Background and objectives

Cognitive behavioral therapy (CBT) is a first-line treatment for anxiety, but it is not widely available as clinical guidelines recommend. We examined the feasibility and efficacy of a novel smartphone-based fully automated digital CBT intervention, ‘Daylight™‘, to improve symptoms of Generalized Anxiety Disorder (GAD).

Methods

In this multiple-baseline design, 21 adults (20 F; mean age 43yrs. range 19–65yrs.) with moderate-to-severe symptoms of GAD were randomized to one of three baseline durations (2-, 4-, or 6-weeks) and then received access to digital CBT. Participants completed daily ratings of anxiety and worry, weekly measures of anxiety, depressive symptoms, and sleep, and measures of anxiety, worry, wellbeing, quality of life, CBT skill acquisition, and work performance at initial assessment prior to baseline randomization, post-intervention, and follow-up.

Results

Digital CBT was found to be feasible in terms of engagement, satisfaction, and safety. For preliminary efficacy, improvements were detected in daily and weekly outcomes of anxiety for most participants. Despite individual differences, significant improvements occurred with the introduction of digital CBT and not during baseline. Overall, 70% of participants no longer had clinically significant symptoms of GAD, 61% no longer had significant depressive symptoms, and 40% no longer had significant sleep difficulty at post-intervention.

Limitations

The study sample was recruited using the internet and was mostly female, limiting the generalizability of the findings.

Conclusions

Findings support the feasibility and efficacy of Daylight. Further examination in randomized controlled trials is now warranted.

中文翻译：

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数字 CBT 干预对广泛性焦虑症症状的可行性和有效性：一项随机多基线研究。

背景和目标

认知行为疗法 (CBT) 是焦虑症的一线治疗方法，但并未像临床指南推荐的那样广泛使用。我们研究了一种基于智能手机的新型全自动数字 CBT 干预“ Daylight™ ”的可行性和有效性，以改善广泛性焦虑症 (GAD) 的症状。

方法

在这个多基线设计中，21 名有中度至重度 GAD 症状的成年人（20 F；平均年龄 43 岁，范围 19-65 岁）被随机分配到三个基线持续时间（2-、4- 或 6-周），然后获得了对数字 CBT 的访问权。参与者在基线随机化之前的初始评估中完成了每日焦虑和担忧评级、每周焦虑、抑郁症状和睡眠测量，以及焦虑、担忧、幸福感、生活质量、CBT 技能获取和工作表现的测量。干预和跟踪。

结果

发现数字 CBT 在参与度、满意度和安全性方面是可行的。对于初步疗效，大多数参与者每天和每周的焦虑结果都有所改善。尽管存在个体差异，但随着数字 CBT 的引入而不是在基线期间出现了显着改善。总体而言，70% 的参与者在干预后不再有临床上显着的 GAD 症状，61% 不再有显着的抑郁症状，40% 不再有显着的睡眠困难。

限制

研究样本是通过互联网招募的，主要是女性，限制了研究结果的普遍性。

结论

调查结果支持Daylight的可行性和有效性。现在需要在随机对照试验中进行进一步检查。