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Human Research Program

Self-guided Depression Treatment on Long-duration Space Flights: A Continuation Study

Completed Technology Project

Project Introduction

During 2008-2009, we completed development and alpha-testing (debugging) of a depression treatment computer program. The program uses video, audio, graphics, and text to guide users through the steps of problem-solving treatment, and evidence-based treatment for depression. Users are guided through the treatment by Dr. Mark Hegel, a national expert in the intervention, who is presented via video and audio. The user's experience is tailored to his or her responses to questions, progress in the treatment, and depression level. Dr. Hegel asks questions and users respond via free text and menus. Each of the program's six sessions involves six steps. The efficacy of problem-solving treatment has been well-established in clinical settings, so our research questions were whether a computer program could be developed to deliver the intervention, and how efficacious it would be. If such a program could be built and is effective, it would be possible to provide a validated intervention to astronauts on long-duration missions who require treatment for depression. After completing development and alpha-testing, we conducted a pilot study to obtain an initial estimate of the program's efficacy. A randomized clinical trial was conducted with a small number of participants (N=14), of which 10 were female, 2 were Latino/Hispanic, and 1 was African American. The mean age was 50.5 years and all had completed at least 4 years of college, making them somewhat analogous to the astronaut population. Half of the participants were assigned to use the depression treatment program for 6 sessions, with a 1-week and 1-month follow-up. The other half were assigned to a wait-list control condition and re-evaluated after 7 weeks. (Note that not receiving a behavioral intervention is likely to be typical for astronauts with depression on long-duration missions, making the wait list a "treatment as usual" condition.) One of the control group participants dropped out of the study and 2 of the experimental group participants' data were omitted due to excessive lapses of time between sessions 3 and 4. The primary outcome was the Hamilton Depression Inventory, a standard measure of depression. No differences were found between groups at pre-test, and the mean for both groups was in the mild range of depression. A comparison of percent change from pre-test to post-test was made for the experimental (treatment) group and the control group. A significant difference (p<.045) was found between groups, with the experimental group improving more. The effect size was large (Cohen's d = 1.73). These results suggest that the depression treatment program may be efficacious for treating minor depression; however, a larger-sample clinical trial is required to confirm them. More »

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This is a historic project that was completed before the creation of TechPort on October 1, 2012. Available data has been included. This record may contain less data than currently active projects.