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Cited by 206Digital Mental Health InterventionsAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesMental Health via Writing

Efficacy of a web-based, crowdsourced peer-to-peer cognitive reappraisal platform for depression: Randomized controlled trial

Open access
Morris, Robert R, Schueller, Stephen M, Picard, Rosalind W·2015·Journal of Medical Internet Research
DOI 10.2196/jmir.4167PMC PMC4395771
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Abstract

BACKGROUND: Self-guided, Web-based interventions for depression show promising results but suffer from high attrition and low user engagement. Online peer support networks can be highly engaging, but they show mixed results and lack evidence-based content. OBJECTIVE: Our aim was to introduce and evaluate a novel Web-based, peer-to-peer cognitive reappraisal platform designed to promote evidence-based techniques, with the hypotheses that (1) repeated use of the platform increases reappraisal and reduces depression and (2) that the social, crowdsourced interactions enhance engagement. METHODS: Participants aged 18-35 were recruited online and were randomly assigned to the treatment group, "Panoply" (n=84), or an active control group, online expressive writing (n=82). Both are fully automated Web-based platforms. Participants were asked to use their assigned platform for a minimum of 25 minutes per week for 3 weeks. Both platforms involved posting descriptions of stressful thoughts and situations. Participants on the Panoply platform additionally received crowdsourced reappraisal support immediately after submitting a post (median response time=9 minutes). Panoply participants could also practice reappraising stressful situations submitted by other users. Online questionnaires administered at baseline and 3 weeks assessed depression symptoms, reappraisal, and perseverative thinking. Engagement was assessed through self-report measures, session data, and activity levels. RESULTS: The Panoply platform produced significant improvements from pre to post for depression (P=.001), reappraisal (P<.001), and perseverative thinking (P<.001). The expressive writing platform yielded significant pre to post improvements for depression (P=.02) and perseverative thinking (P<.001), but not reappraisal (P=.45). The two groups did not diverge significantly at post-test on measures of depression or perseverative thinking, though Panoply users had significantly higher reappraisal scores (P=.02) than expressive writing. We also found significant group by treatment interactions. Individuals with elevated depression symptoms showed greater comparative benefit from Panoply for depression (P=.02) and perseverative thinking (P=.008). Individuals with baseline reappraisal deficits showed greater comparative benefit from Panoply for depression (P=.002) and perseverative thinking (P=.002). Changes in reappraisal mediated the effects of Panoply, but not the expressive writing platform, for both outcomes of depression (ab=-1.04, SE 0.58, 95% CI -2.67 to -.12) and perseverative thinking (ab=-1.02, SE 0.61, 95% CI -2.88 to -.20). Dropout rates were similar for the two platforms; however, Panoply yielded significantly more usage activity (P<.001) and significantly greater user experience scores (P<.001). CONCLUSIONS: Panoply engaged its users and was especially helpful for depressed individuals and for those who might ordinarily underutilize reappraisal techniques. Further investigation is needed to examine the long-term effects of such a platform and whether the benefits generalize to a more diverse population of users. TRIAL REGISTRATION: ClinicalTrials.gov NCT02302248; https://clinicaltrials.gov/ct2/show/NCT02302248 (Archived by WebCite at http://www.webcitation.org/6Wtkj6CXU).

AI snapshot

Written from the paper’s full text.

TL;DR

Panoply, a web-based peer-to-peer cognitive reappraisal platform, produced significant pre-to-post improvements in depression, reappraisal, and perseverative thinking and was more engaging than an active expressive-writing control. It did not significantly outperform expressive writing on depression or perseverative thinking overall, but showed greater benefit for participants with elevated depression or baseline reappraisal deficits, with reappraisal mediating Panoply’s effects.

Key findings

  • Within Panoply, CES-D depression decreased by −3.60 (SD 9.86; P=.001; d=−0.36), ERQ-R reappraisal increased by 2.93 (SD 6.11; P<.001; d=0.48), and PTQ perseverative thinking decreased by −4.42 (SD 10.13; P<.001; d=−0.44). Expressive writing improved depression (−2.20; P=.02) and PTQ (−4.02; P<.001) but not reappraisal (+0.57; P=.45).
  • Between groups at post-test controlling for baseline, there were no significant differences for depression (P=.41) or perseverative thinking (P=.57), but Panoply users had significantly higher reappraisal scores (P=.02; beta=1.98, 95% CI 0.27–3.68). Elevated baseline depression moderated greater Panoply benefit for depression (P=.02) and perseverative thinking (P=.008); baseline reappraisal deficits moderated greater Panoply benefit for depression (P=.002) and perseverative thinking (P=.002).
  • Reappraisal mediated Panoply’s effects on depression (ab=−1.04, SE 0.58, 95% CI −2.67 to −0.12) and perseverative thinking (ab=−1.02, SE 0.61, 95% CI −2.88 to −0.20), but not expressive writing.
  • Engagement was higher for Panoply: UEQ mean 137.10 vs 122.29 (P<.001), words written 1013.28 vs 433.85 (P<.001), and Google session data averaged 21 sessions vs 10, with 9 minutes 18 seconds vs 3 minutes 10 seconds per session; median crowdsourced response time was 9 minutes.

