Efficacy of a self-applied online program to promote resilience and coping skills in university students in four Spanish-speaking countries: study protocol for a randomized controlled trial

Araceli Palma-Gómez, Rocío Herrero, Rosa Baños, Azucena García-Palacios, Claudia Castañeiras, Gabriela Lidia Fernandez, Dario Martín Llull, Lorena Cudris Torres, Libia Alvis Barranco, Leonardo Cárdenas-Gómez, Cristina Botella, Araceli Palma-Gómez, Rocío Herrero, Rosa Baños, Azucena García-Palacios, Claudia Castañeiras, Gabriela Lidia Fernandez, Dario Martín Llull, Lorena Cudris Torres, Libia Alvis Barranco, Leonardo Cárdenas-Gómez, Cristina Botella

Abstract

Background: There is evidence of a high prevalence of depression and anxiety in university students. Therefore, college time is a key period where prevention of mental disorders through interventions that promote resilience and mental health can be relevant. Currently, there are interventions available, but these are insufficient for those who need them. Online interventions are tools that can facilitate global accessibility and are easy for young people to use. CORE (Cultivating Our Resilience) is a self-administered online program, based on Ryff's psychological well-being model, to promote resilience and coping skills in university students at risk of developing symptoms of depression or anxiety. The objective is to evaluate the effectiveness of this intervention protocol in comparison with an active control condition targeting healthy lifestyle, and a waiting list control condition. The study will be conducted in four populations of Spanish-speaking university students (Spain, Argentina, Colombia, and Mexico).

Methods: The study design is a randomized controlled trial (RCT). At least 324 university students will be randomly assigned to three conditions: 1) CORE, a 6-week training program to improve resilience; 2) HLP, a 6-week training to promote a healthy lifestyle; and 3) WL, waiting list control condition. The primary outcome measure will be the Connor-Davidson resilience scale. Additionally, measures of anxiety, depression, quality of life and socio-demographic variables (age, sex, incomes, marital status, among others) will be collected. Participants will be evaluated at pre-treatment, after each module, 6 weeks after allocation, and at 3-month follow-up. Intention-to-treat and per-protocol analyses will be performed.

Discussion: The results of this study will contribute to research on Internet-administered interventions and the implementation of a protocol that includes a series of components designed to improve resilience and coping skills, increase psychological well-being, and prevent depression and anxiety disorders in Spanish-speaking university students. In addition, avenues will be opened up for new research on the effectiveness of these interventions focused on the prevention and promotion of mental health in Spanish-speaking countries.

Trial registration: Registered at ClinicalTrials.gov NCT03903978 on April 2, 2019.

Keywords: Mood disorders; Online interventions; Prevention; Resilience; University students.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Study flowchart
Fig. 2
Fig. 2
CORE training: multimedia tools within the platform: https://www.psicologiaytecnologia.com/

References

    1. World Health Organization. Mental health atlas 2017. Geneva; 2018. Available from: .
    1. World Health Organization. Mental health atlas 2014. Geneva; 2015 [cited 2018 May 21]. Available from: .
    1. Organización Panamericana de la Salud. Depresión y otros trastornos mentales comunes. Estimaciones sanitarias mundiales. Washington, D.C; 2017.
    1. Mihalopoulos C, Vos T, Pirkis J, Carter R. The economic analysis of prevention in mental health programs. Annu Rev Clin Psychol. 2011;7(1):169–201. doi: 10.1146/annurev-clinpsy-032210-104601.
    1. Organización Panamericana de la Salud. La carga de los trastornos mentales en la Región de las Américas, 2018. Organización Mundial de la Salud Oficina Regional para las Américas. Washington, D.C; 2018 [cited 2019 Jul 11]. 1–50 p. Available from: .
    1. Whiteford HA, Degenhardt L, Rehm J, Baxter AJ, Ferrari AJ, Erskine HE, et al. Global burden of disease attributable to mental and substance use disorders: Findings from the Global Burden of Disease Study 2010. Lancet. 2013;382(9904):1575–1586. doi: 10.1016/S0140-6736(13)61611-6.
    1. World Health Organization. WHO | Mental health action plan 2013–2020 [Internet]. WHO Library. World Health Organization; 2013 [cited 2019 Jul 15]. Available from: .
    1. Kessler RC, Angermeyer M, Anthony JC, de Graaf R, Demyttenaere K, Gasquet I, et al. Lifetime prevalence and age-of-onset distributions of mental disorders in the World Health Organization ’ s. World Psychiatry. 2007;6:168–176.
    1. Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62(6):593. doi: 10.1001/archpsyc.62.6.593.
    1. Auerbach RP, Alonso J, Axinn WG, Cuijpers P, Ebert DD, Green JG, et al. Mental disorders among college students in the World Health Organization world mental health surveys. Psychol Med. 2016;46(14):2955–2970. doi: 10.1017/S0033291716001665.
