Project description:BackgroundThe introduction of natural language processing (NLP) technologies has significantly enhanced the potential of self-administered interventions for treating anxiety and depression by improving human-computer interactions. Although these advances, particularly in complex models such as generative artificial intelligence (AI), are highly promising, robust evidence validating the effectiveness of the interventions remains sparse.ObjectiveThe aim of this study was to determine whether self-administered interventions based on NLP models can reduce depressive and anxiety symptoms.MethodsWe conducted a systematic review and meta-analysis. We searched Web of Science, Scopus, MEDLINE, PsycINFO, IEEE Xplore, Embase, and Cochrane Library from inception to November 3, 2023. We included studies with participants of any age diagnosed with depression or anxiety through professional consultation or validated psychometric instruments. Interventions had to be self-administered and based on NLP models, with passive or active comparators. Outcomes measured included depressive and anxiety symptom scores. We included randomized controlled trials and quasi-experimental studies but excluded narrative, systematic, and scoping reviews. Data extraction was performed independently by pairs of authors using a predefined form. Meta-analysis was conducted using standardized mean differences (SMDs) and random effects models to account for heterogeneity.ResultsIn all, 21 articles were selected for review, of which 76% (16/21) were included in the meta-analysis for each outcome. Most of the studies (16/21, 76%) were recent (2020-2023), with interventions being mostly AI-based NLP models (11/21, 52%); most (19/21, 90%) delivered some form of therapy (primarily cognitive behavioral therapy: 16/19, 84%). The overall meta-analysis showed that self-administered interventions based on NLP models were significantly more effective in reducing both depressive (SMD 0.819, 95% CI 0.389-1.250; P<.001) and anxiety (SMD 0.272, 95% CI 0.116-0.428; P=.001) symptoms compared to various control conditions. Subgroup analysis indicated that AI-based NLP models were effective in reducing depressive symptoms (SMD 0.821, 95% CI 0.207-1.436; P<.001) compared to pooled control conditions. Rule-based NLP models showed effectiveness in reducing both depressive (SMD 0.854, 95% CI 0.172-1.537; P=.01) and anxiety (SMD 0.347, 95% CI 0.116-0.578; P=.003) symptoms. The meta-regression showed no significant association between participants' mean age and treatment outcomes (all P>.05). Although the findings were positive, the overall certainty of evidence was very low, mainly due to a high risk of bias, heterogeneity, and potential publication bias.ConclusionsOur findings support the effectiveness of self-administered NLP-based interventions in alleviating depressive and anxiety symptoms, highlighting their potential to increase accessibility to, and reduce costs in, mental health care. Although the results were encouraging, the certainty of evidence was low, underscoring the need for further high-quality randomized controlled trials and studies examining implementation and usability. These interventions could become valuable components of public health strategies to address mental health issues.Trial registrationPROSPERO International Prospective Register of Systematic Reviews CRD42023472120; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023472120.
Project description:Fasting interventions have shown effectiveness in alleviating stress, anxiety and depressive symptoms. However, no quantitative analysis has been carried out thus far. The objective was to determine the effectiveness of fasting interventions on stress, anxiety and depression and if these interventions were associated with increased or decreased fatigue/energy. Overall, 11 studies and 1436 participants were included in the quantitative analyses. After limiting analyses to randomized controlled trials with low risk of bias, we found that fasting groups had lower anxiety (b = -0.508, p = 0.038), depression levels (b= -0.281, p = 0.012) and body mass index compared to controls without increased fatigue. There was no publication bias and no heterogeneity for these results. These interventions were safe, even in patients with type 2 diabetes. These results should be taken with a caveat. These results are preliminary and encouraging and fasting appears to be a safe intervention. Data are not sufficient to recommend one fasting intervention more than the others. No study was carried out in psychiatric populations and further trials should be carried out in these populations that may be good candidates for fasting interventions.