Methods

  • Parallel-arm RCT recruiting online; eligible participants were native English speakers aged 18–35. Randomization was 1:1 to Panoply (n=84 analyzed) or online expressive writing (n=82 analyzed); 270 completed consent/baseline, 217 activated accounts, and 166 (76.5%) completed follow-up. Participants were asked to use their assigned platform at least 25 minutes per week for 3 weeks.
  • Panoply involved posting stressful thoughts/situations and receiving crowdsourced support, debug, and reframe responses from trained MTurk workers and other users; the expressive-writing control mirrored the interface but had no crowd feedback or reappraisal training.
  • Outcomes were CES-D depression, ERQ-R reappraisal, and PTQ perseverative thinking at baseline and 3 weeks, plus UEQ and behavioral activity/session data. Analyses used linear regression controlling for baseline, moderation interactions, and Preacher and Hayes bootstrapping mediation.

Limitations

  • Stated by the paper: the study duration was very short (3 weeks), durability is unknown, the sample was limited to ages 18–35 and was largely female, future studies should compare Panoply with traditional Web-based CBT, the platform targeted only reappraisal, and it was Web-browser based rather than mobile.
  • Evident from the text: outcome analyses included only participants who activated an account and completed follow-up (n=166 of 270 consented), with no data imputation, so attrition and missing data may bias results.
  • Evident from the text: randomization occurred before consent, experimenters were not blind to assignment when answering support emails, and Google session data were not available at the user level, so inferential statistics could not be computed for session frequency/duration.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.2196/jmir.4167

Cites

Statistics

Nothing to recompute.

Claims the paper makes

0 of 15 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    Panoply yielded significantly greater user experience scores than expressive writing (P<.001).

    “Dropout rates were similar for the two platforms; however, Panoply yielded significantly more usage activity (P<.001) and significantly greater user experience scores (P<.001).”
    Quote in the paperNot a substantial claim
  • Findingown data

    The expressive writing platform yielded significant pre to post improvements for depression (P=.02).

    “The expressive writing platform yielded significant pre to post improvements for depression (P=.02) and perseverative thinking (P<.001), but not reappraisal (P=.45).”
    Quote in the paperSubstantial claim
  • Findingown data

    Changes in reappraisal did not mediate the effects of the expressive writing platform for perseverative thinking.

    “Changes in reappraisal mediated the effects of Panoply, but not the expressive writing platform, for both outcomes of depression (ab=-1.04, SE 0.58, 95% CI -2.67 to -.12) and perseverative thinking (ab=-1.02, SE 0.61, 95% CI -2.88 to -.20).”
    Quote in the paperSubstantial claim
  • Findingown data

    Individuals with baseline reappraisal deficits showed greater comparative benefit from Panoply for depression (P=.002).

    “Individuals with baseline reappraisal deficits showed greater comparative benefit from Panoply for depression (P=.002) and perseverative thinking (P=.002).”
    Quote in the paperSubstantial claim
  • Findingown data

    Individuals with elevated depression symptoms showed greater comparative benefit from Panoply for depression (P=.02).

    “Individuals with elevated depression symptoms showed greater comparative benefit from Panoply for depression (P=.02) and perseverative thinking (P=.008).”
    Quote in the paperSubstantial claim
  • May combine two claims. 19
  • The quote only partly states this claim. 3
  • Classified as probably not a substantial claim. 27

  • May combine two claims.

    Findingown data

    The Panoply group averaged a total of over 195 minutes over the course of the study, a considerably longer amount than the suggested 75 minutes.

    “Thus, the Panoply group averaged a total of over 195 minutes over the course of the study, a considerably longer amount than was suggested (75 minutes).”
    Quote in the paperNot a substantial claim

  • The quote only partly states this claim.

    Findingown data

    The indirect effect of Panoply on changes in perseverative thinking via changes in reappraisal was statistically significant.

