Guided internet-based transdiagnostic individually tailored Cognitive Behavioral Therapy for symptoms of depression and/or anxiety in college students: A randomized controlled trial

Eirini Karyotaki; Anke M Klein; Marketa Ciharova; Felix Bolinski; Lisa Krijnen; Lisa de Koning; Leonore de Wit; Claudia M van der Heijde; David D Ebert; Heleen Riper; Neeltje Batelaan; Peter Vonk; Randy P Auerbach; Ronald C Kessler; Ronny Bruffaerts; Sascha Struijs; Reinout W Wiers; Pim Cuijpers

doi:10.1016/j.brat.2021.104028

Guided internet-based transdiagnostic individually tailored Cognitive Behavioral Therapy for symptoms of depression and/or anxiety in college students: A randomized controlled trial

Behav Res Ther. 2022 Mar:150:104028. doi: 10.1016/j.brat.2021.104028. Epub 2022 Jan 4.

Authors

Eirini Karyotaki¹, Anke M Klein², Marketa Ciharova³, Felix Bolinski⁴, Lisa Krijnen⁵, Lisa de Koning⁶, Leonore de Wit³, Claudia M van der Heijde⁷, David D Ebert⁸, Heleen Riper³, Neeltje Batelaan⁹, Peter Vonk⁷, Randy P Auerbach¹⁰, Ronald C Kessler¹¹, Ronny Bruffaerts¹², Sascha Struijs¹³, Reinout W Wiers⁶, Pim Cuijpers³

Affiliations

¹ Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, BT 1081 Amsterdam, the Netherlands; Amsterdam Public Health Research Institute, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, the Netherlands. Electronic address: e.karyotaki@vu.nl.
² Developmental and Educational Psychology of the Institute of Psychology, Leiden University, Leiden, the Netherlands; Addiction, Development, And Psychopathology Lab, Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands.
³ Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, BT 1081 Amsterdam, the Netherlands; Amsterdam Public Health Research Institute, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, the Netherlands.
⁴ Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, BT 1081 Amsterdam, the Netherlands; Amsterdam Public Health Research Institute, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, the Netherlands; Department of Public Mental Health and Prevention, Trimbos Institute (Netherlands Institute of Mental Health and Addiction), Utrecht, the Netherlands.
⁵ Department of Clinical Child and Family Studies, Utrecht University, Utrecht, the Netherlands.
⁶ Addiction, Development, And Psychopathology Lab, Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands.
⁷ Department of Research, Development and Prevention, Student Health Service University of Amsterdam, Amsterdam, the Netherlands.
⁸ Psychology and Digital Mental Health Care, Technical University of Munich, Munich, Germany; Clinical Psychology and Psychotherapy, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany.
⁹ Department of Psychiatry and Department of Epidemiology and Biostatistics, VU University Medical Centre Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
¹⁰ Department of Psychiatry, Columbia University, New York, NY, USA.
¹¹ Department of Health Care Policy, Harvard Medical School, Boston, MA, USA.
¹² Universitair Psychiatrisch Centrum, Centre for Public Health Psychiatry, Katholieke Universiteit Leuven, Leuven, Belgium.
¹³ Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, BT 1081 Amsterdam, the Netherlands; Amsterdam Public Health Research Institute, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, the Netherlands; Institute of Psychology, Leiden University, Leiden, the Netherlands.

PMID: 35066365
DOI: 10.1016/j.brat.2021.104028

Abstract

Common mental disorders, such as depression and anxiety, often emerge in college students during the transition into early adulthood. Mental health problems can seriously impact students' functioning, interpersonal relationships, and academic achievement. Actively reaching out to college students with mental health problems and offering them internet-based interventions may be a promising way of providing low-threshold access to evidence-based treatment in colleges. This randomized controlled trial aimed to assess the effectiveness of a guided web-based transdiagnostic individually tailored Cognitive Behavioral Therapy (iCBT) in treating college students with depression and/or anxiety symptoms. Through an online survey that screened college students' mental health, we recruited 100 college students aged ≥18 years who reported mild to moderate depression and/or anxiety symptoms and were attending colleges in the Netherlands. Participants were randomly allocated to guided iCBT (n = 48) or treatment as usual (TAU) control (n = 52). Primary outcomes were symptoms of depression and anxiety measured at post-treatment (7 weeks post-randomization). We also measured all outcomes at 6- and 12-months post-randomization. All analyses were based on the intention-to-treat principle and were repeated using the complete-case sample. We found no evidence of a difference between the effects of guided iCBT and TAU in any of the examined outcomes (i.e., symptoms of depression and anxiety, quality of life, educational achievement, and college dropout) across all time points (p > .05). There was no evidence that effects of iCBT were associated with treatment satisfaction and adherence. More research into transdiagnostic individually tailored iCBT is necessary. Further, future studies should recruit larger samples to investigate possible smaller but clinically relevant effects of internet-based interventions for college students with depression and/or anxiety.

Keywords: Anxiety; College students; Depression; Internet-based CBT; Transdiagnostic; e-health.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Anxiety / therapy
Cognitive Behavioral Therapy*
Depression / therapy
Humans
Internet
Internet-Based Intervention*
Quality of Life
Students / psychology
Treatment Outcome