Abstract
Adjustment Disorder (AjD) represents a healthcare paradox. On the one hand, it is one of the most diagnosed mental disorders worldwide. On the other hand, AjD and its possible treatment options remain a severely neglected field of research. In this context, we developed a self-guided online intervention for adjustment problems, named ZIEL, and tested its efficacy. It is based on and extends a bibliotherapeutic treatment approach for symptoms of AjD. In our study, a total of 98 individuals who had experienced a life event in the last two years, were randomly assigned to care as usual (CAU) or an online intervention group (CAU + online intervention). The primary endpoint was AjD symptom severity measured by Adjustment Disorder–New Module 20 (ADNM-20). Secondary endpoints were depressive symptoms, quality of life and other variables such as satisfaction and usability. Both the intervention and the control group improved comparably well regarding the severity of adjustment disorder symptoms post-treatment. However, participants in the intervention group showed significantly fewer depressive symptoms and a significantly higher quality of life (Cohen’s d: 0.89 (BDI) and −0.49 (SF-12)). The intervention was well-received by users with an above average usability rating. Overall, the results suggest that the ZIEL intervention has the promise to contribute to the treatment of AjD and reduce symptom burden by means of a scalable low-barrier approach.
Highlights
“It’s really wonderful how much resilience there is in human nature,” famous Dracula novelist Stoker stated at the end of the 19th century, against the background of his own adverse experiences [1]
The conditions in both groups did not differ in terms of Adjustment Disorder (AjD) symptom burden or demographic characteristics
The effect of the Adjustment Disorder-New Module 20 (ADNM-20) was not qualified by significant Group × Time interactions for either the sum score (F1,96 = 2.38, p = ns), or for the subscales (F1,96 = 0.03–3.13, p = ns; see Table 3), meaning that the symptom severity did not decrease significantly in the intervention group compared to the control group
Summary
“It’s really wonderful how much resilience there is in human nature,” famous Dracula novelist Stoker stated at the end of the 19th century, against the background of his own adverse experiences [1]. A more recent development of the same group, called TAO, is currently being tested [22] It combines approaches from cognitive-behavioral therapy (CBT) and Positive Psychology for the guided treatment of AjD. The translational lag with the transfer of current research findings into clinical practice is significantly shorter than with traditional approaches [30] This bears the potential to significantly improve the quality and availability of care for individuals in need on a long-term basis. These considerations form the basis of this study and its two objectives: Firstly, the development of a sustainable self-guided intervention for AjD called “Back to your own life The goal is to contribute and to expand the growing efforts in the field of AjD research and care
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