Denne side blev automatisk oversat, og nøjagtigheden af ​​oversættelsen er ikke garanteret. Der henvises til engelsk version for en kildetekst.

CBT+ til depression (CBT+)

4. august 2026 opdateret af: University of Wisconsin, Madison

ActiveCBT for Depression: Transformering Treatment Through Exercise Priming

Denne undersøgelse undersøger virkningerne af en ny interventionstilgang, der bevidst sekventerer aerob træning umiddelbart før terapisessioner (dvs. kognitiv adfærdsterapi [CBT]) for at bestemme dens virkninger på både specifikke og almindelige faktorer, der ligger til grund for den antidepressive effekt af CBT (dvs. mekanismer) af CBT). For at vurdere nytten af ​​denne behandlingsforøgelse planlægger efterforskerne at udføre et randomiseret kontrolleret forsøg, der involverer 40 voksne med svær depressiv lidelse, som vil se en naturdokumentar, mens de enten hviler stille (kaldet 'CalmCBT') eller træner med moderat intensitet ('ActiveCBT' ) umiddelbart før 8 ugentlige sessioner med CBT. Det er en hypotese, at mål-CBT-mekanismer for antidepressiv virkning (dvs. selvrapporteret arbejdsalliance og adfærdsaktivering) vil blive mere effektivt involveret af ActiveCBT vs. CalmCBT.

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Frontline-behandlinger af svær depressiv lidelse (MDD), herunder kognitiv adfærdsterapi (CBT), har begrænset effektivitet, hvor halvdelen af ​​patienterne ikke reagerer på CBT og halvdelen får tilbagefald inden for 2 år. Der er behov for strategier, der øger styrken af ​​MDD-behandlinger. Vi tester en ny behandlingsstrategi ved hjælp af aerob træning for at forberede en efterfølgende CBT-session ('ActiveCBT'). Det antages, at træningsinitiering fører til større engagement af CBT-virkningsmekanismer gennem både almindelige og specifikke faktorer forbundet med depressionsudfald; denne CBT augmentation tilgang er endnu ikke blevet empirisk testet. Studiet vil bestå af et 8-ugers randomiseret kontrolleret forsøg med 40 voksne med MDD, der udfører 30 minutters moderat træning eller stille hvile (CalmCBT vs. ActiveCBT) forud for ugentlige CBT-sessioner. Ved at bruge en kontrol, der matcher tid og opmærksomhed, vil alle deltagere se en standardiseret dokumentarserie i disse 30 minutter før terapi med den eneste forskel mellem grupper, der er motion eller roligt hvile. Dette projekt vil også anvende maskinlæring og naturlig sprogbehandling via Lyssn-platformen til objektivt at evaluere det sprog og de ord, der bruges under terapien. De overordnede mål er at: 1) demonstrere træningsprimende effekter på mål-CBT-mekanismer, 2) koble psykologisk og neuroplastisk træningspriming til CBT-mekanismer og 3) udforske følsomheden af ​​objektive maskinlæringsbaserede markører fra Lyssn til ActiveCBT-inducerede terapiforskelle . Dette forsøg vil etablere potentialet for et efterfølgende bekræftende effektforsøg for nøje at teste potentialet ved træningspriming for at forbedre behandlingen. Hvis denne innovative, biologisk-informerede tilgang med succes 'primer' efterfølgende terapi, kan denne bruges til at forstærke andre behandlinger og i andre lidelser, hvilket væsentligt forbedrer den mentale sundhedsbehandling.

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

40

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Studiesteder

    • Iowa
      • Ames, Iowa, Forenede Stater, 50010
        • Iowa State University

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Beskrivelse

Inklusionskriterier:

  • Diagnosticeret med DSM-5 MDD, bekræftet via SCID.
  • Har aktuelle depressive symptomer af mindst mild sværhedsgrad defineret ved HAM-D rating ≥8.
  • At være mellem 18 og 65 år.
  • Enten ikke at deltage i nogen mental sundhedsbehandling (f.eks. medicin, psykologisk eller adfærdsmæssig) ELLER på en stabil mental sundhedsbehandling og villig til at opretholde den i hele interventionens længde.
  • Villig og sikker til at dyrke motion baseret på spørgeskemaet om fysisk aktivitetsparathed.
  • At være CBT-naiv (som defineret ved aldrig at gennemgå struktureret CBT).

