Internet-based emotion-regulation training added to CBT in adolescents with depressive and anxiety disorders: A pilot randomized controlled trial to examine feasibility, acceptability, and preliminary effectiveness
Background: Dysfunctional emotion regulation (ER) is associated with symptoms of depression and anxiety in adolescents. This pilot study aimed to examine the acceptability and feasibility of a guided internet-based emotion regulation training (ERT) added to cognitive behavioral therapy (CBT). Furthe...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-03-01
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| Series: | Internet Interventions |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214782922001038 |
| _version_ | 1811160152276992000 |
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| author | Marike A. Wisman Julie Emmelkamp Jack J.M. Dekker Carolien Christ |
| author_facet | Marike A. Wisman Julie Emmelkamp Jack J.M. Dekker Carolien Christ |
| author_sort | Marike A. Wisman |
| collection | DOAJ |
| description | Background: Dysfunctional emotion regulation (ER) is associated with symptoms of depression and anxiety in adolescents. This pilot study aimed to examine the acceptability and feasibility of a guided internet-based emotion regulation training (ERT) added to cognitive behavioral therapy (CBT). Furthermore, we aimed to examine the feasibility of the randomized study design and to provide a first estimate of the effectiveness of CBT + ERT compared with CBT alone in adolescents with depressive or anxiety disorders. Methods: In a pilot randomized controlled trial (RCT) with a parallel group design, 39 patients (13–18 years) with depressive or anxiety disorder were assigned to CBT + ERT (n = 21) or CBT (n = 18). Assessments at baseline, three-months and six-months follow-up included treatment adherence, satisfaction, depressive symptoms, anxiety symptoms, and ER strategies. Results: Adherence to ERT was 66.5 %, and treatment satisfaction was adequate. 76.5 % of eligible patients participated in the study. Linear mixed-model analyses showed significantly reduced anxiety symptoms (p = .003), depressive symptoms (p = .017), and maladaptive ER (p = .014), and enhanced adaptive ER (p = .008) at six months follow-up in the CBT + ERT group compared to controls. Limitations: The sample size was small, and results regarding effectiveness remain preliminary. Data-collection took place during COVID-19, which may have influenced the results. Conclusions: Both the intervention and the study design were found to be feasible. In a larger RCT, however, improvement of recruitment strategy is necessary. Preliminary results indicate potential effectiveness in decreasing anxiety, depression, and emotion dysregulation in adolescents. The next step should be the development of an improved internet-based ERT and its evaluation in a larger RCT. Trial registration: Registered on January 14th, 2020 in The Netherlands Trial Register (NL8304). |
| first_indexed | 2024-04-10T05:52:45Z |
| format | Article |
| id | doaj.art-443775d579964123b2a35b8f8ddadbbd |
| institution | Directory Open Access Journal |
| issn | 2214-7829 |
| language | English |
| last_indexed | 2024-04-10T05:52:45Z |
| publishDate | 2023-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Internet Interventions |
| spelling | doaj.art-443775d579964123b2a35b8f8ddadbbd2023-03-04T04:23:03ZengElsevierInternet Interventions2214-78292023-03-0131100596Internet-based emotion-regulation training added to CBT in adolescents with depressive and anxiety disorders: A pilot randomized controlled trial to examine feasibility, acceptability, and preliminary effectivenessMarike A. Wisman0Julie Emmelkamp1Jack J.M. Dekker2Carolien Christ3Arkin Mental Health Care, Department of Youth and Family, Amsterdam, the Netherlands; Arkin Mental Health Care, Department of Research, Amsterdam, the Netherlands; Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Amsterdam, the Netherlands; Corresponding author at: Arkin Mental Health Care, Department of Research, Klaprozenweg 111, 1033 NN Amsterdam, the Netherlands.Arkin Mental Health Care, Department of Youth and Family, Amsterdam, the Netherlands; Arkin Mental Health Care, Department of Research, Amsterdam, the Netherlands; Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Amsterdam, the NetherlandsArkin Mental Health Care, Department