Accepted for/Published in: JMIR Mental Health
Date Submitted: Nov 2, 2023
Date Accepted: Jun 9, 2024
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Efficacy of a fully automated digital behavioral activation intervention on reducing depressive symptoms and anhedonia
ABSTRACT
Despite significant progress in our understanding of depression, prevalence rates have dramatically increased in recent years. Thus, there is an imperative need for more cost-effective and scalable mental health treatment options – including digital interventions that minimize therapist burden. The current study focuses on a fully automated digital implementation of Behavioral Activation (BA)—a core behavioral component of cognitive-behavioral therapy (CBT) for depression. We examine the efficacy of a one-month fully automated text message-based BA intervention at reducing depressive symptoms and anhedonia. To this end, 111 adults (M = 32.46 years, SD = 7.41) reporting at least moderate current depressive symptoms (PHQ-8 ≥ 10; M = 16.53, SD = 3.90) were recruited entirely online across the U.S. and randomized to one of three conditions: enjoyable activities (i.e., BA), healthy activities (i.e., an active control condition), and passive (i.e., no contact) control. Participants randomized to enjoyable and healthy activities received daily text messages prompting them to complete two activities per day; participants also provided a daily report on the number and enjoyment of activities completed the prior day. Results revealed that participants in the enjoyable activities (BA) condition experienced significantly greater reductions in depressive symptoms and anhedonia compared to participants in the other two conditions. Participants in both active conditions (i.e., enjoyable and healthy activities) reported reduced symptoms of anxiety compared to those in the control condition. These findings provide preliminary evidence regarding the efficacy of a fully automated digital BA intervention for depression, anhedonia, and anxiety symptoms. Moreover, reminders to complete healthy activities may be a promising intervention for reducing anxiety symptoms.
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