{
  "creator": [
    "Fu, Zhongfang",
    "Burger, Huibert ",
    "Arjadi, Retha",
    "Nauta, Maaike H.",
    "Bockting, Claudi L. H."
  ],
  "date": [
    "2021-09-30"
  ],
  "description": [
    "Background: Behavioral activation is an effective treatment for depression that is theorized to facilitate structured increases in enjoyable activities that increase opportunities for contact with positive reinforcement; to date, however, only few mechanistic studies focused on a standalone intervention. Method: Interventions using internet-based behavioral activation or psychoeducation were compared based on data from a randomized-controlled trial of 313 patients with major depressive disorder. Activation level and depression were measured fortnightly (baseline, Weeks 2, 4, 6, 8, 10), using the Patient Health Questionnaire-9 and the Behavioral Activation for Depression Scale-Short Form, respectively. Analysis was performed to determine if a change in activation level mediated treatment efficacy. Results: Latent growth modeling showed that internet-based behavioral activation treatment significantly reduced depressive symptoms from baseline to the end of treatment (standardized coefficient = −.13, p = .017) by increasing the rate of growth in the activation level (mediated effect estimate = −.17, 95% CI [−.27, −.07]. Results from mixed effects and simplex models showed that it took 4 weeks before mediation occurred (i.e., a significant change in activation that led to a reduction in depressive symptoms). Conclusion: Activation level likely mediated the therapeutic effect of behavioral activation on depression in our intervention. This finding may be of significant value to clinicians and depressed individuals who should anticipate a 4-week window before seeing a prominent change in activation level and a 6-week window before depressive symptomatology reduces. Future research must consolidate our findings on how behavioral activation works and when mediation occurs."
  ],
  "format": [
    "application/pdf",
    "text/html",
    "text/xml"
  ],
  "identifier": [
    "https://cpe.psychopen.eu/index.php/cpe/article/view/5467",
    "10.32872/cpe.5467"
  ],
  "language": [
    "eng"
  ],
  "publisher": [
    "PsychOpen GOLD / Leibniz Institut for Psychology (ZPID)"
  ],
  "relation": [
    "https://cpe.psychopen.eu/index.php/cpe/article/view/5467/5467.pdf",
    "https://cpe.psychopen.eu/index.php/cpe/article/view/5467/5467.html",
    "https://cpe.psychopen.eu/index.php/cpe/article/view/5467/5467.xml"
  ],
  "rights": [
    "Copyright (c) 2021 Zhongfang Fu, Huibert Burger, Retha Arjadi, Maaike H. Nauta, Claudi L. H. Bockting",
    "https://creativecommons.org/licenses/by/4.0"
  ],
  "source": [
    "Clinical Psychology in Europe; Vol. 3 No. 3 (2021); 1-24",
    "2625-3410",
    "10.32872/cpe.v3i3"
  ],
  "subject": [
    "psychological interventions",
    "working mechanisms",
    "behavioral activation",
    "depression",
    "internet-based intervention",
    "lay counselors"
  ],
  "title": [
    "Explaining the Efficacy of an Internet-Based Behavioral Activation Intervention for Major Depression: A Mechanistic Study of a Randomized-Controlled Trial"
  ],
  "type": [
    "info:eu-repo/semantics/article",
    "info:eu-repo/semantics/publishedVersion"
  ]
}