    1. Merikangas KR, Nakamura EF, Kessler RC. Epidemiology of mental disorders in children and adolescents. Dialogues Clin Neurosci. 2009;11(1):7–20.
    1. Ibrahim AK, Kelly SJ, Adams CE, Glazebrook C. A systematic review of studies of depression prevalence in university students. J Psychiatr Res. 2013;47(3):391–400. doi: 10.1016/j.jpsychires.2012.11.015.
    1. Cuijpers P, Cristea IA, Ebert DD, Koot HM, Auerbach RP, Bruffaerts R, et al. Psychological treatment of depression in college students: a metaanalysis. Depress Anxiety. 2016;33(5):400–414. doi: 10.1002/da.22461.
    1. Bayram N, Bilgel N. The prevalence and socio-demographic correlations of depression, anxiety and stress among a group of university students. Soc Psychiatry Psychiatr Epidemiol. 2008;43(8):667–672. doi: 10.1007/s00127-008-0345-x.
    1. Adlaf EM, Gliksman L, Demers A, Newton-Taylor B. The prevalence of elevated psychological distress among Canadian undergraduates: findings from the 1998 Canadian campus survey. J Am Coll Health Assoc. 2001;50(2):67–72. doi: 10.1080/07448480109596009.
    1. Cooke R, Bewick BM, Barkham M, Bradley M, Audin K. Measuring, monitoring and managing the psychological well-being of first year university students. Br J Guid Counc. 2006;34(4):505–517. doi: 10.1080/03069880600942624.
    1. Nimh. Depression and College Students. [cited 2019 Jul 11]. Available from: .
    1. Vaez M, Laflamme L. Experienced stress, psychological symptoms, self-rated health and academic achievement: a longitudinal study of swedish university students. Soc Behav Personal Int J. 2008;36(2):183–196. doi: 10.2224/sbp.2008.36.2.183.
    1. Whitton SW, Whisman MA. Relationship satisfaction instability and depression. J Fam Psychol. 2010;24(6):791–794. doi: 10.1037/a0021734.
    1. Hysenbegasi A, Hass SL, Rowland CR. The impact of depression on the academic productivity of university students. J Ment Health Policy Econ. 2005;8(3):145–151.
    1. Fergusson DM, Woodward LJ. Mental health, educational, and social role outcomes of adolescents with depression. Arch Gen Psychiatry. 2002;59(3):225–231. doi: 10.1001/archpsyc.59.3.225.
    1. Harvey SB, Glozier N, Henderson M, Allaway S, Litchfield P, Holland-Elliott K, et al. Depression and work performance: an ecological study using web-based screening. Occup Med (Chic Ill) 2011;61(3):209–211. doi: 10.1093/occmed/kqr020.
    1. Ribeiro ÍJS, Pereira R, Freire IV, de Oliveira BG, Casotti CA, Boery EN. Stress and quality of life Among University students: a systematic literature review. Heal Prof Educ. 2018;4(2):70–77. doi: 10.1016/j.hpe.2017.03.002.
    1. Dray J, Bowman J, Campbell E, Freund M, Hodder R, Wolfenden L, et al. Effectiveness of a pragmatic school-based universal intervention targeting student resilience protective factors in reducing mental health problems in adolescents. J Adolesc. 2017;57:74–89. doi: 10.1016/j.adolescence.2017.03.009.
    1. Stallman HM. Psychological distress in university students: a comparison with general population data. Aust Psychol. 2010;45(4):249–257. doi: 10.1080/00050067.2010.482109.
    1. Huang J, Nigatu YT, Smail-Crevier R, Zhang X, Wang J. Interventions for common mental health problems among university and college students: A systematic review and meta-analysis of randomized controlled trials. J Psychiatric Res. 2018;107:1–10. doi: 10.1016/j.jpsychires.2018.09.018.
    1. Hjemdal O, Vogel PA, Solem S, Hagen K, Stiles TC. The relationship between resilience and levels of anxiety, depression, and obsessive-compulsive symptoms in adolescents. Clin Psychol Psychother. 2011;18(4):314–321. doi: 10.1002/cpp.719.
    1. Minnard CV. A strong building: Foundation of Protective Factors in schools. Child Sch. 2002;24(4):233–246. doi: 10.1093/cs/24.4.233.
    1. Fergus S, Zimmerman MA. Adolecent resilience: a framework for understanding healthy development in the face of risk. Annu Rev Public Health. 2005;26(1):399–419. doi: 10.1146/annurev.publhealth.26.021304.144357.
    1. García del Castillo JA, García del Castillo-López Á, López-Sánchez C, Dias PC. Conceptualización teórica de la resiliencia psicosocial y su relación con la salud. Vol. 16, Health and Addictions. 2016.
    1. Bowes L, Jaffee SR. Biology, Genes, and Resilience: Toward a Multidisciplinary Approach. Trauma Violence Abuse. 2013;14:195–208. doi: 10.1177/1524838013487807.
