Online tool for depression treatment.

Julia Fedotova3/25/2013

Outline

Depression (Unipolar)• Background• Characteristics• Symptoms• Popular Treatment and Relapse

• The Ultimate Answer tool• Positive psychology• Functionality• Why it could be effective for depression treatment,

prevention and post-treatment maintenance

Depression Statistics

Most com

mon psychiatric

illnessThe W

orld Health Organization predicts that 30%

of the world population will be depressed by 2020Depression is am

ong top health conditions causing disability in m

ost parts of the W

orld# 1 condition that causes work disability in the United States of Am

erica

Depression Symptom

s

SadnessNegative affect (guilt, shame, fear)Low Self-EsteemLoss of interest in life’s pleasuresHopelessness

Not a normal reaction to life events Prolonged Severe Lack of positive emotions Reoccurring (Natural course: 85% within 10-15 years after

initial episode) Not always related to personal circumstances

Etiology

GeneticPersonality Environm

ental Biological/neurochem

ical theory: 'chem

ical imbalance' in the brain

(particularly serotonin and norepinephrine neurotransm

itter im

balance)Cognitive theory: cognitive biases

and negative view of self, the world and the future are activated by stressful life events

Most com

mon

treatments

Antidepressant Medication is

#1 choice in the USAbout half of the patients respondSide effectsHigh-relapse rates when m

edication is stopped

(Most patients relapse within 1 year)

Psychotherapy (EBT suggests a shift from

medication psychotherapy)

Medication/Psychotherapy com

boM

ost Effective short termTherapy just as effective as over long term

Psychotherapy Treatm

ent

Major PsychotherapyCBT (cognitive-behavioral therapy)DYN (Psychodynam

ic therapy)IPT (interpersonal therapy)PST (Problem

-Solving therapy)BA (Behavioral Activation)SST (Social Skill training)SUP (Nondirective Supportive Therapy)

No major differences in outcom

es in com

parative study of all 7 type (Cuijpers, et. al., (2008). 7 m

eta-analyses of 53 studies/2,757 patients)

IPT slightly more effective

SUP slightly less effectiveCBT and IPT are best treatm

ent options ( Em

pirically supported/laboratory settings) (W

esten, et. al, 20004)Require m

aintenance

Relapse-recurrencePost CBT treatm

ent with no continuation therapy

29% within 1 year

54% within 2 years

Comparable to other

psychotherapies, but lower than for pharm

acologyContinuation-phase CBT reduced relapse-recurrence

21% at end of the

continuation treatment

(12% superior to other

psychotherapy treatments)

29% at 1 year follow up

(Vittegal, Clark, Dunn & Jarrett, 2007, m

eta-analysis of 28 world published studies including 1,880 participants )

Based on positive psychology (Seligm

an)Identify resilience factors through research on failure and helplessnessBuild resilience skillsOptim

ism is a key/interpretation of

negative events as:Tem

porary LocalChangeable

PERMA: Building blocks of resilience

Positive emotion

Engagement

RelationshipsM

eaning Accom

plishment

Online tool

Take survey Ponder

Ask or answer questions

Search the database for the solutions

Track results

Make wish list

Keep a journal

1 2 3

4

5

6

Want is important now?

7

#Category 0-10

1Basics  2Health  3Environment  4Family  5Friends  6Community  7Love  8Hobby  9Self-esteem  

10Autonomy  11Work  12Money  13Respect  14Flexibility  15Acceptance  16Presence  17Learning  18Values  19Passion  20Giving  

See your graphs

impotancece(x,y,z)*weight_type(x,y,z)* SUM(importansatisfaction(x,y,z))=

8

Why it can be effective

Similarity to IPT and

other effective treatm

ents.Focuses on present and intends to bring life changesIt helps to identify areas that require the m

ost attentionAllows to pursue strategies specific to the identified problem

areasHelps anticipate interpersonal triggers for depressive sym

ptoms

Journal/Track changes over tim

e and see patternsSelf-reported/Subjective W

ell BeingEm

pirical Evidence for positive psychology interventions

use strength in new way & gratitude online exercises (Seligm

an, 2005).

