Mobile-Assisted Cognitive Behavioral Therapy for Negative Symptoms: Open Single-Arm Trial With Schizophrenia Patients.
blended intervention
dysfunctional attitudes
mHealth
mobile phone
motivation
persistent negative symptoms
Journal
JMIR mental health
ISSN: 2368-7959
Titre abrégé: JMIR Ment Health
Pays: Canada
ID NLM: 101658926
Informations de publication
Date de publication:
01 Dec 2020
01 Dec 2020
Historique:
received:
17
09
2020
accepted:
03
11
2020
revised:
03
11
2020
entrez:
1
12
2020
pubmed:
2
12
2020
medline:
2
12
2020
Statut:
epublish
Résumé
Negative symptoms are an important unmet treatment need for schizophrenia. This study is a preliminary, open, single-arm trial of a novel hybrid intervention called mobile-assisted cognitive behavioral therapy for negative symptoms (mCBTn). The primary aim was to test whether mCBTn was feasible and could reduce severity of the target mechanism, defeatist performance attitudes, which are associated with experiential negative symptoms and poor functioning in schizophrenia. Participants with schizophrenia or schizoaffective disorder (N=31) who met prospective criteria for persistent negative symptoms were enrolled. The blended intervention combines weekly in-person group therapy with a smartphone app called CBT2go. The app extended therapy group skills, including recovery goal setting, thought challenging, scheduling of pleasurable activities and social interactions, and pleasure-savoring interventions to modify defeatist attitudes and improve experiential negative symptoms. Retention was excellent (87% at 18 weeks), and severity of defeatist attitudes and experiential negative symptoms declined significantly in the mCBTn intervention with large effect sizes. The findings suggest that mCBTn is a feasible and potentially effective treatment for experiential negative symptoms, if confirmed in a larger randomized controlled trial. The findings also provide support for the defeatist attitude model of experiential negative symptoms and suggest that blended technology-supported interventions such as mCBTn can strengthen and shorten intensive psychosocial interventions for schizophrenia. ClinicalTrials.gov NCT03179696; https://clinicaltrials.gov/ct2/show/NCT03179696.
Sections du résumé
BACKGROUND
BACKGROUND
Negative symptoms are an important unmet treatment need for schizophrenia. This study is a preliminary, open, single-arm trial of a novel hybrid intervention called mobile-assisted cognitive behavioral therapy for negative symptoms (mCBTn).
OBJECTIVE
OBJECTIVE
The primary aim was to test whether mCBTn was feasible and could reduce severity of the target mechanism, defeatist performance attitudes, which are associated with experiential negative symptoms and poor functioning in schizophrenia.
METHODS
METHODS
Participants with schizophrenia or schizoaffective disorder (N=31) who met prospective criteria for persistent negative symptoms were enrolled. The blended intervention combines weekly in-person group therapy with a smartphone app called CBT2go. The app extended therapy group skills, including recovery goal setting, thought challenging, scheduling of pleasurable activities and social interactions, and pleasure-savoring interventions to modify defeatist attitudes and improve experiential negative symptoms.
RESULTS
RESULTS
Retention was excellent (87% at 18 weeks), and severity of defeatist attitudes and experiential negative symptoms declined significantly in the mCBTn intervention with large effect sizes.
CONCLUSIONS
CONCLUSIONS
The findings suggest that mCBTn is a feasible and potentially effective treatment for experiential negative symptoms, if confirmed in a larger randomized controlled trial. The findings also provide support for the defeatist attitude model of experiential negative symptoms and suggest that blended technology-supported interventions such as mCBTn can strengthen and shorten intensive psychosocial interventions for schizophrenia.
TRIAL REGISTRATION
BACKGROUND
ClinicalTrials.gov NCT03179696; https://clinicaltrials.gov/ct2/show/NCT03179696.
Identifiants
pubmed: 33258792
pii: v7i12e24406
doi: 10.2196/24406
pmc: PMC7738249
doi:
Banques de données
ClinicalTrials.gov
['NCT03179696']
Types de publication
Journal Article
Langues
eng
Pagination
e24406Informations de copyright
©Eric Granholm, Jason Holden, Kristen Dwyer, Tanya Mikhael, Peter Link, Colin Depp. Originally published in JMIR Mental Health (http://mental.jmir.org), 01.12.2020.
