The DOI matches its Crossref record; 47 of the 47 references it cites were found in a registry or an index.
Randomized Effectiveness Trial of an Internet, Pure Self-Help, Cognitive Behavioral Intervention for Depressive Symptoms in Young Adults
Open accessAbstract
This study evaluated an Internet-delivered, cognitive behavioral skills training program versus a treatment-as-usual (TAU) control condition targeting depression symptoms in young adults aged 18 to 24 years. Potential participants were mailed a recruitment brochure; if interested, they accessed the study website to complete an online consent and baseline assessment. Intervention participants could access the website at their own pace and at any time. Reminder postcards were mailed periodically to encourage return use of the intervention. The pure self-help intervention was delivered without contact with a live therapist. The primary depression outcome measure was the Patient Health Questionnaire, administered at 0, 5, 10, 16, and 32 weeks after enrollment. A small but significant between-group effect was found from Week 0 to Week 32 for the entire sample (N = 160, d = .20, 95% confidence interval [CI] 0.00-0.50), with a moderate effect among women (n = 128, d .42, 95%C1 = 0.09-0.77). Greater depression reduction was associated with two measures of lower website usage, total minutes, and total number of page hits. Although intervention effects were modest, they were observed against a background of substantial TAU depression pharmacotherapy and psychosocial services. Highly disseminable, low-cost, and self-help interventions such as this have the potential to deliver a significant public health benefit.
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In the citing paper
“Time spent online was not correlated to outcomes in studies that targeted depression [58] and anxiety [59], but was correlated to outcomes in studies of infertility related distress [60] and body dissatisfaction [61].”
From A Systematic Review of the Impact of Adherence on the Effectiveness of e-Therapies (2011) · cites this paper as [58]
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In the citing paper
“Specific daily tasks such as self-monitoring features (e.g. mood or symptom diary) or automated reminders are key elements for monitoring symptom improvement and should therefore be included (Clarke et al., 2009; Wozney et al., 2017).”
From Involving patients' perspective in the development of an internet- and mobile-based CBT intervention for adolescents with chronic medical conditions: Findings from a qualitative study (2021) · cites this paper as Clarke et al., 2009
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“Overall 76% of the studies included in the review as a whole, and all but 4 studies (43, 66, 68, 74) included in the meta-analysis had some risk of bias.”
From What Works and What Doesn’t Work? A Systematic Review of Digital Mental Health Interventions for Depression and Anxiety in Young People (2019) · cites this paper as [43]
Experimental — accuracy not yet measuredIn the citing paper
“The number of pages opened was negatively correlated to outcome in 1 study targeting depression [58] but positively related to outcomes in 2 studies targeting body dissatisfaction [62,63].”
From A Systematic Review of the Impact of Adherence on the Effectiveness of e-Therapies (2011) · cites this paper as [58]
In the citing paper
“The lack of change in these studies may have been due to small sample sizes, an active comparison group [52], mild mental health problems rather than severe symptoms [79], or the fact that participants had previously sought help or were currently in treatment [78].”
From Do online mental health services improve help-seeking for young people? A systematic review (2014) · cites this paper as [52]
In the citing paper
“The quasi-experimental study found a slight but significant increase in help-seeking [52,68,78,79].”
From Do online mental health services improve help-seeking for young people? A systematic review (2014) · cites this paper as [52]
In the citing paper
“Seven studies [52,53,55,63,77-79] developed the intervention that they were evaluating, which may have led to a bias towards more favorable reporting.”
From Do online mental health services improve help-seeking for young people? A systematic review (2014) · cites this paper as [52]
In the citing paper
“small sample size [51,52,55,60,68,78,79]”
From Do online mental health services improve help-seeking for young people? A systematic review (2014) · cites this paper as [52]
In the citing paper
“No change in help-seeking was found in the three RCTs [52,78,79].”
From Do online mental health services improve help-seeking for young people? A systematic review (2014) · cites this paper as [52]
In the citing paper
“A series of studies by Isen and colleagues provided a self-affirmation, coping, and positive emotion intervention to several different patient populations and found an overall relationship between positive affect change and health behavior change[12,13,14,15].”
From An online positive affect skills intervention reduces depression in adults with type 2 diabetes (2014) · cites this paper as [12]
In the citing paper
“An analysis of a number of previous studies of an online intervention for depression in the community and that have used a CBT protocol similar to the intervention in the current study have reported post-treatment effect sizes averaging 1.29, and follow-up effects averaging 1.42, based on samples ranging from 45 – 300 [39,42-48].”
In the citing paper
“Given the rising cost pressure in the mental health domain, skills trainings for various psychological problems have increasingly and successfully been offered as scalable online-based interventions (e.g., Clarke et al., 2009; Rychtarik et al., 2015).”
