Need Satisfaction and Optimal Functioning at Leisure and Work: A Longitudinal Validation Study of the DRAMMA Model

In recent years, there has been an increasing interest in psychological need satisfaction and its role in promoting optimal functioning. The DRAMMA model integrates existing need and recovery models to explain why leisure is connected to optimal functioning (i.e., high well-being and low ill-being). It encompasses six psychological needs: detachment, relaxation, autonomy, mastery, meaning, and affiliation (DRAMMA). While the individual needs of the DRAMMA model have been previously shown to relate to different aspects of optimal functioning, a longitudinal study examining the entire model has not been conducted before. In this longitudinal field study covering leisure and work episodes, we tested the within-person reliability and (construct and criterion) validity of the operationalization of the DRAMMA model in a sample of 279 German employees. Participants filled out measures of DRAMMA need satisfaction and optimal functioning at five measurement times before, during, and after vacation periods in 2016 and 2017. The six-factor model showed good fit to the data. In the multilevel models, relaxation, detachment, autonomy, and mastery had the most consistent within-person effects on optimal functioning, while the relationships between optimal functioning, meaning, and affiliation were considerably weaker. In conclusion, DRAMMA need satisfaction can aid and nurture employees’ optimal functioning

Promoting and prolonging the beneficial effects of a vacation with the help of a smartphone-based intervention

Het doel van dit onderzoek was om te onderzoeken of het positieve effect van vakanties op het herstel, het welbevinden en de werkprestaties van werknemers te versterken en te verlengen zijn met behulp van een smartphone-gebaseerde interventie. In een 4-weekse longitudinale studie onder 79 Finse leraren hebben wij het beloop van herstel, welbevinden, en werkprestatie vóór, tijdens, en na een vakantie onderzocht. Deelnemers werd gevraagd om een herstel-app, genaamd Holidaily, bij voorkeur dagelijks te gebruiken en vijf digitale vragenlijsten in te vullen. De groep kon verdeeld worden in niet-gebruikers, passieve gebruikers, en actieve gebruikers. Uitkomsten van de studie zijn dat de meeste herstel- en welbevinden indicatoren voor alle deelnemers verbeterden tijdens de vakantie. Werkprestatie en concentratievermogen veranderden niet na de vakantie vergeleken met ervoor. Creativiteit daalde direct na de vakantie, maar steeg anderhalve week na de vakantie tot een hoger niveau dan voor de vakantie. Actief gebruik van de app had een positief effect op enkele uitkomstmaten. Zo steeg bij actieve gebruikers hun creativiteit direct na de vakantie, terwijl dit daalde onder passieve gebruikers. Het wegebben van positieve vakantie-effecten lijkt trager onder actieve gebruikers. Maar weinig deelnemers gebruikten de app actief. Desalniettemin duiden onze resultaten erop dat een smartphone-gebaseerde herstel-interventie positieve vakantie-effecten kan verlengen.The aim of this study was to investigate whether beneficial vacation effects can be strengthened and prolonged with a smartphone-based intervention. In a four-week longitudinal study among 79 Finnish teachers, we investigated the development of recovery, well-being, and job performance before, during, and after a one-week vacation in three groups: non-users (n = 51), passive (n = 18) and active (n = 10) users. Participants were instructed to actively use a recovery app (called Holidaily) and complete five digital questionnaires. Most recovery experiences and well-being indicators increased during the vacation. Job performance and concentration capacity showed no significant time effects. Among active app users, creativity at work increased from baseline to after the vacation, whereas among non-users it decreased and among passive users it decreased a few days after the vacation but increased again one and a half weeks after the vacation. The fading of beneficial vacation effects on negative affect seems to have been slower among active app users. Only few participants used the app actively. Still, results suggest that a smartphone-based recovery intervention may support beneficial vacation effects

The more I got, the less I need?: Efficacy of Internet-based guided self-help compared to online psychoeducation for major depressive disorder

