Mediators in psychological and psychoeducational interventions for the prevention of depression and anxiety: A systematic review

P. Moreno-Peral; J.A. Bellón; M.J.H. Huibers; J.M. Mestre; L.J. García-López; S. Taubner; A. Rodríguez-Morejón; F. Bolinski; C.M.D. Sales; S. Conejo-Cerón

doi:10.1016/j.cpr.2020.101813

Mediators in psychological and psychoeducational interventions for the prevention of depression and anxiety: A systematic review

P. Moreno-Peral^*, J.A. Bellón, M.J.H. Huibers, J.M. Mestre, L.J. García-López, S. Taubner, A. Rodríguez-Morejón, F. Bolinski, C.M.D. Sales, S. Conejo-Cerón

^*Corresponding author for this work

Research output: Contribution to journal › Review article › peer-review

Abstract

Although efforts have been undertaken to determine how psychological interventions exert their effects, research on mediators and mechanisms of change remains limited, especially in the field of prevention. We aimed to assess available evidence on mediators of psychological and psychoeducational interventions for the prevention of depression and anxiety in varied populations. A systematic review using PubMed, PsycINFO, Web of Science, Embase, OpenGrey, and the Cochrane Central Register of Controlled Trials was performed. Two independent reviewers assessed the eligibility criteria of all articles, extracted data, determined the risk of bias in randomized controlled trials, and the requirements for mediators. The outcomes were mediators of the incidence of depression or anxiety and/or the reduction of symptoms of depression or anxiety. We identified 28 nested mediator studies within randomized controlled trials involving 7442 participants. Potential cognitive, behavioral, emotional and interpersonal mediators were evaluated in different psychological and psychoeducational interventions to prevent depression and anxiety. The effects were mediated mainly by cognitive variables, which were the most commonly assessed factors. For depression, the mediator with the strongest empirical support was negative thinking in adults. Cognitive change is an important mediator in preventive psychological and psychoeducational interventions for both anxiety and depression.

Original language	English
Article number	101813
Number of pages	19
Journal	Clinical Psychology Review
Volume	76
DOIs	https://doi.org/10.1016/j.cpr.2020.101813
Publication status	Published - 2020
Externally published	Yes

Bibliographical note

Funding Information:
This study was supported by the Prevention and Health Promotion Research Network (redIAPP) RD16/0007 , SAMSERAP group RD16/0007/0010 . This study was partially funded by the European Network on Individualized Psychotherapy Treatment of Young People with Mental Disorders (TREATme) (COST Action CA16102 ) and a fellowship awarded to CS by the Center for Psychology at the University of Porto , Portuguese Foundation for Science and Technology ( FCT UID/ PSI/00050/2013 ) and the EU FEDER and COMPETE programs ( POCI-01-0145- FEDER-007294 ). The funders had no direct role in the design of the study and they had no input in the interpretation or publication of the study results.

Funding Information:
This study was supported by the Prevention and Health Promotion Research Network (redIAPP) RD16/0007, SAMSERAP group RD16/0007/0010. This study was partially funded by the European Network on Individualized Psychotherapy Treatment of Young People with Mental Disorders (TREATme) (COST Action CA16102) and a fellowship awarded to CS by the Center for Psychology at the University of Porto, Portuguese Foundation for Science and Technology (FCT UID/ PSI/00050/2013) and the EU FEDER and COMPETE programs (POCI-01-0145- FEDER-007294). The funders had no direct role in the design of the study and they had no input in the interpretation or publication of the study results.The authors thank the European Network on Individualized Psychotherapy Treatment of Young People with Mental Disorders (TREATme), (COST Action CA16102) for its support.

Publisher Copyright:
© 2020 Elsevier Ltd

Funding

This study was supported by the Prevention and Health Promotion Research Network (redIAPP) RD16/0007 , SAMSERAP group RD16/0007/0010 . This study was partially funded by the European Network on Individualized Psychotherapy Treatment of Young People with Mental Disorders (TREATme) (COST Action CA16102 ) and a fellowship awarded to CS by the Center for Psychology at the University of Porto , Portuguese Foundation for Science and Technology ( FCT UID/ PSI/00050/2013 ) and the EU FEDER and COMPETE programs ( POCI-01-0145- FEDER-007294 ). The funders had no direct role in the design of the study and they had no input in the interpretation or publication of the study results. This study was supported by the Prevention and Health Promotion Research Network (redIAPP) RD16/0007, SAMSERAP group RD16/0007/0010. This study was partially funded by the European Network on Individualized Psychotherapy Treatment of Young People with Mental Disorders (TREATme) (COST Action CA16102) and a fellowship awarded to CS by the Center for Psychology at the University of Porto, Portuguese Foundation for Science and Technology (FCT UID/ PSI/00050/2013) and the EU FEDER and COMPETE programs (POCI-01-0145- FEDER-007294). The funders had no direct role in the design of the study and they had no input in the interpretation or publication of the study results.The authors thank the European Network on Individualized Psychotherapy Treatment of Young People with Mental Disorders (TREATme), (COST Action CA16102) for its support.

