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Expectancy Effects in Self-Help Depression Treatment: First Evidence that the Rationale Given for an Online Study Impacts the Outcome

Published online by Cambridge University Press:  30 October 2017

Barbara Cludius*
Affiliation:
University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Martinistraße 52, Hamburg, Germany
Johanna Schröder
Affiliation:
University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Martinistraße 52, Hamburg, Germany
Steffen Moritz
Affiliation:
University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Martinistraße 52, Hamburg, Germany
*
Correspondence to Barbara Cludius, University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Martinistraße 52, Hamburg, Germany. E-mail: b.cludius@uke.de

Abstract

Background: Positive expectations play an important role in effective treatments for major depressive disorder (MDD). The way a study is contextualized modulates prognostic expectations. Aims: The aim of the study was to test the effect of differing information regarding the rationale given to participants for a study on depression symptoms. Method: Sixty-nine participants with depression symptoms participated in an online study with two conditions. In random order, half were invited to participate in a treatment study and half in a cognition study. After completing the baseline assessment, participants received one of two self-help manuals. Post-assessment was conducted six weeks later. Results: Only about 64% of the participants were reached for post-assessment, and adherence was low. However, our results offer the first evidence that stronger improvements emerged in participants who were told the trial was a treatment study compared with a cognition study. Conclusion: Information given about the rationale for a study could influence symptom reduction in online treatments for patients with MDD. Future (online) studies should attempt to replicate these results.

