Identifying change-dropout patterns during an Internet-based intervention for depression by applying the Muthen-Roy model
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Identifying change-dropout patterns during an Internet-based intervention for depression by applying the Muthen-Roy model. / Arndt, Alice; Lutz, Wolfgang; Rubel, Julian; Berger, Thomas; Meyer, Björn; Schröder, Johanna; Späth, Christina; Hautzinger, Martin; Fuhr, Kristina; Rose, Matthias; Hohagen, Fritz; Klein, Jan Philipp; Moritz, Steffen.
in: COGN BEHAV THERAPY, Jahrgang 49, Nr. 1, 01.2020, S. 22-40.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Identifying change-dropout patterns during an Internet-based intervention for depression by applying the Muthen-Roy model
AU - Arndt, Alice
AU - Lutz, Wolfgang
AU - Rubel, Julian
AU - Berger, Thomas
AU - Meyer, Björn
AU - Schröder, Johanna
AU - Späth, Christina
AU - Hautzinger, Martin
AU - Fuhr, Kristina
AU - Rose, Matthias
AU - Hohagen, Fritz
AU - Klein, Jan Philipp
AU - Moritz, Steffen
PY - 2020/1
Y1 - 2020/1
N2 - To date, only few studies have attempted to investigate non-ignorable dropout during Internet-based interventions by applying an NMAR model, which includes missing data indicators in its equations. Here, the Muthen-Roy model was used to investigate change and dropout patterns in a sample of patients with mild-to-moderate depression symptoms (N = 483) who were randomized to a 12-week Internet-based intervention (deprexis, identifier: NCT01636752). Participants completed the PHQ-9 biweekly during the treatment. We identified four change-dropout patterns: Participants showing high impairment, improvement and low dropout probability (C3, N = 134) had the highest rate of reliable change at 6- and 12-month follow-up. A further pattern was characterized by high impairment, deterioration and high dropout probability (C2, N = 32), another by low impairment, improvement and high dropout probability (C1, N = 198). The last pattern was characterized by high impairment, no change and low dropout probability (C4, N = 119). In addition to deterioration, also rapid improvement may lead to dropout as a result of a perceived "good enough" dosage of treatment. This knowledge may strengthen sensitivity for the mechanisms of dropout and help to consider its meaning in efforts to optimize treatment selection.
AB - To date, only few studies have attempted to investigate non-ignorable dropout during Internet-based interventions by applying an NMAR model, which includes missing data indicators in its equations. Here, the Muthen-Roy model was used to investigate change and dropout patterns in a sample of patients with mild-to-moderate depression symptoms (N = 483) who were randomized to a 12-week Internet-based intervention (deprexis, identifier: NCT01636752). Participants completed the PHQ-9 biweekly during the treatment. We identified four change-dropout patterns: Participants showing high impairment, improvement and low dropout probability (C3, N = 134) had the highest rate of reliable change at 6- and 12-month follow-up. A further pattern was characterized by high impairment, deterioration and high dropout probability (C2, N = 32), another by low impairment, improvement and high dropout probability (C1, N = 198). The last pattern was characterized by high impairment, no change and low dropout probability (C4, N = 119). In addition to deterioration, also rapid improvement may lead to dropout as a result of a perceived "good enough" dosage of treatment. This knowledge may strengthen sensitivity for the mechanisms of dropout and help to consider its meaning in efforts to optimize treatment selection.
U2 - 10.1080/16506073.2018.1556331
DO - 10.1080/16506073.2018.1556331
M3 - SCORING: Journal article
C2 - 30721109
VL - 49
SP - 22
EP - 40
JO - COGN BEHAV THERAPY
JF - COGN BEHAV THERAPY
SN - 1650-6073
IS - 1
ER -