Project description:ObjectivesThe COVID-19 pandemic has been associated with a dramatic rise in symptoms of depression and anxiety. Dispositional mindfulness (DM) and self-compassion (SC) have consistently been associated with psychological disorder symptoms and appear to buffer the effects of stress on depression and anxiety.MethodsAcross two studies (n = 888), we examined direct and indirect (moderation) relationships of DM, SC, COVID-19-related stress, and symptoms of depression and anxiety. We also examined the differential effects of several DM measures (FFMQ-15; FFMQ-39; MAAS) in the relationships of COVID-19 stress and psychological disorder symptoms. We recruited participants (Study 1 n = 350; 42.2% cis women; Study 2 n = 538; 44.3% cis women) online (MTurk) and examined associations of DM, SC, and COVID-19 stress, and emotional impact, and the moderating effect of DM and SC in the relationships of COVID-19-related fears, stress, emotional impacts, and psychological disorder symptoms.ResultsDM and SC were moderately and negatively correlated with COVID-19 fears and stress (correlations ranging r = - .14 to r = - .42) across studies. Study 1 moderation analyses demonstrated SC, but not DM (FFMQ-15), significantly moderated relationships of COVID-19 fears and emotional impacts with symptoms. Study 2 analyses demonstrated the FFMQ-39, but not the MAAS, significantly moderated relationships of COVID-19 stress and psychological disorder symptoms.ConclusionsThese results support the potential protective roles of DM and SC in disrupting pathological trajectories related to naturally elevated pandemic stress. Results also demonstrate the differential associations of several DM measures with COVID-19 stress. Future research should replicate such findings with more diverse samples and using various measures of self-compassion and risk metrics.Supplementary informationThe online version contains supplementary material available at 10.1007/s12671-022-02008-0.
Project description:ObjectiveAlthough research on psychological interventions in generalized anxiety disorder (GAD) has provided evidence of their effectiveness regarding self-reported outcomes, few studies have examined their psychophysiological effects. Heart rate is emerging as a potential biomarker of efficacy in anxiety disorders. This study aimed to investigate the effects of a self-compassion intervention versus a mindfulness intervention on physiological arousal in response to induced stress.MethodsForty-seven patients with GAD had heart rate data collected during a stress task before and after a 2-week pharmacological treatment (known as treatment as usual, TAU), a self-compassion intervention + TAU or a mindfulness intervention + TAU. They also reported state anxiety, positive affect, and negative affect at pre- and post- intervention before the stress task. ANOVAs were conducted to analyze the effects on electrocardiogram data self-reported measurements.ResultsSelf-compassion intervention uniquely decreased heart rate response to a stressor whereas mindfulness intervention did not. Both treatments decreased state anxiety and negative affect to a stressor, while increased positive affect in this context. We also demonstrated a significant correlation between decreased heart rate response and less negative emotions.ConclusionThe Findings provides novel physiological evidence that self-compassion interventions buffer stress reactivity in individuals with GAD. Attention shall be paid to the limitations in small and unequal sample size and a non-randomized study design.
Project description:Self-compassion has shown to be beneficial for individuals' wellbeing; in particular, it has been associated with lower levels of depressive symptoms. The purpose of this study was to further explore the association between self-compassion, as measured by the Self-Compassion Scale (SCS), and depressive symptoms, in a large representative sample of community adults (n?=?734, Mean age?=?55.7, SD?=?15.2). We examined the association of depressive symptoms with the SCS total score, the SCS six subscales (i.e., self-kindness, common humanity, mindfulness, self-judgment, isolation, and over-identification), and the SCS positive and negative items (referred to as self-compassion and self-coldness, respectively). In addition, we explored the predictive ability of self-compassion, self-coldness, and the SCS six subscales on depressive symptoms both cross-sectionally and over a 1-year period of time. Finally, we sought to test the moderating role of self-compassion on the association between self-coldness and depressive symptoms. Results showed that the SCS negative items and subscales were more strongly related to depressive symptoms than the SCS positive items and subscales. Accordingly, self-coldness was a stronger predictor of depressive symptoms, cross-sectionally and over a 1-year timeframe, when compared with self-compassion. Particularly, the feeling of being isolated was shown to be strongly associated with depressive symptoms. We did not find substantial evidence for a moderating role of self-compassion on the association between self-coldness and depressive symptoms. Future research needs to determine the added value of assessing self-coldness and whether or not it is an essential part of self-compassion.
