British Journal of Clinical Psychology

Melville, Katherine M.; Casey, Leanne M.; Kavanagh, David J.

doi: 10.1348/014466509X472138pmid: 19799804

Purpose. The purpose of this review was to present an in‐depth analysis of literature identifying the extent of dropout from Internet‐based treatment programmes for psychological disorders, and literature exploring the variables associated with dropout from such programmes. Methods. A comprehensive literature search was conducted on PSYCHINFO and PUBMED with the keywords: dropouts, drop out, dropout, dropping out, attrition, premature termination, termination, non‐compliance, treatment, intervention, and program, each in combination with the key words Internet and web. A total of 19 studies published between 1990 and April 2009 and focusing on dropout from Internet‐based treatment programmes involving minimal therapist contact were identified and included in the review. Results. Dropout ranged from 2 to 83% and a weighted average of 31% of the participants dropped out of treatment. A range of variables have been examined for their association with dropout from Internet‐based treatment programmes for psychological disorders. Despite the numerous variables explored, evidence on any specific variables that may make an individual more likely to drop out of Internet‐based treatment is currently limited. Conclusions. This review highlights the need for more rigorous and theoretically guided research exploring the variables associated with dropping out of Internet‐based treatment for psychological disorders.

McManus, Freda.; Shafran, Roz.; Cooper, Zafra.

doi: 10.1348/014466509X476567pmid: 19878622

Purpose. The purpose of this paper is to review the rationale for ‘transdiagnostic’ approaches to the understanding and treatment of anxiety disorders. Methods. Databases, searches and examination of the reference lists of relevant studies were used to identify papers of relevance. Results. There is increasing recognition that diagnosis‐specific interventions for single anxiety‐disorders are of less value than might appear since a large proportion of patients have more than one coexisting anxiety disorder and the treatment of one anxiety disorder does not necessarily lead to the resolution of others. As transdiagnostic approaches have the potential to address multiple coexisting anxiety disorders they are potentially more clinically relevant than single anxiety disorder interventions. They may also have advantages in ease of dissemination and in treating anxiety disorder not otherwise specified. Conclusions. The merits of the various transdiagnostic cognitive‐behavioural approaches that have been proposed are reviewed. Such approaches have potential benefits, particularly in striking the balance between completely idiosyncratic formulations and diagnosis‐driven treatments of anxiety disorders. However, caution is needed to ensure that transdiagnostic theories and treatments benefit from progress made by research on diagnosis‐specific treatments, and further empirical work is needed to identify the shared maintaining processes that need to be targeted in the treatment of anxiety disorders.

Loosman, W. L.; Siegert, C. E. H.; Korzec, A.; Honig, A.

doi: 10.1348/014466509X477827pmid: 20021730

Objective. To validate the Hospital Anxiety and Depression Scale (HADS) and the Beck Depression Inventory (BDI) for use in patients with end‐stage renal disease (ESRD) and to compare the outcome of both screening measures with each other. Design. Cross‐sectional and between‐subjects design. The independent variable was the diagnosis depression by the Mini International Neuropsychiatric Interview (MINI). The dependent variables were the HADS and BDI total score. Methods. All 130 patients with ESRD who were treated with haemodialysis (HD) or peritoneal dialyses in the Sint Lucas Andreas Hospital in Amsterdam were eligible for this study and were asked to fill out both HADS and BDI. The outcomes of both rating scales were compared with the diagnosis major depressive episode based on the MINI, which was seen as the gold standard. Receiver operating characteristic curves were used to choose optimal cut‐off values. Results. Of 62 enrolled subjects, 21 (34%) were diagnosed with a depressive disorder. Optimal cut‐off values were ≥12 (HADS) and ≥13 (BDI). Sensitivity was 81.0% (HADS) and 75.0% (BDI). Specificity was 90.2% for both. Conclusions. Both HADS and BDI are valid screening instruments for the diagnosis depression in ESRD patients but there is no statistical difference found between both rating scales.

Gholizadeh, Leila.; Salamonson, Yenna.; Davidson, Patricia M.; Parvan, Kobra.; Frost, Steven A.; Chang, Sungwon.; Hare, David L.

doi: 10.1348/014466509X478709pmid: 20346205

Background. The Cardiac Depression Scale (CDS) is a disease‐specific instrument for measuring depression in cardiac patients. This study was designed to validate the CDS in an Iranian population. Methods. Translation and back‐translation of the 26‐item CDS scale was performed using recommended procedures. The Iranian translation of the CDS (I‐CDS) was administered to 261 individuals in Iran, concurrently with the Beck Depression Inventory. The factor structure of the I‐CDS was examined using exploratory factor analysis procedures to enable comparison with previous psychometric evaluation of the CDS. Receiver operating characteristic curves were used to examine the ability of the I‐CDS to discriminate between categories of depression. Results. First‐order exploratory factor analysis uncovered two robust factors, consistent with the second‐order dimensions originally reported by the developers of this instrument. Cronbach's alpha was .88 for the total 26‐item I‐CDS, indicating satisfactory internal consistency of the I‐CDS. Intercorrelation between the total scores for the I‐CDS and BDI was .62 (p<.001). For the I‐CDS cut‐off of 90, the sensitivity was 85%, and specificity was 61% with a computed area under the curve (AUC) of 0.81 (95% CI, 0.76–0.87). For the I‐CDS cut‐off of 100, the sensitivity was 81%, and specificity was 63% with a computed AUC of 0.81 (95% CI, 0.76–0.87). Conclusion. This validation study of the Iranian version of the CDS demonstrated that it is an acceptable, reliable, and valid measure of depression in people with heart disease.

Auerbach, Randy P.; Abela, John R. Z.; Zhu, Xiongzhao.; Yao, Shuqiao.

doi: 10.1348/014466509X479681pmid: 20100400

Objectives. The primary aim examined whether coping deficits, a greater tendency to utilize maladaptive as opposed to adaptive coping strategies, was associated with increases in depressive symptoms following negative events. The secondary goals examined: the common vulnerability hypothesis, sex differences, and the cross‐cultural generalizability. Design. Following the initial assessment, Canadian adolescents completed three follow‐up assessments every 6 weeks. The Chinese adolescents completed an initial assessment and six follow‐up assessments occurring monthly. Methods. At Time 1, 150 Canadian and 397 Chinese adolescents completed self‐report measures assessing depressive symptoms, anxious symptoms, negative events, and coping. During each of the follow‐up assessments, participants completed self‐report measures assessing depressive symptoms, anxious symptoms, and negative events. Results. In both samples, higher levels of coping deficits were associated with increases in depressive, but not anxious, symptoms following negative events. Gender differences did not emerge. Conclusions. The present study provides a theoretically driven model to examine the impact of broad‐based coping on the development of depressive symptoms.