From Smartphone-Based Emotion Recognition Skills Training for Alexithymia—A Randomized Controlled Pilot Study (2019) · cites this paper as Clarke et al., 2009
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Citations
Cites
Statistical Power Analysis for the Behavioral Sciences
Muller, K. E., & Cohen, J. (1989) · Technometrics · doi:10.2307/1270020 · Cited by 99,603
Statistical power analysis for the behavioral sciences
Cohen, J. (1990) · Computers Environment and Urban Systems · doi:10.1016/0198-9715(90)90050-4 · Cited by 65,417
Spitzer, R. L. (1999) · JAMA · doi:10.1001/jama.282.18.1737 · Cited by 9,802
Cognitive Therapy for Depression
(2012) · PsycEXTRA Dataset · doi:10.1037/e675542012-001 · Cited by 9,678
Positive Psychology Progress: Empirical Validation of Interventions.
Seligman, M. E. P., Steen, T. A., Park, N., & Peterson, C. (2005) · American Psychologist · doi:10.1037/0003-066x.60.5.410 · Cited by 5,947
The PHQ-9: A New Depression Diagnostic and Severity Measure
Kroenke, K., & Spitzer, R. L. (2002) · Psychiatric Annals · doi:10.3928/0048-5713-20020901-06 · Cited by 5,898 · cited 2×
“The psychometric properties of the PHQ-8 are nearly identical to those of the complete PHQ-9 (Corson, Gerrity, & Dobsha, 2004); it possesses excellent sensitivity (.97), specificity (.97), and positive predictive value (.75) for detecting major depression (Kroenke & Spitzer, 2002).”
MethodCognitive Therapy of Depression
HOLLON, S. D., & BECK, A. T. (1979) · Cognitive-Behavioral Interventions · doi:10.1016/b978-0-12-404480-7.50012-5 · Cited by 4,685
The American Journal of Managed Care
(2020) · The American Journal of Managed Care · doi:10.37765/ajmc · Cited by 3,254
Statistical analysis of repeated measures data using SAS procedures.
Littell, R. C., Henry, P. R., & Ammerman, C. B. (1998) · Journal of Animal Science · doi:10.2527/1998.7641216x · Cited by 2,837
Utility of a new procedure for diagnosing mental disorders in primary care. The PRIME-MD 1000 study
Spitzer, R. L. (1994) · JAMA · doi:10.1001/jama.272.22.1749 · Cited by 2,648
Tunis (2003) · doi:10.1001/jama.290.12.1624 · Cited by 1,724
Internet-based cognitive behaviour therapy for symptoms of depression and anxiety: A meta-analysis
SPEK, V., CUIJPERS, P., NYKLÍČEK, I., RIPER, H., KEYZER, J., & POP, V. (2007) · Psychological Medicine · doi:10.1017/s0033291706008944 · Cited by 1,586
Löwe, B., Kroenke, K., Herzog, W., & Gräfe, K. (2004) · Journal of Affective Disorders · doi:10.1016/s0165-0327(03)00198-8 · Cited by 1,558
Using SAS PROC MIXED to Fit Multilevel Models, Hierarchical Models, and Individual Growth Models
Singer, J. D. (1998) · Journal of Educational and Behavioral Statistics · doi:10.2307/1165280 · Cited by 1,092
Wantland, D. J., Portillo, C. J., Holzemer, W. L., Slaughter, R., & McGhee, E. M. (2004) · Journal of Medical Internet Research · doi:10.2196/jmir.6.4.e40 · Cited by 966
Delivering interventions for depression by using the internet: randomised controlled trial
Christensen, H. (2004) · BMJ · doi:10.1136/bmj.37945.566632.ee · Cited by 928
A meta-analysis of the effects of cognitive therapy in depressed patients
Gloaguen, V., Cottraux, J., Cucherat, M., & Blackburn, I.-M. (1998) · Journal of Affective Disorders · doi:10.1016/s0165-0327(97)00199-7 · Cited by 809
Some Conceptual and Statistical Issues in Analysis of Longitudinal Psychiatric Data
Gibbons, R. D. (1993) · Archives of General Psychiatry · doi:10.1001/archpsyc.1993.01820210073009 · Cited by 719
Internet-based self-help for depression: randomised controlled trial
Andersson, G., Bergström, J., Holländare, F., Carlbring, P., Kaldo, V., & Ekselius, L. (2005) · British Journal of Psychiatry · doi:10.1192/bjp.187.5.456 · Cited by 529 · cited 2×
“Interventions for mental disorders such as depression have been created for delivery through the Internet (Andersson et al., 2005; Christensen, Griffiths, & Jorm, 2004; Christensen, Griffiths, Mackinnon, & Britliffe, 2006; Clarke et al., 2005 Seligman, Steen, Park, & Peterson, 2005), typically offering variants of evi…”
BackgroundMethodClarke, G., Eubanks, D., Reid, E., Kelleher, C., O'Connor, E., DeBar, L. L., Lynch, F., Nunley, S., & Gullion, C. (2005) · Journal of Medical Internet Research · doi:10.2196/jmir.7.2.e16 · Cited by 372 · cited 7×
“We also report results for the subsamples of female participants and persons with higher depression scores at baseline (PHQ-8 total score > 10), because previous research suggested better outcomes among these subgroups (Clarke et al., 2002, 2005).”
