TY - JOUR
T1 - Brief Use of Behavioral Activation Features Predicts Benefits of Self-Help App on Depression Symptoms
T2 - Secondary Analysis of a Selective Prevention Trial in Young People
AU - Bralee, Emily
AU - Mostazir, Mohammod
AU - Warren, Fiona C.
AU - Newbold, Alexandra
AU - Hulme, Claire
AU - Cranston, Timothy
AU - Aas, Benjamin
AU - Bear, Holly
AU - Botella, Cristina
AU - Burkhardt, Felix
AU - Ehring, Thomas
AU - Fazel, Mina
AU - Fontaine, Johnny R.J.
AU - Frost, Mads
AU - Garcia-Palacios, Azucena
AU - Greimel, Ellen
AU - Hößle, Christiane
AU - Hovasapian, Arpine
AU - Huyghe, Veerle E.I.
AU - Iversen, Nanna
AU - Karpouzis, Kostas
AU - Löchner, Johanna
AU - Molinari, Guadalupe
AU - Pekrun, Reinhard
AU - Platt, Belinda
AU - Rosenkranz, Tabea
AU - Scherer, Klaus R.
AU - Schlegel, Katja
AU - Schuller, Bjorn W.
AU - Schulte-Korne, Gerd
AU - Suso-Ribera, Carlos
AU - Voigt, Varinka
AU - Voss, Maria
AU - Watkins, Edward R.
N1 - Publisher Copyright:
© 2025 The Author(s)
PY - 2025
Y1 - 2025
N2 - Objective: To explore which cognitive behavioral therapy (CBT) self-help app usage predicted depression during a selective prevention trial. Method: A recent controlled trial (ECoWeB-PREVENT) randomized young people aged 16-22, at increased risk for depression because of elevated worry/rumination, negative appraisals, and/or rejection sensitivity but without past or current history of major depression, to apps that provided self-monitoring, self-monitoring plus CBT self-help, or self-monitoring plus emotional competency self-help. Self-help included coping strategies for moment-by-moment use (Tools) and self-learning/planning exercises (Challenges). On the primary outcome (depression, Patient Health Questionnaire-9 [PHQ-9]) at 3-months follow-up (primary endpoint), only the CBT app outperformed selfmonitoring. In this secondary analysis, only data from participants who used the CBT or self-monitoring apps at least once were analyzed to test what app use predicted change in depression from baseline to 3 months. Results: Of the original 1,262 participants (79% female), 558 were included (CBT, baseline, n = 273, PHQ-9: M = 7.48, SD = 3.9; 3 months, N = 163, PHQ-9: M = 8.83, SD = 4.92; self-monitoring, baseline, n = 285, PHQ-9: M = 7.45, SD = 4.26; 3 months, N = 183, PHQ-9: M = 7.48, SD = 3.9). Neither total app use, self-monitoring, nor use of Tools predicted change in depression (all ps?> .05). Frequency of use of Challenges predicted lower depression symptoms and caseness at 3 months (p = -0.28, 95% CI [-0.53, -0.03], p = .029). Specifically, the use of behavioral activation challenges mediated the effects of the CBT app on depression over3 months (p = -0.59,95% CI [-1.13, -0.05],p = .03). Conclusions: Brief psychoeducation about behavioral activation principles in an app may protect young people from depression over 3 months, even when only used once.
AB - Objective: To explore which cognitive behavioral therapy (CBT) self-help app usage predicted depression during a selective prevention trial. Method: A recent controlled trial (ECoWeB-PREVENT) randomized young people aged 16-22, at increased risk for depression because of elevated worry/rumination, negative appraisals, and/or rejection sensitivity but without past or current history of major depression, to apps that provided self-monitoring, self-monitoring plus CBT self-help, or self-monitoring plus emotional competency self-help. Self-help included coping strategies for moment-by-moment use (Tools) and self-learning/planning exercises (Challenges). On the primary outcome (depression, Patient Health Questionnaire-9 [PHQ-9]) at 3-months follow-up (primary endpoint), only the CBT app outperformed selfmonitoring. In this secondary analysis, only data from participants who used the CBT or self-monitoring apps at least once were analyzed to test what app use predicted change in depression from baseline to 3 months. Results: Of the original 1,262 participants (79% female), 558 were included (CBT, baseline, n = 273, PHQ-9: M = 7.48, SD = 3.9; 3 months, N = 163, PHQ-9: M = 8.83, SD = 4.92; self-monitoring, baseline, n = 285, PHQ-9: M = 7.45, SD = 4.26; 3 months, N = 183, PHQ-9: M = 7.48, SD = 3.9). Neither total app use, self-monitoring, nor use of Tools predicted change in depression (all ps?> .05). Frequency of use of Challenges predicted lower depression symptoms and caseness at 3 months (p = -0.28, 95% CI [-0.53, -0.03], p = .029). Specifically, the use of behavioral activation challenges mediated the effects of the CBT app on depression over3 months (p = -0.59,95% CI [-1.13, -0.05],p = .03). Conclusions: Brief psychoeducation about behavioral activation principles in an app may protect young people from depression over 3 months, even when only used once.
KW - behavioral activation
KW - cognitive behavioral therapy
KW - depression
KW - smartphone app
KW - young people
UR - http://www.scopus.com/inward/record.url?scp=105002001866&partnerID=8YFLogxK
U2 - 10.1037/ccp0000917
DO - 10.1037/ccp0000917
M3 - Article
C2 - 40126557
AN - SCOPUS:105002001866
SN - 0022-006X
VL - 93
SP - 293
EP - 306
JO - Journal of Consulting and Clinical Psychology
JF - Journal of Consulting and Clinical Psychology
IS - 4
ER -
