RESUMEN
BACKGROUND: Cognitive therapy and behavioural activation are both widely applied and effective psychotherapies for depression, but it is unclear which works best for whom. Individual participant data (IPD) meta-analysis allows for examining moderators at the participant level and can provide more precise effect estimates than conventional meta-analysis, which is based on study-level data. AIMS: This article describes the protocol for a systematic review and IPD meta-analysis that aims to compare the efficacy of cognitive therapy and behavioural activation for adults with depression, and to explore moderators of treatment effect. (PROSPERO: CRD42022341602). METHOD: Systematic literature searches will be conducted in PubMed, PsycINFO, EMBASE and the Cochrane Library, to identify randomised clinical trials comparing cognitive therapy and behavioural activation for adult acute-phase depression. Investigators of these trials will be invited to share their participant-level data. One-stage IPD meta-analyses will be conducted with mixed-effects models to assess treatment effects and to examine various available demographic, clinical and psychological participant characteristics as potential moderators. The primary outcome measure will be depressive symptom level at treatment completion. Secondary outcomes will include post-treatment anxiety, interpersonal functioning and quality of life, as well as follow-up outcomes. CONCLUSIONS: To the best of our knowledge, this will be the first IPD meta-analysis concerning cognitive therapy versus behavioural activation for adult depression. This study has the potential to enhance our knowledge of depression treatment by using state-of-the-art statistical techniques to compare the efficacy of two widely used psychotherapies, and by shedding more light on which of these treatments might work best for whom.
RESUMEN
OBJECTIVE: Evaluate an online coping skills program to prevent mental health problems in children and adolescents from divorced or separated families. METHOD: Children ages 11-16 (N = 147) whose families had filed for divorce were recruited using public court records. Participants were blocked by risk-score and randomly assigned to either a control (Internet self-study condition, Best of the Net (BTN) or the experimental intervention, Children of Divorce-Coping With Divorce (CoD-CoD), a 5-module highly interactive online program to promote effective coping skills. Program effects were tested on measures of children's self-reported coping and parent and youth reports of children's mental health problems. RESULTS: Significant main effects indicated that youth in CoD-CoD improved more on self-reported emotional problems relative to BTN youth (d = .37) and had a lower rate of clinically significant self-reported mental health problems (OR = .58, p = .04). A significant Baseline × Treatment interaction indicated that the 55% of youth with highest baseline problems improved more than those in BTN on their self-report of total mental health problems. A significant interaction effect indicated that CoD-CoD improved youth coping efficacy for the 30% of those with the lowest baseline coping efficacy. For the 10% of youth with lowest parent-reported risk at baseline, those who received BTN had lower problems than CoD-CoD participants. CONCLUSIONS: CoD-CoD was effective in reducing youth-reported mental health problems and coping efficacy particularly for high risk youth. Parent-report indicated that, relative to BTN, CoD-CoD had a negative effect on mental health problems for a small group with the lowest risk.
