Online tool for depression treatment.

Julia Fedotova3/25/2013

Outl

ine

Depression (Unipolar)• Background• Characteristics• Symptoms• Popular Treatment and Relapse

• The Ultimate Answer tool• Positive psychology• Functionality• Why it could be effective for depression treatment,

prevention and post-treatment maintenance

De

pr

es

sion

St

ati

stics

Most co

mm

on p

sych

iatric

illness

Th

e W

orld

Health

O

rgan

izatio

n p

red

icts that

30%

of th

e w

orld

p

op

ula

tion

will b

e

dep

resse

d b

y 2

02

0D

epre

ssion

is am

ong

top

h

ealth

con

ditio

ns ca

usin

g

disa

bility

in m

ost p

arts o

f th

e W

orld

# 1

cond

ition

that ca

use

s w

ork d

isability

in th

e

Un

ited

Sta

tes o

f Am

erica

Depre

ssion S

ym

pto

ms

Sadn

ess

Negati

ve

aff

ect

(guilt,

sham

e, fe

ar)

Low

S

elf-

Este

emLo

ss of

inte

res

t in

life’s

ple

asu

res

Hop

ele

ssness

Not a normal reaction to life events Prolonged Severe Lack of positive emotions Reoccurring (Natural course: 85% within 10-15 years after

initial episode)

Not always related to personal circumstances

Etio

logy

Gen

etic

Perso

nality

En

viro

nm

en

tal

Bio

log

ical/n

eu

roch

em

ical th

eory:

'chem

ical im

bala

nce

' in th

e b

rain

(p

articu

larly

sero

ton

in a

nd

n

ore

pin

ep

hrin

e n

eu

rotra

nsm

itter

imb

ala

nce

)C

og

nitiv

e th

eory: co

gnitiv

e b

iase

s and

neg

ativ

e v

iew

of se

lf, the

world

an

d th

e fu

ture

are

activ

ate

d

by stre

ssful life

even

ts

Most co

mm

on

treatm

ents

An

tidepre

ssant M

ed

icatio

n is

#1 ch

oice

in th

e U

SA

bout h

alf o

f the p

atie

nts re

spond

Sid

e e

ffects

Hig

h-re

lap

se ra

tes w

hen m

edica

tion is

stop

ped

(Most p

atie

nts re

lapse

with

in 1

year)

Psy

choth

era

py (E

BT su

gg

ests a

shift fro

m

medica

tion p

sych

oth

era

py)

Med

icatio

n/P

sych

oth

era

py co

mb

oM

ost E

ffectiv

e sh

ort te

rmTh

era

py ju

st as e

ffectiv

e a

s over lo

ng te

rm

Psy

choth

era

py

Treatm

ent

Majo

r Psy

choth

era

py

CB

T (co

gnitiv

e-b

ehavio

ral th

era

py)

DYN

(Psy

chodynam

ic thera

py)

IPT (in

terp

erso

nal th

era

py)

PST (P

roble

m-S

olv

ing

thera

py)

BA

(Behavio

ral A

ctivatio

n)

SST (S

ocia

l Skill tra

inin

g)

SU

P (N

on

dire

ctive S

upportiv

e T

hera

py)

No m

ajo

r diff

ere

nce

s in o

utco

mes

in co

mp

ara

tive stu

dy o

f all 7

typ

e

(Cuijp

ers, e

t. al., (2

00

8). 7

meta

-analy

ses o

f 53 stu

die

s/2,7

57 p

atie

nts)

IPT slig

htly

more

eff

ectiv

eS

UP slig

htly

less e

ffectiv

eC

BT a

nd IP

T a

re b

est tre

atm

ent o

ptio

ns

( Em

pirica

lly su

pporte

d/la

bora

tory

settin

gs)

(Weste

n, e

t. al, 2

0004)

Require

main

tenance

Rela

pse

-recu

rrence

Post C

BT

treatm

ent w

ith

no co

ntin

uatio

n

thera

py

29

% w

ithin

1 y

ear

54

% w

ithin

2 y

ears

Com

para

ble

to o

ther

psy

choth

era

pie

s, bu

t low

er

than

for p

harm

aco

log

y

Contin

uatio

n-

phase

CB

T

reduce

d re

lapse

-re

curre

nce

21

% a

t en

d o

f the

con

tinu

atio

n tre

atm

en

t (1

2%

sup

erio

r to o

ther

psy

choth

era

py tre

atm

en

ts) 2

9%

at 1

year fo

llow

up

(V

itteg

al, C

lark

, Du

nn

& Ja

rrett,

20

07

, meta

-an

aly

sis of 2

8

world

pu

blish

ed

stud

ies

inclu

din

g 1

,88

0 p

articip

an

ts )

