scholarly journals Delivering Cognitive Behavior Therapy to Young Adults With Symptoms of Depression and Anxiety Using a Fully Automated Conversational Agent (Woebot): A Randomized Controlled Trial

2017 ◽  
Vol 4 (2) ◽  
pp. e19 ◽  
Author(s):  
Kathleen Kara Fitzpatrick ◽  
Alison Darcy ◽  
Molly Vierhile
Keyword(s):  
College Students ◽  
Univariate Analysis ◽  
Analysis Of Covariance ◽  
Control Group ◽  
Conversational Agent ◽  
Conversational Agents ◽  
Significant Group ◽  
Web Based ◽  
Symptoms Of Depression ◽  
Self Help

Background Web-based cognitive-behavioral therapeutic (CBT) apps have demonstrated efficacy but are characterized by poor adherence. Conversational agents may offer a convenient, engaging way of getting support at any time. Objective The objective of the study was to determine the feasibility, acceptability, and preliminary efficacy of a fully automated conversational agent to deliver a self-help program for college students who self-identify as having symptoms of anxiety and depression. Methods In an unblinded trial, 70 individuals age 18-28 years were recruited online from a university community social media site and were randomized to receive either 2 weeks (up to 20 sessions) of self-help content derived from CBT principles in a conversational format with a text-based conversational agent (Woebot) (n=34) or were directed to the National Institute of Mental Health ebook, “Depression in College Students,” as an information-only control group (n=36). All participants completed Web-based versions of the 9-item Patient Health Questionnaire (PHQ-9), the 7-item Generalized Anxiety Disorder scale (GAD-7), and the Positive and Negative Affect Scale at baseline and 2-3 weeks later (T2). Results Participants were on average 22.2 years old (SD 2.33), 67% female (47/70), mostly non-Hispanic (93%, 54/58), and Caucasian (79%, 46/58). Participants in the Woebot group engaged with the conversational agent an average of 12.14 (SD 2.23) times over the study period. No significant differences existed between the groups at baseline, and 83% (58/70) of participants provided data at T2 (17% attrition). Intent-to-treat univariate analysis of covariance revealed a significant group difference on depression such that those in the Woebot group significantly reduced their symptoms of depression over the study period as measured by the PHQ-9 (F=6.47; P=.01) while those in the information control group did not. In an analysis of completers, participants in both groups significantly reduced anxiety as measured by the GAD-7 (F1,54= 9.24; P=.004). Participants’ comments suggest that process factors were more influential on their acceptability of the program than content factors mirroring traditional therapy. Conclusions Conversational agents appear to be a feasible, engaging, and effective way to deliver CBT.

Death Threat and Death Concerns in the College Student

1981 ◽  
Vol 11 (2) ◽  
pp. 139-155 ◽  
Author(s):  
Jerome Tobacyk ◽  
Daniel Eckstein
Keyword(s):  
College Students ◽  
College Student ◽  
Trait Anxiety ◽  
Analysis Of Covariance ◽  
Control Group ◽  
Education Students ◽  
Personality Variables ◽  
Personality Differences ◽  
Post Test ◽  
Threat Index

A four part investigation of death orientation in college students using the provided-construct form of the Threat Index and the Death Concern Scale was conducted. Part I investigated the construct validity of the Threat Index, reporting significant predicted correlations of the Threat Index with the Death Concern Scale, Trait Anxiety Scale, and Repression-Sensitization Scale. Part II explored death orientation and personality differences between a Thanatology Group (death education students) and a Control Group. Thanatology students reported significantly lesser death threat and significantly greater death concerns than controls. Part III compared pre-test to post-test changes in death threat and death concerns for the Thanatology Group with pre-post changes for the Control Group. Using analysis of covariance procedures, a significantly greater decline in death threat was obtained in the Thanatology Group relative to the controls. Part IV explored two personality variables–trait anxiety and repression-sensitization–as moderators of change in death orientation in the Thantology Group. Trait anxiety was found to be a significant predictor of change in death threat in the Thanatology Group, with lesser anxiety associated with greater decline in death threat.

scholarly journals Eye tracking and attentional bias for depressive internet memes in depression

2020 ◽  
Author(s):  
Umair Akram ◽  
Jason G. Ellis ◽  
Glhenda Cau ◽  
Frayer Hershaw ◽  
Ashlieen Rajenthran ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Eye Movements ◽  
Attentional Bias ◽  
Control Group ◽  
Depression Symptoms ◽  
Significant Group ◽  
Symptoms Of Depression ◽  
Total Fixation ◽  
Potential Benefits ◽  
Type Interaction

