Understanding the unwanted: a mixed-methods study on negative effects in an internet-based intervention for...

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.