Guided Self-help Urdu Version of the Living Life to the Full Intervention for Secondary School Adolescents with Low Mood and Anxiety in Pakistan: A Feasibility Study

Overview

Journal Heliyon

Specialty Social Sciences

Date 2022 Jul 21

PMID 35859639

Authors

Amna Khalid

Sabahat Haqqani

Christopher Williams

Affiliations

Soon will be listed here.

Abstract

There is limited evidence on the efficacy of Cognitive Behavioral Therapy (CBT) based guided self-help programs to improve low mood and anxiety in Pakistani adolescents. The aims of the current study were to assess the effectiveness of an eight week low intensity CBT-based guided self-help program, Living Life to the Full (LLTTF) on depression, anxiety and social functioning among secondary school adolescents in Pakistan. Fifty-six participants were randomly allocated to immediate (n = 28) and delayed access (n = 28) groups. Measures of depression, anxiety and social functioning were collected at baseline, post intervention and three months follow-up. There were significant improvements in measures of depression (t = -3.47, p < 0.01; = 1.0), anxiety (t = -6.55, p < 0.001; d = 1.91) and social functioning (t = -4.28, p < 0.001) between immediate access and delayed access groups. These differences remained significant at three months follow-up. The study suggests that the Urdu LLTTF book course delivered in classes is effective for reducing depression and anxiety as well as improving social function among adolescents in Pakistan.

Citing Articles

School-based intervention for anxiety using group cognitive behavior therapy in Pakistan: a feasibility randomized controlled trial.

Ijaz S, Rohail I, Irfan S Psicol Reflex Crit. 2024; 37(1):31.

PMID: 39158777 PMC: 11333417. DOI: 10.1186/s41155-024-00311-4.

References

Spitzer R, Kroenke K, Williams J, Lowe B . A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006; 166(10):1092-7. DOI: 10.1001/archinte.166.10.1092. View

Ravens-Sieberer U, Torsheim T, Hetland J, Vollebergh W, Cavallo F, Jericek H . Subjective health, symptom load and quality of life of children and adolescents in Europe. Int J Public Health. 2009; 54 Suppl 2:151-9. DOI: 10.1007/s00038-009-5406-8. View

Spitzer R, Kroenke K, Williams J . Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary Care Evaluation of Mental Disorders. Patient Health Questionnaire. JAMA. 1999; 282(18):1737-44. DOI: 10.1001/jama.282.18.1737. View

Gellatly J, Bower P, Hennessy S, Richards D, Gilbody S, Lovell K . What makes self-help interventions effective in the management of depressive symptoms? Meta-analysis and meta-regression. Psychol Med. 2007; 37(9):1217-28. DOI: 10.1017/S0033291707000062. View

Puchalski Ritchie L, Khan S, Moore J, Timmings C, van Lettow M, Vogel J . Low- and middle-income countries face many common barriers to implementation of maternal health evidence products. J Clin Epidemiol. 2016; 76:229-37. DOI: 10.1016/j.jclinepi.2016.02.017. View

Naeem F, Gul M, Irfan M, Munshi T, Asif A, Rashid S . Brief culturally adapted CBT (CaCBT) for depression: a randomized controlled trial from Pakistan. J Affect Disord. 2015; 177:101-7. DOI: 10.1016/j.jad.2015.02.012. View

Suveg C, Kingery J, Davis M, Jones A, Whitehead M, Jacob M . Still lonely: Social adjustment of youth with and without social anxiety disorder following cognitive behavioral therapy. J Anxiety Disord. 2017; 52:72-78. DOI: 10.1016/j.janxdis.2017.10.005. View

Ahmad S, Hussain S, Shah F, Akhtar F . Urdu translation and validation of GAD-7: A screening and rating tool for anxiety symptoms in primary health care. J Pak Med Assoc. 2017; 67(10):1536-1540. View

Kodal A, Fjermestad K, Bjelland I, Gjestad R, Ost L, Bjaastad J . Long-term effectiveness of cognitive behavioral therapy for youth with anxiety disorders. J Anxiety Disord. 2017; 53:58-67. DOI: 10.1016/j.janxdis.2017.11.003. View

10.

Amin R, Iqbal A, Naeem F, Irfan M . Effectiveness of a culturally adapted cognitive behavioural therapy-based guided self-help (CACBT-GSH) intervention to reduce social anxiety and enhance self-esteem in adolescents: a randomized controlled trial from Pakistan. Behav Cogn Psychother. 2020; 48(5):503-514. DOI: 10.1017/S1352465820000284. View

11.

Mundt J, Marks I, Shear M, Greist J . The Work and Social Adjustment Scale: a simple measure of impairment in functioning. Br J Psychiatry. 2002; 180:461-4. DOI: 10.1192/bjp.180.5.461. View

12.

Husain M, Chaudhry I, Mehmood N, Rehman R, Kazmi A, Hamirani M . Pilot randomised controlled trial of culturally adapted cognitive behavior therapy for psychosis (CaCBTp) in Pakistan. BMC Health Serv Res. 2017; 17(1):808. PMC: 5718081. DOI: 10.1186/s12913-017-2740-z. View

13.

Wang P, Angermeyer M, Borges G, Bruffaerts R, Chiu W, de Girolamo G . Delay and failure in treatment seeking after first onset of mental disorders in the World Health Organization's World Mental Health Survey Initiative. World Psychiatry. 2008; 6(3):177-85. PMC: 2174579. View

14.

Klein J, Jacobs R, Reinecke M . Cognitive-behavioral therapy for adolescent depression: a meta-analytic investigation of changes in effect-size estimates. J Am Acad Child Adolesc Psychiatry. 2007; 46(11):1403-13. PMC: 2270481. DOI: 10.1097/chi.0b013e3180592aaa. View

15.

Williams C, McClay C, Matthews L, McConnachie A, Haig C, Walker A . Community-based group guided self-help intervention for low mood and stress: randomised controlled trial. Br J Psychiatry. 2018; 212(2):88-95. PMC: 6716980. DOI: 10.1192/bjp.2017.18. View

16.

Naeem F, Gobbi M, Ayub M, Kingdon D . Psychologists experience of cognitive behaviour therapy in a developing country: a qualitative study from Pakistan. Int J Ment Health Syst. 2010; 4(1):2. PMC: 2831026. DOI: 10.1186/1752-4458-4-2. View

17.

Reef J, Diamantopoulou S, van Meurs I, Verhulst F, van der Ende J . Child to adult continuities of psychopathology: a 24-year follow-up. Acta Psychiatr Scand. 2009; 120(3):230-8. DOI: 10.1111/j.1600-0447.2009.01422.x. View

18.

Vant Hof E, Cuijpers P, Stein D . Self-help and Internet-guided interventions in depression and anxiety disorders: a systematic review of meta-analyses. CNS Spectr. 2009; 14(2 Suppl 3):34-40. DOI: 10.1017/s1092852900027279. View

19.

Woodward L, Fergusson D . Life course outcomes of young people with anxiety disorders in adolescence. J Am Acad Child Adolesc Psychiatry. 2001; 40(9):1086-93. DOI: 10.1097/00004583-200109000-00018. View

20.

Araya R, Rojas G, Fritsch R, Gaete J, Rojas M, Simon G . Treating depression in primary care in low-income women in Santiago, Chile: a randomised controlled trial. Lancet. 2003; 361(9362):995-1000. DOI: 10.1016/S0140-6736(03)12825-5. View