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Related Experiment Video

Updated: Jan 16, 2026

A New Method for Inducing a Depression-Like Behavior in Rats
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Understanding the unwanted: a mixed-methods study on negative effects in an internet-based intervention for

Friederike Fenski1,2, Manuel Heinrich2, Carmen Schaeuffele2

  • 1Psychologische Hochschule Berlin, Clinical Psychology and Psychotherapy, Berlin, 10179, Germany.

Cognitive Behaviour Therapy
|September 29, 2025
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Summary

Internet-based interventions for depression can cause negative effects. Differentiating between treatment-related and patient-related negative effects is key for improving outcomes and future research.

Keywords:
Negative effectsdepressioninternet-based interventionmixed-methodsside effects

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Area of Science:

  • Mental Health
  • Digital Therapeutics
  • Clinical Psychology

Background:

  • Internet-based interventions (IBIs) show efficacy in treating depression.
  • However, IBIs can elicit negative effects in some individuals.
  • Current research lacks consensus on categorizing and addressing these negative effects.

Purpose of the Study:

  • To identify specific subcategories of negative effects in depression IBIs.
  • To explore predictors of these negative effects.
  • To examine the relationship between negative effects, adherence, and symptom improvement.

Main Methods:

  • A qualitative analysis of negative effects reported by 110 participants in an IBI for depression.
  • Categorization of effects into a framework of treatment-related and patient-related subcategories.
  • Statistical analysis to identify predictors and associations with adherence and symptom improvement.

Main Results:

  • 7% of 1610 participants reported negative effects.
  • Negative effects were categorized into format, contact, implementation, symptoms, and insight.
  • Treatment-related negative effects correlated with lower symptom improvement, unlike patient-related effects.
  • No demographic predictors were identified.

Conclusions:

  • Distinguishing between treatment- and patient-related negative effects is crucial.
  • This differentiation can guide future research and enhance IBI development for depression.
  • Further investigation into the impact of specific negative effect categories is warranted.