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Positive imagery cognitive bias modification (CBM) and internet-based cognitive
behavioral therapy (iCBT): a randomized controlled trial
#MMPMID25805405
Williams AD
; O'Moore K
; Blackwell SE
; Smith J
; Holmes EA
; Andrews G
J Affect Disord
2015[Jun]; 178
(?): 131-41
PMID25805405
show ga
BACKGROUND: Accruing evidence suggests that positive imagery-based cognitive bias
modification (CBM) could have potential as a standalone targeted intervention for
depressive symptoms or as an adjunct to existing treatments. We sought to
establish the benefit of this form of CBM when delivered prior to Internet
cognitive behavioral therapy (iCBT) for depression METHODS: A randomized
controlled trial (RCT) of a 1-week Internet-delivered positive CBM vs. an active
control condition for participants (N=75, 69% female, mean age=42) meeting
diagnostic criteria for major depression; followed by a 10-week iCBT program for
both groups. RESULTS: Modified intent-to-treat marginal and mixed effect models
demonstrated no significant difference between conditions following the CBM
intervention or the iCBT program. In both conditions there were significant
reductions (Cohen?s d .57-1.58, 95% CI=.12-2.07) in primary measures of
depression and interpretation bias (PHQ9, BDI-II, AST-D). Large effect size
reductions (Cohen?s d .81-1.32, 95% CI=.31-1.79) were observed for secondary
measures of distress, disability, anxiety and repetitive negative thinking (K10,
WHODAS, STAI, RTQ). Per protocol analyses conducted in the sample of participants
who completed all seven sessions of CBM indicated between-group superiority of
the positive over control group on depression symptoms (PHQ9, BDI-II) and
psychological distress (K10) following CBM (Hedges g .55-.88, 95% CI=-.03-1.46)
and following iCBT (PHQ9, K10). The majority (>70%) no longer met diagnostic
criteria for depression at 3-month follow-up. LIMITATIONS: The control condition
contained many active components and therefore may have represented a smaller
'dose' of the positive condition. CONCLUSIONS: Results provide preliminary
support for the successful integration of imagery-based CBM into an existing
Internet-based treatment for depression.