TY  - JOUR
AU  - Santopetro, Nicholas
AU  - Jones, Danielle
AU  - Garron, Andrew
AU  - Meyer, Alexandria
AU  - Joyner, Keanan
AU  - Hajcak, Greg
PY  - 2024
DA  - 2024/8/30
TI  - Examining a Fully Automated Mobile-Based Behavioral Activation Intervention in Depression: Randomized Controlled Trial
JO  - JMIR Ment Health
SP  - e54252
VL  - 11
KW  - digital intervention
KW  - digital health
KW  - digital application
KW  - digital applications
KW  - mobile health
KW  - mHealth
KW  - automation
KW  - automate
KW  - automated
KW  - behavioral activation
KW  - BA
KW  - BA intervention
KW  - depression
KW  - depressed
KW  - depressive
KW  - depressive symptoms
KW  - anhedonia
KW  - anhedonia symptoms
KW  - anxiety
KW  - anxious
KW  - anxiety symptoms
KW  - adults
KW  - adult
KW  - psychiatry
KW  - psych
KW  - psychology
KW  - major depressive disorder
KW  - MDD
AB  - Background: Despite significant progress in our understanding of depression, prevalence rates have substantially increased in recent years. Thus, there is an imperative need for more cost-effective and scalable mental health treatment options, including digital interventions that minimize therapist burden. Objective: This study focuses on a fully automated digital implementation of behavioral activation (BA)—a core behavioral component of cognitive behavioral therapy for depression. We examine the efficacy of a 1-month fully automated SMS text message–based BA intervention for reducing depressive symptoms and anhedonia. Methods: To this end, adults reporting at least moderate current depressive symptoms (8-item Patient Health Questionnaire score ≥10) were recruited online across the United States and randomized to one of three conditions: enjoyable activities (ie, BA), healthy activities (ie, an active control condition), and passive control (ie, no contact). Participants randomized to enjoyable and healthy activities received daily SMS text messages prompting them to complete 2 activities per day; participants also provided a daily report on the number and enjoyment of activities completed the prior day. Results: A total of 126 adults (mean age 32.46, SD 7.41 years) with current moderate depressive symptoms (mean score 16.53, SD 3.90) were recruited. Participants in the enjoyable activities condition (BA; n=39) experienced significantly greater reductions in depressive symptoms compared to participants in the passive condition (n=46). Participants in both active conditions—enjoyable activities and healthy activities (n=41)—reported reduced symptoms of anxiety compared to those in the control condition. Conclusions: These findings provide preliminary evidence regarding the efficacy of a fully automated digital BA intervention for depression and anxiety symptoms. Moreover, reminders to complete healthy activities may be a promising intervention for reducing anxiety symptoms. Trial Registration: ClincalTrials.gov NCT06492824; https://clinicaltrials.gov/study/NCT06492824 
SN  - 2368-7959
UR  - https://mental.jmir.org/2024/1/e54252
UR  - https://doi.org/10.2196/54252
DO  - 10.2196/54252
ID  - info:doi/10.2196/54252
ER  -