Predictors of outcome of group and internet-based cognitive behavior therapy
Abstract
Background Little is known about which participant characteristics determine the effectiveness of various types of cognitive behavior therapy for sub-threshold depression. The aim of this study was to investigate which characteristics predict treatment outcome of group and internet-based interventions for sub-threshold depression, with a special focus on (i) the five main personality factors, and (ii) their different predictive power in the different types of treatment.Methods Eighty-five women and 45 men (mean age=55 years, S.D.=4.4) were randomly assigned to a group treatment and an internet-based treatment. The outcome measure was the difference between pre-treatment and post-treatment BDI scores. Analyses of Covariance were conducted to examine which participant characteristics could predict outcome for the two different types of treatment.Results Higher baseline BDI scores (F(1,111)=52.88, p<.01), female gender (F(1,111)=6.45, p=.01), and lower neuroticism scores (F(1,111)=7.24, p=.01) predicted better outcome after both treatments. In the group intervention, participants with higher altruism scores improved significantly more after treatment (F(1,111)=3.94, p=.05) compared to the internet-based condition.Limitations Axis-II disorders were not considered; the study assessed personality traits rather than personality disorders.Conclusions Outcomes of different types of cognitive behavior therapy for sub-threshold depression are partly predicted by different participant characteristics. Neuroticism was associated with worse outcomes in both types of treatment, while altruism seems to be exclusively related to more favorable outcomes in the group treatment.
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Studies show that a higher level of education and being employed are predictors of success on online cognitive-behavioral interventions for depression.
“Studies show that a higher level of education (Spek et al., 2008) and being employed (de Graaf et al., 2010) are predictors of success on online cognitive-behavioral interventions for depression.”
From Online and Mobile Interventions for Problem Gambling, Alcohol, and Drugs: A Systematic Review (2017) · cites this paper as Spek et al., 2008
Higher educational attainment and being married or in a partnered relationship appear to be associated with better adherence to online interventions.
“Two of the more consistent findings are that higher educational attainment and being married or in a partnered relationship appear to be associated with better adherence to online interventions.”
From Predictors of adherence and outcome in internet-based cognitive behavior therapy delivered in a telephone counseling setting (2014) · cites this paper as Spek, Nyklicek, Cuijpers, & Pop, 2008
There is contradictory evidence regarding the effect of relationship status on response to online CBT, with one study reporting better outcomes among married individuals and another reporting better outcomes among those who were separated, widowed or divorced.
“There is a small amount of contradictory evidence regarding the effect of relationship status on response to online CBT, with one study reporting better outcomes among married individuals (Spek et al., 2008), and another study reporting better outcomes among those who were separated, widowed or divorced (Button et al., 2012).”
From Predictors of adherence and outcome in internet-based cognitive behavior therapy delivered in a telephone counseling setting (2014) · cites this paper as Spek et al., 2008
Three studies found that greater pre-treatment depression symptom severity was associated with greater response to online CBT.
“Three studies found that greater pre-treatment depression symptom severity was associated with greater response to online CBT (Button et al., 2012;de Graaf et al., 2010;Spek et al., 2008).”
From Predictors of adherence and outcome in internet-based cognitive behavior therapy delivered in a telephone counseling setting (2014) · cites this paper as Spek et al., 2008
One study found that response to treatment was superior for females and those with higher levels of education.
“However, one study found that response to treatment was superior for females and those with higher levels of education (Spek et al., 2008).”
From Predictors of adherence and outcome in internet-based cognitive behavior therapy delivered in a telephone counseling setting (2014) · cites this paper as Spek et al., 2008
The finding that relationship status was unrelated to outcome is inconsistent with studies that have examined relationship status and outcome in online CBT.
“This finding is inconsistent with studies that have examined relationship status and outcome in online CBT (Button et al., 2012;Spek et al., 2008).”
From Predictors of adherence and outcome in internet-based cognitive behavior therapy delivered in a telephone counseling setting (2014) · cites this paper as Spek et al., 2008
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- Authors
- Spek, V., Nyklíček, I., Cuijpers, P., & Pop, V.
- Affiliations
- Tilburg University (NL)
- Vrije Universiteit Amsterdam (NL)
- Corresponding author
- Spek, Viola
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2008-01
- Volume
- 105
- Issue
- 1-3
- Pages
- 137-145
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W1992663821
- Cited by
- 134
- References
- 37
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 10 · 2022: 10 · 2021: 5 · 2020: 11 · 2019: 4 · 2018: 2 · 2017: 11 · 2016: 14 · 2015: 7 · 2014: 13 · 2013: 15 · 2012: 5
- FWCI
- 7.50
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Affective Disorders (publishedVersion)
- Research portal (Tilburg University) (publishedVersion)
- PubMed (publishedVersion)
- VU Research Portal (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Keywords
- subthreshold depression, cognitive behavioral therapy, online intervention, group therapy, treatment outcome predictors, personality traits, neuroticism, altruism, baseline depression severity, gender differences, older adults
- MeSH terms
- Depression, Female, Humans, Male, Middle Aged, Personality, Prospective Studies, Surveys and Questionnaires, Severity of Illness Index, Therapy, Computer-Assisted, Cognitive Behavioral Therapy, Treatment Outcome, Internet, Diagnostic and Statistical Manual of Mental Disorders
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