The Mediation Effect of Phobic Anxiety on the Treatment Outcome of Activity and Participation across Age: Comparison between Online and Face-to-Face Rehabilitation Aftercare of an RCT
Abstract
:1. Introduction
1.1. Social Participation
1.2. Phobic Anxiety
1.3. Age Differences
1.4. Research Questions
2. Materials and Methods
2.1. Procedure
2.2. Participants
2.3. Aftercare Interventions
2.4. Measurements
2.5. Dropouts
2.6. Statistical Analysis
3. Results
3.1. Preliminary Analyses
3.2. Mediation Effects
3.3. Moderated Mediation Effects
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Petzold, M.B.; Bendau, A.; Plag, J.; Pyrkosch, L.; Maricic, L.M.; Betzler, F.; Rogoll, J.; Große, J.; Ströhle, A. Risk, resilience, psychological distress, and anxiety at the beginning of the COVID-19 pandemic in Germany. Brain Behav. 2020, 10, e01745. [Google Scholar] [CrossRef] [PubMed]
- Lippke, S.; Wienert, J.; Kuhlmann, T.; Fink, S.; Hambrecht, R. Perceived stress, physical activity and motivation: Findings from an internet study. Ann. Sports Med. Res. 2015, 2, 1012. [Google Scholar]
- Korecka, N.; Rabenstein, R.; Pieh, C.; Stippl, P.; Barke, A.; Doering, B.; Gossmann, K.; Humer, E.; Probst, T. Psychotherapy by telephone or internet in Austria and Germany which CBT psychotherapists rate it more comparable to face-to-face psychotherapy in personal contact and have more positive actual experiences compared to previous expectations? Int. J. Environ. Res. Public Health 2020, 17, 7756. [Google Scholar] [CrossRef] [PubMed]
- Raney, L.; Bergman, D.; Torous, J.; Hasselberg, M. Digitally driven integrated primary care and behavioral health: How technology can expand access to effective treatment. Curr. Psychiatry Rep. 2017, 19, 86. [Google Scholar] [CrossRef]
- Poppe, L.; Plaete, J.; Huys, N.; Verloigne, M.; Deveugele, M.; De Bourdeaudhuij, I.; Crombez, G. Process evaluation of an eHealth intervention implemented into general practice: General practitioners’ and patients’ views. Int. J. Environ. Res. Public Health 2018, 15, 1475. [Google Scholar] [CrossRef] [Green Version]
- Hedman, E.; Andersson, G.; Ljótsson, B.; Andersson, E.; Rück, C.; Mörtberg, E.; Lindefors, N. Internet-based cognitive behavior therapy vs. cognitive behavioral group therapy for social anxiety disorder: A randomized controlled non-inferiority trial. PLoS ONE 2011, 6, e18001. [Google Scholar] [CrossRef]
- Carlbring, P.; Andersson, G.; Cuijpers, P.; Riper, H.; Hedman-Lagerlöf, E. Internet-based vs. face-to-face cognitive behavior therapy for psychiatric and somatic disorders: An updated systematic review and meta-analysis. Cogn. Behav. Ther. 2018, 47, 1–18. [Google Scholar] [CrossRef] [Green Version]
- WHO. The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines; World Health Organization: Geneva, Switzerland, 1992. [Google Scholar]
- Nguyen, H.Q.; Carrieri-Kohlman, V.; Rankin, S.H.; Slaughter, R.; Stulbarg, M.S. Internet-based patient education and support interventions: A review of evaluation studies and directions for future research. Comput. Biol. Med. 2004, 34, 95–112. [Google Scholar] [CrossRef]
- Kannisto, K.A.; Korhonen, J.; Adams, C.E.; Koivunen, M.H.; Vahlberg, T.; Välimäki, M.A. Factors associated with dropout during recruitment and follow-up periods of a mhealth-based randomized controlled trial for mobile.net to encourage treatment adherence for people with serious mental health problems. J. Med. Internet Res. 2017, 19, e46. [Google Scholar] [CrossRef]
- Ströhle, A.; Große, J.; Rogoll, J.; Betzler, F.; Maricic, L.M.; Pyrkosch, L.; Plag, J.; Bendau, A.; Petzold, M.B.; Ho, R.C. Decision letter for “risk, resilience, psychological distress, and anxiety at the beginning of the COVID-19 pandemic in Germany”. J. Med. Internet Res. 2020, 20, e11350. [Google Scholar] [CrossRef]
- Emezue, C.; Bloom, T.L. Protocol: Technology-based and digital interventions for intimate partner violence: A meta-analysis and systematic review. Campbell Syst. Rev. 2021, 17, 1132. [Google Scholar] [CrossRef]
