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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT04226742
Other study ID # HS#2019-4901, HS#2020-6071
Secondary ID 1R34MH113616-01A
Status Completed
Phase N/A
First received
Last updated
Start date February 18, 2021
Est. completion date January 4, 2022

Study information

Verified date June 2023
Source University of California, Irvine
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

100 participants will be enrolled in a two-armed randomized controlled trial of the Accumulated Depression and Anxiety Plans and Treatments (ADAPT) platform which integrates internet Cognitive Behavioral Therapy (iCBT) to determine impact on symptoms of depression and anxiety. This trial will pilot the effectiveness of the ADAPT platform, and evaluate the extent to which the ADAPT platform engages putative targets of personal relevance, skills use, and skills mastery.


Description:

The investigators will enroll 100 participants in a two-armed randomized controlled trial of the ADAPT platform (iCBT). Participants will be randomly assigned to receive either the ADAPT platform (treatment) or a similar self-guided platform (control) that contains the didactic material (learning) but lacks the ADAPT platforms "crowd" features. Participants will use their assigned platform for a treatment period of 8 weeks. Participants will receive trial assessments at baseline, week 4, and week 8 (post-treatment). Follow-up evaluations will occur at 16 weeks to evaluate maintenance of gains. This pilot effectiveness trial aims to determine the impact on symptoms of depression and anxiety and whether the platform engages the putative targets of personal relevance, relationship, resulting in increased skills mastery and skills use.


Recruitment information / eligibility

Status Completed
Enrollment 107
Est. completion date January 4, 2022
Est. primary completion date November 5, 2021
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria: - 1) Completion of the Mental Health America Screening to Supports (MHA S2S) or significant mood and anxiety symptoms as defined by an accepted cut-off on a validated measure the Depression Anxiety and Stress Scale (DASS). The accepted cut-off is scores greater than 22; - 2) able to speak and read English; - 3) at least 18 years of age. Exclusion Criteria: - 1) severe suicidality (has ideation, plan, and intent)

Study Design


Intervention

Behavioral:
ADAPT Platform (Treatment)
The ADAPT platform consists of 2 modules based on evidence-based strategies from cognitive-behavioral therapy including cognitive restructuring and behavioral experiments. The platform includes didactic material, interactive tools, and crowd-features. Crowd-features are present to increase personal relevance of content and to promote engagement with the ADAPT platform through accountability. Crowd-features include requesting, responding, and exemplars.
ADAPT Comparison (Control)
The control platform is a self-guided version of the ADAPT platform that includes no crowd-features. As such it will include only didactic material on cognitive restructuring and behavioral experiments and interactive tools.

Locations

Country Name City State
United States University of California Irvine Irvine California

Sponsors (4)

Lead Sponsor Collaborator
University of California, Irvine Mental Health America, National Institute of Mental Health (NIMH), Northwestern University

Country where clinical trial is conducted

United States, 

References & Publications (34)

Braithwaite SR, Giraud-Carrier C, West J, Barnes MD, Hanson CL. Validating Machine Learning Algorithms for Twitter Data Against Established Measures of Suicidality. JMIR Ment Health. 2016 May 16;3(2):e21. doi: 10.2196/mental.4822. — View Citation

Burkhouse KL, Gorka SM, Afshar K, Phan KL. Neural reactivity to reward and internalizing symptom dimensions. J Affect Disord. 2017 Aug 1;217:73-79. doi: 10.1016/j.jad.2017.03.061. Epub 2017 Mar 29. — View Citation

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Christensen H, Griffiths K, Groves C, Korten A. Free range users and one hit wonders: community users of an Internet-based cognitive behaviour therapy program. Aust N Z J Psychiatry. 2006 Jan;40(1):59-62. doi: 10.1080/j.1440-1614.2006.01743.x. — View Citation

Dear BF, Titov N, Schwencke G, Andrews G, Johnston L, Craske MG, McEvoy P. An open trial of a brief transdiagnostic internet treatment for anxiety and depression. Behav Res Ther. 2011 Dec;49(12):830-7. doi: 10.1016/j.brat.2011.09.007. Epub 2011 Sep 28. — View Citation

Duffecy, J., Cai, X., & Mohr, D. C. (2013). Supportive accountability: Measurement of a framework for adherence to behavioral intervention technologies. International Society for Research on Internet Interventions, Chicago, IL.

Eysenbach G. The law of attrition. J Med Internet Res. 2005 Mar 31;7(1):e11. doi: 10.2196/jmir.7.1.e11. — View Citation

First, M. B., Williams, J. B. W., Karg, R. S., & Spitzer, R. L. (2015). Structured clinical interview for DSM-5 disorders, clinician version (SCID-5-CV). Arlington, VA: American Psychiatric Association.

