The goal of PrevenD 2.0 is to deliver a freely accessible, cost-effective, preventive intervention for (recurrent) depression and guide implementation in clinical practice. For this purpose, we aim to maximize the impact of a recently developed and proven effective preventive gamified cognitive control training (CCT) procedure for remitted depressed patients (developed and tested in PrevenD 1.0). In particular, we will be working towards clinical implementation of CCT, addressing key questions which were identified during the process of PrevenD 1.0: (a) further delineating the target population, (b) optimizing and further evaluating the CCT procedure (evaluating effects of training intensity, booster sessions, and interactions with other treatments), and (c) providing a detailed analysis of the societal impact of CCT, from a
Applicant: Ernst Koster | Application number: T000720N
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health economic perspective. In particular, we will:
• Update the PrevenD platform to remain compatible with the most recent devices and browsers;
• Further delineate the target population, allowing for targeted referral to the intervention by clinicians and increasing our understanding of differential etiological pathways towards recurrent depression. For this purpose, we will:
○ Reanalyze data of a large pragmatic trial from PrevenD 1.0, identifying different profiles of (cognitive) vulnerability for depression using clustering techniques in relation to treatment adherence and treatment effects;
○ Use pooled data from previous randomized controlled trials to crossvalidate the predictive role of group membership (based on the latent profiles identified in the previous step) for treatment adherence and treatment response in an independent dataset;
• Building on the eligibility criteria obtained from the previous step, we will identify the optimal dosage of CCT as well as the minimum required dose to obtain treatment effects, experimentally manipulating training intensity in N = 158 RMD patients;
• Informed by both the optimal dosage and minimum dosage necessary to affect functioning, we will investigate whether flexibly adding booster sessions to the CCT protocol based on participants’ emotional wellbeing over a period of one year may lead to more sustainable effects of CCT (N = 101 RMD patients);
• Provide a test of the comparative effectiveness of our ‘optimized’ CCT procedure compared to treatment as usual in terms of prevention of recurrent depression in a large-scale randomized controlled trial (RCT; N = 450 RMD patients) with a one year follow-up period. This RCT will contain three arms (CCT vs. TAU vs. CCT+TAU). As such, it also allows to
model how CCT interacts with TAU (treatment augmentation), offering vital information regarding optimal mode of delivery of CCT;
• Provide a detailed analysis of the societal impact of CCT from a health economic perspective.
• Actively disseminate the results of our research:
○ Release computerized training as free and open source software;
○ Continuation and expansion of our efforts to support use of CCT in clinical practice;
○ Publish results of (we anticipate at least 6) research articles that will be submitted to leading academic journals in clinical psychology/psychiatry;
○ Actively disseminate results among stakeholders through workshops and publications in the specialized press and report to the general public by means of popular media;
○ Produce two PhD theses based on the results of the PrevenD 2.0 project