Type
Research Article
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2017 

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References

Alfonsson, S., Maathz, P. and Hursti, T. (2014). Interformat reliability of digital psychiatric self-report questionnaires: a systematic review. Journal of Medical Internet Research, 16, e268. https://doi.org/10.2196/jmir.3395 CrossRefGoogle ScholarPubMed
Andersson, G. and Cuijpers, P. (2009). Internet-based and other computerized psychological treatments for adult depression: a meta-analysis. Cognitive Behaviour Therapy, 38, 196205. https://doi.org/10.1080/16506070903318960 CrossRefGoogle ScholarPubMed
Beck, A. T., Ward, C. H., Mendelson, M., Mock, J. and Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561571. https://doi.org/10.1001/archpsyc.1961.01710120031004 CrossRefGoogle ScholarPubMed
Bridge, J. A., Birmaher, B., Iyengar, S., Barbe, R. P. and Brent, D. A. (2009). Placebo response in randomized controlled trials of antidepressants for pediatric major depressive disorder. American Journal of Psychiatry, 166, 4249. https://doi.org/10.1176/appi.ajp.2008.08020247 CrossRefGoogle ScholarPubMed
Cuijpers, P., Berking, M., Andersson, G., Quigley, L., Kleirboer, A. and Dobson, K. S. (2013). A meta-analysis of cognitive-behavioural therapy for adult depression, alone and in comparison with other treatments. Canadian Journal of Psychiatry, 58, 376385.CrossRefGoogle ScholarPubMed
Cuijpers, P., Karyotaki, E., Weitz, E., Andersson, G., Hollon, S. D. and van Straten, A. (2014). The effects of psychotherapies for major depression in adults on remission, recovery and improvement: a meta-analysis. Journal of Affective Disorders, 159, 118126. https://doi.org/10.1016/j.jad.2014.02.026 CrossRefGoogle ScholarPubMed
De Graaf, L. E., Huibers, M. J. H., Riper, H., Gerhards, S. A. and Arntz, A. (2009). Use and acceptability of unsupported online computerized cognitive behavioral therapy for depression and associations with clinical outcome. Journal of Affective Disorders, 116, 227231. https://doi.org/10.1016/j.jad.2008.12.009 CrossRefGoogle ScholarPubMed
Devilly, G. J. and Borkovec, T. D. (2000). Psychometric properties of the credibility/expectancy questionnaire. Journal of Behavior Therapy and Experimental Psychiatry, 31, 7386. https://doi.org/10.1016/S0005-7916(00)00012-4 CrossRefGoogle ScholarPubMed
Donker, T., van Straten, A., Marks, I. and Cuijpers, P. (2009). A brief web-based screening questionnaire for common mental disorders: development and validation. Journal of Medical Internet Research, 11, e19. https://doi.org/10.2196/jmir.1134 CrossRefGoogle ScholarPubMed
Fledderus, M., Bohlmeijer, E. T., Pieterse, M. E. and Schreurs, K. M. G. (2012). Acceptance and commitment therapy as guided self-help for psychological distress and positive mental health: a randomized controlled trial. Psychological Medicine, 42, 485495. https://doi.org/10.1017/S0033291711001206 CrossRefGoogle ScholarPubMed
Foa, E. B., Huppert, J. D., Leiberg, S., Langner, R., Kichic, R., Hajcak, G. and Salkovskis, P. M. (2002). The Obsessive-Complusive Inventory: development and validation of a short version. Psychological Assessment, 14, 485496. https://doi.org/10.1037//1040-3590.14.4.485 CrossRefGoogle Scholar
Freeman, D., Garety, P. A., Bebbington, P. E., Smith, B., Rollinson, R., Fowler, D. et al. (2005). Psychological investigation of the structure of paranoia in a non-clinical population. British Journal of Psychiatry: Journal of Mental Science, 186, 427435. https://doi.org/10.1192/bjp.186.5.427 CrossRefGoogle Scholar
Gandjour, A., Telzerow, A. and Lauterbach, K. W. (2004). Costs and quality in the treatment of acute depression in primary care: a comparison between England, Germany and Switzerland. International Clinical Psychopharmacology, 19, 201208. https://doi.org/10.1097/01.yic.0000130230.72877.a1 CrossRefGoogle ScholarPubMed
Gosling, S. D., Vazire, S., Srivastava, S. and John, O. P. (2004). Should we trust web-based studies? A comparative analysis of six preconceptions about internet questionnaires. The American Psychologist, 59, 93104. https://doi.org/10.1037/0003-066X.59.2.93 CrossRefGoogle ScholarPubMed
Gueorguieva, R. and Krystal, J. H. (2004). Move over ANOVA: progress in analyzing repeated-measures data and its reflection in papers published in the Archives of General Psychiatry. Archives of General Psychiatry, 61, 310317. https://doi.org/10.1001/archpsyc.61.3.310 CrossRefGoogle ScholarPubMed
Hancock, J. T. (2007). Digital Deception: Why, When and How People Lie Online. In Oxford Handbook of Internet Psychology (pp. 289–301). https://doi.org/10.1093/oxfordhb/9780199561803.013.0019 CrossRefGoogle Scholar
Hautzinger, M. and Bailer, M. (1993). Allgemeine Depressions-Skala. Göttingen: Beltz Test GmbH.Google Scholar
Hofmann, S. G., Sawyer, A. T., Witt, A. A. and Oh, D. (2010). The effect of mindfulness-based therapy on anxiety and depression: a meta-analytic review. Journal of Consulting and Clinical Psychology, 78, 169183. https://doi.org/10.1037/a0018555 CrossRefGoogle Scholar
Holländare, F., Andersson, G. and Engström, I. (2010). A comparison of psychometric properties between internet and paper versions of two depression instruments (BDI-II and MADRS-S) administered to clinic patients. Journal of Medical Internet Research, 12. https://doi.org/10.2196/jmir.1392 CrossRefGoogle ScholarPubMed