    “The indirect effect of Panoply on changes in depression via changes in reappraisal was statistically significant (ab=-1.02, SE 0.61, 95% CI -2.88 to -0.20).”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    Panoply users could also identify distortions and review crowd-generated feedback, two additional activities that were used frequently but were not included in the word count metric.

    “They could also identify distortions and review crowd-generated feedback—two additional activities that were used frequently but were not included in the word count metric.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Panoply users logged an average of 21 sessions over the 3-week deployment, with an average of 9 minutes and 18 seconds per session; expressive writing users logged an average of 10 sessions, spending an average of 3 minutes and 10 seconds per session.

    “Descriptive statistics from the Google session data revealed that users in the Panoply condition logged 21 sessions over the 3-week deployment on average. Their average time per session was 9 minutes and 18 seconds per session. By comparison, users in the expressive writing condition logged an average of 10 sessions, spending an average of 3 minutes and 10 seconds per session.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Findingown data

    Panoply participants received crowdsourced reappraisal support immediately after submitting a post, with a median response time of 9 minutes.

    “Participants on the Panoply platform additionally received crowdsourced reappraisal support immediately after submitting a post (median response time=9 minutes).”
    Quote in the paperSubstantial claim

  • May combine two claims. The quote only partly states this claim.

    Findingown data

    Participants in the expressive writing condition reported significant changes in depression and perseverative thinking, but not in reappraisal.

    “those in the expressive writing condition reported significant changes in depression and perseverative thinking.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    The sample was 71.7% female.

    “The sample was 71.7% female, with a mean age of 23.7.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Participants were randomized to condition on a 1-to-1 ratio.

    “Participants who submitted their emails were assigned unique, anonymous study IDs and were randomized to condition on a 1-to-1 ratio.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductown data

    The study was a parallel-arm randomized controlled trial assigning participants to either the Panoply intervention or an active control intervention (online expressive writing).

    “We conducted a parallel-arm randomized controlled trial (RCT), assigning participants to either the Panoply intervention or an active control intervention (online expressive writing).”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    A meta-analysis found that expressive writing in various formats can improve physical and psychological health outcomes.

    “A meta-analysis has found that expressive writing in various formats can improve physical and psychological health outcomes [41].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [41] source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductreasoning

    The expressive writing control matched Panoply on nonspecific factors (eg, Web design, user registration, composing negative thoughts) but did not contain reappraisal training or crowdsourced interactions.

    “Our writing condition was a useful control because although it matched Panoply on nonspecific factors (eg, Web design, user registration, composing negative thoughts), it did not contain reappraisal training or crowdsourced interactions.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductnone given

    Randomization occurred prior to any screening procedures and before participants received descriptions of their assigned intervention in the consent form.

    “Randomization occurred prior to any screening procedures and before participants received descriptions of their assigned intervention in the consent form.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Cognitive restructuring, a form of reappraisal, is one of the most common components in Web-based treatments for depression.

    “Cognitive restructuring, a form of reappraisal, is one of the most common components in Web-based treatments for depression [24-27].”
    Quote in the paperNot a substantial claim0 of 4 sources checked
    • cites [24] source

      Not checked in the free run.

    • cites [25] source

      Not checked in the free run.

    • cites [26] source

      Not checked in the free run.

    • cites [27] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    Online assessments required a unique study ID to log in, preventing multiple submissions.

    “The online assessments were hosted by SurveyGizmo and required a unique study ID to log in. This prevented multiple submissions.”
    Quote in the paperNot a substantial claim

  • May combine two claims. The quote only partly states this claim.

    Study design and conductown data

    Dropout rates were similar for the Panoply and expressive writing platforms, with no significant differences at any stage of the study.

    “Dropout rates were similar for the two platforms; however, Panoply yielded significantly more usage activity (P<.001) and significantly greater user experience scores (P<.001).”
    • Also stated in: § Procedures · plain
      “No significant differences existed in the rates of dropout between the control or treatment interventions at any stage of the study.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Many self-guided interventions suffer from high attrition rates and low levels of engagement.

    “In practice, however, many self-guided interventions suffer from high attrition rates and low levels of engagement.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Only four participants emailed the experimenters to request technical support or procedure clarification.

    “However, during the course of the study, only four participants emailed the experimenters to request technical support or procedure clarification.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Expressive writing about negative experiences is a well-studied and efficacious intervention that can help reduce depression symptoms.

    “We did not expect this condition to be inert because writing expressively about negative experiences is a well-studied and efficacious intervention it its own right and can help reduce depression symptoms [40].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [40] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    Experimenters were not blind to the random assignment of participants.