Keywords

Anxiety
Depression
Mediators
Prevention
Systematic review

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.cpr.2020.101813

Cite this

Moreno-Peral, P., Bellón, J. A., Huibers, M. J. H., Mestre, J. M., García-López, L. J., Taubner, S., Rodríguez-Morejón, A., Bolinski, F., Sales, C. M. D., & Conejo-Cerón, S. (2020). Mediators in psychological and psychoeducational interventions for the prevention of depression and anxiety: A systematic review. Clinical Psychology Review, 76, Article 101813. https://doi.org/10.1016/j.cpr.2020.101813

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title = "Mediators in psychological and psychoeducational interventions for the prevention of depression and anxiety: A systematic review",

abstract = "Although efforts have been undertaken to determine how psychological interventions exert their effects, research on mediators and mechanisms of change remains limited, especially in the field of prevention. We aimed to assess available evidence on mediators of psychological and psychoeducational interventions for the prevention of depression and anxiety in varied populations. A systematic review using PubMed, PsycINFO, Web of Science, Embase, OpenGrey, and the Cochrane Central Register of Controlled Trials was performed. Two independent reviewers assessed the eligibility criteria of all articles, extracted data, determined the risk of bias in randomized controlled trials, and the requirements for mediators. The outcomes were mediators of the incidence of depression or anxiety and/or the reduction of symptoms of depression or anxiety. We identified 28 nested mediator studies within randomized controlled trials involving 7442 participants. Potential cognitive, behavioral, emotional and interpersonal mediators were evaluated in different psychological and psychoeducational interventions to prevent depression and anxiety. The effects were mediated mainly by cognitive variables, which were the most commonly assessed factors. For depression, the mediator with the strongest empirical support was negative thinking in adults. Cognitive change is an important mediator in preventive psychological and psychoeducational interventions for both anxiety and depression. ",

keywords = "Anxiety, Depression, Mediators, Prevention, Systematic review",

author = "P. Moreno-Peral and J.A. Bell{\'o}n and M.J.H. Huibers and J.M. Mestre and L.J. Garc{\'i}a-L{\'o}pez and S. Taubner and A. Rodr{\'i}guez-Morej{\'o}n and F. Bolinski and C.M.D. Sales and S. Conejo-Cer{\'o}n",

note = "Funding Information: This study was supported by the Prevention and Health Promotion Research Network (redIAPP) RD16/0007 , SAMSERAP group RD16/0007/0010 . This study was partially funded by the European Network on Individualized Psychotherapy Treatment of Young People with Mental Disorders (TREATme) (COST Action CA16102 ) and a fellowship awarded to CS by the Center for Psychology at the University of Porto , Portuguese Foundation for Science and Technology ( FCT UID/ PSI/00050/2013 ) and the EU FEDER and COMPETE programs ( POCI-01-0145- FEDER-007294 ). The funders had no direct role in the design of the study and they had no input in the interpretation or publication of the study results. Funding Information: This study was supported by the Prevention and Health Promotion Research Network (redIAPP) RD16/0007, SAMSERAP group RD16/0007/0010. This study was partially funded by the European Network on Individualized Psychotherapy Treatment of Young People with Mental Disorders (TREATme) (COST Action CA16102) and a fellowship awarded to CS by the Center for Psychology at the University of Porto, Portuguese Foundation for Science and Technology (FCT UID/ PSI/00050/2013) and the EU FEDER and COMPETE programs (POCI-01-0145- FEDER-007294). The funders had no direct role in the design of the study and they had no input in the interpretation or publication of the study results.The authors thank the European Network on Individualized Psychotherapy Treatment of Young People with Mental Disorders (TREATme), (COST Action CA16102) for its support. Publisher Copyright: {\textcopyright} 2020 Elsevier Ltd",

year = "2020",

doi = "10.1016/j.cpr.2020.101813",

language = "English",

volume = "76",

journal = "Clinical Psychology Review",

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Moreno-Peral, P, Bellón, JA, Huibers, MJH, Mestre, JM, García-López, LJ, Taubner, S, Rodríguez-Morejón, A, Bolinski, F, Sales, CMD & Conejo-Cerón, S 2020, 'Mediators in psychological and psychoeducational interventions for the prevention of depression and anxiety: A systematic review', Clinical Psychology Review, vol. 76, 101813. https://doi.org/10.1016/j.cpr.2020.101813

TY - JOUR

T1 - Mediators in psychological and psychoeducational interventions for the prevention of depression and anxiety

T2 - A systematic review

AU - Moreno-Peral, P.