Références
Schizophr Bull. 2006 Apr;32(2):238-45
pubmed: 16254064
Arch Gen Psychiatry. 2012 Dec;69(12):1216-24
pubmed: 23026889
Psychiatr Rehabil J. 2013 Dec;36(4):289-296
pubmed: 24015913
Psychiatry Res. 2011 Aug 30;189(1):43-8
pubmed: 21704387
Psychiatry Res. 2014 Aug 30;218(3):284-9
pubmed: 24814140
Behav Res Ther. 2012 Feb;50(2):163-7
pubmed: 22209267
Psychiatr Rehabil J. 2006 Fall;30(2):129-36
pubmed: 17076056
Schizophr Bull. 2018 Aug 20;44(5):1010-1020
pubmed: 29939367
Arch Gen Psychiatry. 2012 Feb;69(2):121-7
pubmed: 21969420
JMIR Res Protoc. 2016 Apr 28;5(2):e77
pubmed: 27125771
Schizophr Res. 1990 Jul-Aug;3(4):247-51
pubmed: 2278986
J Behav Ther Exp Psychiatry. 2013 Sep;44(3):300-6
pubmed: 23454550
Am J Geriatr Psychiatry. 2013 Mar;21(3):251-62
pubmed: 23395192
Schizophr Res. 2014 Jun;156(1):96-106
pubmed: 24746468
Schizophr Bull. 2014 Apr;40 Suppl 3:S165-94
pubmed: 24778411
J Consult Clin Psychol. 2014 Dec;82(6):1173-85
pubmed: 24911420
Community Ment Health J. 2019 Aug;55(6):973-978
pubmed: 31175518
J Psychiatr Res. 2010 Jun;44(8):499-505
pubmed: 20006849
Br J Psychiatry. 1990 Dec;157:853-9
pubmed: 2289094
Schizophr Bull. 2014 Nov;40(6):1244-53
pubmed: 24609454
Schizophr Bull. 2016 Nov;42(6):1343-1352
pubmed: 26980144
Schizophr Res. 2015 Jul;165(2-3):175-80
pubmed: 25937461
Can J Psychiatry. 2005 Apr;50(5):247-57
pubmed: 15968839
Schizophr Res. 2020 Feb;216:479-487
pubmed: 31812327
Acta Psychiatr Scand Suppl. 1970;212:11-9
pubmed: 4917967
Schizophr Res. 2017 Jul;185:137-143
pubmed: 28087270
Schizophr Bull. 2006 Apr;32(2):214-9
pubmed: 16481659
J Consult Clin Psychol. 2008 Jun;76(3):491-504
pubmed: 18540742
Schizophr Res. 2014 Apr;154(1-3):89-92
pubmed: 24630140
Schizophr Bull. 2007 Jul;33(4):1013-22
pubmed: 17099070
J Med Internet Res. 2019 Nov 12;21(11):e16393
pubmed: 31714250
Psychiatry Res. 2010 May 15;177(1-2):65-70
pubmed: 20163875
Schizophr Res. 2014 Aug;157(1-3):182-9
pubmed: 24924405
Schizophr Bull. 1987;13(2):261-76
pubmed: 3616518
Schizophr Bull. 2018 Apr 6;44(3):653-661
pubmed: 29036391
Schizophr Bull. 2012 May;38(3):414-25
pubmed: 22080492
Am J Psychiatry. 2013 Feb;170(2):165-72
pubmed: 23377637
Schizophr Res. 2013 Nov;150(2-3):334-8
pubmed: 23815975
JMIR Mhealth Uhealth. 2015 Nov 06;3(4):e102
pubmed: 26546039
Schizophr Bull. 2016 Mar;42(2):448-55
pubmed: 26400871
Eur Neuropsychopharmacol. 2014 May;24(5):737-43
pubmed: 24275698
Schizophr Bull. 2009 Sep;35(5):874-83
pubmed: 19628761
Schizophr Bull. 2018 Aug 20;44(5):1070-1080
pubmed: 29566206
Schizophr Bull. 2019 Jun 18;45(4):752-762
pubmed: 30281086
Schizophr Bull. 2009 Jul;35(4):798-806
pubmed: 18308717
Schizophr Bull. 2018 Apr 6;44(3):475-491
pubmed: 29140460
Psychiatr Serv. 2015 Jul;66(7):764-5
pubmed: 26130154
Schizophr Bull. 2010 Jan;36(1):48-70
pubmed: 19955389
J Clin Psychol. 2009 Aug;65(8):815-30
pubmed: 19572278
Psychol Med. 2015 Feb;45(3):453-65
pubmed: 24993642
Psychiatr Serv. 2017 Nov 1;68(11):1172-1181
pubmed: 28669284
Psychol Med. 2011 Mar;41(3):487-97
pubmed: 20482936
Br J Psychiatry. 2014 Jan;204(1):20-9
pubmed: 24385461
Schizophr Bull. 2010 Jan;36(1):71-93
pubmed: 19955390
Adm Policy Ment Health. 2013 Jul;40(4):340-3
pubmed: 22648635