Articlehybrid2014

Web-based depression treatment: Associations of clients׳ word use with adherence and outcome

Rianne AP van der Zanden · Keshia Curie · Monique van Londen · Jeannet Kramer · Gerard J. Steen · Pim J. Cuijpers

60 citations0/0 files storedJournal of Affective Disorders

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Digital Mental Health Interventions Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes Mental Health via Writing

Abstract

BACKGROUND: The growing number of web-based psychological treatments, based on textual communication, generates a wealth of data that can contribute to knowledge of online and face-to-face treatments. We investigated whether clients' language use predicted treatment outcomes and adherence in Master Your Mood (MYM), an online group course for young adults with depressive symptoms. METHODS: Among 234 participants from a randomised controlled trial of MYM, we tested whether their word use on course application forms predicted baseline levels of depression, anxiety and mastery, or subsequent treatment adherence. We then analysed chat session transcripts of course completers (n=67) to investigate whether word use changes predicted changes in treatment outcomes. RESULTS: Depression improvement was predicted by increasing use of 'discrepancy words' during treatment (e.g. should). At baseline, more discrepancy words predicted higher mastery level. Adherence was predicted by more words used at application, more social words and fewer discrepancy words. LIMITATIONS: Many variables were included, increasing the chance of coincidental results. This risk was constrained by examining only those word categories that have been investigated in relation to depression or adherence. CONCLUSIONS: This is the first study to link word use during treatment to outcomes of treatment that has proven to be effective in an RCT. The results suggest that paying attention to the length of problem articulation at application and to 'discrepancy words' may be wise, as these seem to be psychological markers. To expand knowledge of word use as psychological marker, research on web-based treatment should include text analysis.

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1977The CES-D Scale 1983The Hospital Anxiety and Depression Scale 1978The Structure of Coping 2002Psychological Aspects of Natural Language Use: Our Words, Our Selves 2007Mediators and Mechanisms of Change in Psychotherapy Research 1997A validation study of the Hospital Anxiety and Depression Scale (HADS) in different groups of Dutch subjects 2015The Development and Psychometric Properties of LIWC2015 2004Language use of depressed and depression-vulnerable college students

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