Tur Cintia, Campos Daniel, Suso-Ribera Carlos, Kazlauskas Evaldas, Castilla Diana, Zaragoza Irene, García-Palacios Azucena, Quero Soledad
Departmento de Psicología Básica, Clínica y Psicobiología. Universitat Jaume I, Castellón de la Plana, Spain.
Departmento de Psicología y Sociología, Universidad de Zaragoza, Zaragoza, Spain.
Internet Interv. 2022 Jul 7;29:100558. doi: 10.1016/j.invent.2022.100558. eCollection 2022 Sep.
The death of a loved one has physical, psychological, and social consequences. Between 9.8 and 21.5 % of people who lose a loved one develop Prolonged Grief Disorder (PGD). Internet- and computer-based interventions (i.e., Internet-delivered Cognitive-Behavioral Therapy, iCBT) are cost-effective and scalable alternatives that make it possible to reach more people with PGD. The main goal of the present investigation was to examine the effect and feasibility (usability and satisfaction) of an iCBT () for adults with PGD. A secondary objective was to detect adherence to the app () used to measure daily grief symptoms. The study had a single-case multiple-baseline AB design with six participants. The is organized sequentially in eight modules, and it is based on the dual-process model of coping with bereavement. Evaluations included a pre-to-post treatment assessment of depression, grief symptoms, and typical grief beliefs, along with daily measures of symptom frequency and intensity on the App. Treatment opinions and adherence to the App were also collected. Efficacy data were calculated using a Nonoverlap of All Pairs (NAP) analysis and Reliable Change Index (RCI). The mean age of the sample was 29.5 years (SD = 8.19). Two participants dropped out of the study. Adherence to the App varied across patients (4.8 % -77.8 %). Most participants (75 %) showed a clinically significant change (recovered) in depression, and 50 % obtained a clinically significant improvement (recovered) in symptoms of loss and typical beliefs in complicated grief. The participants reported high usability and satisfaction with the treatment content and format. In sum, the was very well accepted and generally feasible, and it has strong potential for treating PGD. The results support scaling up the treatment by using more complex designs with larger samples (i.e., randomized controlled trials comparing with active conditions).
所爱之人的离世会带来身体、心理和社会方面的影响。在失去所爱之人的人群中，9.8%至21.5%的人会患上持续性悲伤障碍（PGD）。基于互联网和计算机的干预措施（即互联网提供的认知行为疗法，iCBT）是具有成本效益且可扩展的替代方案，使得能够接触到更多患有PGD的人。本研究的主要目的是检验一种iCBT（）对患有PGD的成年人的效果和可行性（可用性和满意度）。次要目标是检测对用于测量每日悲伤症状的应用程序（）的依从性。该研究采用单病例多基线AB设计，有六名参与者。该（）按顺序分为八个模块，基于应对丧亲之痛的双过程模型。评估包括治疗前后对抑郁、悲伤症状和典型悲伤信念的评估，以及在应用程序上对症状频率和强度的每日测量。还收集了对治疗的意见和对应用程序的依从性。疗效数据使用全对非重叠（NAP）分析和可靠变化指数（RCI）进行计算。样本的平均年龄为29.5岁（标准差=8.19）。两名参与者退出了研究。对应用程序的依从性在患者中各不相同（4.8%-77.8%）。大多数参与者（75%）在抑郁方面表现出临床显著变化（康复），50%在复杂悲伤中的丧失症状和典型信念方面获得了临床显著改善（康复）。参与者对治疗内容和形式的可用性和满意度较高。总之，该（）非常受欢迎且总体可行，具有治疗PGD的强大潜力。结果支持通过使用更复杂的设计和更大的样本（即与积极对照条件进行比较的随机对照试验）来扩大治疗规模。
