Brog Noemi Anja, Hegy Julia Katharina, Berger Thomas, Znoj Hansjörg
Department of Health Psychology and Behavioral Medicine, University of Bern, Switzerland.
Department of Clinical Psychology and Psychotherapy, University of Bern, Switzerland.
Internet Interv. 2022 Mar;27:100492. doi: 10.1016/j.invent.2021.100492. Epub 2021 Dec 18.
The COVID-19 pandemic and its far-reaching impact on physical and mental health generate high demand and, accordingly, a great need for treatment opportunities that promote well-being and manage psychological distress. Internet-based interventions are particularly suitable for this purpose. They are easily scalable, readily accessible, and the online format allows for adherence to social distancing. For this reason, we developed an internet-based self-help intervention called ROCO to address psychological distress due to the COVID-19 pandemic. This randomized controlled trial aimed to examine the efficacy of the ROCO intervention.
A total of 107 German-speaking adults with at least mild depressive symptoms were randomized either to the intervention group with direct access to the three-week ROCO intervention plus care as usual or the waiting control group receiving care as usual. Primary outcome (depressive symptoms) and secondary outcomes (stress, anxiety, resilience, emotion regulation, health-related quality of life, embitterment, loneliness, optimism, and self-efficacy) were assessed pre- and post-treatment and at a 6-week follow-up using self-report questionnaires (e.g. Patient Health Questionnaire-9 for depressive symptoms).
The average age was 40.36 years (SD = 14.59) and 81.3% of participants were female. The intervention did not significantly reduce primary depressive symptoms (between-group effect size: = 0.04) and secondary outcomes such as anxiety and stress symptoms (between-group effect size: = -0.19). However, the intervention led to a significant increase in emotion regulation skills (between-group effect size = 0.35) and resilience (between-group effect size = 0.38).
The internet-based self-help intervention cannot be recommended for the purpose of reducing depressive symptoms. However, the increase in emotion regulation skills and resilience suggest that the intervention may be suitable for preventive purposes, like improving overall coping with psychological distress or potential stressors. Future research is needed to examine for whom and how the intervention is most effective.
新冠疫情及其对身心健康的深远影响引发了对促进幸福感和应对心理困扰的治疗机会的高需求，因此迫切需要此类治疗机会。基于互联网的干预措施特别适合这一目的。它们易于扩展、易于获取，并且在线形式有助于遵守社交距离。出于这个原因，我们开发了一种名为ROCO的基于互联网的自助干预措施，以应对新冠疫情导致的心理困扰。这项随机对照试验旨在检验ROCO干预措施的疗效。
共有107名至少有轻度抑郁症状的德语成年人被随机分为干预组和等待对照组。干预组可直接接受为期三周的ROCO干预并照常接受护理，等待对照组则照常接受护理。在治疗前、治疗后以及6周随访时，使用自我报告问卷（例如用于评估抑郁症状的患者健康问卷-9）对主要结局（抑郁症状）和次要结局（压力、焦虑、恢复力、情绪调节、健康相关生活质量、痛苦、孤独感、乐观主义和自我效能感）进行评估。
参与者的平均年龄为40.36岁（标准差=14.59），81.3%为女性。该干预措施并未显著减轻主要抑郁症状（组间效应量：=0.04）以及焦虑和压力症状等次要结局（组间效应量：=-0.19）。然而，该干预措施使情绪调节技能（组间效应量=0.35）和恢复力（组间效应量=0.38）显著提高。
基于互联网的自助干预措施不建议用于减轻抑郁症状。然而，情绪调节技能和恢复力的提高表明，该干预措施可能适用于预防性目的，例如改善应对心理困扰或潜在压力源的整体能力。未来需要进行研究，以确定该干预措施对谁最有效以及如何最有效。