BACKGROUND: This study's aims were to compare the efficacy and negative effects of guided Internet-based cognitive behavior therapy (iCBT) and online psychoeducation (OPE) in people with major depression. METHODS: A total of 131 individuals were randomized. Assessments took place at baseline (T1), six weeks (T2), and three months (T3). The primary endpoint was change in observer-based depression severity from T1 to T2. Potential negative effects were analyzed in terms of suicidal ideations, symptom deterioration, attitudes toward seeking further help, and other adverse events. RESULTS: iCBT (n = 65) and OPE (n = 66) both reduced depressive symptoms from T1 to T2, with large changes observed for iCBT and medium for OPE (iCBT: Cohen's d = 1.09; OPE: d = 0.60). Differences between groups were significant at the primary endpoint (d = 0.36, p = 0.028). OPE continued to have a positive effect from post-treatment to follow-up, while the effect of iCBT remained stable, with differences between groups not being significant anymore at follow-up. Participants who had undergone prior psychotherapy benefited from both treatments; but for those without prior psychotherapy, iCBT was superior also at follow-up. In the iCBT group 26.2% of the participants reported at least one side-effect. LIMITATIONS: The history of psychotherapy was imbalanced between the groups. Some negative effects were assessed in the iCBT group only. CONCLUSIONS: Both iCBT and OPE were effective in reducing depressive symptoms, but with iCBT having a more rapid effect. iCBT was specifically superior in those with no prior history of psychotherapy. Negative effects occurred frequently and should be considered when implementing iCBT. TRIAL REGISTRATION: German clinical trials register: DRKS00005025

Efficacy and moderators of psychological interventions in treating subclinical symptoms of depression and preventing major depressive disorder onsets: protocol for an individual patient data meta-analysis of randomised controlled trials

Introduction: The long-term effectiveness of psychological interventions for the treatment of subthreshold depression and the prevention of depression is unclear and effects vary among subgroups of patients, indicating that not all patients profit from such interventions. Randomised clinical trials are mostly underpowered to examine adequately subgroups and moderator effects. The aim of the present study is, therefore, to examine the short-term and long-term as well as moderator effects of psychological interventions compared with control groups in adults with subthreshold depression on depressive symptom severity, treatment response, remission, symptom deterioration, quality of life, anxiety and the prevention of major depressive disorder (MDD) onsets on individual patient level and study level using an individual patient data meta-analysis approach. Methods and analysis: Systematic searches in PubMed, PsycINFO, Embase and the Cochrane Central Register of Controlled Trials were conducted. We will use the following types of outcome criteria: (A) onset of major depression; (B) time to major depression onset; (C) observer-reported and self-reported depressive symptom severity; (D) response; (E) remission; (F) symptom deterioration; (G) quality of life, (H) anxiety; and (I) suicidal thoughts and behaviours. Multilevel models with participants nested within studies will be used. Missing data will be handled using a joint modelling approach to multiple imputation. A number of sensitivity analyses will be conducted in order test the robustness of our findings. Ethics and dissemination: The investigators of the primary trials have obtained ethical approval for the data used in the present study and for sharing the data, if this was necessary, according to local requirements and was not covered from the initial ethic assessment. This study will summarise the available evidence on the short-term and long-term effectiveness of preventive psychological interventions for the treatment of subthreshold depression and prevention of MDD onset. Identification of subgroups of patients in which those interventions are most effective will guide the development of evidence-based personalised interventions for patients with subthreshold depression. PROSPERO registration number: CRD42017058585

Promoting and prolonging the beneficial effects of a vacation with the help of a smartphone-based intervention

The aim of this study was to investigate whether beneficial vacation effects can be strengthened and prolonged with a smartphone-based intervention. In a four-week longitudinal study among 79 Finnish teachers, we investigated the development of recovery, well-being, and job performance before, during, and after a one-week vacation in three groups: non-users (n = 51), passive (n = 18) and active (n = 10) users. Participants were instructed to actively use a recovery app (called Holidaily) and complete five digital questionnaires. Most recovery experiences and well-being indicators increased during the vacation. Job performance and concentration capacity showed no significant time effects. Among active app users, creativity at work increased from baseline to after the vacation, whereas among non-users it decreased and among passive users it decreased a few days after the vacation but increased again one and a half weeks after the vacation. The fading of beneficial vacation effects on negative affect seems to have been slower among active app users. Only few participants used the app actively. Still, results suggest that a smartphone-based recovery intervention may support beneficial vacation effects

GET.ON Mood Enhancer: efficacy of Internet-based guided self-help compared to psychoeducation for depression: an investigator-blinded randomised controlled trial

Background: Major depressive disorder (MDD) imposes a considerable disease burden on individuals and societies. A large number of randomised controlled trials (RCTs) have shown the efficacy of Internet-based guided self-help interventions in reducing symptoms of depression. However, study quality varies considerably. The aim of this study is to evaluate the efficacy of a new Internet-based guided self-help intervention (GET.ON Mood Enhancer) compared to online-based psychoeducation in an investigator-blinded RCT.Methods/design: A RCT will be conducted to compare the efficacy of GET.ON Mood Enhancer with an active control condition receiving online psychoeducation on depression (OPD). Both treatment groups will have full access to treatment as usual. Adults with MDD (n = 128) will be recruited and randomised to one of the two conditions. Primary outcome will be observer-rated depressive symptoms (HRSD-24) by independent assessors blind to treatment conditions. Secondary outcomes include changes in self-reported depressive symptom severity, anxiety and quality of life. Additionally, potential negative effects of the treatments will systematically be evaluated on several dimensions (for example, symptom deteriorations, attitudes toward seeking psychological help, relationships and stigmatisation). Assessments will take place at baseline, 6 and 12 weeks after randomisation.Discussion: This study evaluates a new Internet-based guided self-help intervention for depression using an active control condition (psychoeducation-control) and an independent, blinded outcome evaluation. This study will further enhance the evidence for Internet-based guided self-help interventions for MDD.Trial registration: German Clinical Trial Registration (DRKS): DRKS00005025. © 2014 Ebert et al.; licensee BioMed Central Ltd

