TY - JOUR
T1 - The MARIGOLD study
T2 - Feasibility and enhancement of an online intervention to improve emotion regulation in people with elevated depressive symptoms
AU - Addington, Elizabeth L.
AU - Cheung, Elaine Ooi Yan
AU - Bassett, Sarah M.
AU - Kwok, Ian
AU - Schuette, Stephanie A.
AU - Shiu, Eva
AU - Yang, Dershung
AU - Cohn, Michael A.
AU - Leykin, Yan
AU - Saslow, Laura R.
AU - Moskowitz, Judith Tedlie
N1 - Funding Information:
This work was supported, in part, by the National Institutes of Health [grant numbers MH101265 , CA193193 , UL1TR001422 ] and by the Agency for Healthcare Research and Quality [grant number 5T32HS000084-19 ]. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Publisher Copyright:
© 2019 Elsevier B.V.
PY - 2019/10/1
Y1 - 2019/10/1
N2 - Background: This manuscript describes the first two phases of pilot testing MARIGOLD, an online self-guided positive emotion skills intervention for adults with elevated depressive symptoms, along with enhancements to overcome retention and adherence problems reported in previous research. Methods: Adults with elevated depressive symptoms were recruited online and assessed at baseline, post-intervention, 1- and 3-month follow-up. Phase 1 participants (n = 58) were randomized to MARIGOLD, daily emotion reporting, or waitlist. Phase 2 participants (n = 79) were randomized to MARIGOLD plus one enhancement: online discussion board (ODB), virtual badges (VB), or facilitator contact (FC). Post-intervention interviews assessed acceptability. Intention-to-treat analyses examined retention, adherence, and preliminary efficacy. Results: In both phases, retention and adherence did not differ between groups. MARIGOLD skills were highly acceptable, but qualitative results indicate web-based features (e.g., log-in, ODB, VB) require refinement prior to larger testing. Neither phase demonstrated between-group differences in preliminary efficacy. In Phase 1 within-group analyses, MARIGOLD and emotion reporting control demonstrated a similar pattern of findings (stable depressive symptoms, increased positive emotion, decreased negative emotion and stress), whereas the waitlist group significantly increased in depressive mood. Most Phase 2 within-group analyses demonstrated the expected pattern of results (i.e., decreases in PHQ-8 and negative emotion, increases in positive emotion). However, CES-D scores were stable in FC; perceived stress was stable in FC and ODB. Limitations: This pilot study is not powered to evaluate efficacy. Conclusion: Positive emotion skills, plus enhancements for web-based, self-guided delivery, warrant additional study in people with elevated depressive symptoms.
AB - Background: This manuscript describes the first two phases of pilot testing MARIGOLD, an online self-guided positive emotion skills intervention for adults with elevated depressive symptoms, along with enhancements to overcome retention and adherence problems reported in previous research. Methods: Adults with elevated depressive symptoms were recruited online and assessed at baseline, post-intervention, 1- and 3-month follow-up. Phase 1 participants (n = 58) were randomized to MARIGOLD, daily emotion reporting, or waitlist. Phase 2 participants (n = 79) were randomized to MARIGOLD plus one enhancement: online discussion board (ODB), virtual badges (VB), or facilitator contact (FC). Post-intervention interviews assessed acceptability. Intention-to-treat analyses examined retention, adherence, and preliminary efficacy. Results: In both phases, retention and adherence did not differ between groups. MARIGOLD skills were highly acceptable, but qualitative results indicate web-based features (e.g., log-in, ODB, VB) require refinement prior to larger testing. Neither phase demonstrated between-group differences in preliminary efficacy. In Phase 1 within-group analyses, MARIGOLD and emotion reporting control demonstrated a similar pattern of findings (stable depressive symptoms, increased positive emotion, decreased negative emotion and stress), whereas the waitlist group significantly increased in depressive mood. Most Phase 2 within-group analyses demonstrated the expected pattern of results (i.e., decreases in PHQ-8 and negative emotion, increases in positive emotion). However, CES-D scores were stable in FC; perceived stress was stable in FC and ODB. Limitations: This pilot study is not powered to evaluate efficacy. Conclusion: Positive emotion skills, plus enhancements for web-based, self-guided delivery, warrant additional study in people with elevated depressive symptoms.
KW - Depression
KW - Emotions
KW - Happiness
KW - Internet
KW - Telemedicine
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U2 - 10.1016/j.jad.2019.07.049
DO - 10.1016/j.jad.2019.07.049
M3 - Article
C2 - 31302525
AN - SCOPUS:85068591366
SN - 0165-0327
VL - 257
SP - 352
EP - 364
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
ER -