    1. Stallard P, Buck R. Preventing depression and promoting resilience: feasibility study of a school-based cognitive-behavioural intervention. Br J Psychiatry. 2013;202(s54):s18–s23. doi: 10.1192/bjp.bp.112.119172.
    1. Davydov DM, Stewart R, Ritchie K, Chaudieu I. Resilience and mental health. Clin Psychol Rev. 2010;30(5):479–495. doi: 10.1016/j.cpr.2010.03.003.
    1. Gillham JE, Reivich KJ, Freres DR, Chaplin TM, Shatté AJ, Samuels B, et al. School-based prevention of depressive symptoms: a randomized controlled study of the effectiveness and specificity of the penn resiliency program. J Consult Clin Psychol. 2007;75(1):9–19. doi: 10.1037/0022-006X.75.1.9.
    1. Luthar SS, Cicchetti D, Becker B. The construct of resilience: a critical evaluation and guidelines for future work. Child Dev. 2000;71(3):543–562. doi: 10.1111/1467-8624.00164.
    1. Galante J, Dufour G, Benton A, Howarth E, Vainre M, Croudace TJ, et al. Protocol for the mindful student study: a randomised controlled trial of the provision of a mindfulness intervention to support university students’ well-being and resilience to stress. BMJ Open. 2016;6(11):e012300. doi: 10.1136/bmjopen-2016-012300.
    1. Joyce S, Shand F, Tighe J, Laurent SJ, Bryant RA, Harvey SB. Road to resilience: a systematic review and meta-analysis of resilience training programmes and interventions. BMJ Open. 2018;8(6):e017858. doi: 10.1136/bmjopen-2017-017858.
    1. Afifi TD, Merrill AF, Davis S. The theory of resilience and relational load. Pers Relatsh. 2016;23(4):663–683. doi: 10.1111/pere.12159.
    1. Steinhardt M, Dolbier C. Evaluation of a resilience intervention to enhance coping strategies and protective factors and decrease symptomatology. J Am Coll Heal. 2008;56(4):445–453. doi: 10.3200/JACH.56.44.445-454.
    1. Burton NW, Pakenham KI, Brown WJ. Evaluating the effectiveness of psychosocial resilience training for heart health, and the added value of promoting physical activity: a cluster randomized trial of the READY program. BMC Public Health. 2009;9(1):427. doi: 10.1186/1471-2458-9-427.
    1. Lee JH, Nam SK, Kim AR, Kim B, Lee MY, Lee SM. Resilience: a meta-analytic approach. J Couns Dev. 2013;91(3):269–279. doi: 10.1002/j.1556-6676.2013.00095.x.
    1. Helmreich I, Kunzler A, Chmitorz A, König J, Binder H, Wessa M, et al. Psychological interventions for resilience enhancement in adults. Cochrane Database Syst Rev. 2017;2 2017(2).
    1. Leppin AL, Bora PR, Tilburt JC, Gionfriddo MR, Zeballos-Palacios C, Dulohery MM, et al. The Efficacy of Resiliency Training Programs: A Systematic Review and Meta-Analysis of Randomized Trials. PLoS One. 2014;9(10):e111420. doi: 10.1371/journal.pone.0111420.
    1. Macedo T, Wilheim L, Gonçalves R, Coutinho ESF, Vilete L, Figueira I, et al. Building resilience for future adversity: a systematic review of interventions in non-clinical samples of adults. BMC Psychiatry. 2014;14(1):227. doi: 10.1186/s12888-014-0227-6.
    1. García-Herrera Pérez BJ, Nogueras Monillas E, Muñoz Cobos F, Morales Asencio J. Guía de Práctica Clínica para el tratamiento de la depresión en Atención Primaria. Distrito Sanitario Málaga-UGC Salud Mental Hospital Regional Universitario “Carlos Haya,” editor. Málaga; 2001.
    1. The National Institute for Health and Care Excellence. The NICE Guideline on the Treatment and Depression the Treatment and Management of Depression [Internet]. NICE guidelines [CG90]. 2009. 1–592 p. Available from: .
    1. Nieuwsma JA, Trivedi RB, McDuffie J, Kronish I, Benjamin D, Williams JW. Brief psychotherapy for depression: a systematic review and meta-analysis. Int J Psychiatry Med. 2012;43(2):129–151. doi: 10.2190/PM.43.2.c.
    1. Castro A, García-Palacios A, García-Campayo J, Mayoral F, Botella C, García-Herrera JM, et al. Efficacy of low-intensity psychological intervention applied by ICTs for the treatment of depression in primary care: a controlled trial. BMC Psychiatry. 2015;15(1):106. doi: 10.1186/s12888-015-0475-0.
    1. Gallardo-Escudero A, Muñoz Alférez MJ, María E, Del Pozo P, Aliaga IL. La etapa universitaria no favorece el estilo de vida saludable en lasestudiantes granadinas. Nutr HospNutr Hosp. 2015;31(2):975–979.