Kelders, S. M., Kok, R. N., Ossebaard, H. C. and Van Gemert-Pijnen, J. E. W. C. (2012). Persuasive system design does matter: a systematic review of adherence to web-based interventions. Journal of Medical Internet Research. https://doi.org/10.2196/jmir.2104 CrossRefGoogle Scholar
Kessler, R. C., Aguilar-Gaxiola, S., Alonso, J., Chatterji, S., Lee, S., Ormel, J. et al. (2009). The global burden of mental disorders: an update from the WHO World Mental Health (WMH) Surveys. Epidemiologia e Psichiatria Sociale, 18, 2333.CrossRefGoogle ScholarPubMed
Khan, A. and Brown, W. A. (2015). Antidepressants versus placebo in major depression: an overview. World Psychiatry, 14, 294300. https://doi.org/10.1002/wps.20241 CrossRefGoogle ScholarPubMed
Kirsch, I. (2005). Placebo psychotherapy: synonym or oxymoron? Journal of Clinical Psychology, 61, 791803. https://doi.org/10.1002/jclp.20126 CrossRefGoogle ScholarPubMed
Kirsch, I., Deacon, B. J., Huedo-Medina, T. B., Scoboria, A., Moore, T. J. and Johnson, B. T. (2008). Initial severity and antidepressant benefits: a meta-analysis of data submitted to the food and drug administration. PLoS Medicine, 5, 260268. https://doi.org/10.1371/journal.pmed.0050045 CrossRefGoogle ScholarPubMed
Kirsch, I. and Low, C. B. (2013). Suggestion in the treatment of depression. American Journal of Clinical Hypnosis, 55, 221229. https://doi.org/10.1080/00029157.2012.738613 CrossRefGoogle ScholarPubMed
Kohn, R., Saxena, S., Levav, I. and Saraceno, B. (2004). The treatment gap in mental health care. Bulletin of the World Health Organization, 82, 858866. https://doi.org//S0042-96862004001100011 Google ScholarPubMed
Mohr, D. C., Ho, J., Duffecy, J., Baron, K. G., Lehman, K. A., Jin, L. et al. (2010). Perceived barriers to psychological treatments and their relationship to depression. Journal of Clinical Psychology, 66, 394409. https://doi.org/10.1002/jclp.20659 CrossRefGoogle ScholarPubMed
Moritz, S., Ramdani, N., Klass, H., Andreou, C., Jungclaussen, D., Eifler, S. et al. (2014). Overconfidence in incorrect perceptual judgments in patients with schizophrenia. Schizophrenia Research: Cognition, 1, 165170. https://doi.org/10.1016/j.scog.2014.09.003 Google ScholarPubMed
Moritz, S., Van Quaquebeke, N., Hauschildt, M., Jelinek, L. et al. (2012). Good news for allegedly bad studies. Assessment of psychometric properties may help to elucidate deception in online studies on OCD. Journal of Obsessive-Compulsive and Related Disorders, 1, 331335. https://doi.org/10.1016/j.jocrd.2012.07.001 CrossRefGoogle Scholar
National Institute for Health and Clinical Excellence (2012). The treatment and management of depression in adults. NICE guideline (CG90). Google Scholar
Radloff, L. S. (1977). The CES-D Scale: a self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385401. https://doi.org/10.1177/014662167700100306 CrossRefGoogle Scholar
Rief, W., Nestoriuc, Y., Weiss, S., Welzel, E., Barsky, A. J. and Hofmann, S. G. (2009). Meta-analysis of the placebo response in antidepressant trials. Journal of Affective Disorders, 118, 18. https://doi.org/10.1016/j.jad.2009.01.029 CrossRefGoogle ScholarPubMed
Rutherford, B. R. and Roose, S. P. (2013). A model of placebo response in antidepressant clinical trials. American Journal of Psychiatry, 170, 723733. https://doi.org/10.1176/appi.ajp.2012.12040474 CrossRefGoogle Scholar
Salkovskis, P., Rimes, K., Stephenson, D., Sacks, G. and Scott, J. (2006). A randomized controlled trial of the use of self-help materials in addition to standard general practice treatment of depression compared to standard treatment alone. Psychological Medicine, 36, 325–33. https://doi.org/10.1017/S0033291705006422 CrossRefGoogle ScholarPubMed
Sotsky, S. M., Glass, D. R., Shea, M. T., Pilkonis, P. A., Collins, J. F., Elkin, I. et al. (1991). Patient predictors of response to psychotherapy and pharmacotherapy: findings in the NIMH treatment of depression collaborative research program. American Journal of Psychiatry, 148, 9971008.Google ScholarPubMed
Spek, V., Cuijpers, P., Nyklícek, I., Riper, H., Keyzer, J. and Pop, V. (2007). Internet-based cognitive behaviour therapy for symptoms of depression and anxiety: a meta-analysis. Psychological Medicine, 37, 319328. https://doi.org/10.1017/S0033291706008944 CrossRefGoogle ScholarPubMed
Strauss, C., Cavanagh, K., Oliver, A. and Pettman, D. (2014). Mindfulness-based interventions for people diagnosed with a current episode of an anxiety or depressive disorder: a meta-analysis of randomised controlled trials. PLoS ONE, 9. https://doi.org/10.1371/journal.pone.0096110 CrossRefGoogle ScholarPubMed
Swartzman, L. C. and Burkell, J. (1998). Expectations and the placebo effect in clinical drug trials: why we should not turn a blind eye to unblinding, and other cautinoary notes. Clinical Pharmacology and Therapeutics, 64, 17.CrossRefGoogle ScholarPubMed
Van't Hof, E., Cuijpers, P. and Stein, D. J. (2009). Self-help and internet-guided interventions in depression and anxiety disorders: a systematic review of meta-analyses. CNS Spectrums, 14, 3440.CrossRefGoogle ScholarPubMed
Weigold, A., Weigold, I. K. and Russell, E. J. (2013). Examination of the equivalence of self-report survey-based paper-and-pencil and internet data collection methods. Psychological Methods, 18, 5370. https://doi.org/10.1037/a0031607 CrossRefGoogle ScholarPubMed
World Health Organization (2015). Depression Fact Sheet no. 369. Retrieved from: http://www.who.int/mediacentre/factsheets/fs369/en/ Google Scholar
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