AbstractPrevious research highlights the potential benefits of engaging with depressive internet memes for those experiencing symptoms of depression. This study aimed to determine whether: compared to non-depressed controls, individuals experiencing depressive symptoms were quicker to orient and maintain overall attention for internet memes depicting depressive content relative to neutral memes. N = 21 individuals were grouped based on the severity of reported depression symptoms using the PhQ-9. Specifically, a score of:  ≤ 4 denoted the control group; and  ≥ 15 the depressive symptoms group. Participants viewed a series of meme pairs depicting depressive and neutral memes for periods of 4000 ms. Data for the first fixation onset and duration, total fixation count and total fixation and gaze duration of eye-movements were recorded. A significant group x meme-type interaction indicated that participants with depressive symptoms displayed significantly more fixations on depressive rather than neutral memes. These outcomes provide suggestive evidence for the notion that depressive symptoms are associated with an attentional bias towards socio-emotionally salient stimuli.

scholarly journals Association between markers of cardiovascular risk and clinical parameters of periodontitis

2013 ◽  
Vol 42 (5) ◽  
pp. 336-343 ◽  
Author(s):  
José Eduardo Gomes Domingues ◽  
Mario Vianna Vettore ◽  
Emerson Silva Lima
Keyword(s):  
Cardiovascular Risk ◽  
Periodontal Disease ◽  
Dental Plaque ◽  
Univariate Analysis ◽  
Plasma Concentrations ◽  
Analysis Of Covariance ◽  
High Density Lipoproteins ◽  
Control Group ◽  
Case Group ◽  
Clinical Parameters

INTRODUCTION: Periodontal disease is an inflammatory response to bacteria that reside in the gum tissue and can have systemic repercussion. OBJECTIVE: The aim of this study was to assess the relationship between periodontitis and markers of cardiovascular risk. MATERIAL AND METHOD: Ninety selected patients were assigned into two groups in accordance with their levels of probing pocket depth (PPD) and Clinical Attachment Level (CAL): control group, n= 45 (< 4 sites with PPD ≥ 4.0 mm and CAL ≥ 3.0 mm) and case group, n= 45 (≥ 30% of sites with PPD ≥ 4.0 mm and CAL ≥3.0 mm). Plasma concentrations of C-reactive protein, high sensitive CRP, high-density lipoproteins (HDL-c) and electronegative low density lipoproteins (LDL) were assessed in all participants. Data from medical history and socioeconomic level were also collected from patients. RESULT: Plasma levels of HDL-c were lower in subjects with periodontal disease (p = 0.016) and were inversely associated with the number of sites with PPD ≥ 3 mm (rho= -0.325) and number of sites with PPD ≥ 3 mm and CAL ≥ 3 mm (rho= -0.216). These associations remained significant after adjustments for dental plaque and smoking using Univariate Analysis of Covariance (p < 0.05). Adjusted odds ratio between periodontal disease and levels of HDL-c was 0.94 (CI95% 0.88-0.99) after adjusting for age, smoking and dental plaque. Other investigated markers of cardiovascular risk were not related to periodontal disease. CONCLUSION: Clinical parameters of periodontitis were inversely associated with plasma concentrations of HDL-c.

scholarly journals Using ePortfolio-based Learning Approach to Facilitate Knowledge Sharing and Creation of College Students

2017 ◽  
Author(s):  
Chi-Cheng Chang ◽  
Pao-Nan Chou ◽  
Chaoyan Liang
Keyword(s):  
College Students ◽  
Multivariate Analysis ◽  
Knowledge Sharing ◽  
T Test ◽  
Analysis Of Covariance ◽  
Control Group ◽  
Learning Approach ◽  
Before And After ◽  
Group A ◽  
Experimental Group

The purpose of the present study was to examine the effects of the ePortfolio-based learning approach (ePBLA) on knowledge sharing and creation with 92 college students majoring in electrical engineering as the participants. Multivariate analysis of covariance (MANCOVA) with a covariance of pretest on knowledge sharing and creation was conducted for examining differences in knowledge sharing and creation between an experimental group (a total of 47 participants using ePBLA) and a control group (a total of 45 participants not using ePBLA or creating eportfolio). A t-test was also performed for examining the differences in knowledge sharing and creation of the experimental group before and after using ePBLA. The results showed that: a) the experimental group had significantly better knowledge sharing and creation than the control group; and b) the experimental group had significantly better knowledge sharing and creation after using ePBLA. The results implied that ePBLA facilitated knowledge sharing and creation. Furthermore, relationships between knowledge sharing and creation were also enhanced by the use of ePBLA

scholarly journals A three-armed randomised controlled trial investigating the comparative impact of guidance on the efficacy of a web-based stress management intervention and health impairing and promoting mechanisms of prevention

