Predictors and moderators of the response of adults with intellectual disabilities and depression to behavioural activation and guided self‐help therapies.
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| Title: | Predictors and moderators of the response of adults with intellectual disabilities and depression to behavioural activation and guided self‐help therapies. |
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| Authors: | Melville, C. A., Hatton, C., Beer, E., Hastings, R. P., Cooper, S.‐A., McMeekin, N., Dagnan, D., Appleton, K., Scott, K., Fulton, L., Jones, R. S. P., McConnachie, A., Zhang, R., Knight, R., Knowles, D., Williams, C., Briggs, A., Jahoda, A. |
| Source: | Journal of Intellectual Disability Research. Oct2023, Vol. 67 Issue 10, p986-1002. 17p. 5 Charts. |
| Subjects: | Research, Confidence intervals, Behavior therapy, Regression analysis, Treatment effectiveness, Randomized controlled trials, Mathematical variables, Mental depression, Research funding, Descriptive statistics, Intellect, Statistical sampling, Intellectual disabilities, Secondary analysis, Health self-care, Adults |
| Abstract: | Background: No previous studies have reported predictors and moderators of outcome of psychological therapies for depression experienced by adults with intellectual disabilities (IDs). We investigated baseline variables as outcome predictors and moderators based on a randomised controlled trial where behavioural activation was compared with guided self‐help. Methods: This study was an exploratory secondary data analysis of data collected during a randomised clinical trial. Participants (n = 161) were randomised to behavioural activation or guided self‐help and followed up for 12 months. Pre‐treatment variables were included if they have previously been shown to be associated with an increased risk of having depression in adults with IDs or have been reported as a potential predictor or moderator of outcome of treatment for depression with psychological therapies. The primary outcome measure, the Glasgow Depression Scale for Adults with Learning Disabilities (GDS‐LD), was used as the dependant variable in mixed effects regression analyses testing for predictors and moderators of outcome, with baseline GDS‐LD, treatment group, study centre and antidepressant use as fixed effects, and therapist as a random effect. Results: Higher baseline anxiety (mean difference in outcome associated with a 1 point increase in anxiety 0.164, 95% confidence interval [CI] 0.031, 0.297; P = 0.016), lower performance intelligence quotient (IQ) (mean difference in outcome associated with a 1 point increase in IQ 0.145, 95% CI 0.009, 0.280; P = 0.037) and hearing impairment (mean difference 3.449, 95% CI 0.466, 6.432; P = 0.024) were predictors of poorer outcomes, whilst greater severity of depressive symptoms at baseline (mean difference in outcome associated with 1 point increase in depression −0.160, 95% CI −0.806, −0.414; P < 0.001), higher expectation of change (mean difference in outcome associated with a 1 point increase in expectation of change −1.013, 95% CI −1.711, −0.314; p 0.005) and greater percentage of therapy sessions attended (mean difference in outcome with 1 point increase in percentage of sessions attended −0.058, 95% CI −0.099, −0.016; P = 0.007) were predictors of more positive outcomes for treatment after adjusting for randomised group allocation. The final model included severity of depressive and anxiety symptoms, lower WASI performance IQ subscale, hearing impairment, higher expectation of change and percentage of therapy sessions attended and explained 35.3% of the variance in the total GDS‐LD score at 12 months (R2 = 0.353, F4, 128 = 17.24, P < 0.001). There is no evidence that baseline variables had a moderating effect on outcome for treatment with behavioural activation or guided self‐help. Conclusions: Our results suggest that baseline variables may be useful predictors of outcomes of psychological therapies for adults with IDs. Further research is required to examine the value of these potential predictors. However, our findings suggest that therapists consider how baseline variables may enable them to tailor their therapeutic approach when using psychological therapies to treat depression experienced by adults with IDs. [ABSTRACT FROM AUTHOR] |
| Copyright of Journal of Intellectual Disability Research is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Psychology and Behavioral Sciences Collection |
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| Header | DbId: pbh DbLabel: Psychology and Behavioral Sciences Collection An: 172273357 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