Gorka SM, Burkhouse KL, Afshar K, Phan KL. Error-related brain activity and internalizing disorder symptom dimensions in depression and anxiety. Depress Anxiety. 2017 Nov;34(11):985-995. doi: 10.1002/da.22648. Epub 2017 Sep 20. — View Citation

Gorka SM, Lieberman L, Klumpp H, Kinney KL, Kennedy AE, Ajilore O, Francis J, Duffecy J, Craske MG, Nathan J, Langenecker S, Shankman SA, Phan KL. Reactivity to unpredictable threat as a treatment target for fear-based anxiety disorders. Psychol Med. 2017 Oct;47(14):2450-2460. doi: 10.1017/S0033291717000964. Epub 2017 Apr 24. — View Citation

Hahn EA, Devellis RF, Bode RK, Garcia SF, Castel LD, Eisen SV, Bosworth HB, Heinemann AW, Rothrock N, Cella D; PROMIS Cooperative Group. Measuring social health in the patient-reported outcomes measurement information system (PROMIS): item bank development and testing. Qual Life Res. 2010 Sep;19(7):1035-44. doi: 10.1007/s11136-010-9654-0. Epub 2010 Apr 25. — View Citation

Hollandare F, Johnsson S, Randestad M, Tillfors M, Carlbring P, Andersson G, Engstrom I. Randomized trial of Internet-based relapse prevention for partially remitted depression. Acta Psychiatr Scand. 2011 Oct;124(4):285-94. doi: 10.1111/j.1600-0447.2011.01698.x. Epub 2011 Mar 14. — View Citation

Johnston L, Titov N, Andrews G, Dear BF, Spence J. Comorbidity and internet-delivered transdiagnostic cognitive behavioural therapy for anxiety disorders. Cogn Behav Ther. 2013;42(3):180-92. doi: 10.1080/16506073.2012.753108. Epub 2013 Mar 4. — View Citation

Kelders SM, Bohlmeijer ET, Pots WT, van Gemert-Pijnen JE. Comparing human and automated support for depression: Fractional factorial randomized controlled trial. Behav Res Ther. 2015 Sep;72:72-80. doi: 10.1016/j.brat.2015.06.014. Epub 2015 Jul 6. — View Citation

Kirkpatrick T, Manoukian L, Dear BF, Johnston L, Titov N. A feasibility open trial of internet-delivered cognitive-behavioural therapy (iCBT) among consumers of a non-governmental mental health organisation with anxiety. PeerJ. 2013 Nov 28;1:e210. doi: 10.7717/peerj.210. eCollection 2013. — View Citation

Kroenke K, Spitzer RL, Williams JB, Monahan PO, Lowe B. Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection. Ann Intern Med. 2007 Mar 6;146(5):317-25. doi: 10.7326/0003-4819-146-5-200703060-00004. — View Citation

Lovibond PF, Lovibond SH. The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behav Res Ther. 1995 Mar;33(3):335-43. doi: 10.1016/0005-7967(94)00075-u. — View Citation

Lovibond, S. H., & Lovibond, P. F. (1993). Manual for the Depression Anxiety Stress Scales (DASS). Psychology Foundation Monograph, University of New South Wales.

MacArthur Foundation's Initiative (2004). The Macarthur initiative on depression and primary care at Dartmouth and Duke: Depression management toolkit. Hanover, NH: Dartmouth.

Miner AS, Schueller SM, Lattie EG, Mohr DC. Creation and validation of the Cognitive and Behavioral Response to Stress Scale in a depression trial. Psychiatry Res. 2015 Dec 30;230(3):819-25. doi: 10.1016/j.psychres.2015.10.033. Epub 2015 Oct 30. — View Citation

Mohr DC, Tomasino KN, Lattie EG, Palac HL, Kwasny MJ, Weingardt K, Karr CJ, Kaiser SM, Rossom RC, Bardsley LR, Caccamo L, Stiles-Shields C, Schueller SM. IntelliCare: An Eclectic, Skills-Based App Suite for the Treatment of Depression and Anxiety. J Med Internet Res. 2017 Jan 5;19(1):e10. doi: 10.2196/jmir.6645. — View Citation

Munoz RF, Aguilera A, Schueller SM, Leykin Y, Perez-Stable EJ. From online randomized controlled trials to participant preference studies: morphing the San Francisco Stop Smoking site into a worldwide smoking cessation resource. J Med Internet Res. 2012 Jun 27;14(3):e64. doi: 10.2196/jmir.1852. — View Citation

Munoz RF. Using evidence-based internet interventions to reduce health disparities worldwide. J Med Internet Res. 2010 Dec 17;12(5):e60. doi: 10.2196/jmir.1463. — View Citation

Muñoz, R. F., Bunge, E. L., Chen, K., Schueller, S. M., Bravin, J. I., Shaughnessy, E. A., & Pérez- Stable, E. J. (2015). Massive open online interventions: A novel model for delivering behavioral-health services worldwide. Clinical Psychological Science. Advanced Online Publication. http://doi.org/10.1177/2167702615583840

Nguyen, T., O'Dea, B., Larsen, M., Phung, D., Venkatesh, S., & Christensen, H. (2015, November). Differentiating sub-groups of online depression-related communities using textual cues. In International Conference on Web Information Systems Engineering (pp. 216-224). Springer International Publishing.

