Articlediamond2021

Explaining the efficacy of an internet-based behavioral activation intervention for major depression: A mechanistic study of a randomized-controlled trial

Zhongfang Fu · Huibert Burger · Retha Arjadi · Maaike H. Nauta · Claudi Bockting

16 citations0/0 files storedClinical Psychology in Europe

No readable copy stored yet — this record is metadata only.

No open-access location is known for this record yet.

Literature note Cite in a project Citation map

Digital Mental Health Interventions Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes Psychotherapy Techniques and Applications

Abstract

Background: Behavioral activation is an effective treatment for depression that is theorized to facilitate structured increases in enjoyable activities that increase opportunities for contact with positive reinforcement; to date, however, only few mechanistic studies focused on a standalone intervention. Method: Interventions using internet-based behavioral activation or psychoeducation were compared based on data from a randomized-controlled trial of 313 patients with major depressive disorder. Activation level and depression were measured fortnightly (baseline, Weeks 2, 4, 6, 8, 10), using the Patient Health Questionnaire-9 and the Behavioral Activation for Depression Scale-Short Form, respectively. Analysis was performed to determine if a change in activation level mediated treatment efficacy. Results: Latent growth modeling showed that internet-based behavioral activation treatment significantly reduced depressive symptoms from baseline to the end of treatment (standardized coefficient = -.13, p = .017) by increasing the rate of growth in the activation level (mediated effect estimate = -.17, 95% CI [-.27, -.07]. Results from mixed effects and simplex models showed that it took 4 weeks before mediation occurred (i.e., a significant change in activation that led to a reduction in depressive symptoms). Conclusion: Activation level likely mediated the therapeutic effect of behavioral activation on depression in our intervention. This finding may be of significant value to clinicians and depressed individuals who should anticipate a 4-week window before seeing a prominent change in activation level and a 6-week window before depressive symptomatology reduces. Future research must consolidate our findings on how behavioral activation works and when mediation occurs.

Paper brief

Loading…

Cite this work

Citation unavailable for this work.

BibTeX RIS CSL-JSON

No public copy is stored for this record, so only the metadata is cited.

Citations in this library

Citation map →

Stored only when both papers are in the corpus — 16 citations exist upstream.

References

2007Mediators and Mechanisms of Change in Psychotherapy Research 1974A behavioral approach to depression.2006Behavioral activation treatments of depression: A meta-analysis 2006National Collaborating Centre for Mental Health 1973A functional analysis of depression.1990Functional analysis in behavior therapy 2011The Behavioral Activation for Depression Scale–Short Form: Development and Validation 2010A critical review of assessment strategies to measure the behavioral activation model of depression

Cited by

2024Mechanisms of change in digital interventions for depression: A systematic review and meta-analysis of six mediator domains 2025Evaluating the necessity of booster sessions in relapse prevention for depression: a longitudinal study 2024Web-based imagery behavioral activation (WIMBA): Study protocol for a randomized controlled trial testing the effects, acceptability, and feasibility of a mental imagery activity scheduling training delivered online 2025Early changes in passively sensed homestay predict depression symptom improvement during digital behavioral activation

Explore the map →

Papers that cite the same references — the relational fallback while embeddings are still backfilling.

Imported from OpenAlex (CC0) — nothing here is generated.