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| Items | – Name: Title Label: Title Group: Ti Data: Predictors and moderators of the response of adults with intellectual disabilities and depression to behavioural activation and guided self‐help therapies. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Melville%2C+C%2E+A%2E%22">Melville, C. A.</searchLink><br /><searchLink fieldCode="AR" term="%22Hatton%2C+C%2E%22">Hatton, C.</searchLink><br /><searchLink fieldCode="AR" term="%22Beer%2C+E%2E%22">Beer, E.</searchLink><br /><searchLink fieldCode="AR" term="%22Hastings%2C+R%2E+P%2E%22">Hastings, R. P.</searchLink><br /><searchLink fieldCode="AR" term="%22Cooper%2C+S%2E‐A%2E%22">Cooper, S.‐A.</searchLink><br /><searchLink fieldCode="AR" term="%22McMeekin%2C+N%2E%22">McMeekin, N.</searchLink><br /><searchLink fieldCode="AR" term="%22Dagnan%2C+D%2E%22">Dagnan, D.</searchLink><br /><searchLink fieldCode="AR" term="%22Appleton%2C+K%2E%22">Appleton, K.</searchLink><br /><searchLink fieldCode="AR" term="%22Scott%2C+K%2E%22">Scott, K.</searchLink><br /><searchLink fieldCode="AR" term="%22Fulton%2C+L%2E%22">Fulton, L.</searchLink><br /><searchLink fieldCode="AR" term="%22Jones%2C+R%2E+S%2E+P%2E%22">Jones, R. S. P.</searchLink><br /><searchLink fieldCode="AR" term="%22McConnachie%2C+A%2E%22">McConnachie, A.</searchLink><br /><searchLink fieldCode="AR" term="%22Zhang%2C+R%2E%22">Zhang, R.</searchLink><br /><searchLink fieldCode="AR" term="%22Knight%2C+R%2E%22">Knight, R.</searchLink><br /><searchLink fieldCode="AR" term="%22Knowles%2C+D%2E%22">Knowles, D.</searchLink><br /><searchLink fieldCode="AR" term="%22Williams%2C+C%2E%22">Williams, C.</searchLink><br /><searchLink fieldCode="AR" term="%22Briggs%2C+A%2E%22">Briggs, A.</searchLink><br /><searchLink fieldCode="AR" term="%22Jahoda%2C+A%2E%22">Jahoda, A.</searchLink> – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22Journal+of+Intellectual+Disability+Research%22">Journal of Intellectual Disability Research</searchLink>. Oct2023, Vol. 67 Issue 10, p986-1002. 17p. 5 Charts. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22Research%22">Research</searchLink><br /><searchLink fieldCode="DE" term="%22Confidence+intervals%22">Confidence intervals</searchLink><br /><searchLink fieldCode="DE" term="%22Behavior+therapy%22">Behavior therapy</searchLink><br /><searchLink fieldCode="DE" term="%22Regression+analysis%22">Regression analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Treatment+effectiveness%22">Treatment effectiveness</searchLink><br /><searchLink fieldCode="DE" term="%22Randomized+controlled+trials%22">Randomized controlled trials</searchLink><br /><searchLink fieldCode="DE" term="%22Mathematical+variables%22">Mathematical variables</searchLink><br /><searchLink fieldCode="DE" term="%22Mental+depression%22">Mental depression</searchLink><br /><searchLink fieldCode="DE" term="%22Research+funding%22">Research funding</searchLink><br /><searchLink fieldCode="DE" term="%22Descriptive+statistics%22">Descriptive statistics</searchLink><br /><searchLink fieldCode="DE" term="%22Intellect%22">Intellect</searchLink><br /><searchLink fieldCode="DE" term="%22Statistical+sampling%22">Statistical sampling</searchLink><br /><searchLink fieldCode="DE" term="%22Intellectual+disabilities%22">Intellectual disabilities</searchLink><br /><searchLink fieldCode="DE" term="%22Secondary+analysis%22">Secondary analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Health+self-care%22">Health self-care</searchLink><br /><searchLink fieldCode="DE" term="%22Adults%22">Adults</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Background: No previous studies have reported predictors and moderators of outcome of psychological therapies for depression experienced by adults with intellectual disabilities (IDs). We investigated baseline variables as outcome predictors and moderators based on a randomised controlled trial where behavioural activation was compared with guided self‐help. Methods: This study was an exploratory secondary data analysis of data collected during a randomised clinical trial. Participants (n = 161) were randomised to behavioural activation or guided self‐help and followed up for 12 months. Pre‐treatment variables were included if they have previously been shown to be associated with an increased risk of having depression in adults with IDs or have been reported as a potential predictor or moderator of outcome of treatment for depression with psychological therapies. The primary outcome measure, the