    1. Rodríguez F, Palma X, Romo Á, Escobar D, Aragú B, Espinoza L, et al. Hábitos alimentarios, actividad física y nivel socioeconómico enestudiantes universitarios de Chile. Nutr HospNutr Hosp. 2013;28(2):447–455.
    1. Sánchez-Ojeda MA, De Luna-Bertos E. Hábitos de vida saludable en la población universitaria. Nutr Hosp. 2015;31(5):1910–1919.
    1. Kazdin AE. Technology-based interventions and reducing the burdens of mental illness: perspectives and comments on the special series. Cogn Behav Pract. 2015;22(3):359–366. doi: 10.1016/j.cbpra.2015.04.004.
    1. Kazdin AE, Rabbitt SM. Novel models for delivering mental health services and reducing the burdens of mental illness. Clin Psychol Sci. 2013;1(2):170–191. doi: 10.1177/2167702612463566.
    1. Kazdin AE, Blase SL. Rebooting psychotherapy research and practice to reduce the burden of mental illness. Perspect Psychol Sci. 2011;6(1):21–37. doi: 10.1177/1745691610393527.
    1. Christensen H, Hickie IB. Using e-health applications to deliver new mental health services. Med J Aust. 2010;192(11 Suppl):S53–S56.
    1. Eurostats. Digital economy and society statistics - households and individuals Statistics Explained. 2018 [cited 2019 Jul 15]. Available from: .
    1. Rojas EF, Poveda L. Estado de la banda ancha en Ámerica Latina y el Caribe. 2017. Santiago; 2018 [cited 2019 Jul 15]. Available from: .
    1. Baños RM, Etchemendy E, Mira A, Riva G, Gaggioli A, Botella C. Online positive interventions to promote well-being and resilience in the adolescent population: a narrative review. Front Psychiatry. 2017;8:10. doi: 10.3389/fpsyt.2017.00010.
    1. Day V, McGrath PJ, Wojtowicz M. Internet-based guided self-help for university students with anxiety, depression and stress: a randomized controlled clinical trial. Behav Res Ther. 2013;51(7):344–351. doi: 10.1016/j.brat.2013.03.003.
    1. Räsänen P, Lappalainen P, Muotka J, Tolvanen A, Lappalainen R. An online guided ACT intervention for enhancing the psychological wellbeing of university students: a randomized controlled clinical trial. Behav Res Ther. 2016;78:30–42. doi: 10.1016/j.brat.2016.01.001.
    1. Becker TD, Torous JB. Recent developments in digital mental health interventions for college and university students. Curr Treat Options Psychiatry. 2019;6(3):210–220. doi: 10.1007/s40501-019-00178-8.
    1. Ebert DD, Zarski A-C, Christensen H, Stikkelbroek Y, Cuijpers P, Berking M, et al. Internet and computer-based cognitive behavioral therapy for anxiety and depression in youth: a meta-analysis of randomized controlled outcome trials. PLoS One. 2015;10(3):e0119895. doi: 10.1371/journal.pone.0119895.
    1. Herrero R, Mira A, Cormo G, Etchemendy E, Baños R, García-Palacios A, et al. An internet based intervention for improving resilience and coping strategies in university students: study protocol for a randomized controlled trial. Internet Interv. 2019;16:43–51. doi: 10.1016/j.invent.2018.03.005.
    1. Rose RD, Buckey JC, Zbozinek TD, Motivala SJ, Glenn DE, Cartreine JA, et al. A randomized controlled trial of a self-guided, multimedia, stressmanagement and resilience training program. Behav Res Ther. 2013;51(2):106–112.
    1. Berger T, Hämmerli K, Gubser N, Andersson G, Caspar F. Internet-based treatment of depression: a randomized controlled trial comparing guided with unguided self-help. Cogn Behav Ther. 2011;40(4):251–266. doi: 10.1080/16506073.2011.616531.
    1. Andrews G, Cuijpers P, Craske MG, McEvoy P, Titov N. Computer therapy for the anxiety and depressive disorders is effective, acceptable and practical health care: a meta-analysis. PLoS One. 2010;5(10):e13196. doi: 10.1371/journal.pone.0013196.
    1. Botella C, Mira A, Herrero R, García-palacios A. Un programa de intervención auto-aplicado a través de Internet para el tratamiento de la depresión: “Sonreír es divertido.”. Aloma Rev Psicol Ciències l’Educació i l’Esport. 2015;33(2):39–48.
    1. Montero-Marín J, Araya R, Pérez-Yus MC, Mayoral F, Gili M, Botella C, et al. An internet-based intervention for depression in primary Care in Spain: a randomized controlled trial. J Med Internet Res. 2016;18(8):e231. doi: 10.2196/jmir.5695.
    1. Ashford MT, Olander EK, Ayers S. Computer- or web-based interventions for perinatal mental health: a systematic review. J Affect Disord. 2016;197:134–146. doi: 10.1016/j.jad.2016.02.057.
    1. Griffiths KM, Christensen H. Internet-based mental health programs: a powerful tool in the rural medical kit. Aust J Rural Health. 2007;15(2):81–87. doi: 10.1111/j.1440-1584.2007.00859.x.
