Predictors and Moderators of Response to Internet-Delivered Interpersonal Psychotherapy and Cognitive Behavior Therapy for Depression
Open accessAbstract
Background By identifying which predictors and moderators lead to beneficial outcomes, accurate selection of the best initial treatment will have significant benefits for depressed individuals.Method An automated, fully self-guided randomized controlled internet-delivered noninferiority trial was conducted comparing two new interventions (Interpersonal Psychotherapy [IPT; n=620] and Cognitive Behavioral Therapy [CBT; n=610]) to an active control intervention (MoodGYM; n=613) over a period of 4 weeks to spontaneous visitors of an internet-delivered therapy website (e-couch). A range of putative predictors and moderators (socio-demographic characteristics [age, gender, marital status, education level], clinical characteristics [depression/anxiety symptoms, disability, quality of life, medication use], skills [mastery and dysfunctional attitudes] and treatment preference) were assessed using internet-delivered self-report measures at baseline and immediately following treatment and at six months follow-up. Analyses were conducted using Mixed Model Repeated Measures (MMRM).Results Female gender, lower mastery and lower dysfunctional attitudes predicted better outcome at post-test and/or follow-up regardless of intervention. No overall differential effects for condition on depression as a function of outcome were found. However, based on time-specific estimates, a significant interaction effect of age was found. For younger people, internet-delivered IPT may be the preferred treatment choice, whereas older participants derive more benefits from internet-delivered CBT programs.Limitations Although the sample of participants was large, power to detect moderator effects was still lacking.Conclusions Different e-mental health programs may be more beneficial for specific age groups. The findings raise important possibilities for increasing depression treatment effectiveness and improving clinical practice guidelines for depression treatment of different age groups.
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Not all people respond in the same way to psychological treatments, including technology-supported treatments.
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Program adherence was moderate across the studies and not dissimilar to that of clinical studies.
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- Authors
- Donker, T., Batterham, P. J., Warmerdam, L., Bennett, K., Bennett, A., Cuijpers, P., Griffiths, K. M., & Christensen, H.
- Affiliations
- Black Dog Institute (AU)
- Australian National University (AU)
- Amsterdam Public Health (NL)
- Corresponding author
- Donker, T.
- ORCID
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2013-10
- Volume
- 151
- Issue
- 1
- Pages
- 343-351
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W2091355781
- Cited by
- 115
- References
- 75
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 10 · 2023: 9 · 2022: 11 · 2021: 8 · 2020: 6 · 2019: 15 · 2018: 9 · 2017: 15 · 2016: 11 · 2015: 7 · 2014: 6
- FWCI
- 12.23
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- VU Research Portal (publishedVersion)
- ANU Open Research (Australian National University) (submittedVersion, other-oa)
- Multilingual Matters (Channel View Publications) (submittedVersion)
- 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 › Social Psychology › Mental Health Treatment and Access
- Keywords
- online therapy, interpersonal psychotherapy, cognitive behavioral therapy, depression, predictors of treatment response, treatment moderators, age differences, gender differences, mastery, dysfunctional attitudes, e-mental health, MoodGYM, treatment selection
- MeSH terms
- Adolescent, Adult, Age Factors, Attitude to Health, Depression, Female, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, Psychotherapy, Sex Factors, Therapy, Computer-Assisted, Cognitive Behavioral Therapy, Treatment Outcome, Young Adult
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