A randomized controlled trial of surf and hike therapy for U.S. active duty service members with major depressive disorder
Abstract Background Major depressive disorder (MDD) is the most prevalent mental health disorder worldwide, including among U.S. service members. In addition to evidence-based treatments, activity-based approaches have been shown to effectively treat depressive symptoms, particularly when they occur...
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| Format: | Article |
| Language: | English |
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BMC
2023-02-01
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| Series: | BMC Psychiatry |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12888-022-04452-7 |
| _version_ | 1797863866589249536 |
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| author | Kristen H. Walter Nicholas P. Otis Travis N. Ray Lisa H. Glassman Jessica L. Beltran Kim T. Kobayashi Elliott Betty Michalewicz-Kragh |
| author_facet | Kristen H. Walter Nicholas P. Otis Travis N. Ray Lisa H. Glassman Jessica L. Beltran Kim T. Kobayashi Elliott Betty Michalewicz-Kragh |
| author_sort | Kristen H. Walter |
| collection | DOAJ |
| description | Abstract Background Major depressive disorder (MDD) is the most prevalent mental health disorder worldwide, including among U.S. service members. In addition to evidence-based treatments, activity-based approaches have been shown to effectively treat depressive symptoms, particularly when they occur in the natural environment. Methods This study compared two activity-based interventions, Surf Therapy and Hike Therapy, on depression outcomes among 96 active duty service members with MDD. Participants were randomized to 6 weeks of Surf or Hike Therapy. Clinician-administered and self-report measures were completed at preprogram, postprogram, and 3-month follow-up. A brief depression/anxiety measure was completed before and after each activity session. Results Multilevel modeling results showed that continuous depression outcomes changed significantly over time (ps < .001). Although service members in Hike Therapy reported higher average depression scores than those in Surf Therapy, the trajectory of symptom improvement did not significantly differ between groups. Regarding MDD diagnostic status, there were no significant differences between the groups at postprogram (p = .401), but Surf Therapy participants were more likely to remit from MDD than were those in Hike Therapy at the 3-month follow-up (p = .015). Limitations The sample consisted of service members, so results may not generalize to other populations. Most participants received concurrent psychotherapy or pharmacotherapy, and, although statistically accounted for, results should be interpreted in this context. Conclusions Both Surf and Hike Therapies appear to be effective adjunctive interventions for service members with MDD. Research is needed to examine the effectiveness of these therapies as standalone interventions. Trial registration Clinical trials registration number NCT03302611; First registered on 05/10/2017. |
| first_indexed | 2024-04-09T22:43:40Z |
| format | Article |
| id | doaj.art-46473d85b9a44726870e7528d493bb46 |
| institution | Directory Open Access Journal |
| issn | 1471-244X |
| language | English |
| last_indexed | 2024-04-09T22:43:40Z |
| publishDate | 2023-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Psychiatry |
| spelling | doaj.art-46473d85b9a44726870e7528d493bb462023-03-22T12:00:39ZengBMCBMC Psychiatry1471-244X2023-02-0123111410.1186/s12888-022-04452-7A randomized controlled trial of surf and hike therapy for U.S. active duty service members with major depressive disorderKristen H. Walter0Nicholas P. Otis1Travis N. Ray2Lisa H. Glassman3Jessica L. Beltran4Kim T. Kobayashi Elliott5Betty Michalewicz-Kragh6Health and Behavioral Sciences, Naval Health Research CenterHealth and Behavioral Sciences, Naval Health Research CenterHealth and Behavioral Sciences, Naval Health Research CenterHealth and Behavioral Sciences, Naval Health Research CenterHealth and Behavioral Sciences, Naval Health Research CenterDepartment of Public Health, Naval Medical Center San DiegoDepartment of Public Health, Naval Medical Center San DiegoAbstract Background Major depressive disorder (MDD) is the most prevalent mental health disorder worldwide, including among U.S. service members. In addition to evidence-based treatments, activity-based approaches have been shown to effectively treat depressive symptoms, particularly when they occur in the natural environment. Methods This study compared two activity-based interventions, Surf Therapy and Hike Therapy, on depression outcomes among 96 active duty service members with MDD. Participants were randomized to 6 weeks of Surf or Hike Therapy. Clinician-administered and self-report measures were completed at preprogram, postprogram, and 3-month follow-up. A brief depression/anxiety measure was completed before and after each activity session. Results Multilevel modeling results showed that continuous depression outcomes changed significantly over time (ps < .001). Although service members in Hike Therapy reported higher average depression scores than those in Surf Therapy, the trajectory of symptom improvement did not significantly differ between groups. Regarding MDD diagnostic status, there were no significant differences between the groups at postprogram (p = .401), but Surf Therapy participants were more likely to remit from MDD than were those in Hike Therapy at the 3-month follow-up (p = .015). Limitations The sample consisted of service members, so results may not generalize to other populations. Most participants received concurrent psychotherapy or pharmacotherapy, and, although statistically accounted for, results should be interpreted in this context. Conclusions Both Surf and Hike Therapies appear to be effective adjunctive interventions for service members with MDD. Research is needed to examine the effectiveness of these therapies as standalone interventions. Trial registration Clinical trials registration number NCT03302611; First registered on 05/10/2017.https://doi.org/10.1186/s12888-022-04452-7DepressionPhysical activityExerciseNature exposureNature-based recreation therapyNatural environment |
| spellingShingle | Kristen H. Walter Nicholas P. Otis Travis N. Ray Lisa H. Glassman Jessica L. Beltran Kim T. Kobayashi Elliott Betty Michalewicz-Kragh A randomized controlled trial of surf and hike therapy for U.S. active duty service members with major depressive disorder BMC Psychiatry Depression Physical activity Exercise Nature exposure Nature-based recreation therapy Natural environment |
| title | A randomized controlled trial of surf and hike therapy for U.S. active duty service members with major depressive disorder |
| title_full | A randomized controlled trial of surf and hike therapy for U.S. active duty service members with major depressive disorder |
| title_fullStr | A randomized controlled trial of surf and hike therapy for U.S. active duty service members with major depressive disorder |
| title_full_unstemmed | A randomized controlled trial of surf and hike therapy for U.S. active duty service members with major depressive disorder |
| title_short | A randomized controlled trial of surf and hike therapy for U.S. active duty service members with major depressive disorder |
| title_sort | randomized controlled trial of surf and hike therapy for u s active duty service members with major depressive disorder |
| topic | Depression Physical activity Exercise Nature exposure Nature-based recreation therapy Natural environment |
| url | https://doi.org/10.1186/s12888-022-04452-7 |
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