    1. Hayward L, MacGregor AD, Peck DF, Wilkes P. The feasibility and effectiveness of computer-guided CBT (FearFighter) in a rural area. Behav Cogn Psychother. 2007;35(4):409–419. doi: 10.1017/S1352465807003670.
    1. Kaltenthaler E, Brazier J, De Nigris E, Tumur I, Ferriter M, Beverley C, et al. Computerised cognitive behaviour therapy for depression and anxiety update: a systematic review and economic evaluation. Health Technol Assess (Rockv) 2006;10(33):iii.
    1. Mitchell J, Vella-Brodrick D, Klein B. Positive psychology and the internet: a mental health opportunity. E-J Appl Psychol 2010 30;6(2):30–41.
    1. Muñoz RF. Using evidence-based internet interventions to reduce health disparities worldwide. J Med Internet Res. 2010;12(5):e60. doi: 10.2196/jmir.1463.
    1. Heber E, Ebert DD, Lehr D, Cuijpers P, Berking M, Nobis S, et al. The benefit of web- and computer-based interventions for stress: a systematic review and meta-analysis. J Med Internet Res. 2017;19(2):e32. doi: 10.2196/jmir.5774.
    1. Sander L, Rausch L, Baumeister H. Effectiveness of internet-based interventions for the prevention of mental disorders: a systematic review and meta-analysis. JMIR Ment Heal. 2016;3(3):e38. doi: 10.2196/mental.6061.
    1. Díaz-García A, González-Robles A, Fernández-Álvarez J, García-Palacios A, Baños RM, Botella C. Efficacy of a Transdiagnostic internet-based treatment for emotional disorders with a specific component to address positive affect: study protocol for a randomized controlled trial. BMC Psychiatry. 2017;17(1):145. doi: 10.1186/s12888-017-1297-z.
    1. Bernal G, Domenech Rodríguez MM. Cultural adaptation in context: Psychotherapy as a historical account of adaptations. In Bernal G, DomenechRodríguez MM, editors Cultural adaptations: Tools for evidence-based practice with diverse populations. Whashington: American Psychological Association. 2012:3–22.
    1. Chowdhary N, Jotheeswaran AT, Nadkarni A, Hollon SD, King M, Jordans MJD, et al. The methods and outcomes of cultural adaptations of psychological treatments for depressive disorders: a systematic review. Psychol Med. 2014;44(6):1131–1146. doi: 10.1017/S0033291713001785.
    1. Chu J, Leino A. Advancement in the maturing science of cultural adaptations of evidence-based interventions. J Consult Clin Psychol. 2017;85(1):45–57. doi: 10.1037/ccp0000145.
    1. Helms JE. An examination of the evidence in culturally adapted evidence-based or empirically supported interventions. Transcult Psychiatry. 2015 Apr [cited 2020 Jan 29];52(2):174–97. Available from: .
    1. Salamanca-Sanabria A, Richards D, Timulak L. Adapting an internet-delivered intervention for depression for a Colombian college student population: an illustration of an integrative empirical approach. Internet Interv. 2019;15(October 2018):76–86. doi: 10.1016/j.invent.2018.11.005.
    1. Hall GCN, Ibaraki AY, Huang ER, Marti CN, Stice E. A meta-analysis of cultural adaptations of psychological interventions. Behav Ther. 2016;47(6):993–1014. doi: 10.1016/j.beth.2016.09.005.
    1. Vally Z, Maggott C. Evaluating the Outcome of Cultural Adaptations of Cognitive-Behavioural Therapy for Adult Depression: a Meta-Analysis. Int J Advanc Counselling. 2015;37(4):293–304.
    1. Arjadi R, Nauta MH, Chowdhary N, et al. A systematic review of online interventions for mental health in low and middle income countries: a neglected field. Glob Ment Health (Camb) 2015;2:e12. doi: 10.1017/gmh.2015.10.
    1. Ryff CD. Happiness is everything, or is it? Explorations on the meaning of psychological well-being. J Pers Soc Psychol. 1989;57(6):1069–1081. doi: 10.1037/0022-3514.57.6.1069.
    1. van Dierendonck D. The construct validity of Ryff’s scales of psychological well-being and its extension with spiritual well-being. Pers Individ Dif. 2004;36(3):629–643. doi: 10.1016/S0191-8869(03)00122-3.
    1. Díaz D, Rodríguez-Carvajal R, Blanco A, Moreno-Jiménez B, Gallardo I, Valle C, et al. Adaptación española de las escalas de bienestar psicológico de Ryff. Psicothema. 2006;18(3):572–577.
    1. Watson D, Clark LA, Tellegen A. Development and validation of brief measures of positive and negative affect: the PANAS scales. J Pers Soc Psychol. 1988;54(6):1063–1070. doi: 10.1037/0022-3514.54.6.1063.