of Research, Amsterdam, the Netherlands; Department of Clinical Psychology, Vrije Universiteit Amsterdam, Amsterdam, the NetherlandsArkin Mental Health Care, Department of Research, Amsterdam, the Netherlands; GGZ inGeest Specialized Mental Health Care, Department of Research and Innovation, Amsterdam, the NetherlandsBackground: Dysfunctional emotion regulation (ER) is associated with symptoms of depression and anxiety in adolescents. This pilot study aimed to examine the acceptability and feasibility of a guided internet-based emotion regulation training (ERT) added to cognitive behavioral therapy (CBT). Furthermore, we aimed to examine the feasibility of the randomized study design and to provide a first estimate of the effectiveness of CBT + ERT compared with CBT alone in adolescents with depressive or anxiety disorders. Methods: In a pilot randomized controlled trial (RCT) with a parallel group design, 39 patients (13–18 years) with depressive or anxiety disorder were assigned to CBT + ERT (n = 21) or CBT (n = 18). Assessments at baseline, three-months and six-months follow-up included treatment adherence, satisfaction, depressive symptoms, anxiety symptoms, and ER strategies. Results: Adherence to ERT was 66.5 %, and treatment satisfaction was adequate. 76.5 % of eligible patients participated in the study. Linear mixed-model analyses showed significantly reduced anxiety symptoms (p = .003), depressive symptoms (p = .017), and maladaptive ER (p = .014), and enhanced adaptive ER (p = .008) at six months follow-up in the CBT + ERT group compared to controls. Limitations: The sample size was small, and results regarding effectiveness remain preliminary. Data-collection took place during COVID-19, which may have influenced the results. Conclusions: Both the intervention and the study design were found to be feasible. In a larger RCT, however, improvement of recruitment strategy is necessary. Preliminary results indicate potential effectiveness in decreasing anxiety, depression, and emotion dysregulation in adolescents. The next step should be the development of an improved internet-based ERT and its evaluation in a larger RCT. Trial registration: Registered on January 14th, 2020 in The Netherlands Trial Register (NL8304).http://www.sciencedirect.com/science/article/pii/S2214782922001038Internet-basedEmotion regulationAdolescenceDepressionAnxietyeHealth |
| spellingShingle | Marike A. Wisman Julie Emmelkamp Jack J.M. Dekker Carolien Christ Internet-based emotion-regulation training added to CBT in adolescents with depressive and anxiety disorders: A pilot randomized controlled trial to examine feasibility, acceptability, and preliminary effectiveness Internet Interventions Internet-based Emotion regulation Adolescence Depression Anxiety eHealth |
| title | Internet-based emotion-regulation training added to CBT in adolescents with depressive and anxiety disorders: A pilot randomized controlled trial to examine feasibility, acceptability, and preliminary effectiveness |
| title_full | Internet-based emotion-regulation training added to CBT in adolescents with depressive and anxiety disorders: A pilot randomized controlled trial to examine feasibility, acceptability, and preliminary effectiveness |
| title_fullStr | Internet-based emotion-regulation training added to CBT in adolescents with depressive and anxiety disorders: A pilot randomized controlled trial to examine feasibility, acceptability, and preliminary effectiveness |
| title_full_unstemmed | Internet-based emotion-regulation training added to CBT in adolescents with depressive and anxiety disorders: A pilot randomized controlled trial to examine feasibility, acceptability, and preliminary effectiveness |
| title_short | Internet-based emotion-regulation training added to CBT in adolescents with depressive and anxiety disorders: A pilot randomized controlled trial to examine feasibility, acceptability, and preliminary effectiveness |
| title_sort | internet based emotion regulation training added to cbt in adolescents with depressive and anxiety disorders a pilot randomized controlled trial to examine feasibility acceptability and preliminary effectiveness |
| topic | Internet-based Emotion regulation Adolescence Depression Anxiety eHealth |
| url | http://www.sciencedirect.com/science/article/pii/S2214782922001038 |
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