Project description:Introduction. Pregnancy is a unique time in a woman's life that can be both exciting and challenging. It is also a period that can be associated with significant stress, anxiety, and depression, which can have negative consequences for both the mother and the baby. Mindfulness interventions are known to be a well-suited treatment and prevention method for psychiatric symptoms in pregnancy, and web-based applications have been explored. We here present an up-to-date systematic review and meta-analysis of randomized-controlled trials to investigate the effect of digital-based mindfulness interventions on depressive, anxiety, and stress symptoms during pregnancy. Methods. The systematic literature search and data extraction was performed by two independent raters. It resulted in 13 eligible studies overall comprising 1373 participants. We conducted random-effects meta-analyses for depressive, anxiety, and stress symptoms after completion of a digital mindfulness intervention (compared to a control group). Results. Digital mindfulness intervention methods were significantly able to reduce depression (g = -0.47, 95% CI [-0.9; -0.09]) and anxiety symptoms (g = -0.41, 95% CI [-0.77; -0.05]), but not stress symptoms. These effects were moderated by the attrition rate (βDepression = 0.025, pDepression < 0.01; βAnxiety = 0.022, pAnxiety < 0.01; βStress = 0.022, pStress < 0.01). Primiparity also had a significant influence on the intervention effect regarding depression symptoms (β = 0.033, p = 0.024). Conclusions. Digital mindfulness interventions are a promising method to reduce mental health symptoms in pregnant women. We identified certain parameters moderating this effect, for example, primiparity and the attrition rate.
Project description:ObjectivesHealth care professionals have elevated rates of burnout and compassion fatigue which are correlated with poorer quality of life and patient care, and inversely correlated with self-compassion. Primary studies have evaluated the extent to which mindfulness-based interventions increase self-compassion with contradictory findings. A meta-analytic review of the literature was conducted to quantitatively synthesize the effects of mindfulness-based interventions on self-compassion among health care professionals.MethodsTwenty-eight treatment outcome studies were identified eligible for inclusion. Five cumulative effect sizes were calculated using random-effects models to evaluate differences of changes in self-compassion for treatment and control groups. Within and between group comparisons were evaluated. Sub-group and moderator analyses were conducted to explore potential moderating variables.ResultsTwenty-seven articles (k = 29, N = 1020) were utilized in the pre-post-treatment meta-analysis. Fifteen samples (52%) included health care professionals and fourteen (48%) professional health care students. Results showed a moderate effect size between pre-post-treatment comparisons (g = .61, 95% CI = .47 to .76) for self-compassion and a strong effect size for pre-treatment to follow-up (g = .76, 95% CI = .41 to 1.12). The effect size comparing post-treatment versus post-control was moderate. One exploratory moderator analysis was significant, with stronger effects for interventions with a retreat component.ConclusionsFindings suggest mindfulness-based interventions improve self-compassion in health care professionals. Additionally, a variety of mindfulness-based programs may be useful for employees and trainees. Future studies with rigorous methodology evaluating effects on self-compassion and patient care from mindfulness-based interventions are warranted to extend findings and explore moderators.
Project description:ObjectivesSelf-compassion-focused interventions may be able to decrease posttraumatic stress symptoms. However, previous studies demonstrated mixed effects in which a series of confounders were not systematically quantified. In this study, a systematic review with meta-analysis was conducted to quantify the effects of self-compassion-focused therapies on posttraumatic stress disorder.MethodsTwelve eligible studies were included after a systematic search of databases. Outcome measures were extracted for posttraumatic stress disorder.ResultsOur data indicated a medium protective effect on posttraumatic stress symptoms (SMD = - 0.65), with most of the studies (8/12) coming from clinical settings. More importantly, longer interventions were associated with better posttraumatic stress outcomes (p < 0.001). Baseline or changes in self-compassion scores were not associated with posttraumatic stress outcomes post-interventions.ConclusionsOverall, findings from this meta-analysis quantified the complex influence of self-compassion-focused interventions on posttraumatic stress symptoms and may provide insights for optimizing intervention strategies.Systematic review and meta-analysis registration prospero crd42020208663Supplementary informationThe online version contains supplementary material available at 10.1007/s12671-021-01732-3.