Efficacy of a smartphone-based intervention — “Holidaily” — promoting recovery behaviour in workers after a vacation: study protocol for a randomised controlled trial

Background: While work-related rumination increases the risk of acute stressors developing into chronic load reactions and adverse health, mental detachment has been suggested as a way to interrupt this chain. Despite the importance of mentally detaching from work during leisure time, workers seem to struggle to disengage and, instead, experience the constant mental representation of work-related stressors, regardless of their absence. Those who struggle with work-related rumination could benefit from an easy-access intervention that fosters mental detachment by promoting recreational activities. Especially during vacations, workers appear to naturally engage in sufficient recovery activities; however, this beneficial behaviour is not sustained. The smartphone app-based intervention “Holidaily” promotes recovery behaviour and, thus, mental detachment from work with the intension of extending the beneficial effects of workers’ vacations into their daily working life. Methods: This randomised-controlled trial (RCT) evaluates the efficacy of “Holidaily”. The Holidaily app is a German stand-alone program for mobile devices with either Android/iOS operating systems. The sample includes workers, who are awaiting to go on vacation and are randomly assigned to either the intervention (IG) or a waitlist-control group (CG). The IG receives two weeks pre-vacation access to Holidaily, while the CG receives access two weeks post-vacation. On a daily basis participants in the IG are provided with three options promoting recreational activities and beneficial recovery experiences. Online questionnaires are distributed to all participants at several timepoints. The primary outcome measure assesses participants’ work-related rumination (Irritation Scale). A significant difference two weeks post-vacation is expected, favouring the IG. Secondary outcomes include symptoms of depression, insomnia severity, emotional exhaustion, thinking about work, recovery experiences, vacation specifics, work and personal characteristics. To help explain the intervention’s effect, explorative analyses will investigate the mediation properties of the frequency of engaging in recreational activities and the moderation properties of Holidaily users’ experiences. Discussion: If successful, workers will maintain their recovery behaviour beyond their vacation into daily working life. Findings could, therefore, provide evidence for low-intensity interventions that could be very valuable from a public-health perspective. App-based interventions have greater reach; hence, more workers might access preventative tools to protect themselves from developing adverse health effects linked to work-related rumination. Further studies will still be needed to investigate whether the vacation phenomenon of “lots of fun quickly gone” can be defied and long-term benefits attained

Efficacy and Moderators of Internet-Based Interventions in Adults with Subthreshold Depression: An Individual Participant Data Meta-Analysis of Randomized Controlled Trials

Introduction: Evidence on effects of Internet-based interventions to treat subthreshold depression (sD) and prevent the onset of major depression (MDD) is inconsistent. Objective: We conducted an individual participant data meta-analysis to determine differences between intervention and control groups (IG, CG) in depressive symptom severity (DSS), treatment response, close to symptom-free status, symptom deterioration and MDD onset as well as moderators of intervention outcomes. Methods: Randomized controlled trials were identified through systematic searches via PubMed, PsycINFO, Embase and Cochrane Library. Multilevel regression analyses were used to examine efficacy and moderators. Results: Seven trials (2,186 participants) were included. The IG was superior in DSS at all measurement points (posttreatment: 6-12 weeks; Hedges' g = 0.39 [95% CI: 0.25-0.53]; follow-up 1: 3-6 months; g = 0.30 [95% CI: 0.15-0.45]; follow-up 2: 12 months, g = 0.27 [95% CI: 0.07-0.47], compared with the CG. Significantly more participants in the IG than in the CG reached response and close to symptom-free status at all measurement points. A significant difference in symptom deterioration between the groups was found at the posttreatment assessment and follow-up 2. Incidence rates for MDD onset within 12 months were lower in the IG (19%) than in the CG (26%). Higher initial DSS and older age were identified as moderators of intervention effect on DSS. Conclusions: Our findings provide evidence for Internet-based interventions to be a suitable low-threshold intervention to treat individuals with sD and to reduce the incidence of MDD. This might be particularly true for older people with a substantial symptom burden