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

描述（由申请人提供）：有证据表明，在互联网上的自助程序可能是有价值的人与重性抑郁症。然而，在以前的研究中，效果大小通常是适度的。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强调。可以想象的是，针对同质用户群体使用交互式视频的计算机自助程序对重度抑郁症患者尤其有价值。拟议的干预开发/探索性研究（R34）项目旨在解决这一问题，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。拟议的项目是及时的，因为许多（如果不是大多数的话）战斗人员从伊拉克或阿富汗返回与家人一起生活。因此，配偶经常发现自己要处理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复杂化（如果不是沉淀的话）。此外，距离、时间不足、资源不足、认识有限和服务资格不明确可能使配偶难以参加面对面的治疗方案。万维网和/或光盘等技术可帮助满足这些需要。拟议的项目将适应和增强现有的认知行为互联网计算机程序在随机试验中显示，是有效的成人健康维护组织成员与重性抑郁症。该计划将进行调整，重点关注那些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。目前的系统主要是文本系统，将增加相关的视频。更新后的计划将由治疗重度抑郁症的配偶进行审查，然后根据他们的建议进行修改。将在随机设计中针对现有系统对修改后的程序进行测试。结果测量将包括用户满意度，关于重性抑郁症的知识，重性抑郁症的症状和对治疗的态度。拟议的项目将产生计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，退伍军人事务和卫生保健系统的研究人员谁拥有专业知识，在重度抑郁症，互动计算机技术开发和家庭研究。这项研究与公共卫生的相关性是多重的。首先，拟议的项目将改进可能特别有利于军人家庭的技术。其次，研究数据将提供重要信息，说明定制互联网行为健康干预措施以满足同质用户群体的需求的价值。第三，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。

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.