    1. Cohen J. Statistical power analysis for the behavioral sciences. 2. Hillsdale: Lawrence Earlbaum Associates. Lawrence Earlbaum Associates; 1988.
    1. Muller KE, Edwards LJ, Simpson SL, Taylor DJ. Statistical tests with accurate size and power for balanced linear mixed models. Stat Med. 2007;26(19):3639. doi: 10.1002/sim.2827.
    1. Ryff CD. Psychological well-being revisited: advances in the science and practice of Eudaimonia. Psychother Psychosom. 2014;83(1):10–28. doi: 10.1159/000353263.
    1. Castro A, García-Palacios A, García-Campayo J, Mayoral F, Botella C, García-Herrera JM, et al. Efficacy of low-intensity psychological intervention applied by ICTs for the treatment of depression in primary care: A controlled trial. BMC Psychiatry. 2015;15(1):1–10. doi: 10.1186/s12888-015-0475-0.
    1. Monreal-Bartolomé A, Barceló-Soler A, Castro A, Pérez-Ara MÁ, Gili M, Mayoral F, et al. Efficacy of a blended low-intensity internet-delivered psychological programme in patients with multimorbidity in primary care: study protocol for a randomized controlled trial. BMC Psychiatry [Internet]. 2019 Dec 11 [cited 2020 Feb 1];19(1):66. Available from: .
    1. Gómez-Juanes R, Roca M, Gili M, García-Campayo J, García-Toro M. Estilo de vida saludable: un factor de protección minusvalorado frente a la depresión. Psiquiatr Biológica. 2017;24(3):97–105. doi: 10.1016/j.psiq.2017.10.004.
    1. Connor KM, Davidson JRT. Development of a new resilience scale: The Connor-Davidson Resilience Scale (CD-RISC) Depress Anxiety. 2003;18(2):76. doi: 10.1002/da.10113.
    1. Yu X, Zhang J. Factor analysis and psychometric evaluation of the Connor-Davidson resilience scale (CD-RISC) with Chinese people. Soc Behav Personal Int J. 2007;35(1):19–30. doi: 10.2224/sbp.2007.35.1.19.
    1. Singh K, Yu X. Psychometric evaluation of the Connor-Davidson resilience scale (CD-RISC) in a sample of Indian students. J Psychol. 2010;1(1):23–30. doi: 10.1080/09764224.2010.11885442.
    1. Crespo M, Fernandez-Lansac V, Soberón C. Adaptación Española de la “Escala de Resiliencia de Connor-Davidson” (CD-RISC) en situaciones de estrés crónico. Behav Psychol. 2014;22:219–238.
    1. Manzano-García G, Ayala Calvo JC. Propiedades psicométricas de la Escala de Resiliencia de Connor-Davidson en una muestra de emprendedores españoles. Psicothema. 2013;25(2):245–251.
    1. Sandín B, Chorot P, Lostao L, Joiner TE, Santed MA, Valiente RM. Escalas PANAS de afecto positivo y negativo: validación factorial y convergencia transcultural. Psicothema. 1999;11:37–51.
    1. Feldman GC, Joormann J, Johnson SL. Responses to positive affect: a self-report measure of rumination and dampening. Cognit Ther Res. 2008;32(4):507–525. doi: 10.1007/s10608-006-9083-0.
    1. Johnson SL, Jones S. Cognitive correlates of mania risk: are responses to success, positive moods, and manic symptoms distinct or overlapping? J Clin Psychol. 2009;65(9):891–905. doi: 10.1002/jclp.20585.
    1. Botella C, Molinari G, Fernández-Álvarez J, Guillén V, García-Palacios A, Baños RM, et al. Development and validation of the openness to the future scale: a prospective protective factor. Health Qual Life Outcomes. 2018;16(1):72. doi: 10.1186/s12955-018-0889-8.
    1. Kroenke K, Spitzer RL, Williams JBW. The PHQ-9. J Gen Intern Med. 2001;16(9):606–613. doi: 10.1046/j.1525-1497.2001.016009606.x.
    1. Wittkampf KA, Naeije L, Schene AH, Huyser J, van Weert HC. Diagnostic accuracy of the mood module of the patient health questionnaire: a systematic review. Gen Hosp Psychiatry. 2007;29(5):388–395. doi: 10.1016/j.genhosppsych.2007.06.004.
    1. Bentley KH, Gallagher MW, Carl JR, Barlow DH. Development and validation of the overall depression severity and impairment scale. Psychol Assess. 2014;26(3):815–830. doi: 10.1037/a0036216.
    1. Osma J, Quilez-Orden A, Suso-Ribera C, Peris-Baquero O, Norman SB, Bentley KH, et al. Psychometric properties and validation of the Spanish versions of the overall anxiety and depression severity and impairment scales. J Affect Disord. 2019;252(March):9–18. Available from: 10.1016/j.jad.2019.03.063.
    1. Norman SB, Hami Cissell S, Means-Christensen AJ, Stein MB. Development and validation of an overall anxiety severity and impairment scale (OASIS) Depress Anxiety. 2006;23(4):245–249. doi: 10.1002/da.20182.
