RECOVERY: A Transdiagnostic Intervention for Anxiety and Depression

Not Applicable

• Conditions: Dysthymic Disorder; Panic Disorder; Social Phobia; Generalized Anxiety Disorder; Depression; Specific Phobia
• Interventions: Behavioral: Transdiagnostic; Behavioral: Recovery (Transdiagnostic & self)

• Registration Number: NCT03917550
• Lead Sponsor: West University of Timisoara

Brief Summary

To investigate the efficacy and acceptability of a guided internet delivered transdiagnostic intervention, targeting mild to moderate clinical symptoms of anxiety and depression and emphasizing the changes taking place at the level of the structures of the self.

Detailed Description

The effectiveness of a Transdiagnostic Cognitive-Behavioral Treatment will be compared with an improved version of it, in which new intervention techniques were added, pointing out the importance of improving some self-concept dimensions in reducing symptoms of anxiety and depression. In order to prove this, the study design will include two active intervention groups; a standard transdiagnostic intervention protocol will be delivered to one group and an improved version of the same transdiagnostic protocol will be delivered to the other group. The new added techniques targets some self-concepts, namely self-compassion, unconditional self-acceptance and self-esteem. The main goal of the study is to concurrently test effectiveness of these two transdiagnostic approaches in reducing symptoms of anxiety and depression and improving the above-mentioned self-concepts. This non-inferiority trial has the power to detect an effect size larger than Cohen's d = .40 (including 20% attrition at post-test and 6 month follow-up)

Study Timeline

• Study Start: 2019-03-18
• Status Verified: 2019-04
• Study First Submitted: 2019-04-14
• Study First Submitted QC: 2019-04-14
• Last Update Submitted: 2019-04-14
• Study First Posted: 2019-04-17
• Last Update Posted: 2019-04-17
• Primary Completion: 2019-08-30
• Study Completion: 2020-03-27

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 260

Inclusion Criteria

1. be fluent in Romanian,
2. be at least 18 years of age,
3. have at least a clinical diagnosis of major depressive disorder/dysthymia, and/or generalized anxiety disorder, and/or social anxiety disorder, panic anxiety disorder and/or Agoraphobia, specific phobia or any combination of these conditions on Structured Clinical Interview for the Diagnostic and Statistical Manual for Mental Disorders 5 (SCID-I 5)

Exclusion Criteria

1. suicidal plans,
2. changes in the dosage if psychotropic medication during the last month (if present),
3. have bipolar disorder or psychosis (according to medication status),
4. have an alcohol/substance abuse and/or dependence disorder,
5. currently take part in other psychological treatment,
6. obvious obstacle to participation (i.e., no current Internet access, long travel plans during the treatment period etc.)

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Transdiagnostic	Transdiagnostic	This arm represents the Transdiagnostic intervention program for emotional disorders. The intervention, based on the Cognitive Behavioral Therapy (CBT) principles, is designed to encourage participants to confront and experience uncomfortable emotions, and use adaptive coping mechanisms.
Recovery (Transdiagnostic & self)	Recovery (Transdiagnostic & self)	A longitudinal study conducted before has shown that self-compassion, unconditional self-acceptance, self-esteem and self concept clarity could be considered risk factors for the severity of the clinical symptoms in anxiety and depression. This is the main reason why this arm consists of the Transdiagnostic intervention program for emotional disorders plus a number of intervention techniques targeting the self-concepts mentioned before. The intervention, based on the Cognitive Behavioral Therapy (CBT) principles, is designed to encourage participants to confront and experience uncomfortable emotions, and use adaptive coping mechanisms. Moreover, additional intervention techniques targeting self-concepts will be used to improve participants' self.

Primary Outcome Measures

Name	Time	Method
Generalized Anxiety Disorder 7 (GAD7)	Absolute values (average score) of GAD7 at 10 weeks (post-intervention)	Generalized Anxiety Disorder 7 (GAD7) was designed to measure participant's level of generalized anxiety or worry. The scale is unidimensional and the total score ranges from 0 to 21. Low scores are associated with low levels of worry, while high scores are associated with high levels of worry.
Patient Health Questionnaire 9 (PHQ9)	Absolute values (average score) of PHQ9 at 10 weeks (post-intervention)	The Patient Health Questionnaire 9 (PHQ9) was designed to measure participant's level of depression. The scale is unidimensional and the total score ranges from 0 to 27. Low scores are associated with low levels of depression, while high scores are associated with high levels of depression.
Panic Disorder Severity Scale-Self Report (PDSS-SR)	Absolute values (average score) of PDSS-SR at 10 weeks (post-intervention)	The PDSS-SR was designed to measure participant's level of panic. The scale is unidimensional and the total score rages from 0 to 28. Low scores are associated with low levels of panic, while high scores are associated with high levels of panic.
Social Phobia Inventory (SPIN)	Absolute values (average score) of SPIN at 10 weeks (post-intervention)	The SPIN was designed to measure participant's level of social phobia. The scale is unidimensional and the total score ranges from 0 to 68. Low scores are associated with low levels of social phobia, while high scores are associated with high levels of social phobia.