Glasgow Depression Scale for Adults with Learning Disabilities (GDS‐LD), was used as the dependant variable in mixed effects regression analyses testing for predictors and moderators of outcome, with baseline GDS‐LD, treatment group, study centre and antidepressant use as fixed effects, and therapist as a random effect. Results: Higher baseline anxiety (mean difference in outcome associated with a 1 point increase in anxiety 0.164, 95% confidence interval [CI] 0.031, 0.297; P = 0.016), lower performance intelligence quotient (IQ) (mean difference in outcome associated with a 1 point increase in IQ 0.145, 95% CI 0.009, 0.280; P = 0.037) and hearing impairment (mean difference 3.449, 95% CI 0.466, 6.432; P = 0.024) were predictors of poorer outcomes, whilst greater severity of depressive symptoms at baseline (mean difference in outcome associated with 1 point increase in depression −0.160, 95% CI −0.806, −0.414; P < 0.001), higher expectation of change (mean difference in outcome associated with a 1 point increase in expectation of change −1.013, 95% CI −1.711, −0.314; p 0.005) and greater percentage of therapy sessions attended (mean difference in outcome with 1 point increase in percentage of sessions attended −0.058, 95% CI −0.099, −0.016; P = 0.007) were predictors of more positive outcomes for treatment after adjusting for randomised group allocation. The final model included severity of depressive and anxiety symptoms, lower WASI performance IQ subscale, hearing impairment, higher expectation of change and percentage of therapy sessions attended and explained 35.3% of the variance in the total GDS‐LD score at 12 months (R2 = 0.353, F4, 128 = 17.24, P < 0.001). There is no evidence that baseline variables had a moderating effect on outcome for treatment with behavioural activation or guided self‐help. Conclusions: Our results suggest that baseline variables may be useful predictors of outcomes of psychological therapies for adults with IDs. Further research is required to examine the value of these potential predictors. However, our findings suggest that therapists consider how baseline variables may enable them to tailor their therapeutic approach when using psychological therapies to treat depression experienced by adults with IDs. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of Journal of Intellectual Disability Research is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1111/jir.13063 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 17 StartPage: 986 Subjects: – SubjectFull: Research Type: general – SubjectFull: Confidence intervals Type: general – SubjectFull: Behavior therapy Type: general – SubjectFull: Regression analysis Type: general – SubjectFull: Treatment effectiveness Type: general – SubjectFull: Randomized controlled trials Type: general – SubjectFull: Mathematical variables Type: general – SubjectFull: Mental depression Type: general – SubjectFull: Research funding Type: general – SubjectFull: Descriptive statistics Type: general – SubjectFull: Intellect Type: general – SubjectFull: Statistical sampling Type: general – SubjectFull: Intellectual disabilities Type: general – SubjectFull: Secondary analysis Type: general – SubjectFull: Health self-care Type: general – SubjectFull: Adults Type: general Titles: – TitleFull: Predictors and moderators of the response of adults with intellectual disabilities and depression to behavioural activation and guided self‐help therapies. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Melville, C. A. – PersonEntity: Name: NameFull: Hatton, C. – PersonEntity: Name: NameFull: Beer, E. – PersonEntity: Name: NameFull: Hastings, R. P. – PersonEntity: Name: NameFull: Cooper, S.‐A. – PersonEntity: Name: NameFull: McMeekin, N. – PersonEntity: Name: NameFull: Dagnan, D. – PersonEntity: Name: NameFull: Appleton, K. – PersonEntity: Name: NameFull: Scott, K. – PersonEntity: Name: NameFull: Fulton, L. – PersonEntity: Name: NameFull: Jones, R. S. P. – PersonEntity: Name: NameFull: McConnachie, A. – PersonEntity: Name: NameFull: Zhang, R. – PersonEntity: Name: NameFull: Knight, R. – PersonEntity: Name: NameFull: Knowles, D. – PersonEntity: Name: NameFull: Williams, C. – PersonEntity: Name: NameFull: Briggs, A. – PersonEntity: Name: NameFull: Jahoda, A. IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 10 Text: Oct2023 Type: published Y: 2023 Identifiers: – Type: issn-print Value: 09642633 Numbering: – Type: volume Value: 67 – Type: issue Value: 10 Titles: – TitleFull: Journal of Intellectual Disability Research Type: main |
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