    “To be able to answer specific questions about either the control or treatment app, experimenters were not blind to the random assignment of participants.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Of 217 individuals who activated an account, 166 (76.5%) completed the follow-up questionnaires.

    “A total of 217 individuals activated an account (Panoply=108, expressive writing=109). Of these, 166 (76.5%) completed the follow-up questionnaires.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    A recent review of self-guided, Web-based treatments found a median completion rate of 56%.

    “A recent review of self-guided, Web-based treatments found a median completion rate of 56% [6].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [6] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Incomplete survey data were not included in the analyses.

    “Incomplete survey data were not included in the analyses.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Donkin et al found that the total number of modules completed was less important than the level of activity observed per login in an online intervention for depression.

    “Further, Donkin et al recently examined the relationship between various engagement metrics and outcome in an online intervention for depression and found that the total number of modules completed was less important than the level of activity observed per login [6].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [6] source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    Individuals who participated frequently on unstructured, online mental health forums reported greater psychological distress over time.

    “For example, Kaplan et al showed that individuals who participated frequently on unstructured, online mental health forums reported greater psychological distress over time [13].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [13] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S4 (based).

    Study design and conductnone given

    Panoply offers additional structure, training, and moderation to ensure that all interactions on the site are aligned with evidence-based therapeutic techniques.

    “Panoply also offers additional structure, training, and moderation to ensure that all interactions on the site are aligned with evidence-based therapeutic techniques.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationreasoning

    Adherence rate for module completion does not apply to Panoply or the expressive writing intervention.

    “Adherence rate for module completion, while a common metric for many online mental health interventions, does not apply to Panoply or the expressive writing intervention.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    Reappraisal helped reduce depression and perseverative thinking for the Panoply platform, but not the expressive writing platform.

    “Our mediation analyses suggest that reappraisal helped reduce depression and perseverative thinking for the Panoply platform, but not the expressive writing platform.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Expressive writing is a useful control comparison for evaluating Panoply.
    • The authors state this as an assumption: Change in reappraisal is the key skill taught through Panoply.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Panoply posts containing offensive material, off-topic content, or language related to self-harm are excluded from the system.

    “Any post that contains offensive material, off-topic content, or language related to self-harm is excluded from the system.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    Before being given a chance to respond to a peer's post, each respondent is trained to use a specific therapeutic technique.

    “Before being given a chance to respond to the post of a peer, each respondent is trained to use a specific therapeutic technique.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisenone given

    A CES-D score of 16 or higher suggests a high level of depression and is often used as a cut-off to determine clinically relevant symptoms.

    “A score of 16 or higher suggests a high level of depression and is often used as a cut-off to determine clinically relevant symptoms.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    Users are increasingly likely to "snack" on apps, visiting them frequently, but in short bursts.

    “Users are increasingly likely to “snack” on apps, visiting them frequently, but in short bursts [17,18].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [17] source

      Not checked in the free run.

    • cites [18] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Both platforms underwent several usability studies, both in the lab and over the Web, before the RCT was conducted.

    “Both platforms underwent several usability studies, both in the lab and over the Web.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Responses on Panoply are vetted by other crowd helpers before being returned to the person who made the original post.

    “Also, responses are vetted by other crowd helpers before being returned to the person who made the original post.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable).

    Premisecitation

    Cognitive reappraisal is an adaptive emotion regulatory technique that involves reinterpreting the meaning of a thought or situation to change its emotional trajectory.

    “A critical skill taught in CBT for depression is cognitive reappraisal—an adaptive emotion regulatory technique that involves reinterpreting the meaning of a thought or situation to change its emotional trajectory [23].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [23] Gross, James J, 2003, J Pers Soc Psychol source

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    Reappraisal is considered an adaptive regulatory strategy and is associated with positive psychological functioning, including increased positive affect, well-being, and interpersonal functioning.

    “Reappraisal is considered an adaptive regulatory strategy and is associated with positive psychological functioning, including increased positive affect, well-being, and interpersonal functioning [23].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [23] Gross, James J, 2003, J Pers Soc Psychol source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The study was approved by the MIT Committee on the Use of Humans as Experimental Subjects (ref. no. 1311006002).

    “The study was approved by the MIT Committee on the Use of Humans as Experimental Subjects (ref. no. 1311006002).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    No significant differences in baseline demographic and symptom characteristics or dropout rates were observed between the treatment and control interventions.