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Patricia Nixon ◽  
Leif Boß ◽  
Elena Heber ◽  
David Daniel Ebert ◽  
Dirk Lehr
Keyword(s):  
Perceived Stress ◽  
Depressive Symptomatology ◽  
Controlled Trial ◽  
Significant Group ◽  
Web Based ◽  
Wait List Control ◽  
Work Related ◽  
Self Help ◽  
Secondary Outcomes ◽  
Randomised Controlled

Abstract Background Web-based stress management interventions (SMI) fit increasingly digital lifestyles, reduce barriers of uptake and are easily scalable. SMIs might lower levels of stress in employees and thereby contribute to the prevention of depressive symptomatology. Different guidance formats can impact the efficacy of SMIs, with higher intensity assumed to result in larger effects. However, head-to-head comparisons of guidance formats are rare. This is the first trial to examine the impact of adherence-focused guidance compared to self-help on the efficacy of an occupational SMI compared to a wait list control condition. Additionally, it will be investigated if the SMI enfolds its impact on preventing depressive symptomatology by different pathways through reducing health impairing and increasing promoting factors. Methods A three-armed randomised controlled trial (RCT) on an occupational SMI was conducted. 404 employees with elevated levels of perceived stress (PSS-10 ≥ 22) were randomly assigned to: adherence-focused guidance (AFG), self-help (SH) or a wait list control group (WLC). The primary outcome was perceived stress (PSS-10). Secondary outcomes included health- and work-related measures. A parallel mediation analysis with stress and resilience as mediators for the effect on depression (CES-D) was carried out. Data collection took place at baseline (T1), after 7 weeks (T2) and 6 months (T3). Results The SMI was effective for all groups on the primary and secondary outcomes. For stress, analyses of covariance (ANCOVA) revealed significant group effects at T2 (F2,400 = 36.08, P < .001) and T3 (F2,400 = 37.04, P < .001) with large effect sizes for AFG (T2: d = 0.83; T3: d = 0.85) and SH (T2: d = 0.88; T3: d = 0.91) compared to WLC. No significant group differences were found for the efficacy between AFG and SH on the outcomes. Adherence in terms of completed modules was significantly higher for AFG compared to SH. The SMI’s impact on depression was mediated by perceived stress: a1b1 = − 0.77, 95% CI [− 1.26, − 0.34] and resilience: a2b2 = − 0.62, 95% CI [− 1.05, − 0.26]. Conclusions The SMI was effective for reducing stress and improving other health- and work-related outcomes, irrespective of the guidance format. Results did not demonstrate superiority of adherence-focused guidance for the efficacy but for adherence in terms of completed modules. Among other reasons, better communication strategies about offered guidance and awareness-raising measures are discussed. Results from mediation analysis suggest that preventive SMIs should be designed to reach two goals: reducing the risk factor of stress and simultaneously increasing health promoting factors such as resilience. Trial registration German Clinical Trial Registration (DRKS) DRKS00005687, 6/6/2014.

scholarly journals Effectiveness of an Internet- and App-Based Intervention for College Students With Elevated Stress: Randomized Controlled Trial (Preprint)

2017 ◽  
Author(s):  
Mathias Harrer ◽  
Sophia Helen Adam ◽  
Rebecca Jessica Fleischmann ◽  
Harald Baumeister ◽  
Randy Auerbach ◽  
...  
Keyword(s):  
Mental Health ◽  
College Students ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Waitlist Control ◽  
Symptoms Of Depression ◽  
Randomized Controlled ◽  
Waitlist Control Group