Secondary Outcome Measures

Name	Time	Method
New General Self-Efficacy Scale (NGSE)	Absolute values (average score) of NGSE at 10 weeks (post-intervention)	NGSE was designed to measure participant's level of Self-Efficacy. The scale is unidimensional and the total score rages from 8 to 40. Low scores are associated with low levels of Self-Efficacy, while high scores are associated with high levels of Self-Efficacy.
Self-Concept Clarity Scale (SCCS)	Absolute values (average score) of SCCS at 10 weeks (post-intervention)	SCCS was designed to measure participant's level of their Self-Concept Clarity. The scale is unidimensional and the total score rages from 12 to 60. Low scores are associated with low levels of Self-Clarity, while high scores are associated with high levels of Self-Clarity.
Beck Depression Inventory-II (BDI-II)	Absolute values (average score) of BDI-II at 10 weeks (post-intervention)	The Beck Depression Inventory-II (BDI-II) was designed to measure participant's level of depression. The scale is unidimensional and the total score ranges from 0 to 63. Low scores are associated with low levels of depression, while high scores are associated with high levels of depression.
Rosenberg Self-Esteem Scale (RSES)	Absolute values (average score) of RSES at 10 weeks (post-intervention)	Rosenberg Self-Esteem Scale was designed to measure participant's level of Self-Esteem. The scale is unidimensional and the total score rages from 10 to 40. Low scores are associated with low levels of Self-Esteem, while high scores are associated with high levels of Self-Esteem.
Overall Anxiety Severity and Impairment Scale (OASIS)	Absolute values (average score) of OASIS at 10 weeks (post-intervention)	The OASIS was designed to measure participant's level of overall anxiety level. The scale is unidimensional and the total score rages from 0 to 20. Low scores are associated with low levels of anxiety, while high scores are associated with high levels of anxiety.
Unconditional Self-Acceptance Questionnaire (USAQ)	Absolute values (average score) of USAQ at 10 weeks (post-intervention)	USAQ was designed to measure participant's level of unconditional Self-Acceptance. The scale is unidimensional and the total score rages from 20 to 140. Low scores are associated with low levels of unconditional Self-Acceptance, while high scores are associated with high levels of unconditional Self-Acceptance.
Overall Depression Severity and Impairment Scale (ODSIS)	Absolute values (average score) of ODSIS at 10 weeks (post-intervention)	The ODSIS was designed to measure participant's level of overall depression level. The scale is unidimensional and the total score rages from 0 to 20. Low scores are associated with low levels of depression, while high scores are associated with high levels of depression.
Self-Compassion Scale (SCS)	Absolute values (average score) of SCS at 10 weeks (post-intervention)	SCS was designed to measure participant's level of their Self-Compassion. The scale is multidimensional and the total score rages from 26 to 130. Low scores are associated with low levels of Self-Compassion, while high scores are associated with high levels of Self-Compassion.
Minnesota Multiphasic Personality Inventory 2 Neagtive Treatment Indicator Scale (MMPI2TRT)	Absolute values (average score) of MMPI2TRT at 10 weeks (post-intervention)	MMPI2TRT was designed to measure participants negative attitudes toward doctors/mental health professionals and unwilling to discuss personal problems. The scale is unidimensional and the total score rages from 0 to 26. Low scores are associated positive attitudes towards doctors and willingness to discuss problems while high scores are associated with negative attitudes toward doctors and unwilling to discuss personal problems.
Personality Clinical Form - Neagtive TReaTment Indicator Scale (PCFTRT)	Absolute values (average score) of PCFTRT at 10 weeks (post-intervention)	PCFTRT is a new subscale designed to assess participants negative attitudes toward mental health professionals and unwilling to discuss personal problems. The subscale is unidimensional and the total score rages from 0 to 24. Low scores are associated positive attitudes towards doctors and willingness to discuss problems while high scores are associated with negative attitudes toward doctors and unwilling to discuss personal problems.
Work and Social Adjustment Scale (WSAS)	Absolute values (average score) of WSAS at 10 weeks (post-intervention)	Work and Social Adjustment Scale (WSAS) was designed to measure symptom interference. The scale is unidimensional and the total score ranges from 0 to 40. Low scores are associated with higher levels of functioning (less interference of clinical symptoms) while high scores are associated with lower levels of functioning (or high interference of clinical symptoms).
Penn State Worry Questionnaire (PSWQ)	Absolute values (average score) of PSWQ at 10 weeks (post-intervention)	The PSWQ was designed to measure participant's level of generalized anxiety or worry. The scale is unidimensional and the total score ranges from 16 to 80. Low scores are associated with low levels of worry, while high scores are associated with high levels of worry.
Anxiety Sensitivity Index 16 (ASI16)	Absolute values (average score) of ASI at 10 weeks (post-intervention)	The ASI was designed to measure participant's level of anxiety sensitivity. The scale is unidimensional and the total score rages from 0 to 64. Low scores are associated with low levels of anxiety sensitivity, while high scores are associated with high levels of anxiety sensitivity.

Trial Locations

Locations (1)

West University of Timisoara; 🇷🇴 Timișoara, Timiș, Romania