Evaluation And Improvement Of The Implementation Of The Intention To Treat Model In Controlled Trials Of Psychotherapies
Funder
National Health and Medical Research Council
Funding Amount
$409,000.00
Summary
Randomized controlled trials (RCTs) are the best way to determine whether patients benefit from a new treatment. In these trials patients are randomly assigned to the new, active treatment, or to a placebo or existing treatment. The groups are compared at the end of the trial. RCTs may be mounted for psychotherapy and educational programs as well as for new drugs and other medical procedures. A major problem for RCTs concerns their statistical analysis when some participants drop out before the ....Randomized controlled trials (RCTs) are the best way to determine whether patients benefit from a new treatment. In these trials patients are randomly assigned to the new, active treatment, or to a placebo or existing treatment. The groups are compared at the end of the trial. RCTs may be mounted for psychotherapy and educational programs as well as for new drugs and other medical procedures. A major problem for RCTs concerns their statistical analysis when some participants drop out before the end of the trial. Dropout is common in trials. Participants may drop out because they feel no benefit from the treatment, dislike side effects, or even because they have recovered quickly. Thus, to compare the groups remaining at the end of trial may introduce serious bias. The Intention to Treat (ITT) principle which has been widely adopted states that outcomes from all patients who enter a trial should be compared at its end. To achieve this, the last available observation for a participant who withdraws is often 'carried forward' to the end of the trial. While currently believed to be conservative, there is evidence that this approach is not always optimal. This project will examine the way in which dropout is treated in trials of two common psychiatric conditions: depression and anxiety disorders. The project will also undertake simulation research to investigate which of a number of modern methods of data analysis yield the most accurate results when participants drop out, and how changes in the design of trials might improve accuracy. The project is important because it will enable researchers to improve the conduct of trials in the future. Erroneous conclusions drawn from RCTs stand to condemn those suffering from disorders to ineffective treatment and to lead to the premature abandonment of potentially useful interventions which are falsely claimed to lack efficacy.Read moreRead less
Theoretically Guided Improvement In The Treatment Of Social Phobia: A Randomised Controlled Trial.
Funder
National Health and Medical Research Council
Funding Amount
$302,830.00
Summary
Social phobia is a serious mental disorder that affects up to 13% of the population across their lifetime and causes marked life interference and costs to the community. Treatments for social phobia have been improving over the past decades and currently, there is good outcome with standard treatment packages. However, several authors have pointed out that treatment outcomes, while good, are far from perfect. We have recently developed a model of social anxiety that points out how people with so ....Social phobia is a serious mental disorder that affects up to 13% of the population across their lifetime and causes marked life interference and costs to the community. Treatments for social phobia have been improving over the past decades and currently, there is good outcome with standard treatment packages. However, several authors have pointed out that treatment outcomes, while good, are far from perfect. We have recently developed a model of social anxiety that points out how people with social phobia may be different to the average. Based on this model, we can make several predictions for potential improvements to current treatment packages. The current grant seeks to test these improvements. The proposal is to compare people with social phobia who receive a standard treatment package with those who receive this packaged plus the newly predicted components. It is predicted that the addition of these extra components will results in considerably greater improvements in both the short and long terms.Read moreRead less
First-Line Management Of Youth Depression: A Randomised Placebo-Controlled Trial Of Fluoxetine And Cognitive Behavioural Therapy
Funder
National Health and Medical Research Council
Funding Amount
$1,316,648.00
Summary
The study aims to establish how to best treat adolescents and young adults when they present to mental health clinics with moderate-to-severe depression. There is, at present, considerable uncertainty as to whether young people should be started on antidepressant treatment at the same time as psychotherapy, or whether psychotherapy alone be commenced first. The study aims to clarify this important issue by implementing a trial that compares both treatment approaches.
Personalising The Delivery Of E-mental Health Interventions For Eating Disorders
Funder
National Health and Medical Research Council
Funding Amount
$632,429.00
Summary
This Investigator Grant aims to evaluate the efficacy and cost-effectiveness of an eHealth prevention and treatment program using a stepped-care approach. Findings are expected to show that eating disorders can be effectively and efficiently treated and prevented through low intensity, cheap, and widely available digital interventions, and by doing so it will directly address the unmet needs of people with or at risk for an eating disorder in a practical, scalable, and cost-effective manner.
Stress Vulnerability In Youth With Borderline Personality Disorder
Funder
National Health and Medical Research Council
Funding Amount
$873,689.00
Summary
Borderline personality disorder (BPD) is a severe mental disorder with adverse long-term outcomes, including suicide. BPD is characterised by vulnerability to stressful life events and catastrophic responses to stress. This study of youth early in the course of BPD examines the baseline biological characteristics of the stress response system, how these characteristics might be influenced by treatment and how this relates to treatment outcome. The findings will inform early intervention for BPD.