BACKGROUND Mental health problems are highly prevalent among college students. Most students with poor mental health, however, do not receive professional help. Internet-based self-help formats may increase the utilization of treatment. OBJECTIVE The aim of this randomized controlled trial was to evaluate the efficacy of an internet-based, app-supported stress management intervention for college students. METHODS College students (n=150) with elevated levels of stress (Perceived Stress Scale 4-item version, PSS-4 ≥8) were randomly assigned to either an internet- and mobile-based stress intervention group with feedback on demand or a waitlist control group. Self-report data were assessed at baseline, posttreatment (7 weeks), and 3-month follow-up. The primary outcome was perceived stress posttreatment (PSS-4). Secondary outcomes included mental health outcomes, modifiable risk and protective factors, and college-related outcomes. Subgroup analyses were conducted in students with clinically relevant symptoms of depression (Center for Epidemiological Studies’ Depression Scale >17). RESULTS A total of 106 participants (76.8%) indicated that they were first-time help-seekers, and 77.3% (intervention group: 58/75; waitlist control group: 58/75) showed clinically relevant depressive symptoms at baseline. Findings indicated significant effects of the intervention compared with the waitlist control group for stress (d=0.69; 95% CI 0.36-1.02), anxiety (d=0.76; 95% CI 0.43-1.09), depression (d=0.63; 95% CI 0.30-0.96), college-related productivity (d=0.33; 95% CI 0.01-0.65), academic work impairment (d=0.34; 95% CI 0.01-0.66), and other outcomes after 7 weeks (posttreatment). Response rates for stress symptoms were significantly higher for the intervention group (69%, 52/75) compared with the waitlist control group (35%, 26/75, P<.001; number needed to treat=2.89, 95% CI 2.01-5.08) at posttest (7 weeks). Effects were sustained at 3-month follow-up, and similar findings emerged in students with symptoms of depression. CONCLUSIONS Internet- and mobile-based interventions could be an effective and cost-effective approach to reduce consequences of college-related stress and might potentially attract students with clinically relevant depression who would not otherwise seek help. CLINICALTRIAL German Clinical Trial Register DRKS00010212; http://www.drks.de/drks_web/navigate.do? navigationId=trial.HTML&TRIAL_ID=DRKS00010212 (Archived by WebCite at http://www.webcitation.org/6w55Ewhjd)

Student Decision Making in Technology Application

2011 ◽  
pp. 155-167
Author(s):  
Ali Ahmed ◽  
Abdulaziz Elfessi
Keyword(s):  
Decision Making ◽  
Statistical Significance ◽  
Analysis Of Covariance ◽  
Control Group ◽  
Full Time ◽  
Web Based ◽  
Technology Application ◽  
Decision Making Processes ◽  
Initial Score ◽  
Level Of Significance

This study investigated factors that influence students’ decision-making processes in selecting a classroom or online course, student technology skills and experience, and concerns students have about Internet integration. Students completed a survey questionnaire and web-based pretests and posttests. A Likert scale instrument was completed by students in both a control group and an experimental group. Independent two-sample t-tests and an analysis of covariance (ANCOVA), using the initial score as the covariate, were conducted. Level of significance (alpha) was set at .05 to achieve statistical significance for all analyses. Both groups in this study were full-time, on-campus students with access to the same technology resources. Findings reveal that students’ perceptions and experiences were quite similar.

scholarly journals Efeitos do polimento na potência aeróbia máxima em atletas de indoor soccer

2016 ◽  
Vol 18 (3) ◽  
pp. 341 ◽  
Author(s):  
Leonardo De Sousa Fortes ◽  
Jeferson Macedo Vianna ◽  
Delton Manoel dos Santos Silva ◽  
Marcio André Gouvea ◽  
Edilson Serpeloni Cyrino
Keyword(s):  
Repeated Measures ◽  
Aerobic Power ◽  
Univariate Analysis ◽  
Young Male ◽  
Analysis Of Covariance ◽  
Control Group ◽  
Maximum Aerobic Power ◽  
Level 1 ◽  
And Control

DOI: http://dx.doi.org/10.5007/1980-0037.2016v18n3p341 The aim of this study was to analyze the effect of tapering on maximum aerobic power (VO2max) in young male indoor soccer athletes. Participants were 78 athletes aged 12-17 years randomly divided into experimental (EG) and control group (CG). Both groups did the same training planning until the last three weeks (tapering phase). Only EG performed tapering. Tapering lasted three weeks adopting the linear tapering method. VO2max was estimated by Yo-Yo intermittent Recovery Level 1 early in the season and in the last week of each. Univariate analysis of covariance (ANCOVA) was conducted for repeated measures to compare VO2max among groups according to mesocycle. The results presented effect of time (F (4.74)= 42.02, p = 0.01) and group (F (2.76) = 35.87, p = 0.01). Overall, the findings of this study suggest that the implementation of the tapering strategy in the last weeks of training is more efficient to improve VO2max than the constant maintenance of loads.

scholarly journals Electronic Self-Report Assessment for Cancer and Self-Care Support: Results of a Multicenter Randomized Trial

2014 ◽  
Vol 32 (3) ◽  
pp. 199-205 ◽  
Author(s):  
Donna L. Berry ◽  
Fangxin Hong ◽  
Barbara Halpenny ◽  
Ann H. Partridge ◽  
Jesse R. Fann ◽  
...  
Keyword(s):  
Intervention Group ◽  
Self Care ◽  
Symptom Distress ◽  
Self Report ◽  
Analysis Of Covariance ◽  
Control Group ◽  
Web Based ◽  
Significant Difference ◽  
Distress Scale ◽  
Care Support