Project description:Loneliness and depression are significant mental health challenges among college students; however, the intricate relationship between these phenomena remains unclear, particularly in the context of self-compassion. In this comprehensive study, we employ a cross-lagged panel network (CLPN) analysis to investigate the symptom-level association between depression and loneliness while exploring the potential moderating influence of self-compassion. Our sample consisted of 2785 college students, who were categorized into high- and low-self-compassion groups based on scores from the Self-Compassion Scale. Depressive symptoms were assessed using the Patient Health Questionnaire-9, while the UCLA Loneliness Scale-8 measured loneliness expressions. Our findings indicate that self-compassion plays a crucial role in the relationship between depression and loneliness. Specifically, we observed distinctive patterns within the high and low-self-compassion groups. In the low-self-compassion group, "energy" emerged as the most influential symptom, whereas "motor function" exhibited the highest influence in the high-self-compassion group. Furthermore, among individuals with high self-compassion, the pathway from depression to loneliness was characterized by "guilt-being alone when desired," while the reverse path from loneliness to depression encompassed "left out-feeling sad" and "left out-anhedonia." Conversely, in the low-self-compassion group, depression and loneliness demonstrated a more intricate mutual triggering relationship, suggesting that self-compassion effectively moderates the association between these variables. This study provides valuable insights into the underlying mechanisms driving the interplay between depression and loneliness, shedding light on the pivotal role of self-compassion in this intricate dynamic.
Project description:BackgroundResearch suggests that depressive disorders exist on a continuum, with subthreshold symptoms causing considerable population burden and increasing individual risk of developing major depressive disorder. An alternative strategy to professional treatment of subthreshold depression is population promotion of effective self-help interventions that can be easily applied by an individual without professional guidance. The evidence for self-help interventions for depressive symptoms is reviewed in the present work, with the aim of identifying promising interventions that could inform future health promotion campaigns or stimulate further research.MethodsA literature search for randomised controlled trials investigating self-help interventions for depressive disorders or depressive symptoms was performed using PubMed, PsycINFO and the Cochrane Database of Systematic Reviews. Reference lists and citations of included studies were also checked. Studies were grouped into those involving participants with depressive disorders or a high level of depressive symptoms, or non-clinically depressed participants not selected for depression. A number of exclusion criteria were applied, including trials with small sample sizes and where the intervention was adjunctive to antidepressants or psychotherapy.ResultsThe majority of interventions searched had no relevant evidence to review. Of the 38 interventions reviewed, the ones with the best evidence of efficacy in depressive disorders were S-adenosylmethionine, St John's wort, bibliotherapy, computerised interventions, distraction, relaxation training, exercise, pleasant activities, sleep deprivation, and light therapy. A number of other interventions showed promise but had received less research attention. Research in non-clinical samples indicated immediate beneficial effects on depressed mood for distraction, exercise, humour, music, negative air ionisation, and singing; while potential for helpful longer-term effects was found for autogenic training, light therapy, omega 3 fatty acids, pets, and prayer. Many of the trials were poor quality and may not generalize to self-help without professional guidance.ConclusionA number of self-help interventions have promising evidence for reducing subthreshold depressive symptoms. Other forms of evidence such as expert consensus may be more appropriate for interventions that are not feasible to evaluate in randomised controlled trials. There needs to be evaluation of whether promotion to the public of effective self-help strategies for subthreshold depressive symptoms could delay or prevent onset of depressive illness, reduce functional impairment, and prevent progression to other undesirable outcomes such as harmful use of substances.