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Positive Imagery-Based Cognitive Bias Modification as a Web-Based Treatment Tool for Depressed Adults: A Randomized Controlled Trial.

Blackwell SE, Browning M, Mathews A, Pictet A, Welch J, Davies J, Watson P, Geddes JR, Holmes EA - Clin Psychol Sci (2015)

Bottom Line: Targeting neglected cognitive aspects may provide a useful route.In exploratory analyses, compared with the control, imagery CBM significantly improved anhedonia over the intervention and improved depression symptoms as a whole for those participants with fewer than five episodes of depression and those who engaged to a threshold level of imagery.Anhedonia may be a useful treatment target for future work.

View Article: PubMed Central - PubMed

Affiliation: Medical Research Council Cognition and Brain Sciences Unit.

ABSTRACT

Depression is a global health problem requiring treatment innovation. Targeting neglected cognitive aspects may provide a useful route. We tested a cognitive-training paradigm using positive mental imagery (imagery cognitive bias modification, imagery CBM), developed via experimental psychopathology studies, in a randomized controlled trial. Training was delivered via the Internet to 150 individuals with current major depression. Unexpectedly, there was no significant advantage for imagery CBM compared with a closely matched control for depression symptoms as a whole in the full sample. In exploratory analyses, compared with the control, imagery CBM significantly improved anhedonia over the intervention and improved depression symptoms as a whole for those participants with fewer than five episodes of depression and those who engaged to a threshold level of imagery. Results suggest avenues for improving imagery CBM to inform low-intensity treatment tools for depression. Anhedonia may be a useful treatment target for future work.

No MeSH data available.


Related in: MedlinePlus

Results: Graphs show (a) primary efficacy analyses (BDI-II, intention to treat), (b) analysis of anhedonia, (c) change in BDI-II in the subgroup of participants with fewer than five depressive episodes, and (d) illustration of change in BDI-II in participants who scored above a “vividness threshold” in the imagery condition (n = 27) with the control condition as comparison. Estimated marginal means from the mixed-model analysis are displayed. Error bars represent 1 SE. BDI-II = Beck Depression Inventory–II; CBM = cognitive bias modification.
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fig2-2167702614560746: Results: Graphs show (a) primary efficacy analyses (BDI-II, intention to treat), (b) analysis of anhedonia, (c) change in BDI-II in the subgroup of participants with fewer than five depressive episodes, and (d) illustration of change in BDI-II in participants who scored above a “vividness threshold” in the imagery condition (n = 27) with the control condition as comparison. Estimated marginal means from the mixed-model analysis are displayed. Error bars represent 1 SE. BDI-II = Beck Depression Inventory–II; CBM = cognitive bias modification.

Mentions: There was no significant difference between the two conditions in change in BDI-II scores from baseline to posttreatment (our primary outcome), t(141.11) = 0.21, p = .83, d = 0.04, 95% CI = [–0.29, 0.36] (see Fig. 2). For the overall mixed model (over five time points), there was a main effect of time, F(4, 132.34) = 37.55, p < .001, which indicated a decrease in BDI-II scores over the five time points, and no significant effect of condition, F(1, 142.76) < 1. The overall interaction of condition and time was nonsignificant, F(4, 132.34) < 1. Within-groups effect sizes for change from baseline (d) ranged from 0.83, 95% CI = [0.54, 1.13], at posttreatment to 1.45 [1.07, 1.83] at 6-month follow-up in the imagery condition and from 0.74 [0.46, 1.03] at posttreatment to 1.26 [0.89, 1.62] at 6-month follow-up in the control condition. Between-groups effect sizes for change from baseline (d) during the follow-up period ranged from 0.07 [–0.25, 0.40] at 1-month follow-up to 0.02 [–0.31, 0.35] at 6-month follow-up. Table S1 in the Supplemental Material available online provides estimated marginal means and effect sizes derived from the mixed-model analysis of BDI-II over the five study time points.