Base

d o

n p

ositiv

e p

sych

olo

gy

(Selig

man

)Id

en

tify re

silien

ce fa

ctors th

rou

gh

re

search

on

failu

re a

nd

help

lessn

ess

Bu

ild re

silien

ce skills

Op

timism

is a ke

y/in

terp

reta

tion

of

neg

ativ

e e

ven

ts as:

Tem

pora

ry

Loca

lC

hangeab

le

PE

RM

A: B

uild

ing

blo

cks o

f resilie

nce

Positiv

e e

motio

nEng

agem

ent

Rela

tion

ship

sM

eanin

g

Acco

mplish

ment

On

line

too

l

Take survey Ponder

Ask or answer questions

Search the database for the solutions

Track results

Make wish list

Keep a journal

1 2 3

4

5

6

Want is important now?

7

#Category 0-10

1Basics  2Health  3Environment  4Family  5Friends  6Community  7Love  8Hobby  9Self-esteem  

10Autonomy  11Work  12Money  13Respect  14Flexibility  15Acceptance  16Presence  17Learning  18Values  19Passion  20Giving  

See your graphs

impotancece(x,y,z)*weight_type(x,y,z)* SUM(importansatisfaction(x,y,z))=

8

Why it ca

n b

e e

ffectiv

e

Sim

ilarity

to IP

T a

nd

oth

er e

ffectiv

e

treatm

en

ts.Fo

cuse

s on p

rese

nt a

nd

inte

nd

s to b

ring life

changes

It help

s to id

entify

are

as th

at

require

the m

ost a

ttentio

nA

llow

s to p

ursu

e stra

tegie

s sp

ecifi

c to th

e id

entifi

ed

pro

ble

m a

reas

Help

s anticip

ate

inte

rperso

nal

triggers fo

r depre

ssive

sym

pto

ms

Journ

al/Tra

ck changes o

ver tim

e

and se

e p

atte

rns

Self-re

porte

d/S

ubje

ctive

Well B

ein

gEm

pirica

l Evid

ence

for

positiv

e p

sych

olo

gy

inte

rven

tion

suse

strength

in n

ew

way &

gra

titude o

nlin

e e

xercise

s (S

elig

man, 2

005).

Wh

y it

can

be

eff

ect

ive

May h

elp

to

inte

rpre

t even

ts as lo

cal

20 ca

teg

orie

s

May h

elp

to

inte

rpre

t even

ts as te

mp

ora

ryTra

cking o

ver tim

e

Journ

al

Learn

ing a

bout

people

experie

nce

s th

rough se

arch

ing

for a

nsw

ers

May h

elp

to

inte

rpre

t even

ts as ch

an

geab

leTra

cking o

ver tim

e

Journ

al

Learn

ing a

bout

people

experie

nce

s th

rough se

arch

ing

for a

nsw

ers

Why it can be effective May lead to positive emotion

Realization how well one is doing in all other areas of life Realization may lead to gratitude and the gratitude exercise

showed the largest positive changes in Seligman’s study. Sharing emotions and feelings with others By helping other people who are going through the same issues Writing about experiences and emotions

Journal/questions Wish list

Not alone in their suffering Empathy from people who give advice

Advanta

ges

Free

Onlin

e!

Availa

ble

real-tim

e, a

ny tim

eM

ain

tenan

ce th

era

py is n

ot fre

quent (e

very

oth

er w

eek, m

on

thly

)C

an a

sk a q

uestio

ns o

r get su

pport fro

m

oth

ers w

hen n

eed it. (co

mpare

to b

y-m

onth

ly)

IPT a

n C

BT a

re tim

e-lim

ited

Don’t h

ave to

be d

iagnose

d w

ith

depre

ssion

An

on

ym

ou

sSham

eM

en a

re le

ss likely

to se

ek tre

atm

ent

No stig

ma

Advanta

ges

Availa

ble

to e

very

on

e Varie

ty o

f conditio

ns d

iffer in

severity

and

tim

e co

urse

DSM

-IV ca

tegorie

s not e

mpirica

lly

sup

porte

d a

nd co

ntro

versia

l. (Weste

n, e

t. al., 2

004

). Pre

ventio

ns

Ad

equate

treatm

ent is n

ot a

vaila

ble

to

every

on

eTh

era

pist p

ractice

wh

at th

ey a

re tra

ined to

do a

nd

not n

ece

ssarily

the e

mpirica

lly

sup

porte

d ty

pes o

f thera

pie

s (Weste

n e

t al.,2

004)

