Internet Self-Help Program for Major Depressive Disorder in Spouses of Combatants

战斗人员配偶重度抑郁症互联网自助计划

• 批准号: 7496018
• 负责人: BENTSON H MCFARLAND
• 金额: $ 18.85万
• 依托单位: OREGON HEALTH & SCIENCE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-13 至 2010-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7496018
• 关键词: Address; Adult; Affect; Afghanistan; Attitude; Awareness; Behavior Therapy; Behavioral; Caring; Climacteric; Cognitive; Condition; Confidentiality; Contractor; Data; Department of Defense; Depressed mood; Development; Eligibility Determination; Event; Evidence based practice; Exposure to; Face; Family; Family Study; Family member; Federal Government; Feedback; Funding Opportunities; Generic Drugs; Hand; Health Maintenance Organizations; Healthcare Systems; Individual; Informed Consent; Internet; Intervention; Iraq; Knowledge; Life; Major Depressive Disorder; Measures; Mental Health Services; Military Personnel; Nature; Online Systems; Outcome Measure; Participant; Pilot Projects; Population; Private Sector; Public Health; Randomized; Randomized Clinical Trials; Randomized Controlled Clinical Trials; Recruitment Activity; Research; Research Personnel; Research Project Grants; Resources; Safety; Services; Spouses; Stigmata; Suggestion; Symptoms; System; Technology; Testing; Time; Update; Upper arm; Veterans; War; Work; Writing; base; behavioral health; computer program; computer technology development; computerized; depressive symptoms; design; emotional distress; experience; interest; member; programs; satisfaction; self help; size; social stigma; therapy development; treatment program

DESCRIPTION (provided by applicant): There is evidence to suggest that self-help programs on the Internet may be of value for people with major depressive disorder. However, effect sizes in previous research have usually been modest. Limitations of earlier work include the general nature of the interventions and emphasis on written materials. It is conceivable that computerized self-help programs employing interactive videos aimed at a homogeneous user population could be especially valuable for individuals with major depressive disorder. The proposed Intervention Development / Exploratory Research (R34) project is designed to address this issue by tailoring for spouses of combat veterans a previously developed Internet intervention aimed at people with major depressive disorder. The proposed project is timely because many if not most combatants return from Iraq or Afghanistan to live with their families. Therefore, spouses not infrequently find themselves dealing with consequences of the family members' exposure to combat. Spouses with major depressive disorder constitute a relatively homogeneous group whose emotional distress is complicated by (if not precipitated by) the combatant's war zone experiences. Moreover, distance, lack of time, inadequate resources, limited awareness, and unclear eligibility for services may make it difficult for spouses to participate in face to face treatment programs. Technologies such as the World Wide Web and-or CD-ROMs could help address these needs. The proposed project will adapt and augment an existing cognitive-behavioral Internet computer program shown in randomized trials to be efficacious for adult health maintenance organization members with major depressive disorder. The program will be adapted to focus on issues that are of key importance to depressed spouses of combatants who have served in Iraq or Afghanistan. The current, chiefly textual, system will be augmented with pertinent videos. The updated program will be reviewed by spouses in treatment for major depressive disorder and then modified based on their suggestions. The modified program will be tested against the existing system in a randomized design. Outcome measures will include user satisfaction, knowledge about major depressive disorder, symptoms of major depressive disorder, and attitudes toward treatment. The proposed project will generate data needed to plan a large-scale randomized clinical trial. The project unites academic, military, Veterans Affairs, and health care system researchers who have expertise in major depressive disorder, inter-active computer technology development, and family studies. The relevance of the research to public health is several-fold. First, the proposed project will refine technology that may especially benefit military service members' families. Second, data from the study will provide important information about the value of tailoring Internet behavioral health interventions to meet the needs of homogeneous user groups. Third, the research will examine ways to increase the assistance provided to people with major depressive disorder via computerized self-help systems.

描述（由申请人提供）：有证据表明互联网上的自助计划可能对重度抑郁症患者有价值。然而，先前研究中的效应大小通常不大。早期工作的局限性包括干预措施的一般性质和对书面材料的重视。可以想象，针对同质用户群体的采用交互式视频的计算机化自助程序对于患有重度抑郁症的个人来说可能特别有价值。拟议的干预开发/探索性研究（R34）项目旨在通过为退伍军人的配偶量身定制先前开发的针对重度抑郁症患者的互联网干预措施来解决这一问题。拟议的项目是及时的，因为许多（如果不是大多数）战斗人员从伊拉克或阿富汗返回与家人住在一起。因此，配偶经常发现自己要面对家庭成员遭受战斗的后果。患有重度抑郁症的配偶构成了一个相对同质的群体，其情绪困扰因战斗人员的战区经历而变得复杂（如果不是加剧的话）。此外，距离、时间不足、资源不足、意识有限以及服务资格不明确可能使配偶难以参与面对面的治疗计划。万维网和/或 CD-ROM 等技术可以帮助满足这些需求。拟议的项目将调整和增强现有的认知行为互联网计算机程序，随机试验显示该程序对患有重度抑郁症的成人健康维护组织成员有效。该计划将进行调整，重点关注对曾在伊拉克或阿富汗服役的战斗人员的抑郁配偶至关重要的问题。当前主要是文本系统将通过相关视频进行增强。更新后的计划将由正在接受重度抑郁症治疗的配偶进行审查，然后根据他们的建议进行修改。修改后的程序将在随机设计中针对现有系统进行测试。结果指标将包括用户满意度、对重度抑郁症的了解、重度抑郁症的症状以及对治疗的态度。拟议的项目将生成规划大规模随机临床试验所需的数据。该项目联合了学术、军事、退伍军人事务和医疗保健系统研究人员，他们在重度抑郁症、交互式计算机技术开发和家庭研究方面拥有专业知识。该研究与公共卫生的相关性是多方面的。首先，拟议的项目将完善技术，特别有利于军人家庭。其次，该研究的数据将提供有关定制互联网行为健康干预措施以满足同质用户群体需求的价值的重要信息。第三，该研究将探讨如何通过计算机自助系统增加对重度抑郁症患者的援助。