Clarke Janine, Proudfoot Judith, Birch Mary-Rose, Whitton Alexis E, Parker Gordon, Manicavasagar Vijaya, Harrison Virginia, Christensen Helen, Hadzi-Pavlovic Dusan
BMC Psychiatry. 2014 Sep 26;14:272. doi: 10.1186/s12888-014-0272-1.
Online psychotherapy is clinically effective yet why, how, and for whom the effects are greatest remain largely unknown. In the present study, we examined whether mental health self-efficacy (MHSE), a construct derived from Bandura's Social Learning Theory (SLT), influenced symptom and functional outcomes of a new mobile phone and web-based psychotherapy intervention for people with mild-to-moderate depression, anxiety and stress.
STUDY I: Data from 49 people with symptoms of depression, anxiety and/or stress in the mild-to-moderate range were used to examine the reliability and construct validity of a new measure of MHSE, the Mental Health Self-efficacy Scale (MHSES).
We conducted a secondary analysis of data from a recently completed randomised controlled trial (N = 720) to evaluate whether MHSE effected post-intervention outcomes, as measured by the Depression, Anxiety and Stress Scales (DASS) and Work and Social Adjustment Scale (WSAS), for people with symptoms in the mild-to-moderate range.
STUDY I: The data established that the MHSES comprised a unitary factor, with acceptable internal reliability (Cronbach's alpha = .89) and construct validity.
The intervention group showed significantly greater improvement in MHSE at post-intervention relative to the control conditions (p's < = .000). MHSE mediated the effects of the intervention on anxiety and stress symptoms. Furthermore, people with low pre-treatment MHSE reported the greatest post-intervention gains in depression, anxiety and overall distress. No effects were found for MHSE on work and social functioning.
Mental health self-efficacy influences symptom outcomes of a self-guided mobile phone and web-based psychotherapeutic intervention and may itself be a worthwhile target to increase the effectiveness and efficiency of online treatment programs.
Australian New Zealand Clinical Trials Registry ACTRN12610000625077.
在线心理治疗在临床上是有效的，但其效果为何、如何产生以及对哪些人效果最佳在很大程度上仍不清楚。在本研究中，我们检验了源自班杜拉社会学习理论（SLT）的心理健康自我效能感（MHSE）是否会影响一种针对轻度至中度抑郁、焦虑和压力人群的新型手机及网络心理治疗干预的症状和功能结局。
研究I：来自49名有轻度至中度抑郁、焦虑和/或压力症状的人的数据被用于检验一种新的MHSE测量工具——心理健康自我效能量表（MHSES）的信度和结构效度。
研究II：我们对一项最近完成的随机对照试验（N = 720）的数据进行了二次分析，以评估MHSE是否会影响干预后结局，这些结局通过抑郁、焦虑和压力量表（DASS）以及工作和社会适应量表（WSAS）来衡量，针对的是有轻度至中度症状的人群。
研究I：数据表明MHSES包含一个单一因素，具有可接受的内部信度（克朗巴哈系数α = 0.89）和结构效度。
研究II：干预组在干预后相对于对照组在MHSE方面有显著更大的改善（p值≤0.000）。MHSE介导了干预对焦虑和压力症状的影响。此外，治疗前MHSE较低的人在干预后抑郁、焦虑和总体痛苦方面的改善最大。未发现MHSE对工作和社会功能有影响。
心理健康自我效能感会影响一种自助式手机及网络心理治疗干预的症状结局，其本身可能是提高在线治疗项目有效性和效率的一个有价值的目标。
澳大利亚和新西兰临床试验注册中心ACTRN12610000625077。