NO

every

one re

sponds to

conventio

nal

treatm

ent

Insu

rance

mig

ht n

ot b

e a

vaila

ble

for

main

tenan

ce tre

atm

ents

Oth

er tre

atm

ents m

ight n

ot b

e a

fford

ab

le

Th

e

Me

ssag

e

Ma

rketing

cam

paig

nMo

bile

en

ab

led

Future Directions

The Ultimate Answer on-line tool can be an effective solution for depression treatment as well as prevention and post-treatment maintenance.

Q&

A

ultimate_answer

TheUltimateAnswer

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Thank you!

• What would make you to use on-line tool?• Who would you rather get answers from?

• People who experienced similar issues or moods in the past

• Professional psychologist?• Psychiatrist?• Anyone who is available to share or give an advice?

• Questions

www.TheUltimateAnswer.org

Refe

rence

s

Butcher J.N

., Munika, S

., Ho

oley, J.M (2009

). Abn

orma

l P

sychology(14th Ed.).B

oston: Pearson E

ducation, Inc.C

uijp

ers, P., v

an S

trate

n A

., Andersso

n, G

., Oppen,

P.(2008

). Journ

al o

f Consu

lting a

nd C

linica

l Psy

cholo

gy. Psy

choth

era

py fo

r Depre

ssion

in

Adu

lts: A M

eta

-An

aly

sis of C

om

para

tive O

utco

me

Stu

die

s. 6 (7

6), p

. 909-9

22

Hollo

n, D

., Thase

, M.,, M

arkiw

itz, J. (2002

) Tre

atm

ent a

nd P

reventio

n o

f Depre

ssion.

Psy

cholo

gica

l Scie

nce

in th

e p

ublic in

tere

st 3(2

), p. 4

2 – 7

7.

Lyubom

irsky, S

. (2007). T

he h

ow

of h

ap

pin

ess: A

new

appro

ach

to g

ettin

g th

e life

you

wan

t. New

Yo

rk: Pe

ngu

in P

ress.

Penn

ebake

r J. W. W

riting A

bout E

motio

nal

Exp

erin

ce. (1

997) P

sych

olo

gica

l Scie

nce

, 8(3

), p.

16

2-1

66.

Tan S

. (200

6). Jo

urn

al o

f Psy

cholo

gy a

nd

Christia

nity

, Vol. 2

5(1

), p. 6

8-7

3. A

pp

lied Po

sitive

Psy

cholo

gy: P

uttin

g Po

sitive Psy

cholo

gy in

to

Pra

cticeSelig

man, M

. E. P., S

teen, T. A

., Park

, N., &

Pe

terso

n, C

. (2005

). Positiv

e p

sych

olo

gy p

rogre

ss: Em

pirica

l valid

atio

nof in

terv

en

tions. A

merica

n

Psy

choio

gist, 6

0,4

10-4

21.

Vitte

ngl, J., Ja

rrett, R

., Cla

rk, L. (2

009

). C

ontin

uatio

n-P

hase

Cognitiv

e T

hera

py’s E

ffect o

n

Rem

ission a

nd R

eco

very. Jo

urn

al o

f Consu

lting a

nd

Clin

ical P

sych

olo

gy, 7

7(2

), 367

– 371.

Wad

a, K

., Sasa

ki, T., Jitsuik

i, H., Yo

shim

ura

, Y., Era

bi, H

., Had

a, Y., Ya

mash

ita, M

. (2

00

6).M

anic/H

ypom

anic S

witch

Durin

g A

cute

A

ntid

ep

ressa

nt Tre

atm

ent fo

r Unip

ola

r Depre

ssion

Jo

urn

al o

f Clin

ical P

sych

op

harm

aco

log

y. 26

(5),

51

2-5

15

Weste

n D

., Novotn

y, C

., Thom

pso

n-B

ren

ner, H

. (2

00

4). T

he E

mpirica

l Sta

tus o

f Em

pirica

lly

Su

pporte

d Psy

choth

era

pie

s: Assu

mp

tions,

Findin

gs, a

nd R

ep

ortin

g in

Contro

lled

Clin

ical

Trials.