Modelling changes in anxiety and depression during low‐intensity cognitive behavioural therapy: An application of growth mixture models

McDevitt-Petrovic, Orla; Shevlin, Mark; Kirby, Karen

doi:10.1111/bjc.12237

Cited by 5 publications

(6 citation statements)

References 58 publications

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“…Additionally, some evidence indicate that treatment effects are somewhat lower for SAD and panic disorder with agoraphobia than many other anxiety disorders (Carpenter et al, 2018) and agoraphobic avoidance is found to be the most consistent predictor of poor treatment response in CBT for panic disorders and agoraphobia (Porter & Chambless, 2015). Notably, also in an IAPT context, presenting with SAD or agoraphobia as a comorbid problem predicted poor treatment response (McDevitt‐Petrovic et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Social anxiety and agoraphobia symptoms effectively treated by Prompt Mental Health Care versus TAU at 6‐ and 12‐month follow‐up: Secondary analysis from a randomized controlled trial

Knapstad

Smith

2021

Depression and Anxiety

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Background Prompt Mental Health Care (PMHC, Norwegian adaption of Improving Access to Psychological Therapies) has shown effects on symptoms of anxiety and depression compared to treatment as usual (TAU). In this secondary analysis, we examine the effectiveness of PMHC among clients presenting with symptoms of social anxiety disorder (SAD) and/or agoraphobia on core symptoms at 6‐ and 12‐month follow‐up. Methods Randomized controlled trial in two PMHC sites (70:30 ratio PMHC:TAU). Of participants, 61.3% (n = 472) scored at caseness for SAD and 47.7% (n = 367) for agoraphobia (40% both). Effects on SAD avoidance and physiological discomfort (SPIN‐9), SAD cognitions (ATQ‐SA), agoraphobic avoidance (MIA‐8), and agoraphobic cognitions (ATQ‐AP) were examined in piecewise growth models. Results The PMHC group showed substantially greater symptom reduction than the TAU group for all outcomes: At 6‐month follow‐up, the between‐group effect sizes were d −0.60 (95% CI: −0.94 to −0.26) for SPIN‐9, −0.45 (95% CI: −0.70 to −0.20) for ATQ‐SA, −0.50 (95% CI: −0.87 to −0.13) for MIA‐8, and −0.61 (95% CI: −0.92 to −0.31) for ATQ‐AP. All effects were sustained at similar level at a 12‐month follow‐up. Conclusion PMHC effectively alleviated SAD and agoraphobia symptoms, and individuals struggling with such symptoms constituted a large proportion of clients. Although results should be interpreted with caution due to risk of attrition bias, they lend further support for a scale‐up of PMHC and similar initiatives. Individuals struggling with SAD and/or agoraphobia stood out as relatively high burdened, whereas only one of five had sought help the last 12 months, underscoring the need for the PMHC service.

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Section: Introductionmentioning

confidence: 99%

Social anxiety and agoraphobia symptoms effectively treated by Prompt Mental Health Care versus TAU at 6‐ and 12‐month follow‐up: Secondary analysis from a randomized controlled trial

Knapstad

Smith

2021

Depression and Anxiety

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“…15,16,32,40,41 Once trajectory membership has been established, it can be used as a dependent or independent variable to explore predictors of health trajectories and their contribution to future health outcomes. 8,13,28,47,48…”

Section: Growth Mixture Modelling (Gmm) Presentationmentioning

confidence: 99%

<p>Trajectory Modelling Techniques Useful to Epidemiological Research: A Comparative Narrative Review of Approaches</p>

Nguefack

Pagé

Katz

et al. 2020

CLEP

228

145

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Trajectory modelling techniques have been developed to determine subgroups within a given population and are increasingly used to better understand intra- and inter-individual variability in health outcome patterns over time. The objectives of this narrative review are to explore various trajectory modelling approaches useful to epidemiological research and give an overview of their applications and differences. Guidance for reporting on the results of trajectory modelling is also covered. Trajectory modelling techniques reviewed include latent class modelling approaches, ie, growth mixture modelling (GMM), group-based trajectory modelling (GBTM), latent class analysis (LCA), and latent transition analysis (LTA). A parallel is drawn to other individual-centered statistical approaches such as cluster analysis (CA) and sequence analysis (SA). Depending on the research question and type of data, a number of approaches can be used for trajectory modelling of health outcomes measured in longitudinal studies. However, the various terms to designate latent class modelling approaches (GMM, GBTM, LTA, LCA) are used inconsistently and often interchangeably in the available scientific literature. Improved consistency in the terminology and reporting guidelines have the potential to increase researchers’ efficiency when it comes to choosing the most appropriate technique that best suits their research questions.

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“…Other related factors are also associated with prognosis following treatment, including comorbid anxiety symptoms, panic, or somatization symptoms [ 12 , 13 , 23 ]. Other factors appear to be evidenced as prognostic factors, such as employment status [ 24 , 25 ] and marital status [ 15 , 26 ], and there is a group of factors that are not typically evaluated in many studies, but which have been found to be associated with worse prognosis: higher disability [ 13 , 19 ]; higher suicidal risk or behavior [ 15 , 25 ], higher rumination, cognitive, and attentional biases [ 27 , 28 ]; and higher anhedonia [ 29 ].…”

Section: Introductionmentioning

confidence: 99%

Long-term depressive symptom trajectories and related baseline characteristics in primary care patients: Analysis of the PsicAP clinical trial

Prieto-Vila,

González-Blanch,

Estupiñá Puig

et al. 2024

Eur. Psychiatr.

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Background. There is heterogeneity in the long-term trajectories of depressive symptoms among patients. To date, there has been little effort to inform the long-term trajectory of symptom change and the factors associated with different trajectories. Such knowledge is key to treatment decision-making in primary care, where depression is a common reason for consultation. We aimed to identify distinct long-term trajectories of depressive symptoms and explore pre-treatment characteristics associated with them. Methods. A total of 483 patients from the PsicAP clinical trial were included. Growth mixture modeling was used to identify long-term distinct trajectories of depressive symptoms, and multinomial logistic regression models to explore associations between pre-treatment characteristics and trajectories. Results. Four trajectories were identified that best explained the observed response patterns: "recovery" (64.18%), "late recovery" (10.15%), "relapse" (13.67%), and "chronicity" (12%). There was a higher likelihood of following the recovery trajectory for patients who had received psychological treatment in addition to the treatment as usual. Chronicity was associated with higher depressive severity, comorbidity (generalized anxiety, panic, and somatic symptoms), taking antidepressants, higher emotional suppression, lower levels on life quality, and being older. Relapse was associated with higher depressive severity, somatic symptoms, and having basic education, and late recovery was associated with higher depressive severity, generalized anxiety symptoms, greater disability, and rumination. Conclusions. There were different trajectories of depressive course and related prognostic factors among the patients. However, further research is needed before these findings can significantly influence care decisions.

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Modelling changes in anxiety and depression during low‐intensity cognitive behavioural therapy: An application of growth mixture models

Cited by 5 publications

References 58 publications

Social anxiety and agoraphobia symptoms effectively treated by Prompt Mental Health Care versus TAU at 6‐ and 12‐month follow‐up: Secondary analysis from a randomized controlled trial

Social anxiety and agoraphobia symptoms effectively treated by Prompt Mental Health Care versus TAU at 6‐ and 12‐month follow‐up: Secondary analysis from a randomized controlled trial

<p>Trajectory Modelling Techniques Useful to Epidemiological Research: A Comparative Narrative Review of Approaches</p>

Long-term depressive symptom trajectories and related baseline characteristics in primary care patients: Analysis of the PsicAP clinical trial

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