AU - Bellón, J.A.

AU - Huibers, M.J.H.

AU - Mestre, J.M.

AU - García-López, L.J.

AU - Taubner, S.

AU - Rodríguez-Morejón, A.

AU - Bolinski, F.

AU - Sales, C.M.D.

AU - Conejo-Cerón, S.

N1 - Funding Information: This study was supported by the Prevention and Health Promotion Research Network (redIAPP) RD16/0007 , SAMSERAP group RD16/0007/0010 . This study was partially funded by the European Network on Individualized Psychotherapy Treatment of Young People with Mental Disorders (TREATme) (COST Action CA16102 ) and a fellowship awarded to CS by the Center for Psychology at the University of Porto , Portuguese Foundation for Science and Technology ( FCT UID/ PSI/00050/2013 ) and the EU FEDER and COMPETE programs ( POCI-01-0145- FEDER-007294 ). The funders had no direct role in the design of the study and they had no input in the interpretation or publication of the study results. Funding Information: This study was supported by the Prevention and Health Promotion Research Network (redIAPP) RD16/0007, SAMSERAP group RD16/0007/0010. This study was partially funded by the European Network on Individualized Psychotherapy Treatment of Young People with Mental Disorders (TREATme) (COST Action CA16102) and a fellowship awarded to CS by the Center for Psychology at the University of Porto, Portuguese Foundation for Science and Technology (FCT UID/ PSI/00050/2013) and the EU FEDER and COMPETE programs (POCI-01-0145- FEDER-007294). The funders had no direct role in the design of the study and they had no input in the interpretation or publication of the study results.The authors thank the European Network on Individualized Psychotherapy Treatment of Young People with Mental Disorders (TREATme), (COST Action CA16102) for its support. Publisher Copyright: © 2020 Elsevier Ltd

PY - 2020

Y1 - 2020

N2 - Although efforts have been undertaken to determine how psychological interventions exert their effects, research on mediators and mechanisms of change remains limited, especially in the field of prevention. We aimed to assess available evidence on mediators of psychological and psychoeducational interventions for the prevention of depression and anxiety in varied populations. A systematic review using PubMed, PsycINFO, Web of Science, Embase, OpenGrey, and the Cochrane Central Register of Controlled Trials was performed. Two independent reviewers assessed the eligibility criteria of all articles, extracted data, determined the risk of bias in randomized controlled trials, and the requirements for mediators. The outcomes were mediators of the incidence of depression or anxiety and/or the reduction of symptoms of depression or anxiety. We identified 28 nested mediator studies within randomized controlled trials involving 7442 participants. Potential cognitive, behavioral, emotional and interpersonal mediators were evaluated in different psychological and psychoeducational interventions to prevent depression and anxiety. The effects were mediated mainly by cognitive variables, which were the most commonly assessed factors. For depression, the mediator with the strongest empirical support was negative thinking in adults. Cognitive change is an important mediator in preventive psychological and psychoeducational interventions for both anxiety and depression.

AB - Although efforts have been undertaken to determine how psychological interventions exert their effects, research on mediators and mechanisms of change remains limited, especially in the field of prevention. We aimed to assess available evidence on mediators of psychological and psychoeducational interventions for the prevention of depression and anxiety in varied populations. A systematic review using PubMed, PsycINFO, Web of Science, Embase, OpenGrey, and the Cochrane Central Register of Controlled Trials was performed. Two independent reviewers assessed the eligibility criteria of all articles, extracted data, determined the risk of bias in randomized controlled trials, and the requirements for mediators. The outcomes were mediators of the incidence of depression or anxiety and/or the reduction of symptoms of depression or anxiety. We identified 28 nested mediator studies within randomized controlled trials involving 7442 participants. Potential cognitive, behavioral, emotional and interpersonal mediators were evaluated in different psychological and psychoeducational interventions to prevent depression and anxiety. The effects were mediated mainly by cognitive variables, which were the most commonly assessed factors. For depression, the mediator with the strongest empirical support was negative thinking in adults. Cognitive change is an important mediator in preventive psychological and psychoeducational interventions for both anxiety and depression.

KW - Anxiety

KW - Depression

KW - Mediators

KW - Prevention

KW - Systematic review

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U2 - 10.1016/j.cpr.2020.101813

DO - 10.1016/j.cpr.2020.101813

M3 - Review article

C2 - 32045780

AN - SCOPUS:85079064639

SN - 0272-7358

VL - 76

JO - Clinical Psychology Review

JF - Clinical Psychology Review

M1 - 101813

ER -

Mediators in psychological and psychoeducational interventions for the prevention of depression and anxiety: A systematic review

Abstract

Bibliographical note

Funding

Keywords

UN SDGs

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