Ekskluderingskriterier:

  • aktuelt gravid, ammer eller planlægger at blive gravid,
  • svær fedme (BMI=40)
  • diagnosticeret med livslang eller nuværende psykose, mani eller bipolar lidelse via SCID
  • diagnosticeret med den aktuelle stofbrugsforstyrrelse via SCID
  • udgøre en overhængende risiko for selvskade eller skade på andre, vurderet via C-SSRS
  • udviser adfærdsforstyrrelser (f.eks. aggression, let-moderat kognitiv svækkelse), som ville forstyrre studiedeltagelsen væsentligt, vurderet af klinisk forskningspersonale

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Dobbelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Aktiv CBT
Deltagerne vil gennemføre en standardiseret 30-minutters træningssession på en stationær cykel før terapien. Deltagerne vil se en af ​​8 standardiserede 30-minutters naturdokumentarvideoer, mens de træner.
Deltagerne vil gennemføre en standardiseret 30-minutters aerob træningssession på en stationær cykel forud for terapien. Overvågede træningssessioner vil bestå af steady-state træning med en moderat intensitet svarende til en '13' eller 'noget hård' vurdering af opfattet anstrengelse. Kontinuerlig overvågning af puls, modstand/belastning og RPE vil forekomme under hele træningen. For at matche grupperne tæt, vil deltagerne også se 30-minutters naturvideoer, mens de træner.
Aktiv komparator: CalmCBT
Deltagerne vil se en af ​​8 standardiserede 30-minutters naturdokumentarvideoer, mens de hviler stille før terapi.
Deltagerne vil se en af ​​8 standardiserede 30-minutters naturvideoer, mens de hviler stille før terapi. Disse er følelsesmæssigt neutrale videoer og vil give deltagere i begge grupper mulighed for at få den samme mængde opmærksomhed og kontakttid.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Average Self-reported Working Alliance Measured by Working Alliance Inventory (WAI)
Tidsramme: Weeks 1-8 CBT+ visits
Working Alliance Inventory-Short Revised (WAI) is a 12-item survey on experiences over a therapy session and connection with a therapist. It consists of three subscales: tasks, goals, and therapist-client bond. The total range of scores is from 12-84 with higher scores indicating a better therapeutic alliance.
Weeks 1-8 CBT+ visits
Self-reported Behavioral Activation Measured by Behavioral Activation for Depression Scale (BADS)
Tidsramme: Intake, Weeks 1-8 CBT+ visits, Week 9 (Post-therapy), 12-week follow up, 1-year follow-up
The Behavioral Activation for Depression Scale (BADS) will be used to assess changes in behavioral activity. The scale is designed to be administered weekly to measure changes over the course of Behavioral Activation for depression. It consists of 25 questions that inquire about Activation, Avoidance/Rumination, Work/School Impairment, and Social Impairment. Each item is rated on a 7-point scale from 0 (Not at all) to 6 (Completely) with total scores ranging: 0-150 where higher scores indicate greater behavioral activation.
Intake, Weeks 1-8 CBT+ visits, Week 9 (Post-therapy), 12-week follow up, 1-year follow-up

