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Moderators of Guided and Unguided Self-Help for Depression: The Role of Self-Regulation
AuthorEpstein, Emerson Michael
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Self-help interventions for depression have been used to help reduce the gap inthe need for treatment and the availability of resources. However, not everyone benefits from self-help and unguided self-help tends to have poorer treatment response and higher dropout than guided self-help. Nonetheless, some people still benefit from unguided self- help. Unguided self-help leans heavily on the individual to initiate and maintain change and those with self-regulation are more like to engage in change on their own. The purpose of this study was to understand the self-regulatory processes that may be used to stratify patients into guided and unguided interventions. Using theories of self-regulation, we proposed four self-regulatory processes that impact change, are known to be variable in depressive disorders, and might affect whom benefits from guided versus unguided self-help: autonomous motivation, goal specificity, response inhibition, and delay discounting. After enrolling 336 participants and included 184 in our primary analyses, we observed significant treatment effects of our two self-help groups. We did not observe a significant difference between our two experimental groups on any outcomes (e.g., treatment response, odds of completing, etc.). Significant interactions between these self- regulatory variables and our group term were seldom observed. Some self-regulatory processes did predict outcomes for our entire sample. Implications for future research are discussed.