Internet-based modular program BADI for adjustment disorder: protocol of a randomized controlled trial

Abstract

BackgroundAdjustment disorder is one of the most common mental health diagnoses. Still it receives relatively little attention from researchers trying to establish best interventions to treat it. With high prevalence of stressful life events, which might be leading to adjustment disorder, and limited resources of mental health service providers, online interventions could be a very practical way of helping people who have these disorders or are in the risk to develop them. The proposed study protocol is aimed to describe a randomized controlled trial of an internet-based modular intervention for adjustment disorder as it is defined in a proposal for the ICD-11.Methods/designThis study is a two-armed Randomized Controlled Trial (RCT) to examine the effectiveness of a web-based intervention BADI (Brief Adjustment Disorder Intervention) for adjustment disorder symptoms. BADI has four modules: Relaxation, Time management, Mindfulness and Strengthening relationships. It is based on stress and coping research and integrates evidence-based treatment approaches such as Cognitive Behavioural therapy (CBT), mindfulness and body-mind practices, as well as exercises for enhancing social support. Primary outcome of the study are symptoms of adjustment disorder and well-being. Engagement into the program and motivation for change is a secondary outcome. All participants after completing the baseline assessment are randomly assigned to one of the two groups: either to the one in which participant will instantly gain access to the BADI intervention or a group in which participants will be given access to the BADI program after waiting one month. Participants of BADI can choose exercises of the program flexibly. There is no particular order in which the exercises should be completed.DiscussionStudy will provide new insights of modular internet-based interventions efficacy for adjustment disorders. The study will also provide information about the role of motivation and expectancies on engagement in modular internet-based interventions. In case this RCT supports effectiveness of fully automated version of BADI, it could be used very broadly. It could become a cost-effective and accessible intervention for adjustment disorder.Trial registrationThe study was retrospectively registered with the Australian and New Zealand Clinical Trials Registry with the registration number ACTRN12616000883415. Registered 5 July, 2016.

A scoping review of ICD-11 adjustment disorder research

“…The second AjD intervention is the self-help unguided internet-delivered Brief Adjustment Disorder Intervention (BADI) developed by a Vilnius University group in Lithuania (Eimontas et al, 2017; Skruibis et al, 2016). The BADI intervention has four modules with three exercises in each of the modules, including relaxation, daily activity planning, interpersonal relationship conflict management, and mindfulness.…”

Risk factors of ICD-11 adjustment disorder in the Lithuanian general population exposed to life stressors

“…We used a cut-off of ≥23 for the total ADNM-8 symptom score to identify a probable ICD-11 adjustment disorder diagnosis based on previous studies of ICD-11 adjustment disorder in Lithuania Skruibis et al, 2016). This ADNM-8 symptom cut-off score was used in two intervention studies for diagnosis and clinical outcome measures of ICD-11 adjustment disorder .…”

A Brief Measure of the International Classification of Diseases-11 Adjustment Disorder: Investigation of Psychometric Properties in an Adult Help-Seeking Sample

“…Data were collected online, and all participants provided informed consent for the online study. Data for this study were extracted from a database of registered users of the internet-based self-help intervention for AjD (BADI) [17]. BADI is a short-term, self-help, stress-management program based on the principles of cognitive behavioral therapy and mindfulness.…”

“…This revision was based on the recent study that supported the 2-factor structure of the ICD-11 AjD definition [16]. We tested the psychometric properties of the ADNM-8 in the helpseeking sample that registered for the internet-based intervention for AjD in Lithuania [17].…”