    “No significant differences in baseline characteristics or dropout rates were observed between the control and treatment interventions (Table 1).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    Panoply produced significantly less depression and perseverative thinking for individuals with high depression scores at baseline.

    “Panoply produced significantly less depression and perseverative thinking for individuals with high depression scores at baseline.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Expressive writing is a useful control comparison for evaluating Panoply.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Online peer support networks are extremely popular and are known to naturally engage users.

    “Online peer support networks are extremely popular and are known to naturally engage users.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    Repeated use of the system produced significant benefits, particularly for depressed individuals and for those who typically underutilize reappraisal strategies.

    “We found that repeated use of our system produced significant benefits, particularly for depressed individuals and for those who typically underutilize reappraisal strategies.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Expressive writing is a useful control comparison for evaluating Panoply.
    • The authors state this as an assumption: Change in reappraisal is the key skill taught through Panoply.
40 of 40

  • The paper relies on this without support.

    Users aged 18-35 are more likely to have experience with anonymous, social messaging platforms.

    “This age range was selected because users in this age group are more likely to have experience with anonymous, social messaging platforms, and this study sought to find initial support for this platform rather than investigating widespread implementation.”

  • The paper relies on this without support.

    The peer-based learning approach used in Panoply has rarely, if ever, been used in the context of Web-based depression interventions.

    “To our knowledge, this peer-based learning approach has rarely, if ever, been used in the context of Web-based depression interventions.”

  • The paper relies on this without support.

    Rumination is a risk factor for depression and suicide and plays a causal role in the development and maintenance of depressive illness.

    “Rumination is considered a risk factor for depression and suicide and is thought to play a causal role in the development and maintenance of depressive illness.”

  • The paper relies on this without support.

    Expressive writing is a useful control comparison for evaluating Panoply.

    “while expressive writing was a useful control comparison for many reasons”

  • The authors state this as an assumption.

    Change in reappraisal is the key skill taught through Panoply.

    “because we believed that change in reappraisal is the key skill taught through Panoply”
5 of 5

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Peer networks have already made it possible to create content on demand and in nearly real-time based on each person's need.

    “This has already been made possible through the use of peer networks to create content on demand and in nearly real-time based on each person's need (Morris, Schueller, & Picard, 2015).”

    From Ecological momentary interventions for depression and anxiety (2017) · cites this paper as Morris, Schueller, & Picard, 2015

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

  • Expressive-writing depression confidence interval is not centered on its reported mean change

    Minor

    The reported 95% confidence interval has a midpoint of -3.22, not the reported mean change of -2.20. A confidence interval for this mean change should be centered on its estimate.

    Reported -2.2 · recomputed -3.22

1 of 1

The citation lists haven’t been fetched yet

References 48 · Cited by 206

Research works printed but not linked: 3

  1. Armstrong, P W, 1981, Biomedicine, 34, 65
  2. LaugwitzBHeldTSchreppMConstruction and evaluation of a user experience questionnaire2008Proceedings of the 4th Symposium of the Workgroup Human-Computer Interaction and Usability Engineering of the Austrian Computer Society on HCI and Usability for Education and Work2008AustriaSpringer-Verlag
  3. 10.2196/jmir.1923 · DOI · Paper page

Authors
Morris, R. R., Schueller, S. M., & Picard, R. W.
Affiliations
  • MIT Media Lab (US)
  • Northwestern University (US)
Corresponding author
Morris, Robert R
ORCID
Venue
Journal of Medical Internet Research
Publisher
JMIR Publications Inc.
Published
2015-03-30
Volume
17
Issue
3
Pages
e72
ISSN
1438-8871 (ISSN-L)
DOI
10.2196/jmir.4167
PMC
PMC4395771
OpenAlex
W2167299310
Semantic Scholar
0f41dadbdcee447e68668b3dadc4e843772a6118
Cited by
206
References
48
Citations by year
2026: 20 · 2025: 20 · 2024: 15 · 2023: 14 · 2022: 20 · 2021: 20 · 2020: 25 · 2019: 20 · 2018: 16 · 2017: 22 · 2016: 9 · 2015: 5
FWCI
28.09
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Journal of Medical Internet Research (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
National Institute of Mental Health (K08MH102336)
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 via Writing
Keywords
depression, cognitive reappraisal, peer support, online intervention, self-guided treatment, expressive writing, perseverative thinking, user engagement, attrition, young adults, social support networks, digital mental health interventions, treatment effect heterogeneity
MeSH terms
Adolescent, Adult, Depression, Female, Humans, Male, Surveys and Questionnaires, Internet, Young Adult, Crowdsourcing

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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

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