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Change in Clinician-rated Depression Symptoms Measured by GRID-Hamilton Depression Rating Scale (GRID-HAM-D) From Intake
Tidsramme: Intake, Week 9 (Post-therapy), 12-week follow up, 1-year follow up
The GRID-HAM-D is a clinician-completed questionnaire that will be used to rate depressive symptom severity. The questionnaire is designed for adults and is used to rate the intensity and frequency of depressive symptoms by probing mood, feelings of guilt, suicidal ideation, insomnia, agitation or retardation, anxiety, weight loss, and somatic symptoms. As recommended by the Depression Rating Scale Standardization Team, Clinical Interviewers will follow the Structured Interview Guide and use GRID scoring, in which dimensions of intensity and frequency of a symptom are rated independently for each item. Total scores are calculated from each question and range from 0 to 52, with higher scores indicated greater depressive symptom severity.
Intake, Week 9 (Post-therapy), 12-week follow up, 1-year follow up
Change in Self-reported Depression Symptoms Measured by Patient Health Questionnaire-9 (PHQ-9) From Week 1
Tidsramme: Weeks 1-8 CBT+ visits, Week 9 (Post-therapy), 12-week follow up, 1-year follow-up
The Patient Health Questionnaire-9 (PHQ-9) is a 9-question self-report instrument used to assess presence and severity of depressive symptoms, with scores categorized 0-4, 5-9, 10-14, 15-19, and 20-27 as minimal, mild, moderate, moderately severe, and severe depression, respectively.
Weeks 1-8 CBT+ visits, Week 9 (Post-therapy), 12-week follow up, 1-year follow-up
MDD Diagnosis Measured by Structured Clinical Interview for DSM-5 Disorders (SCID)
Tidsramme: Intake, Week 9 (Post-therapy), 12-week follow up, 1-year follow up
The SCID is a clinician-administered semi-structured interview guide for making diagnoses according to the diagnostic criteria published in the American Psychiatric Association's Diagnostic and Statistical Manual for Mental Disorders (DSM-5). It provides diagnoses for inclusion and exclusionary diagnoses. Results show number of participants who meet criteria for Major Depressive Disorder (i.e., 'checked') or no longer meet criteria (i.e., 'unchecked').
Intake, Week 9 (Post-therapy), 12-week follow up, 1-year follow up
Average Anhedonia Measured by Dimensional Anhedonia Rating Scale (DARS)
Tidsramme: Weeks 1-8 CBT+ visits (repeated 3 times [before exercise/calm condition, immediately after exercise/calm condition, and after therapy])
The DARS is a self-report measure that assesses state anhedonia across multiple domains. DARS is a 17-item survey on state anhedonia divided into four domains: hobbies, food/drink, social activities, and sensory experiences. Subjects must list two activities within each of these categories that they consider their favorite and then respond to questions regarding their interest in/enjoyment of those activities on a 5-point Likert scale from "Not at all" (0) to "Very much" (4), with total scores ranging from 0 to 68, with higher scores representing reduced anhedonia.
Weeks 1-8 CBT+ visits (repeated 3 times [before exercise/calm condition, immediately after exercise/calm condition, and after therapy])
Average Anhedonia Measured by an Anhedonia Visual Analogue Scale (Anhedonia VAS)
