4.3 Article

Developing an internet-delivered intervention targeting residual cognitive symptoms after major depressive disorder: a person-based approach

Journal

JOURNAL OF MENTAL HEALTH
Volume -, Issue -, Pages -

Publisher

TAYLOR & FRANCIS INC
DOI: 10.1080/09638237.2021.2022618

Keywords

cognitive remediation; cognitive enhancement therapy; cognitive impairment; internet-based treatment; mood disorder; depression; qualitative

Funding

  1. Norges Forskningsrad [NFR:259293]

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This study aimed to understand the needs and perspectives of adults with a history of depression during the development of a novel internet-based intervention for residual cognitive symptoms after major depressive disorder (MDD). The findings from exploratory and think-aloud interviews highlighted the experiences of cognitive difficulties, coping strategies, and the requirements for an intervention. The results suggest that including psychoeducation, compensatory strategies, and elements to enhance acceptance and motivation in the intervention may address the concerns and consequences of cognitive difficulties.
Background Cognitive difficulties are rarely addressed after the treatment of major depressive disorder (MDD). New scalable treatments are needed. To ensure relevance and engagement of novel interventions, there is a need to understand the perspectives of the users. Aim Explore former depressed adults needs and perspectives during the planning and development of a novel internet-delivered intervention targeting residual cognitive symptoms after MDD. Method The planning phase included exploratory qualitative interviews with former depressed adults (n = 16). In the development phase, a prototype including psychoeducation, attention training and compensatory strategies was tested in think-aloud interviews with former depressed adults (n = 7) and psychologists (n = 4). Data were analysed thematically. Results Analysis of exploratory interviews identified four themes. Experiences of residual cognitive symptoms consisted of two sub-themes (Everyday life is more demanding; Concerns about cognitive difficulties). Coping with residual cognitive symptoms had two sub-themes (Compensatory strategies; Acceptance). Needs from an intervention consisted of two-subthemes (Being overwhelmed; Not being motivated; Frequent registration). Analysis of think-aloud interviews was organized into three themes: Positive perceptions of content; Concerns regarding content; Perceptions of Layout, Visuals and Navigation. Conclusion The intervention may address concerns and consequences of cognitive difficulties by including psychoeducation, compensatory strategies and elements to increase acceptance and motivation, provided in manageable proportions.

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