MoodSwings: an online self-guided intervention for bipolar disorder
AuthorLauder, Susan Dorothy
Document TypePhD thesis
Access StatusOpen Access
© 2016 Dr. Susan Dorothy Lauder
Bipolar disorder is a chronic illness characterised by extreme mood swings. The efficacy limitations of medication alone have flagged a role for adjunctive psychosocial treatments. Despite strong evidence for these interventions, accessing such specialised programs is problematic. Online psychosocial interventions have been found to be effective for a range of mental illness, and some burgeoning work that has evaluated online bipolar programs is encouraging. This current study seeks to further contribute to this embryonic work. Two studies are described within this thesis. Study one, aimed to test the efficacy of a self-guided online intervention (MoodSwings) for bipolar disorder. In a head to head trial of an international sample, 156 participants with bipolar disorder were randomised to receive either a psychoeducation (PE) based program, or the same PE program plus additional interactive Cognitive Behavioural Therapy elements. A mixed model repeated measure (MMRM) analysis found a significant (p = 0.02) difference between the two groups at 12 months on mania scores. Both groups also demonstrated significant within group differences. An exploratory analysis based on effect sizes >.8 found the following potential factors suggestive of having an impact on outcomes: demographic factors associated with functionality, time on site, locus of control and medication adherence. Study two utilised the same participant sample and reports on the use of MoodSwingssmall group discussion boards. It aimed to explore their role in enhancing social support and identifying the types of supportive exchanges. Contrary to the hypotheses, no significant differences (p = .271) were found on social support levels between high and low posting groups. In addition, those on higher posting boards did not demonstrate greater program engagement (p = .298). There was a significantly higher number of posts by those in the PE condition in comparison to the CBT group (p <.000). Qualitatively the posts contained many supportive comments, the most frequent demonstrated emotional support. This current study was limited by only using self-report assessments, a moderate sample size, and a high attrition rate in the completion of follow up assessments. The head-to-head study design did not allow for a determination of whether MoodSwings was superior to a control condition or treatment as usual. Further studies could explore this using an attention control condition. A guided intervention model would also provide an interesting contrast to the current studies self-guided approach in terms of additional costs and benefits. There is also a great opportunity to further explore the use of online discussion boards both as a tool of engagement and as having its own therapeutic elements. MoodSwings is one of the first online programs for BD. Its findings are encouraging and pave the way for future studies to build on this work.
Keywordsbipolar disorders; online intervention; psychosocial
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- Psychiatry - Theses