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Assessment and Disruption of Ruminative Episodes to Enhance Mobile Cognitive Behavioral Therapy Just-in-Time Adaptive
1Children's Hospital, Los Angeles, Department of Adolescent and Young Adult, Los Angeles, CA, United States.
JMIR Formative Research
|January 5, 2023
Summary
This study piloted a mobile intervention using just-in-time adaptive intervention (JITAI) with rumination-focused cognitive behavioral therapy (RFCBT) to reduce depressive rumination. The JITAI-MRFCBT significantly decreased rumination episodes and duration, supporting its use for curbing depressive symptoms.
Area of Science:
- Digital mental health
- Clinical psychology
- Behavioral science
Background:
- Just-in-time adaptive interventions (JITAI) provide tailored support for dynamic individual needs.
- The mechanism by which rumination-focused cognitive behavioral therapy (RFCBT) blocks emotional cascades is not fully understood.
- Mobile adaptations of RFCBT (MRFCBT) and JITAIs are underexplored.
Purpose of the Study:
- To pilot-test a fully automated JITAI leveraging RFCBT.
- To investigate methods for identifying and blocking cascading depressive rumination.
- To evaluate the efficacy of a mobile RFCBT JITAI (JITAI-MRFCBT) in a randomized controlled trial.
Main Methods:
- A randomized controlled trial (RCT) was conducted with patients receiving therapy for clinical depression.
- Participants were randomly assigned to either JITAI-MRFCBT or a no-treatment control group via a double-blind procedure.
- Participants used smartphones for 35 days, receiving daily SMS reminders to self-report rumination symptoms, with the JITAI-MRFCBT group receiving treatment materials.
Main Results:
- JITAI-MRFCBT significantly reduced the number of rumination episodes compared to the control group (P<.001).
- Participants in the JITAI-MRFCBT group showed a greater reduction in average time spent ruminating (P=.04).
- The intervention appeared to reduce the carryover of rumination from one episode to the next.
Conclusions:
- JITAI-MRFCBT shows promise in reducing negative rumination by delivering RFCBT precisely when needed.
- This approach effectively blocks subsequent rumination episodes by addressing the immediate trigger.
- Leveraging mobile technology with MRFCBT is a viable strategy for mitigating depressive symptoms.
Keywords:
depressiondepressive ruminationjust-in-time adaptive interventionmHealthmental healthmobile healthmobile phoneMore Related Videos
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