O'Dea, B., Wan, S., Batterham, P. J., Calear, A. L., Paris, C., & Christensen, H. (2015). Detecting suicidality on Twitter. Internet Interventions, 2(2), 183-188. http://dx.doi.org/10.1016/j.invent.2015.03.005

Preacher KJ, Hayes AF. Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behav Res Methods. 2008 Aug;40(3):879-91. doi: 10.3758/brm.40.3.879. — View Citation

Schueller SM, Mohr DC. Initial Field Trial of a Coach-Supported Web-Based Depression Treatment. Int Conf Pervasive Comput Technol Healthc. 2015 Aug;2015:10.4108/icst.pervasivehealth.2015.260115. doi: 10.4108/icst.pervasivehealth.2015.260115. Epub 2015 Aug 3. — View Citation

Smith P, Scott R, Eshkevari E, Jatta F, Leigh E, Harris V, Robinson A, Abeles P, Proudfoot J, Verduyn C, Yule W. Computerised CBT for depressed adolescents: Randomised controlled trial. Behav Res Ther. 2015 Oct;73:104-10. doi: 10.1016/j.brat.2015.07.009. Epub 2015 Jul 21. — View Citation

Titov N, Dear BF, Johnston L, Lorian C, Zou J, Wootton B, Spence J, McEvoy PM, Rapee RM. Improving adherence and clinical outcomes in self-guided internet treatment for anxiety and depression: randomised controlled trial. PLoS One. 2013 Jul 3;8(7):e62873. doi: 10.1371/journal.pone.0062873. Print 2013. — View Citation

Titov N, Dear BF, Schwencke G, Andrews G, Johnston L, Craske MG, McEvoy P. Transdiagnostic internet treatment for anxiety and depression: a randomised controlled trial. Behav Res Ther. 2011 Aug;49(8):441-52. doi: 10.1016/j.brat.2011.03.007. Epub 2011 Apr 3. — View Citation

Titov N, Dear BF, Staples LG, Bennett-Levy J, Klein B, Rapee RM, Shann C, Richards D, Andersson G, Ritterband L, Purtell C, Bezuidenhout G, Johnston L, Nielssen OB. MindSpot Clinic: An Accessible, Efficient, and Effective Online Treatment Service for Anxiety and Depression. Psychiatr Serv. 2015 Oct;66(10):1043-50. doi: 10.1176/appi.ps.201400477. Epub 2015 Jul 1. — View Citation

van Ballegooijen W, Cuijpers P, van Straten A, Karyotaki E, Andersson G, Smit JH, Riper H. Adherence to Internet-based and face-to-face cognitive behavioural therapy for depression: a meta-analysis. PLoS One. 2014 Jul 16;9(7):e100674. doi: 10.1371/journal.pone.0100674. eCollection 2014. — View Citation

van Mierlo T. The 1% rule in four digital health social networks: an observational study. J Med Internet Res. 2014 Feb 4;16(2):e33. doi: 10.2196/jmir.2966. — View Citation

* Note: There are 34 references in allClick here to view all references

Outcome

Type Measure Description Time frame Safety issue
Primary Depression Scores at Week 16 The primary outcome of symptoms of depression will be measured with the self-report depression subscale of the Depression Anxiety Stress Scale (DASS). The subscale for depression ranges from 7 to 28 with lower values (lowest value = 7) indicating lower levels of depression and higher values (highest value = 28) indicating higher levels of depression. Absolute scores at Week 16
Primary Anxiety Scores at 16 Weeks The primary outcome of symptoms of anxiety will be measured with the self-report anxiety subscale of the Depression Anxiety Stress Scale (DASS). The subscale for anxiety ranges from 7 to 28 with lower values (lowest value = 7) indicating lower levels of anxiety and higher values (highest value = 28) indicating higher levels of anxiety. Absolute scores at Week 16
Secondary Cognitive and Behavioral Skills Scores at 16 Weeks A secondary outcome is the Frequency of Actions and Thoughts (FATS), which assesses the use of cognitive and behavioral skills. Total scores indicate the average of each item rating and range from 0-4. Lower scores indicate less frequent use of cognitive and behavioral skills and higher scores indicate more frequent use of cognitive and behavioral skills. Absolute scores at Week 16
Secondary Self-efficacy Scores at 16 Weeks A secondary outcome is the Coping Self-Efficacy (CSE), which produces a single score that ranges from 0-260 with lower scores representing lower coping self-efficacy and higher scores indicating higher coping self-efficacy. Absolute scores at Week 16
Secondary Accountability Scores at 16 Weeks A secondary outcome is the Supportive Accountability Questionnaire (SAQ), which produces a single score than ranges from 7-91. Data reported are the SAQ total scores with lower levels indicating less supportive accountability and higher values indicating greater supportive accountability. Absolute scores at Week 16
Secondary Social Functioning Scores at 16 Weeks Functioning will be assessed with the Patient-Reported Outcomes Measurement Information System (PROMIS) Ability to Participate in Social Roles and Activities Scale which produces T-scores that have a mean of 50 and a standard deviation of 10. Lower scores indicate lower participation in social roles and activities and higher scores indicate higher participation in social roles and activities. Absolute scores at Week 16
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