    1. González-Robles A, Mira A, Miguel C, Molinari G, Díaz-García A, García-Palacios A, et al. A brief online transdiagnostic measure: Psychometric properties of the Overall Anxiety Severity and Impairment Scale (OASIS) among Spanish patients with emotional disorders. PLoS One. 2018;13(11):e0206516. doi: 10.1371/journal.pone.0206516.
    1. Spitzer RL, Kroenke K, Williams JBW, Löwe B. A brief measure for assessing generalized anxiety disorder. Arch Intern Med. 2006;166(10):1092. doi: 10.1001/archinte.166.10.1092.
    1. Löwe B, Decker O, Müller S, Brähler E, Schellberg D, Herzog W, et al. Validation and standardization of the generalized anxiety disorder screener (GAD-7) in the general population. Med Care. 2008;46(3):266–274. doi: 10.1097/MLR.0b013e318160d093.
    1. García-Campayo J, Zamorano E, Ruiz MA, Pardo A, Pérez-Páramo M, López-Gómez V, et al. Cultural adaptation into Spanish of the generalized anxiety disorder-7 (GAD-7) scale as a screening tool. Health Qual Life Outcomes. 2010;8:1–11. doi: 10.1186/1477-7525-8-8.
    1. Solis J, Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983;24:385–396. doi: 10.2307/2136404.
    1. Cohen S, Williamson GM. Perceived stress in a probability sample of the US. In: Spacapam S, Oskamp S, editors. The Social Psychology of Health: Claremont Symposium on Applied Social Psychology. 1988. pp. 31–67.
    1. Mitchell AM, Crane PA, Kim Y. Perceived stress in survivors of suicide: psychometric properties of the perceived stress scale. Res Nurs Health. 2008;31(6):576–585. doi: 10.1002/nur.20284.
    1. Raes F, Pommier E, Neff KD, Van Gucht D. Construction and factorial validation of a short form of the self-compassion scale. Clin Psychol Psychother Clin Psychol Psychother. 2011;18:250–255. doi: 10.1002/cpp.702.
    1. Neff KD. The development and validation of a scale to measure self-compassion. Self Identity. 2003;2(3):223–250. doi: 10.1080/15298860309027.
    1. Rammstedt B, John OP. Measuring personality in one minute or less: a 10-item short version of the big five inventory in English and German. J Res Pers. 2007;41(1):203–212. doi: 10.1016/j.jrp.2006.02.001.
    1. John OP, Srivastava SP. The Big-five Trait Taxonomy: History, Measurement, and Theoretical Perspectives. Guilford, editor. New York; 1999.
    1. Devilly GJ, Borkovec TD. Psychometric properties of the credibility/expectancy questionnaire. J Behav Ther Exp Psychiatry. 2000;31(2):73–86. doi: 10.1016/S0005-7916(00)00012-4.
    1. Attkisson CC, Greenfield TK. The Use of Psychological Testing for Treatment Planning and Outcome Assessment. 1994. Client satisfaction Questionnaire-8 and service satisfaction Scale-30; pp. 402–420.
    1. Larsen DL, Attkisson CC, Hargreaves WA, Nguyen TD. Assessment of client/patient satisfaction: development of a general scale. Eval Program Plann. 1979;2(3):197–207. doi: 10.1016/0149-7189(79)90094-6.
    1. Attkisson CC, Zwick R. The client satisfaction questionnaire: psychometric properties and correlations with service utilization and psychotherapy outcome. Eval Program Plann. 1982;5(3):233–237. doi: 10.1016/0149-7189(82)90074-X.
    1. Roberts RE, Attkisson CC. Assessing client satisfaction among hispanics. Eval Program Plann. 1983;6(3–4):401–413. doi: 10.1016/0149-7189(83)90019-8.
    1. Kiluk BD, Serafini K, Frankforter T, Nich C, Carroll KM. Only connect: the working alliance in computer-based cognitive behavioral therapy. Behav Res Ther. 2014;63:139–146. doi: 10.1016/j.brat.2014.10.003.
    1. Schulz KF, Altman DG, Moher D. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. BMC Med. 2010;24:8.
    1. Gueorguieva R, Krystal JH. Move over ANOVA: Progress in Analyzing Repeated-Measures Data and Its Reflection in Papers Published in the Archives of General Psychiatry. Arch Gen Psychiatry. 2004;61:310–317. doi: 10.1001/archpsyc.61.3.310.
    1. Wright CC, Sim J. Intention-to-treat approach to data from randomized controlled trials: a sensitivity analysis. J Clin Epidemiol. 2003;56(9):833–842. doi: 10.1016/S0895-4356(03)00155-0.
    1. Ryff CD, Singer B. Psychological Weil-being: meaning, measurement, and implications for psychotherapy research. Psychother Psychosom. 1996;65(1):14–23. doi: 10.1159/000289026.