Why it can be effective

May help to

interpret events as local

20 categoriesM

ay help to interpret events as tem

poraryTracking over tim

e JournalLearning about people experiences through searching for answers

May help to

interpret events as changeable

Tracking over time

JournalLearning about people experiences through searching for answers

Why it can be effective May lead to positive emotion

Realization how well one is doing in all other areas of life Realization may lead to gratitude and the gratitude exercise

showed the largest positive changes in Seligman’s study. Sharing emotions and feelings with others By helping other people who are going through the same issues Writing about experiences and emotions

Journal/questions Wish list

Not alone in their suffering Empathy from people who give advice

Advantages

FreeOnline!Available real-tim

e, any time

Maintenance therapy is not frequent

(every other week, monthly)

Can ask a questions or get support from

others when need it. (compare to by-

monthly)

IPT an CBT are time-lim

itedDon’t have to be diagnosed with depression

Anonymous

Shame

Men are less likely to seek treatm

entNo stigm

a

Advantages

Available to everyone Variety of conditions differ in severity and tim

e courseDSM

-IV categories not empirically

supported and controversial. (Westen, et.

al., 2004). PreventionsAdequate treatm

ent is not available to everyoneTherapist practice what they are trained to do and not necessarily the em

pirically supported types of therapies (W

esten et al.,2004)NO everyone responds to conventional treatm

entInsurance m

ight not be available for m

aintenance treatments

Other treatments m

ight not be affordable

The Message

Ma

rketing campaignM

obile enabled

Future Directions

The Ultimate Answer on-line tool can be an effective solution for depression treatment as well as prevention and post-treatment maintenance.

Q&A

ultimate_answer

TheUltimateAnswer

We would love to hear your feedback!

Thank you!

• What would make you to use on-line tool?• Who would you rather get answers from?

• People who experienced similar issues or moods in the past

• Professional psychologist?• Psychiatrist?• Anyone who is available to share or give an advice?

• Questions

www.TheUltimateAnswer.org

References

Butcher J.N

., Munika, S

., Hooley, J.M

(2009). Abnorm

al P

sychology(14th Ed.).B

oston: Pearson E

ducation, Inc.

Cuijpers, P., van Straten A., Andersson, G., Oppen, P.(2008). Journal of Consulting and Clinical Psychology. Psychotherapy for Depression in Adults: A M

eta-Analysis of Com

parative Outcome Studies. 6 (76), p. 909-

922

Hollon, D., Thase, M.,, M

arkiwitz, J. (2002) Treatm

ent and Prevention of Depression. Psychological Science in the public interest 3(2), p. 42 – 77.

Lyubomirsky, S. (2007). The how

of happiness: A new

approach to getting the life you want.

New York: Penguin Press.

Pennebaker J. W. W

riting About Emotional

Experince. (1997) Psychological Science, 8(3), p. 162-166.

Tan S. (2006). Journal of Psychology and Christianity, Vol. 25(1), p. 68-73. Applied Positive Psychology: Putting Positive Psychology into Practice

Seligman, M

. E. P., Steen, T. A., Park, N., & Peterson, C. (2005). Positive psychology progress: Em

pirical validationof interventions. Am

erican Psychoiogist, 60,410-421.

Vittengl, J., Jarrett, R., Clark, L. (2009). Continuation-Phase Cognitive Therapy’s Effect on Rem

ission and Recovery. Journal of Consulting and Clinical Psychology, 77(2), 367 – 371.

Wada, K., Sasaki, T., Jitsuiki, H

., Yoshimura, Y.,

Erabi, H., H

ada, Y., Yamashita, M

. (2006).M

anic/Hypom

anic Switch D

uring Acute Antidepressant Treatm

ent for Unipolar

Depression Journal of Clinical

Psychopharmacology. 26 (5), 512-515

Westen D., Novotny, C., Thom

pson-Brenner, H. (2004). The Em

pirical Status of Empirically

Supported Psychotherapies: Assumptions,

Findings, and Reporting in Controlled Clinical Trials.