Abstract
BackgroundInternet interventions have been shown to be effective in treating anxiety disorders. Most interventions to date focus on single disorders and disregard potential comorbidities.ObjectiveThe aim of this mixed-methods study was to investigate feasibility, user experience, and effects of a newly developed individually tailored transdiagnostic guided internet intervention for anxiety disorders.MethodsThis study is an uncontrolled, within-group, baseline, postintervention pilot trial with an embedded qualitative and quantitative process and effect evaluation. In total, 49 adults with anxiety disorders (generalized anxiety disorder n=20, social phobia n=19, agoraphobia without panic n=12, panic with agoraphobia n=6, panic without agoraphobia n=4, subclinical depression n=41) received access to the 7-session intervention. We examined motivation and expectations, intervention use, user experience, impact, and modification requests. Qualitative data were assessed using semistructured interviews and analyzed by qualitative content analysis. Quantitative outcomes included symptom severity of anxiety and depression (Hamilton Anxiety Rating Scale [HAM-A], Quick Item Inventory of Depressive Symptomatology clinician rating [QIDS-C]), diagnostic status in clinical interviews (Mini International Neuropsychiatric Interview [MINI]), and web-based self-reports (Generalized Anxiety Disorder–7 [GAD-7], Center for Epidemiological Studies Depression Scale [CES-D], Beck Anxiety Inventory [BAI], Panic and Agoraphobia Scale [PAS], Social Phobia Scale [SPS], Patient Health Questionnaire–9 [PHQ-9]) at baseline and postassessment. Quantitative data was analyzed by comparing within-group means expressed as Cohen d.ResultsAnxiety symptom severity (HAM-A d=1.19) and depressive symptoms (QIDS-C d=0.42) improved significantly, and 54% (21/39) no longer were diagnosed as having any anxiety disorder. The main positive effects were the general improvement of disease burden and attentiveness to feelings and risk situations while the main negative effects experienced were lack of change in disease burden and symptom deterioration. The most prevalent reasons for participation were the advantages of online treatment, symptom burden, and openness toward online treatment. Helpful factors included support, psychoeducation and practicing strategies in daily life; the main hindering factors were too little individualization and being overwhelmed by the content and pace.ConclusionsThe intervention was found to be feasible and results show preliminary data indicating potential efficacy for improving anxiety and depression. The next step should be the evaluation within a randomized controlled trial. Concerning intervention development, it was found that future interventions should emphasize individualization even more in order to further improve the fit to individual characteristics, preferences, and needs.
Highlights
Internet interventions can be effective means of treating mental health problems such as anxiety disorders [1,2,3]
Anxiety disorders are highly prevalent [4], and individuals suffering from anxiety disorders tend to experience significant impairment in quality of life and a decreased sense of well-being and occupational and family satisfaction [5,6]
Meta-analytic evidence has found internet interventions to be efficacious with medium to large effect sizes for the treatment of anxiety disorders [3,15,16,17]
Summary
Internet interventions can be effective means of treating mental health problems such as anxiety disorders [1,2,3]. Anxiety disorders are highly prevalent [4], and individuals suffering from anxiety disorders tend to experience significant impairment in quality of life and a decreased sense of well-being and occupational and family satisfaction [5,6]. The fact that the majority of individuals who suffer from a mental disorder do not receive treatment is a demanding public health issue [11]. Meta-analytic evidence has found internet interventions to be efficacious with medium to large effect sizes for the treatment of anxiety disorders [3,15,16,17]. Internet interventions have been shown to be effective in treating anxiety disorders. Most interventions to date focus on single disorders and disregard potential comorbidities
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