JMIR Publications

ABSTRACT

Background:

Emotional disorders (ED) are among the most prevalent mental disorders, with comorbidity rates ranging between 40 and 80%. In the past few decades, evidence-based psychological treatments have been shown to be effective in the treatment of ED. However, the scale of these treatments is not sufficient to reduce the disease burden of mental disorders. It is therefore essential to implement innovative solutions to achieve a successful dissemination of psychological treatment protocols, and in this regard, the use of Information and Communication Technologies like the Internet can be very useful. Furthermore, the literature suggests that not everyone suffering from ED receives the appropriate treatment, and that these interventions do not reach everyone in need. This situation has led to the development of new intervention proposals based on the transdiagnostic perspective, which tries to address the underlying processes common to ED. Most of these transdiagnostic interventions focus primarily on down-regulating negative affectivity, and less attention has been paid to strengths and the up-regulation of positive affectivity (PA), despite its importance for well-being and mental health.

Objective:

This study presents a Randomized Controlled Trial that evaluates the efficacy in a community sample of a transdiagnostic Internet-based treatment for ED that includes traditional cognitive-behavioral therapy components and a specific component to address positive affect (PA).

Methods:

Participants were randomly assigned to a) a Transdiagnostic Internet-based protocol (TIBP), b) a Transdiagnostic Internet-based protocol + positive affect component (TIBP+PA), or c) a Waiting List control group (WL). Data on depression, anxiety, and positive and negative affectivity before and after treatment were analyzed.

Results:

Within-group comparisons indicated significant pre-post reductions in the two experimental conditions. In the TIBP+PA condition, effect sizes were large on all the primary outcomes, whereas the TIBP condition obtained large effect sizes for BDI-II and PANAS-N, and medium effect sizes for BAI and PANAS-P. Between-group comparisons revealed that participants who received one of the two active treatments scored better at post-treatment, compared to the WL. Although there were non-statistically significant differences between the two intervention groups on the PA measure, effect sizes were consistently larger in the TIBP+PA condition, compared to the standard transdiagnostic protocol.

Conclusions:

Overall, the findings indicate that ED can be effectively treated with a transdiagnostic intervention via the Internet, as significant improvements in depression, anxiety and quality of life measures were observed. On regarding PA measures, promising effects were found, but more research is needed to study the role of PA as a therapeutic component. This study aims to contribute to the literature on the efficacy of online transdiagnostic interventions to ED in general; more specifically, it explores the possible impact of a specific component designed to up-regulate PA. Clinical Trial: ClinicalTrial.gov NCT02578758; https://clinicaltrials.gov/ct2/show/NCT02578758