Purpose The purpose of this trial was to evaluate the effect of a Web-based, self-report assessment and educational intervention on symptom distress during cancer therapy. Patients and Methods A total of 752 ambulatory adult participants were randomly assigned to symptom/quality-of-life (SxQOL) screening at four time points (control) versus screening, targeted education, communication coaching, and the opportunity to track/graph SxQOL over time (intervention). A summary of the participant-reported data was delivered to clinicians at each time point in both groups. All participants used the assessment before a new therapeutic regimen, at 3 to 6 weeks and 6 to 8 weeks later, completing the final assessment at the end of therapy. Change in Symptom Distress Scale–15 (SDS-15) score from pretreatment to end of study was compared using analysis of covariance and regression analysis adjusting for selected variables. Results We detected a significant difference between study groups in mean SDS-15 score change from baseline to end of study: 1.27 (standard deviation [SD], 6.7) in the control group (higher distress) versus −0.04 (SD, 5.8) in the intervention group (lower distress). SDS-15 score was reduced by an estimated 1.21 (95% CI, 0.23 to 2.20; P = .02) in the intervention group. Baseline SDS-15 score (P < .001) and clinical service (P = .01) were predictive. Multivariable analyses suggested an interaction between age and study group (P = .06); in subset analysis, the benefit of intervention was strongest in those age > 50 years (P = .002). Conclusion Web-based self-care support and communication coaching added to SxQOL screening reduced symptom distress in a multicenter sample of participants with various diagnoses during and after active cancer treatment. Participants age > 50 years, in particular, may have benefited from the intervention.

scholarly journals Do Nonsuicidal Severely Depressed Individuals with Diabetes Profit from Internet-Based Guided Self-Help? Secondary Analyses of a Pragmatic Randomized Trial

2019 ◽  
Vol 2019 ◽  
pp. 1-11 ◽  
Author(s):  
Sandra Schlicker ◽  
Kiona K. Weisel ◽  
Claudia Buntrock ◽  
Matthias Berking ◽  
Stephanie Nobis ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Depressive Symptom ◽  
Treatment Response ◽  
Symptom Severity ◽  
Treatment Modalities ◽  
Control Group ◽  
Web Based ◽  
Self Help ◽  
Depressive Symptom Severity ◽  
Disease Specific

Introduction. Diabetes mellitus type 1 and type 2 are linked to higher prevalence and occurrences of depression. Internet-based depression- and diabetes-specific cognitive behavioral therapies (CBT) can be effective in reducing depressive symptom severity and diabetes-related emotional distress. The aim of the study was to test whether disease-specific severity indicators moderate the treatment outcome in a 6-week minimally guided web-based self-help intervention on depression and diabetes (GET.ON Mood Enhancer Diabetes (GET.ON M.E.D.)) and to determine its effectiveness in a nonsuicidal severely depressed subgroup. Methods. Randomized controlled trial- (RCT-) based data (N=253) comparing GET.ON M.E.D. to an online psychoeducation control group was used to test disease-specific severity indicators as predictors/moderators of a treatment outcome. Changes in depressive symptom severity and treatment response were examined in a nonsuicidal severely depressed subgroup (CES−D>40; N=40). Results. Major depressive disorder diagnosis at the baseline (pprf6=0.01), higher levels of depression (Beck Depression Inventory II; pprpo=0.00; pprf6=0.00), and lower HbA1c (pprpo=0.04) predicted changes in depressive symptoms. No severity indicator moderated the treatment outcome. Severely depressed participants in the intervention group showed a significantly greater reduction in depressive symptom severity (dprpo=2.17, 95% Confidence Interval (CI): 1.39-2.96) than the control condition (dprpo=0.92; 95% CI: 0.001-1.83), with a between-group effect size of dprpo=1.05 (95% CI: 0.11-1.98). Treatment response was seen in significantly more participants in the intervention (4/20; 20%) compared to the control group (0/20, 0%; χ2 2N=40=4.44; p<0.02). At the 6-month follow-up, effects were maintained for depressive symptom reduction (dpr6f=0.71; 95% CI: 0.19-1.61) but not treatment response. Conclusion. Disease-specific severity indicators were not related to a differential effectiveness of guided self-help for depression and diabetes. Clinical meaningful effects were observed in nonsuicidal severely depressed individuals, who do not need to be excluded from web-based guided self-help. However, participants should be closely monitored and referred to other treatment modalities in case of nonresponse.

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