Abstract
BackgroundPrevious randomized controlled trials (RCTs) have shown a significant intervention effect of internet-based computerized cognitive behavioral therapy (iCBT) on improving nonclinical depressive symptoms among healthy workers and community residents in a primary prevention setting. Time preference is one’s relative valuation for having a reward (eg, money) at present than at a later date. Time preference may affect the effectiveness of cognitive behavioral therapy.ObjectiveThis RCT aimed to test the difference of intervention effect of an iCBT program on improving nonclinical depressive symptoms between two subgroups classified post-hoc on the basis of time preference among workers in Japan.MethodsAll workers in one corporate group (approximate n=20,000) were recruited. Participants who fulfilled the inclusion criteria were randomly allocated to either intervention or control groups. Participants in the intervention group completed 6 weekly lessons and homework assignments within the iCBT program. The Beck Depression Inventory-II (BDI-II) and Kessler’s Psychological Distress Scale (K6) measures were obtained at baseline and 3-, 6-, and 12-month follow-ups. Two subgroups were defined by the median of time preference score at baseline.ResultsOnly few (835/20,000, 4.2%) workers completed the baseline survey. Of the 835 participants, 706 who fulfilled the inclusion criteria were randomly allocated to the intervention or control group. Participants who selected irrational time preference options were excluded (21 and 18 participants in the intervention and control groups, respectively). A three-way interaction (group [intervention/control] × time [baseline/follow-up] × time preference [higher/lower]) effect of iCBT was significant for BDI-II (t1147.42=2.33, P=.02) and K6 (t1254.04=2.51, P=.01) at the 3-month follow-up, with a greater effect of the iCBT in the group with higher time preference. No significant three-way interaction was found at the 6- and 12-month follow-ups.ConclusionsThe effects of the iCBT were greater for the group with higher time preference at the shorter follow-up, but it was leveled off later. Workers with higher time preference may change their cognition or behavior more quickly, but these changes may not persist.Trial RegistrationUMIN Clinical Trials Registry UMIN000014146; https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi? recptno=R000016466 (Archived by WebCite at http://www.webcitation.org/70o2rNk2V)
Highlights
Depressive disorder is one of the most prevalent psychiatric disorders, affecting around 340 million people worldwide [1] and is associated with a substantial deterioration in quality of life and economic loss in the community and the workplace [2,3]
A three-way interaction effect of internet-based computerized cognitive behavioral therapy (iCBT) was significant for Beck Depression Inventory-II (BDI-II) (t1147.42=2.33, P=.02) and Kessler’s Psychological Distress Scale major depressive disorder (MDD) (K6) (t1254.04=2.51, P=.01) at the 3-month follow-up, with a greater effect of the iCBT in the group with higher time preference
The effects of the iCBT were greater for the group with higher time preference at the shorter follow-up, but it was leveled off later
Summary
Depressive disorder is one of the most prevalent psychiatric disorders, affecting around 340 million people worldwide [1] and is associated with a substantial deterioration in quality of life and economic loss in the community and the workplace [2,3]. Previous randomized controlled trials (RCTs) have shown a significant intervention effect of iCBT for improving nonclinical depressive symptoms [8,9] and preventing the onset of new major depressive episodes (MDEs) [10] among healthy workers and community residents. A recent study reported that individual differences in reward processing, measured by reward positivity, contribute to the effectiveness of CBT for depression [16] This result implies that CBT may decrease depressive symptoms by enhancing the brain’s reward function. Previous randomized controlled trials (RCTs) have shown a significant intervention effect of internet-based computerized cognitive behavioral therapy (iCBT) on improving nonclinical depressive symptoms among healthy workers and community residents in a primary prevention setting. Time preference may affect the effectiveness of cognitive behavioral therapy
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.