    1. Ryff CD, Love GD, Essex MJ, Singer B. Handbook of aging and mental health. Boston: Springer US; 1998. Resilience in adulthood and later life; pp. 69–96.
    1. Copeland W, Shanahan L, Costello EJ, Angold A. Cumulative prevalence of psychiatric disorders by young adulthood: a prospective cohort analysis from the Great Smoky Mountains study. J Am Acad Child Adolesc Psychiatry. 2011;50(3):252–261. doi: 10.1016/j.jaac.2010.12.014.
    1. Calear AL, Christensen H. Systematic review of school-based prevention and early intervention programs for depression. J Adolesc. 2010;33(3):429–438. doi: 10.1016/j.adolescence.2009.07.004.
    1. Cuijpers P, Driessen E, Hollon SD, van Oppen P, Barth J, Andersson G. The efficacy of non-directive supportive therapy for adult depression: a meta-analysis. Clin Psychol Rev. 2012;32(4):280–291. doi: 10.1016/j.cpr.2012.01.003.
    1. van Zoonen K, Buntrock C, Ebert DD, Smit F, Reynolds CF, Beekman AT, et al. Preventing the onset of major depressive disorder: a meta-analytic review of psychological interventions. Int J Epidemiol. 2014;43(2):318–329. doi: 10.1093/ije/dyt175.
    1. Organización Panamericana de la Salud. Depresión y otros trastornos mentales comunes. Washington, D.C; 2017. Available from: .
    1. Organización Mundial de la Salud. Plan de acciόn sobre salud mental 2013–2020. Organ Mund la salud. 2013;54. Available from: .
    1. Cuijpers P, Cristea IA, Ebert DD, Koot HM, Auerbach RP, Bruffaerts R, et al. Psychological treatment of depression in college students: A metaanalysis. Vol. 33, Depression and Anxiety. 2016. p. 400–14.
    1. Stengård E, Appelqvist-Schmidlechner K. Mental health promotion in young people-an Investment for the Future [internet]. Copenhagen, Denmark; 2010 [cited 2019 Jul 16]. Available from: .
    1. Hollon SD, Muñoz RF, Barlow DH, Beardslee WR, Bell CC, Bernal G, et al. Psychosocial intervention development for the prevention and treatment of depression: Promoting innovation and increasing access. Biological Psychiatry. 2002;52:610–630. doi: 10.1016/S0006-3223(02)01384-7.
    1. New Freedom Commision on Mental Health. Achieving the promise: Transforming mental health care in America | Suicide Prevention Resource Center [Internet]. 2003 [cited 2020 Jan 24]. Available from: .
    1. Barbato A, Vallarino M, Rapisarda F, Lora A, Caldas De Almeida M. EU compass for action on mental health and well-being. Access to mental health care in europe [Internet]. 2014 [cited 2018 May 21]. Available from: .
    1. Caldas de Almeida JM, Frasquilho D, Mateus P, Antunes A, Cardoso G, Silva M, et al. EU-Compass for action on mental health and wellbeing. Summary and analysis of key developments in member states and stakeholders [Internet]. 2017 [cited 2018 May 21]. Available from: .
    1. van Ballegooijen W, Cuijpers P, van Straten A, Karyotaki E, Andersson G, Smit JH, et al. Adherence to Internet-Based and Face-to-Face Cognitive Behavioural Therapy for Depression: A Meta-Analysis. PLoS One. 2014;9(7):e100674. doi: 10.1371/journal.pone.0100674.
    1. Spek V, Cuijpers P, Nyklícek I, Riper H, Keyzer J, Pop V. Internet-based cognitive behaviour therapy for symptoms of depression and anxiety: a meta-analysis. Psychol Med. 2007;37(03):319. doi: 10.1017/S0033291706008944.
    1. Barak A, Klein B, Proudfoot JG. Defining internet-supported therapeutic interventions. Ann Behav Med. 2009;38(1):4–17. doi: 10.1007/s12160-009-9130-7.
    1. Ritterband LM, Andersson G, Christensen HM, Carlbring P, Cuijpers P. Directions for the International Society for Research on internet interventions (ISRII) J Med Internet Res. 2006;8(3):e23. doi: 10.2196/jmir.8.3.e23.
    1. Salamanca-Sanabria A, Richards D, Timulak L, Castro-Camacho L, Mojica-Perilla M, Parra-Villa Y. Assessing the efficacy of a culturally adapted cognitive behavioural internet-delivered treatment for depression: protocol for a randomised controlled trial. BMC Psychiatry. 2018;18(1):53. doi: 10.1186/s12888-018-1634-x.
    1. Arjadi R, Nauta MH, Chowdhary N, Bockting CLH. A systematic review of online interventions for mental health in low and middle income countries: a neglected field. Glob Ment Heal. 2015;2:e12. doi: 10.1017/gmh.2015.10.

Source: PubMed

Sponsoren und Mitarbeiter

Krankheiten

Drogeninterventionen

3
Abonnieren