@Article{info:doi/10.2196/32007，作者=“范·格努格滕，克莱尔·罗莎莉和舒曼斯，乔西恩和胡根多伦，阿德里安·W和阿拉亚，里卡多和安德森，格哈德和巴哈斯，罗莎和博泰拉，克里斯蒂娜和塞尔加·帕绍亚，阿琳达和切斯拉克，罗曼和艾伯特，大卫·丹尼尔和加尔·帕拉西奥斯，阿祖塞纳和哈佐，让-巴蒂斯特和埃雷罗，洛克·i}和霍尔茨曼，埃{i}米和凯梅伦，莉斯和克莱布尔，安尼特和克里格，托比亚斯和斯莫克图诺维奇，埃韦利纳和蒂茨勒，Ingrid and Topooco, Naira and Urech, Antoine and Smit, Johannes H and Riper, Heleen”，标题=“重度抑郁症行为激活的理论框架:基于智能手机的生态瞬间评估研究”，期刊=“JMIR Ment Health”，年=“2021”，月=“12”，日=“6”，卷=“8”，数=“12”，页=“e32007”，关键词=“抑郁症;行为激活;理论框架;生态瞬时评价;随机截距交叉滞后面板模型;行为;框架;教育津贴;智能手机; mental health; treatment; engagement; mood", abstract="Background: Behavioral activation (BA), either as a stand-alone treatment or as part of cognitive behavioral therapy, has been shown to be effective for treating depression. The theoretical underpinnings of BA derive from Lewinsohn et al's theory of depression. The central premise of BA is that having patients engage in more pleasant activities leads to them experiencing more pleasure and elevates their mood, which, in turn, leads to further (behavioral) activation. However, there is a dearth of empirical evidence about the theoretical framework of BA. Objective: This study aims to examine the assumed (temporal) associations of the 3 constructs in the theoretical framework of BA. Methods: Data were collected as part of the ``European Comparative Effectiveness Research on Internet-based Depression Treatment versus treatment-as-usual'' trial among patients who were randomly assigned to receive blended cognitive behavioral therapy (bCBT). As part of bCBT, patients completed weekly assessments of their level of engagement in pleasant activities, the pleasure they experienced as a result of these activities, and their mood over the course of the treatment using a smartphone-based ecological momentary assessment (EMA) application. Longitudinal cross-lagged and cross-sectional associations of 240 patients were examined using random intercept cross-lagged panel models. Results: The analyses did not reveal any statistically significant cross-lagged coefficients (all P>.05). Statistically significant cross-sectional positive associations between activities, pleasure, and mood levels were identified. Moreover, the levels of engagement in activities, pleasure, and mood slightly increased over the duration of the treatment. In addition, mood seemed to carry over, over time, while both levels of engagement in activities and pleasurable experiences did not. Conclusions: The results were partially in accordance with the theoretical framework of BA, insofar as the analyses revealed cross-sectional relationships between levels of engagement in activities, pleasurable experiences deriving from these activities, and enhanced mood. However, given that no statistically significant temporal relationships were revealed, no conclusions could be drawn about potential causality. A shorter measurement interval (eg, daily rather than weekly EMA reports) might be more attuned to detecting potential underlying temporal pathways. Future research should use an EMA methodology to further investigate temporal associations, based on theory and how treatments are presented to patients. Trial Registration: ClinicalTrials.gov, NCT02542891, https://clinicaltrials.gov/ct2/show/NCT02542891; German Clinical Trials Register, DRKS00006866, https://tinyurl.com/ybja3xz7; Netherlands Trials Register, NTR4962, https://www.trialregister.nl/trial/4838; ClinicalTrials.Gov, NCT02389660, https://clinicaltrials.gov/ct2/show/NCT02389660; ClinicalTrials.gov, NCT02361684, https://clinicaltrials.gov/ct2/show/NCT02361684; ClinicalTrials.gov, NCT02449447, https://clinicaltrials.gov/ct2/show/NCT02449447; ClinicalTrials.gov, NCT02410616, https://clinicaltrials.gov/ct2/show/NCT02410616; ISRCTN registry, ISRCTN12388725, https://www.isrctn.com/ISRCTN12388725 ", issn="2368-7959", doi="10.2196/32007", url="https://mental.www.mybigtv.com/2021/12/e32007", url="https://doi.org/10.2196/32007", url="http://www.ncbi.nlm.nih.gov/pubmed/34874888" }