Feasibility and efficacy of a digital CBT intervention for symptoms of Generalized Anxiety Disorder: A randomized multiple-baseline study.
Anxiety
Cognitive behavioral therapy
Digital
Single-case experimental design
Smartphone
Journal
Journal of behavior therapy and experimental psychiatry
ISSN: 1873-7943
Titre abrégé: J Behav Ther Exp Psychiatry
Pays: Netherlands
ID NLM: 0245075
Informations de publication
Date de publication:
03 2021
03 2021
Historique:
received:
23
12
2019
revised:
10
07
2020
accepted:
17
08
2020
pubmed:
21
9
2020
medline:
25
8
2021
entrez:
20
9
2020
Statut:
ppublish
Résumé
Cognitive behavioral therapy (CBT) is a first-line treatment for anxiety, but it is not widely available as clinical guidelines recommend. We examined the feasibility and efficacy of a novel smartphone-based fully automated digital CBT intervention, 'Daylight™', to improve symptoms of Generalized Anxiety Disorder (GAD). In this multiple-baseline design, 21 adults (20 F; mean age 43yrs. range 19-65yrs.) with moderate-to-severe symptoms of GAD were randomized to one of three baseline durations (2-, 4-, or 6-weeks) and then received access to digital CBT. Participants completed daily ratings of anxiety and worry, weekly measures of anxiety, depressive symptoms, and sleep, and measures of anxiety, worry, wellbeing, quality of life, CBT skill acquisition, and work performance at initial assessment prior to baseline randomization, post-intervention, and follow-up. Digital CBT was found to be feasible in terms of engagement, satisfaction, and safety. For preliminary efficacy, improvements were detected in daily and weekly outcomes of anxiety for most participants. Despite individual differences, significant improvements occurred with the introduction of digital CBT and not during baseline. Overall, 70% of participants no longer had clinically significant symptoms of GAD, 61% no longer had significant depressive symptoms, and 40% no longer had significant sleep difficulty at post-intervention. The study sample was recruited using the internet and was mostly female, limiting the generalizability of the findings. Findings support the feasibility and efficacy of Daylight. Further examination in randomized controlled trials is now warranted.
Sections du résumé
BACKGROUND AND OBJECTIVES
Cognitive behavioral therapy (CBT) is a first-line treatment for anxiety, but it is not widely available as clinical guidelines recommend. We examined the feasibility and efficacy of a novel smartphone-based fully automated digital CBT intervention, 'Daylight™', to improve symptoms of Generalized Anxiety Disorder (GAD).
METHODS
In this multiple-baseline design, 21 adults (20 F; mean age 43yrs. range 19-65yrs.) with moderate-to-severe symptoms of GAD were randomized to one of three baseline durations (2-, 4-, or 6-weeks) and then received access to digital CBT. Participants completed daily ratings of anxiety and worry, weekly measures of anxiety, depressive symptoms, and sleep, and measures of anxiety, worry, wellbeing, quality of life, CBT skill acquisition, and work performance at initial assessment prior to baseline randomization, post-intervention, and follow-up.
RESULTS
Digital CBT was found to be feasible in terms of engagement, satisfaction, and safety. For preliminary efficacy, improvements were detected in daily and weekly outcomes of anxiety for most participants. Despite individual differences, significant improvements occurred with the introduction of digital CBT and not during baseline. Overall, 70% of participants no longer had clinically significant symptoms of GAD, 61% no longer had significant depressive symptoms, and 40% no longer had significant sleep difficulty at post-intervention.
LIMITATIONS
The study sample was recruited using the internet and was mostly female, limiting the generalizability of the findings.
CONCLUSIONS
Findings support the feasibility and efficacy of Daylight. Further examination in randomized controlled trials is now warranted.
Identifiants
pubmed: 32950939
pii: S0005-7916(19)30269-1
doi: 10.1016/j.jbtep.2020.101609
pii:
doi:
Banques de données
ISRCTN
['ISRCTN89276818']
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
101609Subventions
Organisme : Department of Health
Pays : United Kingdom
Informations de copyright
Copyright © 2020 Elsevier Ltd. All rights reserved.