BackgroundMethodResultInfluentialSelf-citationKazdin, A. E., & Bass, D. C. (1989) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.57.1.138 · Cited by 337
SPEK, V., NYKLÍČEK, I., SMITS, N., CUIJPERS, P., RIPER, H., KEYZER, J., & POP, V. (2007) · Psychological Medicine · doi:10.1017/s0033291707000542 · Cited by 307
van Straten, A., Cuijpers, P., & Smits, N. (2008) · Journal of Medical Internet Research · doi:10.2196/jmir.954 · Cited by 297
Dose-effect relations and responsive regulation of treatment duration: The good enough level.
Barkham, M., Connell, J., Stiles, W. B., Miles, J. N. V., Margison, F., Evans, C., & Mellor-Clark, J. (2006) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.74.1.160 · Cited by 293
Palmqvist, B., Carlbring, P., & Andersson, G. (2007) · Expert Review of Pharmacoeconomics & Outcomes Research · doi:10.1586/14737167.7.3.291 · Cited by 290
Clarke, G., Reid, E., Eubanks, D., O'Connor, E., DeBar, L. L., Kelleher, C., Lynch, F., & Nunley, S. (2002) · Journal of Medical Internet Research · doi:10.2196/jmir.4.3.e14 · Cited by 256 · cited 4×
“The first trial failed to find any significant program effect, possibly because of very low use of the intervention website (Clarke et al., 2002).”
BackgroundMethodResultInfluentialSelf-citationOnline randomized controlled trial of brief and full cognitive behaviour therapy for depression
CHRISTENSEN, H., GRIFFITHS, K. M., MACKINNON, A. J., & BRITTLIFFE, K. (2006) · Psychological Medicine · doi:10.1017/s0033291706008695 · Cited by 249
Internet-Based Mental Health Interventions
Ybarra, M. L., & Eaton, W. W. (2005) · Mental Health Services Research · doi:10.1007/s11020-005-3779-8 · Cited by 241
The case for practical clinical trials in psychiatry.
March, J. S., Silva, S. G., Compton, S., Shapiro, M., Califf, R., & Krishnan, R. (2005) · American Journal of Psychiatry · doi:10.1176/appi.ajp.162.5.836 · Cited by 240
Kazdin, A. E., & Bass, D. C. (1989) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.57.1.138 · Cited by 236
Corson, K., Gerrity, M., & Dobscha, S. K. (2004) · PubMed · Cited by 214
Griffiths, K. M., & Christensen, H. (2006) · Clinical Psychologist · doi:10.1080/13284200500378696 · Cited by 210
Newman, M. G., Erickson, T., Przeworski, A., & Dzus, E. (2003) · Journal of Clinical Psychology · doi:10.1002/jclp.10128 · Cited by 206
Researcher allegiance and meta-analysis: The case of cognitive therapy for depression.