Tidsramme: Weeks 1-8 CBT+ visits (repeated 3 times [before exercise/calm condition, immediately after exercise/calm condition, and after therapy])
An anhedonia Visual Analog Scale [VAS] with 0 indicating 'No pleasure at all' and 100 indicating 'Greatest pleasure imaginable' will be used to measure anhedonia. The VAS will be used to provide a supplementary assessment of anhedonia.
Weeks 1-8 CBT+ visits (repeated 3 times [before exercise/calm condition, immediately after exercise/calm condition, and after therapy])
Serum Brain Derived Neurotrophic Factor (BDNF)
Tidsramme: Weeks 1, 4, and 8 CBT+ visits (before exercise/calm condition, immediately after exercise/calm condition, and after therapy)
Serum BDNF will be quantified from a standard blood draw. Blood samples collected during Visits 1, 4, and 8 will be allowed to clot for 30 minutes and then centrifuged for ten minutes at 5500 RPM and 4 ◦C. Following centrifugation, blood serum will be extracted with samples stored at -80 ◦C until BDNF analysis. Enzyme-linked immunosorbent assay (ELISA) kits will measure the concentration of total BDNF in the serum according to the manufacturer's instructions. Each blood sample will be run in duplicate and averaged.
Weeks 1, 4, and 8 CBT+ visits (before exercise/calm condition, immediately after exercise/calm condition, and after therapy)
Change in Anxiety Measured by Generalized Anxiety Disorder 7 (GAD-7) From Intake
Tidsramme: Intake, week 4 CBT+ visit, Week 9 (Post-therapy), 12-week follow up, 1-year follow up
Generalized Anxiety Disorder 7 (GAD-7) is a self-reported questionnaire for measuring generalized anxiety disorder. GAD-7 has seven items, which measure the severity of various signs of GAD according to reported response categories of: Not at all (0 points), Several days (1 point), More than half the days (2 points), and Nearly every day (3 points). A total score is calculated ranging from 0 to 21, with higher scores indicating more severe anxiety symptoms.
Intake, week 4 CBT+ visit, Week 9 (Post-therapy), 12-week follow up, 1-year follow up
Average Automatic Thoughts Measured by Automatic Thoughts Questionnaire (ATQ)
Tidsramme: Intake, weeks 1-8 CBT+ visits, Week 9 (Post-therapy), 12-week follow up, 1-year follow-up
The ATQ is a 30-item instrument that measures the frequency of automatic negative statements about the self. Each item is rated on the frequency of an occurrence from "not at all" to "all the time". Total scores are the sum of all 30 items (ranging 30-150), with higher totals indicating a higher level of automatic negative self-statements.
Intake, weeks 1-8 CBT+ visits, Week 9 (Post-therapy), 12-week follow up, 1-year follow-up
Average Session Effectiveness Measured by Session Evaluation Questionnaire (SEQ)
Tidsramme: Weeks 1-8 CBT+ visits
Session Evaluation Questionnaire (SEQ) will be used to evaluate session effectiveness. This includes responses to twenty-one items in a 7-point bipolar adjective format questionnaire to assess how the client feels about each CBT session. The questionnaire assesses session depth, smoothness, positivity, and arousal. An overall score of the subscales will be used in this study (ranging 7-28). Higher scores indicate more favorable session evaluations.
Weeks 1-8 CBT+ visits

