Document Type
Article
Publication Date
2024
DOI
10.2196/56201
Publication Title
Journal of Medical Internet Research
Volume
26
Pages
e56201
Abstract
Background:
The constant rise in the prevalence of major depressive disorder calls for new, effective, and accessible interventions that can rapidly and effectively reach a wide range of audiences. Recent developments in the digital health domain suggest that dedicated online platforms may potentially address this gap. Focusing on targeting ruminative thought, a major symptomatic hallmark of depression, in this study we hypothesized that delivering a digital health-based intervention designed to systematically facilitate thought progression would substantially alleviate depression.
Objective:
The study aims to investigate the efficacy of a novel digital intervention on the reduction of depressive symptoms. This intervention was designed as an easy-to-use gamified app specifically aimed to facilitate thought progression through intense practicing of associative, semantically broad, fast, and creative thought patterns.
Methods:
A randomized clinical trial was conducted, comparing changes in depression symptoms between participants who used the app in the intervention group (n=74) and waitlist control group (n=27) over the course of 8 weeks. All participants filled out a battery of clinical questionnaires to assess the severity of depression at baseline and 4 and 8 weeks after starting the study. These primarily included the Montgomery-Åsberg Depression Rating Scale (MADRS) and the Patient Health Questionnaire-9 as well as the Positive Affect Negative Affect Scale-Negative Affect Score, Ruminative Response Scale, and Symptoms of Depression Questionnaire. Additional questionnaires were implemented to assess anxiety, positive affect, anhedonia, and quality of life.
Results:
The results indicate that across multiple clinical measurements, participants in the intervention group who played the gamified app showed greater and faster improvement in depressive symptoms compared with their waitlist control counterparts. The difference between the groups in MADRS improvement was -7.01 points (95% CI -10.72 to -3.29; P<.001; Cohen d=0.67). Furthermore, the difference in improvement between groups persisted up to 4 weeks posttrial (MADRS differences at week 12: F(49,2)=6.62; P=.003; ηp(2)=0.21). At the end of the trial, participants who played the app showed high interest in continuing using the app.
Conclusions:
The results demonstrate that a gamified app designed to facilitate thought progression is associated with improvement in depressive symptoms. Given its innovative and accessibility features, this gamified method aiming to facilitate thought progression may successfully complement traditional treatments for depression in the future, providing a safe and impactful way to enhance the lives of individuals experiencing depression and anxiety.
Trial Registration:
ClinicalTrials.gov NCT05685758; https://clinicaltrials.gov/study/NCT05685758.
Rights
© Shai-Lee Yatziv, Paola Pedrelli, Shira Baror, Sydney Ann DeCaro, Noam Shachar, Bar Sofer, Sunday Hull, Joshua Curtiss, Moshe Bar. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 07.11.2024.
This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research (ISSN 1438-8871), is properly cited. The complete bibliographic information, a link to the original publication on https://www.jmir.org/, as well as this copyright and license information must be included
Data Availability
Article states: "The datasets generated during and analyzed during this study are available from the corresponding author on reasonable request. The up-to-date app version can be accessed via the MoodBloom app, which is available on the App Store or Google Play Store."
Original Publication Citation
Yatziv, S. L., Pedrelli, P., Baror, S., DeCaro, S. A., Shachar, N., Sofer, B., Hull, S., Curtiss, J., & Bar, M. (2024). Facilitating thought progression to reduce depressive symptoms: Randomized controlled trial. Journal of Medical Internet Research, 26: e56201. https://doi.org/10.2196/56201
ORCID
0000-0002-5023-7634 (Hull)
Repository Citation
Yatziv, Shai-Lee; Pedrelli, Paola; Baror, Shira; DeCaro, Sydney Ann; Shachar, Noam; Sofer, Bar; Hull, Sunday; Curtiss, Joshua; and Bar, Moshe, "Facilitating Thought Progression to Reduce Depressive Symptoms: Randomized Controlled Trial" (2024). Psychology Faculty Publications. 210.
https://digitalcommons.odu.edu/psychology_fac_pubs/210
Multimedia Appendix 1
jmir_v26i1e56201_app2.pdf (1072 kB)
Multimedia Appendix 2