Gaffan, E. A., Tsaousis, I., & Kemp-Wheeler, S. M. (1995) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.63.6.966 · Cited by 194
Fisher, W. H. (2008) · Psychiatric Services · doi:10.1176/appi.ps.59.5.579 · Cited by 147
Self-help and guided self-help for eating disorders
Perkins, S., Murphy, R., Schmidt, U. H., & Williams, C. (2006) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004191.pub2 · Cited by 135
Estimating the Economic Burden of Depression in Children and Adolescents
Lynch, F. L., & Clarke, G. N. (2006) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2006.07.001 · Cited by 127
Self-citationExploration of DSM-IV Criteria in Primary Care Patients With Medically Unexplained Symptoms
Smith, R. C., Gardiner, J. C., Lyles, J. S., Sirbu, C. M., Dwamena, F. C., Hodges, A., Collins, C. E., Lein, C., Given, C. W., Given, B. A., et al. (2005) · Psychosomatic Medicine · doi:10.1097/01.psy.0000149279.10978.3e · Cited by 118
The Behavioral management of anxiety, depression, and pain
Davidson, P. O. (1976) · Brunner/Mazel eBooks · Cited by 104
Strain, J. J. (1979) · Contemporary Psychology · doi:10.1037/019113 · Cited by 49
Internet–based cognitive–behavioral self help for depression
Andersson, G. (2006) · Expert Review of Neurotherapeutics · doi:10.1586/14737175.6.11.1637 · Cited by 46
Self-help Internet interventions for mental disorders
Pull, C. B. (2005) · Current Opinion in Psychiatry · doi:10.1097/01.yco.0000198103.31155.73 · Cited by 41
Handbook of Behavioral Group Therapy
(1985) · Applied clinical psychology · doi:10.1007/978-1-4684-4958-7 · Cited by 34
Ackermann, R. T., Rosenman, M. B., Downs, S. M., Holmes, A. M., Katz, B. P., Li, J., Zillich, A. J., Carney, C. P., & Inui, T. S. (2005) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2005.05.009 · Cited by 26
Feaster, D. J., Newman, F. L., & Rice, C. (2003) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.382 · Cited by 25
A Behavioral Group Therapy Approach to the Treatment of Depression
Lewinsohn, P. M., Breckenridge, J. S., Antonuccio, D. O., & Teri, L. L. (1985) · Applied clinical psychology · doi:10.1007/978-1-4684-4958-7_11 · Cited by 11
Emslie (1998) · doi:10.1002/(sici)1520-6394(1998)7:1
Research works printed but not linked: 3
- Fairburn C. G., 1997, Handbook of treatment for eating disordns, 494
- Fidler F., 2008, Evidence-based outcome research: A practical guide to conducting randomized controlled trials for psychosocial interventions, 315
- Perkins S. J., 2006, Cochrane Database Systematic Revi, 3, CD004191
Cited by
Sorted by citations
Computer-based psychological treatments for depression: A systematic review and meta-analysis
Richards, D., & Richardson, T. (2012) · Clinical Psychology Review · doi:10.1016/j.cpr.2012.02.004 · Cited by 1,442
Internet-Based and Other Computerized Psychological Treatments for Adult Depression: A Meta-Analysis
Andersson, G., & Cuijpers, P. (2009) · Cognitive Behaviour Therapy · doi:10.1080/16506070903318960 · Cited by 1,368
Yatham, L. N., Kennedy, S. H., Parikh, S. V., Schaffer, A., Beaulieu, S., Alda, M., O’Donovan, C., MacQUEEN, G. M., McIntyre, R. S., Sharma, V., et al. (2012) · Bipolar Disorders · doi:10.1111/bdi.12025 · Cited by 1,230
A Systematic Review of the Impact of Adherence on the Effectiveness of e-Therapies
Donkin, L., Christensen, H., Naismith, S. L., Neal, B., Hickie, I. B., & Glozier, N. (2011) · Journal of Medical Internet Research · doi:10.2196/jmir.1772 · Cited by 876
Karyotaki, E., Riper, H., Twisk, J., Hoogendoorn, A., Kleiboer, A., Mira, A., Mackinnon, A., Meyer, B., Botella, C., Littlewood, E., et al. (2017) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2017.0044 · Cited by 691
Metadata
- Authors
- Clarke, G., Kelleher, C., Hornbrook, M., DeBar, L., Dickerson, J., & Gullion, C.
- Affiliations
- Kaiser Permanente (US)
- Venue
- Cognitive Behaviour Therapy
- Publisher
- Informa UK Limited
- Published
- 2009-05-13
- Volume
- 38
- Issue
- 4
- Pages
- 222-234
- ISSN
- 1650-6073 (ISSN-L)
- 1651-2316
- PMC
- PMC2829099
- OpenAlex
- W2017824397
- Cited by
- 154
- References
- 47
- Citations by year
- 2026: 5 · 2025: 11 · 2024: 7 · 2023: 8 · 2022: 9 · 2021: 10 · 2020: 6 · 2019: 9 · 2018: 8 · 2017: 8 · 2016: 7 · 2015: 11 · 2014: 19 · 2013: 9 · 2012: 9
- FWCI
- 10.41
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Cognitive Behaviour Therapy (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R24MH061422)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Keywords
- online intervention, cognitive behavioral therapy, self-help, depression, young adults, depressive symptoms, medication adherence, website usage, gender differences, dissemination, low-cost interventions
- MeSH terms
- Depressive Disorder, Female, Humans, Male, Patient Acceptance of Health Care, Self-Help Groups, Cognitive Behavioral Therapy, Internet, Young Adult
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