- Krupa, T.; Moll, S.; Fossey, E. Beyond employment: A broader vision linking activity and participation to health, well-being, and recovery. Psychiatr. Serv. 2020, 71, 956–958. [Google Scholar] [CrossRef] [Green Version]
- Levasseur, M.; Richard, L.; Gauvin, L.; Raymond, É. Inventory and analysis of definitions of social participation found in the aging literature: Proposed taxonomy of social activities. Soc. Sci. Med. 2010, 71, 2141–2149. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- World Health Organization. International Classification of Functioning, Disability and Health; American Psychological Association: Washington, DC, USA, 2021. [Google Scholar]
- Muschalla, B.; Linden, M. Workplace phobia, workplace problems, and work ability among primary care patients with chronic mental disorders. J. Am. Board Fam. Med. 2014, 27, 486–494. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Baker, S.; Warburton, J.; Waycott, J.; Batchelor, F.; Hoang, T.; Dow, B.; Ozanne, E.; Vetere, F. Combatting social isolation and increasing social participation of older adults through the use of technology: A systematic review of existing evidence. Australas. J. Ageing 2018, 37, 184–193. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Rabung, S.; Harfst, T.; Kawski, S.; Koch, U.; Wittchen, H.-U.; Schulz, H. Psychometrische überprüfung einer verkürzten version der »hamburger module zur erfassung allgemeiner aspekte psychosozialer gesundheit für die therapeutische praxis« (HEALTH-49). [Psychometric analysis of a short form of the “Hamburg Modules for the Assessment of Psychosocial Health” (HEALTH-49)]. Zeitschrift Psychosomatische Medizin Psychotherapie 2009, 55, 162–179. [Google Scholar] [CrossRef]
- Hesse, B.; Hansen, D.; Finholt, T.; Munson, S.; Kellogg, W.; Thomas, J.C. Social participation in health 2.0. Computer 2010, 43, 45–52. [Google Scholar] [CrossRef]
- Dragioti, E.; Gerdle, B.; Levin, L.-Å.; Bernfort, L.; Dong, H.-J. Association between participation activities, pain severity, and psychological distress in old age: A population-based study of Swedish older adults. Int. J. Environ. Res. Public Health 2021, 18, 2795. [Google Scholar] [CrossRef]
- Lippke, S.; Gao, L.; Keller, F.M.; Becker, P.; Dahmen, A. Adherence with online therapy vs. face-to-face therapy and online therapy vs. care as usual: Secondary analysis of two randomized controlled trials. J. Med. Internet Res. 2021. accepted. [Google Scholar]
- Grammatikopoulos, I.; Koutentakis, C. Social activity and participation as determinants of anxiety and depression among elderly in primary care. Ann. Gen. Psychiatry 2010, 9, S137. [Google Scholar] [CrossRef] [Green Version]
- Wardenaar, K.; Lim, C.; Al-Hamzawi, A.; Alonso, J. The cross-national epidemiology of specific phobia in the world mental health surveys—CORRIGENDUM. Psychol. Med. 2017, 48, 878. [Google Scholar] [CrossRef] [Green Version]
- Spitzer, R.L.; Endicott, J.; Robins, E. Clinical criteria for psychiatric diagnosis and DSM-III. Am. J. Psychiatry 1975, 132, 1187–1192. [Google Scholar] [CrossRef]
- Regier, D.A.; Kuhl, E.A.; Kupfer, D.J. The DSM-5: Classification and criteria changes. World Psychiatry 2013, 12, 92–98. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Kendler, K.S.; Aggen, S.H.; Werner, M.; Fried, E.I. A topography of 21 phobic fears: Network analysis in an epidemiological sample of adult twins. Psychol. Med. 2020, 1–8. [Google Scholar] [CrossRef]
- Lieb, R.; Miché, M.; Gloster, A.T.; Beesdo-Baum, K.; Meyer, A.H.; Wittchen, H.-U. Impact of specific phobia on the risk of onset of mental disorders: A 10-year prospective-longitudinal community study of adolescents and young adults. Depress. Anxiety 2016, 33, 667–675. [Google Scholar] [CrossRef] [PubMed]
- Mansell, W. Coping with Fears and Phobias: A CBT Guide to Understanding and Facing Your Anxieties; Simon and Schuster: Manhattan, NY, USA, 2007. [Google Scholar]
- Craske, M.G.; Niles, A.N.; Burklund, L.J.; Wolitzky-Taylor, K.B.; Vilardaga, J.C.P.; Arch, J.J.; Saxbe, D.E.; Lieberman, M.D. Randomized controlled trial of cognitive behavioral therapy and acceptance and commitment therapy for social phobia: Outcomes and moderators. J. Consult. Clin. Psychol. 2014, 82, 1034–1048. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Wright, B.D.; Cooper, C.; Scott, A.J.; Tindall, L.; Ali, S.; Bee, P.; Biggs, K.; Breckman, T.; Iii, T.E.D.; Gega, L.; et al. Clinical and cost-effectiveness of one-session treatment (OST) versus multisession cognitive-behavioural therapy (CBT) for specific phobias in children: Protocol for a non-inferiority randomised controlled trial. BMJ Open 2018, 8, e025031. [Google Scholar] [CrossRef]
- Hatemi, P.K.; McDermott, R.; Eaves, L.J.; Kendler, K.S.; Neale, M.C. Fear as a disposition and an emotional state: A genetic and environmental approach to out-group political preferences. Am. J. Political Sci. 2013, 57, 279–293. [Google Scholar] [CrossRef]
- Titov, N.; Andrews, G.; Choi, I.; Schwencke, G.; Mahoney, A. Shyness 3: Randomized controlled trial of guided versus unguided internet-based cbt for social phobia. Aust. N. Z. J. Psychiatry 2008, 42, 1030–1040. [Google Scholar] [CrossRef]
- Campos, D.; Mira, A.; Bretón-López, J.; Castilla, D.; Botella, C.; Baños, R.M.; Quero, S. The acceptability of an internet-based exposure treatment for flying phobia with and without therapist guidance: Patients’ expectations, satisfaction, treatment preferences, and usability. Neuropsychiatr. Dis. Treat. 2018, 14, 879–892. [Google Scholar] [CrossRef] [Green Version]
- Nieminen, K.; Andersson, G.; Wijma, B.; Ryding, E.-L.; Wijma, K. Treatment of nulliparous women with severe fear of childbirth via the Internet: A feasibility study. J. Psychosom. Obstet. Gynecol. 2016, 37, 37–43. [Google Scholar] [CrossRef] [Green Version]
- Rogers, M.A.; Lemmen, K.; Kramer, R.; Mann, J.; Chopra, V. Internet-delivered health interventions that work: Systematic review of meta-analyses and evaluation of website availability. J. Med. Internet Res. 2017, 19, e90. [Google Scholar] [CrossRef]
- Kok, R.N.; Beekman, A.T.; Cuijpers, P.; van Straten, A. Adherence to a web-based pre-treatment for phobias in outpatient clinics. Internet Interv. 2017, 9, 38–45. [Google Scholar] [CrossRef]
- Andersson, G.; Carlbring, P.; Grimlund, A. Predicting treatment outcome in internet versus face to face treatment of panic disorder. Comput. Hum. Behav. 2008, 24, 1790–1801. [Google Scholar] [CrossRef]
- Borghouts, J.; Eikey, E.; Mark, G.; De Leon, C.; Schueller, S.M.; Schneider, M.; Stadnick, N.; Zheng, K.; Mukamel, D.; Sorkin, D.H. Barriers to and facilitators of user engagement with digital mental health interventions: Systematic review. J. Med. Internet Res. 2021, 23, e24387. [Google Scholar] [CrossRef]
- Cooper, C.; Bebbington, P.; McManus, S.; Meltzer, H.; Stewart, R.; Farrell, M.; King, M.; Jenkins, R.; Livingston, G. The treatment of common mental disorders across age groups: Results from the 2007 adult psychiatric morbidity survey. J. Affect. Disord. 2010, 127, 96–101. [Google Scholar] [CrossRef]
- Choi, N.G.; DiNitto, D.M. The digital divide among low-income homebound older adults: Internet use patterns, eHealth literacy, and attitudes toward computer/internet use. J. Med. Internet Res. 2013, 15, e93. [Google Scholar] [CrossRef] [PubMed]
- Guay, C.; Auger, C.; Demers, L.; Ben Mortenson, W.; Miller, W.C.; Gélinas-Bronsard, D.; Ahmed, S. Components and outcomes of internet-based interventions for caregivers of older adults: Systematic review. J. Med. Internet Res. 2017, 19, e313. [Google Scholar] [CrossRef]
- Kofmehl, J.J. Online Versus in-Person Therapy: Effect of Client Demographics and Personality Characteristics. Ph.D. Thesis, Walden University, Minneapolis, MN, USA, 2017. [Google Scholar]
- Deutsche Rentenversicherung. Framework Concept for After-Care for Medical Rehabilitation According to §15 SGB VI (Last Version Dated 1 July 2019). June 2015. Available online: https://www.deutsche-rentenversicherung.de/DRV/DE/Experten/Infos-fuer-Reha-Einrichtungen/Grundlagen-und-Anforderungen/Konzepte-und-Positionspapiere/konzepte_positionspapiere.html (accessed on 1 June 2021).
- Kobelt, A.; Grosch, E. Indikation zur ambulanten Nachsorge (Curriculum Hannover) in der Psychosomatischen Rehabilitation. [Indication for outpatient aftercare (Curriculum Hannover) in psychosomatic rehabilitation]. Psychotherapeut 2005, 50, 340–346. [Google Scholar] [CrossRef]
- Dahmen, A.; Gao, L.; Keller, F.M.; Lehr, D.; Becker, P.; Lippke, S. Wirksamkeit webbasierter psychotherapeutische Nachsorge nach psychosomatischer Rehabilitation—Ein Test in zwei Randomized Controlled Trials [Efficacy of web-based psychotherapeutic follow-up after psychosomatic rehabilitation—A test in two Randomized Controlled Trials]. Die Rehabilitation 2021. accepted. [Google Scholar]
- Van Buuren, S.; Groothuis-Oudshoorn, K. Mice: Multivariate imputation by chained equations in R. J. Stat. Softw. 2011, 45, 1–67. [Google Scholar] [CrossRef] [Green Version]
- Jakobsen, J.C.; Gluud, C.; Wetterslev, J.; Winkel, P. When and how should multiple imputation be used for handling missing data in randomised clinical trials—A practical guide with flowcharts. BMC Med. Res. Methodol. 2017, 17, 1–10. [Google Scholar] [CrossRef] [Green Version]
- Gaffert, P.; Meinfelder, F.; Bosch, V. Towards an MI-Proper Predictive Mean Matching. Available online: https://www.uni-bamberg.de/fileadmin/uni/fakultaeten/sowi_lehrstuehle/statistik/Personen/Dateien_Florian/properPMM.pdf (accessed on 22 September 2020).
- Rosseel, Y.; Oberski, D.; Byrnes, J.; Vanbrabant, L.; Savalei, V.; Merkle, E.; Hallquist, M.; Rhemtulla, M.; Katsikatsou, M.; Barendse, M. Package ‘lavaan’. Available online: https://cran.r-project.org/web/packages/lavaan/index.html (accessed on 28 September 2020).
- Sigström, R.; Östling, S.; Karlsson, B.; Waern, M.; Gustafson, D.; Skoog, I. A population-based study on phobic fears and DSM-IV specific phobia in 70-year olds. J. Anxiety Disord. 2011, 25, 148–153. [Google Scholar] [CrossRef]
- Paige, S.R.; Miller, M.D.; Krieger, J.L.; Stellefson, M.; Cheong, J. Electronic health literacy across the lifespan: Measurement invariance study. J. Med. Internet Res. 2018, 20, e10434. [Google Scholar] [CrossRef]
- Axelsson, E.; Andersson, E.; Ljótsson, B.; Björkander, D.; Hedman-Lagerlöf, M.; Hedman-Lagerlöf, E. Effect of internet vs. face-to-face cognitive behavior therapy for health anxiety: A randomized noninferiority clinical trial. JAMA Psychiatry 2020, 77, 915–924. [Google Scholar] [CrossRef] [PubMed]
- Salawu, A.; Green, A.; Crooks, M.G.; Brixey, N.; Ross, D.H.; Sivan, M. A Proposal for multidisciplinary tele-rehabilitation in the assessment and rehabilitation of COVID-19 survivors. Int. J. Environ. Res. Public Health 2020, 17, 4890. [Google Scholar] [CrossRef] [PubMed]
- Magnezi, R.; Bergman, Y.S.; Grosberg, D. Online activity and participation in treatment affects the perceived efficacy of social health networks among patients with chronic illness. J. Med. Internet Res. 2014, 16, e12. [Google Scholar] [CrossRef] [PubMed]
- Fonseca, A.; Osma, J. Using information and communication technologies (ICT) for mental health prevention and treatment. Int. J. Environ. Res. Public Health 2021, 18, 461. [Google Scholar] [CrossRef] [PubMed]
- Solomou, I.; Constantinidou, F. Prevalence and predictors of anxiety and depression symptoms during the COVID-19 pandemic and compliance with precautionary measures: Age and sex matter. Int. J. Environ. Res. Public Health 2020, 17, 4924. [Google Scholar] [CrossRef]
Variables | Face-to-Face Treatment | Online Treatment | Range | t | p | Cohen’s d | ||
n | M (SD) | n | M (SD) | |||||
Age (years) | 68 | 51.10 (9.72) | 74 | 50.70 (8.93) | 27–67 | 0.26 | 0.798 | 0.04 |
G1 (years, n = 50) | 22 | 39.10 (6.65) | 28 | 41.32 (5.80) | 27–49 | −1.27 | 0.212 | 0.36 |
G2 (years, n = 45) | 21 | 53.29 (2.24) | 24 | 52.67 (2.06) | 50–56 | 0.97 | 0.339 | 0.29 |
G3 (years, n = 47) | 25 | 59.84 (2.19) | 22 | 60.50 (2.60) | 57–67 | −0.95 | 0.350 | 0.28 |
Phobic anxiety T1 | 68 | 1.56 (0.63) | 74 | 1.87 (1.01) | 1–5 | −2.16 | 0.032 | 0.36 |
Activity and participation T1 | 68 | 2.85 (0.89) | 74 | 3.08 (0.96) | 1–5 | −1.49 | 0.138 | 0.25 |
Variables | Face-to-Face Treatment | Online Treatment | χ2 | p | Cohen’s h | |||
n | % | n | % | |||||
Gender | 1.18 | 0.277 | 0.18 | |||||
Women | 39 | 57.4% | 49 | 66.2% | ||||
Men | 29 | 42.6% | 25 | 33.8% | ||||
Marital status | 3.27 | 0.071 | 0.30 | |||||
Married | 36 | 52.9% | 28 | 37.8% | ||||
Unmarried | 32 | 47.1% | 46 | 62.2% | ||||
Employment status | 1.15 | 0.285 | 0.18 | |||||
Employed | 49 | 72.1% | 59 | 79.7% | ||||
Unemployed | 19 | 27.9% | 15 | 20.3% | ||||
Education level | 0.133 | 0.715 | 0.06 | |||||
Elementary school | 37 | 54.4% | 38 | 51.4% | ||||
Higher school and above | 31 | 45.6% | 36 | 48.6% |
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Gao, L.; Dahmen, A.; Keller, F.M.; Becker, P.; Lippke, S. The Mediation Effect of Phobic Anxiety on the Treatment Outcome of Activity and Participation across Age: Comparison between Online and Face-to-Face Rehabilitation Aftercare of an RCT. Int. J. Environ. Res. Public Health 2021, 18, 10919. https://doi.org/10.3390/ijerph182010919
Gao L, Dahmen A, Keller FM, Becker P, Lippke S. The Mediation Effect of Phobic Anxiety on the Treatment Outcome of Activity and Participation across Age: Comparison between Online and Face-to-Face Rehabilitation Aftercare of an RCT. International Journal of Environmental Research and Public Health. 2021; 18(20):10919. https://doi.org/10.3390/ijerph182010919
Chicago/Turabian StyleGao, Lingling, Alina Dahmen, Franziska Maria Keller, Petra Becker, and Sonia Lippke. 2021. "The Mediation Effect of Phobic Anxiety on the Treatment Outcome of Activity and Participation across Age: Comparison between Online and Face-to-Face Rehabilitation Aftercare of an RCT" International Journal of Environmental Research and Public Health 18, no. 20: 10919. https://doi.org/10.3390/ijerph182010919