Andre resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Nature Connectedness Index (NCI)
Tidsramme: Indtag, uge ​​1, 4 og 8 CBT+ besøg (før træning/rolig tilstand, umiddelbart efter træning/rolig tilstand og efter terapi)
NCI består af 6 spørgsmål vedrørende naturforbundethed. Deltagerne svarer ved hjælp af en 7-punkts Likert-skala, der spænder fra 1 (Helt uenig) til 7 (Helt enig), med højere score, der indikerer større niveauer af naturforbundethed.
Indtag, uge ​​1, 4 og 8 CBT+ besøg (før træning/rolig tilstand, umiddelbart efter træning/rolig tilstand og efter terapi)
Sundhedshistoriske spørgsmål
Tidsramme: Indtag
Helbredshistorie vil blive selvrapporteret. Derudover vil deltagerne blive bedt om at angive deres nuværende medicin.
Indtag
Demografisk spørgeskema
Tidsramme: Indtag
Demografiske karakteristika, herunder alder, køn, race, uddannelse, civilstand, erhvervsmæssig status og husstandsindkomst vil blive registreret eller målt for at karakterisere stikprøven.
Indtag
Adverse Childhood Experience Survey (ACES)
Tidsramme: Indtag
ACES består af 16 spørgsmål, der vedrører respondenternes første 18 leveår. Deltagerne svarer med ja eller nej til, om der opstod en uønsket hændelse i barndommen. Uønskede hændelser spørgsmål er grupperet efter kategorier. Deltagerne scores for hver begivenhedskategori, de udsættes for, med score fra 0 (ueksponeret) til 7 (eksponeret for alle kategorier).
Indtag
Average Lyssn Generated Scores
Tidsramme: Weeks 1-8 CBT+ visits
Lyssn is an AI-powered assessment platform for recording and managing session files, and all clinical interviews and therapy sessions will be recorded on the Lyssn platform. Lyssn will process the audio files from therapy sessions to generate session-level data regarding collaboration and empathy as metrics related to the primary client ratings of working alliance, as well as generating CTRS fidelity metrics which will be used in the ongoing supervision and fidelity monitoring of all sessions.
Weeks 1-8 CBT+ visits
Change in Monitor-assessed Physical Activity Measured by Accelerometry
Tidsramme: Intake, weeks 4 & 8 CBT+ visits (monitors worn 1 week following each time point)
Participants will place an activPAL on the midline of the thigh on either leg and wear the monitor during all waking hours, removing it only for water-based activities (e.g., swimming). For data to be valid, the monitor must have been worn for 20 hours on at least 4 days, including a minimum of 3 weekdays and 1 weekend day. Sleep time will be parsed out from each day's sitting/lying time automatically using PALanalysis. From these data, average minutes of sitting per day will be used to assess total sedentary time, minutes of stepping time with a cadence ≥75 and <100 will be used to assess minutes of light-intensity physical activity and minutes of stepping time with a cadence ≥100 will be used to assess minutes of moderate to vigorous physical activity (MVPA).
Intake, weeks 4 & 8 CBT+ visits (monitors worn 1 week following each time point)
Change in Quality of Life Measured by the 36-Item Short Form Health Survey (SF-36)
Tidsramme: Intake, week 4 CBT+ visit, Week 9 (Post-therapy), 12-week follow up, 1-year follow up
The SF-36 assesses health-related quality of life. It consists of eight scaled scores (including vitality, physical functioning, bodily pain, general health perceptions, physical role functioning, emotional role functioning, social role functioning, and mental health), which are the weighted sums of the questions in their section. Each scale is directly transformed into a 0-100 scale on the assumption that each question carries equal weight. The higher the score the less disability (i.e., a score of zero is equivalent to maximum disability and a score of 100 is equivalent to no disability).
Intake, week 4 CBT+ visit, Week 9 (Post-therapy), 12-week follow up, 1-year follow up
Change in Self-reported Physical Activity Measured by the International Physical Activity Questionnaire - Short Form (IPAQ-SF)
Tidsramme: Intake, week 4 CBT+ visit, Week 9 (Post-therapy), 12-week follow up, 1-year follow up
The IPAQ is a physical activity questionnaire that inquires about average amounts of walking, moderate physical activity, vigorous physical activity, and sitting time per week.
Intake, week 4 CBT+ visit, Week 9 (Post-therapy), 12-week follow up, 1-year follow up
Change in Suicidal Thoughts Measured by the Columbia-Suicide Severity Rating Scale (CSSRS)
Tidsramme: Intake, weeks 1-8 CBT+ visits, Week 9 (Post-therapy), 12-week follow up, 1-year follow-up
The C-SSRS will be used to assess and monitor suicide ideation and behavior. The severity of the ideation subscale is rated on a 5-point ordinal scale: 1 = wish to be dead, 2 = nonspecific active suicidal thoughts, 3 = suicidal thoughts with methods, 4 =suicidal intent, and 5 = suicidal intent with plan. Suicide behaviors are rated on a nominal scale that includes actual, aborted, and interrupted attempts; preparatory behavior; and non-suicidal,self-injurious behavior.
Intake, weeks 1-8 CBT+ visits, Week 9 (Post-therapy), 12-week follow up, 1-year follow-up

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Samarbejdspartnere

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

1. september 2023

Primær færdiggørelse (Faktiske)

1. juni 2025

Studieafslutning (Faktiske)

1. juni 2025

Datoer for studieregistrering

Først indsendt

14. august 2023

Først indsendt, der opfyldte QC-kriterier

14. august 2023

Først opslået (Faktiske)

21. august 2023

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

26. august 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

4. august 2026

Sidst verificeret

1. august 2026

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • 1R61MH129407 (U.S. NIH-bevilling/kontrakt)
  • 1R61MH129407-01A1 (U.S. NIH-bevilling/kontrakt)

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

Studerer et amerikansk FDA-reguleret lægemiddelprodukt

Ingen

Studerer et amerikansk FDA-reguleret enhedsprodukt

Ingen

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .