Does outcome expectancy predict outcomes in online depression prevention? Secondary analysis of randomised-controlled trials

Research output: Journal contributionsJournal articlesResearchpeer-review

Authors

  • Janika Thielecke
  • Paula Kuper
  • David Ebert
  • Pim Cuijpers
  • Filip Smit
  • Heleen Riper
  • Dirk Lehr
  • Claudia Buntrock

Background: Evidence shows that online interventions could prevent depression. However, to improve the effectiveness of preventive online interventions in individuals with subthreshold depression, it is worthwhile to study factors influencing intervention outcomes. Outcome expectancy has been shown to predict treatment outcomes in psychotherapy for depression. However, little is known about whether this also applies to depression prevention. The aim of this study was to investigate the role of participants' outcome expectancy in an online depression prevention intervention. Methods: A secondary data analysis was conducted using data from two randomised-controlled trials (N = 304). Multilevel modelling was used to explore the effect of outcome expectancy on depressive symptoms and close-to-symptom-free status postintervention (6–7 weeks) and at follow-up (3–6 months). In a subsample (n = 102), Cox regression was applied to assess the effect on depression onset within 12 months. Explorative analyses included baseline characteristics as possible moderators. Outcome expectancy did not predict posttreatment outcomes or the onset of depression. Results: Small effects were observed at follow-up for depressive symptoms (β = −.39, 95% confidence interval [CI]: [−0.75, −0.03], p =.032, padjusted =.130) and close-to-symptom-free status (relative risk = 1.06, 95% CI: [1.01, 1.11], p =.013, padjusted = 0.064), but statistical significance was not maintained when controlling for multiple testing. Moderator analyses indicated that expectancy could be more influential for females and individuals with higher initial symptom severity. Conclusion: More thoroughly designed, predictive studies targeting outcome expectancy are necessary to assess the full impact of the construct for effective depression prevention. Patient or Public Contribution: This secondary analysis did not involve patients, service users, care-givers, people with lived experience or members of the public. However, the findings incorporate the expectations of participants using the preventive online intervention, and these exploratory findings may inform the future involvement of participants in the design of indicated depression prevention interventions for adults. Clinical Trial Registration: Original studies: DRKS00004709, DRKS00005973; secondary analysis: osf.io/9xj6a.

Original languageEnglish
Article numbere13951
JournalHealth Expectations
Volume27
Issue number1
ISSN1369-6513
DOIs
Publication statusPublished - 02.2024

Bibliographical note

Funding Information:
The authors would like to thank Avery Veldhouse for proofreading the manuscript. Funding for the original studies was received from the European Union (project number: EFRE: CCI 2007DE161PR001) and the BARMER GEK (German statutory health insurance company). The funders did not have a role in study design, data collection, analysis the interpretation of results or the decision to publish the study results. This secondary analysis did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors. Open Access funding enabled and organized by Projekt DEAL.

Funding Information:
The authors would like to thank Avery Veldhouse for proofreading the manuscript. Funding for the original studies was received from the European Union (project number: EFRE: CCI 2007DE161PR001) and the BARMER GEK (German statutory health insurance company). The funders did not have a role in study design, data collection, analysis the interpretation of results or the decision to publish the study results. This secondary analysis did not receive any specific grant from funding agencies in the public, commercial or not‐for‐profit sectors. Open Access funding enabled and organized by Projekt DEAL.

Publisher Copyright:
© 2023 The Authors. Health Expectations published by John Wiley & Sons Ltd.

    Research areas

  • CBT, depression, expectancy, online intervention, prediction, prevention, secondary analyses
  • Psychology

DOI