合起来。 ESM 涉及对参与者日常环境中发生的行为进行采样，从而提高生态有效性并减少回顾性偏差。 34 名患有原发性重度抑郁症的成年人将被随机分配接受为期 16 周的自我系统治疗 (SST)，这是一种新的短期、有经验支持的抑郁症心理治疗，针对激励动机和目标追求的缺陷，或者治疗- 照常（TAU）。参与者将在治疗前完成一系列个体差异和诊断措施。将在治疗前和治疗后收集为期一周的强化 ESM，在此期间，参与者将在每天的随机时间收到信号，回答有关多个领域（例如情感、认知和目标追求）当前功能的问题通过基于电话的交互式语音应答 (IVR) 系统。在 16 周的治疗过程中，参与者将在每周随机选择的两天完成类似的 IVR 评估。拟议的研究将检验三个主要假设。 (1) 与 TAU 患者相比，SST 患者在治疗过程中对促销目标和活动的参与度以及与目标相关的日常积极情绪体验的增加更大。 (2) 与 TAU 患者相比，SST 患者在治疗过程中对预防目标和活动的参与度以及与目标相关的日常负面情绪经历的减少幅度更大。 (3) 在 SST 条件下，未能追求或实现促进目标的历史以及长期调节取向的个体差异（即促进和预防目标的取向强度）将缓和 SST 对抑郁症状变化和抑郁症状变化的影响。促销目标参与度的日常体验。拟议的研究将对重要的公共卫生问题产生重大影响，并将扩大我们对抑郁症心理治疗如何发挥作用的了解。从这项研究中获得的数据将为针对抑郁症患者治疗引起的变化过程的性质进行更大规模的规划研究提供良好的经验和理论框架。公共卫生相关性：抑郁症是一个主要的公共卫生问题，也是工业化国家发病和残疾的主要原因。该项目将通过评估患有临床抑郁症的成年人在日常生活中的表现来研究他们在短期心理治疗过程中的变化。该项目将导致人们更全面地了解治疗如何影响患者的日常功能，并且与改善治疗结果直接相关。

项目成果

期刊论文数量（5）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

The Effects of Psychotherapy for Major Depressive Disorder on Daily Mood and Functioning: A Longitudinal Experience Sampling Study.

重度抑郁症心理治疗对日常情绪和功能的影响：纵向经验抽样研究。

DOI：
发表时间：
2017-04
期刊：
影响因子：
2.8
作者：
Eddington, Kari M;Burgin, Chris J;Silvia, Paul J;Fallah, Niloofar;Majestic, Catherine;Kwapil, Thomas R
通讯作者：
Kwapil, Thomas R

Reports of Therapy Skill Use and Their Efficacy in Daily Life in the Short-term Treatment of Depression.

抑郁症短期治疗中治疗技巧的使用及其在日常生活中的功效的报告。