Positive Imagery-Based Cognitive Bias Modification as a Web-Based Treatment Tool for Depressed Adults: A Randomized Controlled Trial.

Blackwell SE, Browning M, Mathews A, Pictet A, Welch J, Davies J, Watson P, Geddes JR, Holmes EA - Clin Psychol Sci (2015)

Results: Graphs show (a) primary efficacy analyses (BDI-II, intention to treat), (b) analysis of anhedonia, (c) change in BDI-II in the subgroup of participants with fewer than five depressive episodes, and (d) illustration of change in BDI-II in participants who scored above a “vividness threshold” in the imagery condition (n = 27) with the control condition as comparison. Estimated marginal means from the mixed-model analysis are displayed. Error bars represent 1 SE. BDI-II = Beck Depression Inventory–II; CBM = cognitive bias modification.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2 - License 3
Show All Figures
getmorefigures.php?uid=PMC4359210&req=5

fig2-2167702614560746: Results: Graphs show (a) primary efficacy analyses (BDI-II, intention to treat), (b) analysis of anhedonia, (c) change in BDI-II in the subgroup of participants with fewer than five depressive episodes, and (d) illustration of change in BDI-II in participants who scored above a “vividness threshold” in the imagery condition (n = 27) with the control condition as comparison. Estimated marginal means from the mixed-model analysis are displayed. Error bars represent 1 SE. BDI-II = Beck Depression Inventory–II; CBM = cognitive bias modification.
Mentions: There was no significant difference between the two conditions in change in BDI-II scores from baseline to posttreatment (our primary outcome), t(141.11) = 0.21, p = .83, d = 0.04, 95% CI = [–0.29, 0.36] (see Fig. 2). For the overall mixed model (over five time points), there was a main effect of time, F(4, 132.34) = 37.55, p < .001, which indicated a decrease in BDI-II scores over the five time points, and no significant effect of condition, F(1, 142.76) < 1. The overall interaction of condition and time was nonsignificant, F(4, 132.34) < 1. Within-groups effect sizes for change from baseline (d) ranged from 0.83, 95% CI = [0.54, 1.13], at posttreatment to 1.45 [1.07, 1.83] at 6-month follow-up in the imagery condition and from 0.74 [0.46, 1.03] at posttreatment to 1.26 [0.89, 1.62] at 6-month follow-up in the control condition. Between-groups effect sizes for change from baseline (d) during the follow-up period ranged from 0.07 [–0.25, 0.40] at 1-month follow-up to 0.02 [–0.31, 0.35] at 6-month follow-up. Table S1 in the Supplemental Material available online provides estimated marginal means and effect sizes derived from the mixed-model analysis of BDI-II over the five study time points.

Bottom Line: Targeting neglected cognitive aspects may provide a useful route.In exploratory analyses, compared with the control, imagery CBM significantly improved anhedonia over the intervention and improved depression symptoms as a whole for those participants with fewer than five episodes of depression and those who engaged to a threshold level of imagery.Anhedonia may be a useful treatment target for future work.

View Article: PubMed Central - PubMed

Affiliation: Medical Research Council Cognition and Brain Sciences Unit.

ABSTRACT

Depression is a global health problem requiring treatment innovation. Targeting neglected cognitive aspects may provide a useful route. We tested a cognitive-training paradigm using positive mental imagery (imagery cognitive bias modification, imagery CBM), developed via experimental psychopathology studies, in a randomized controlled trial. Training was delivered via the Internet to 150 individuals with current major depression. Unexpectedly, there was no significant advantage for imagery CBM compared with a closely matched control for depression symptoms as a whole in the full sample. In exploratory analyses, compared with the control, imagery CBM significantly improved anhedonia over the intervention and improved depression symptoms as a whole for those participants with fewer than five episodes of depression and those who engaged to a threshold level of imagery. Results suggest avenues for improving imagery CBM to inform low-intensity treatment tools for depression. Anhedonia may be a useful treatment target for future work.

No MeSH data available.


Related in: MedlinePlus