Mood, Activity Participation, and Leisure Engagement Satisfaction (MAPLES): results from a randomised controlled pilot feasibility trial for low mood in acquired brain injury.
Mood, Activity Participation, and Leisure Engagement Satisfaction (MAPLES): results from a randomised controlled pilot feasibility trial for low mood in acquired brain injury.
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DOI：
10.1186/s12916-023-03128-7
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发表时间：
2023-11-16
期刊：
影响因子：
9.3
通讯作者：
Manly, Tom
中科院分区：
文献类型：
--
作者：
Kusec, Andrea;Murphy, Fionnuala C.;Peers, Polly V.;Bennett, Ron;Carmona, Estela;Korbacz, Aleksandra;Lawrence, Cara;Cameron, Emma;Bateman, Andrew;Watson, Peter;Allanson, Judith;Dutoit, Pieter;Manly, Tom
关键词：
获得性脑损伤（ABI）与抑郁症风险增加有关。ABI中抑郁症的现有疗法（例如，认知行为疗法）具有混合的功效。行为激活（BA），一种鼓励参与积极强化活动的干预措施，显示出希望。主要目的是评估两个8周BA组的可行性、可接受性和潜在疗效。从当地ABI服务机构、慈善机构和通过社交媒体自我推荐招募的成人（≥ 18岁）被随机分配至不同条件。活动计划组（AP;“传统”BA）培训参与者计划8周的强化活动。活动参与组（AE;“体验式”BA）鼓励仅在会议期间参与积极活动。将两个BA组与8周Waitlist组（WL）进行比较。主要结果，可行性和可接受性，通过招聘，保留，出勤率和定性反馈组进行了评估。通过对自我报告的活动水平、抑郁和焦虑（干预前和干预后以及1个月随访时）进行盲态评估，评估次要结局（潜在疗效），并在试验组间进行比较。由于COVID-19，数据是亲自和远程收集的。N = 60例受试者被随机分配至AP（随机分配n = 22;总计n = 29）、AE（随机分配n = 22;总计n = 28）或WL后重新随机分配（总计n = 16）。无论是面对面还是远程，AP和AE都被评为同样令人愉快和有益的。在探索疗效时，58.33%的AP成员有临床意义的活动水平改善，相对于50%的AE和38.5%的WL。AP和AE组的抑郁相对于WL减少，但只有AP参与者表现出相对于AE和WL的焦虑减少。AP参与者注意到学习策略的好处，以增加活动和学习其他小组成员。AE参与者在选择会议活动时重视社会讨论和选择。现场和远程组BA在ABI中是可行和可接受的。虽然传统的和经验的BA可能是有效的，这些可能有不同的机制。Clinicaltrials.gov，NCT 03874650。方案版本2.3，2020年5月26日。在线版本包含补充材料，可通过10.1186/s12916-023-03128-7获得。
Acquired brain injury (ABI) is linked to increased depression risk. Existing therapies for depression in ABI (e.g., cognitive behavioural therapy) have mixed efficacy. Behavioural activation (BA), an intervention that encourages engaging in positively reinforcing activities, shows promise. The primary aims were to assess feasibility, acceptability, and potential efficacy of two 8-week BA groups. Adults (≥ 18 years) recruited from local ABI services, charities, and self-referral via social media were randomised to condition. The Activity Planning group (AP; “traditional” BA) trained participants to plan reinforcing activities over 8 weeks. The Activity Engagement group (AE; “experiential” BA) encouraged engagement in positive activities within session only. Both BA groups were compared to an 8-week Waitlist group (WL). The primary outcomes, feasibility and acceptability, were assessed via recruitment, retention, attendance, and qualitative feedback on groups. The secondary outcome, potential efficacy, was assessed via blinded assessments of self-reported activity levels, depression, and anxiety (at pre- and post-intervention and 1 month follow-up) and were compared across trial arms. Data were collected in-person and remotely due to COVID-19. N = 60 participants were randomised to AP (randomised n = 22; total n = 29), AE (randomised n = 22; total n = 28), or re-randomised following WL (total n = 16). Whether in-person or remote, AP and AE were rated as similarly enjoyable and helpful. In exploring efficacy, 58.33% of AP members had clinically meaningful activity level improvements, relative to 50% AE and 38.5% WL. Both AP and AE groups had depression reductions relative to WL, but only AP participants demonstrated anxiety reductions relative to AE and WL. AP participants noted benefits of learning strategies to increase activities and learning from other group members. AE participants valued social discussion and choice in selecting in-session activities. Both in-person and remote group BA were feasible and acceptable in ABI. Though both traditional and experiential BA may be effective, these may have different mechanisms. Clinicaltrials.gov, NCT03874650. Protocol version 2.3, May 26 2020. The online version contains supplementary material available at 10.1186/s12916-023-03128-7.
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