TY - JOUR
T1 - Predicting clinical outcomes in a blended care intervention for early psychosis
T2 - Acceptance and Commitment Therapy in Daily-Life (ACT-DL)
AU - Bonnier, Rafael A.
AU - Beames, Joanne R.
AU - Kiekens, Glenn
AU - van Aubel, Evelyne
AU - Schirmbeck, Frederike
AU - de Haan, Lieuwe
AU - Marcelis, Machteld
AU - van der Gaag, Mark
AU - van Winkel, Ruud
AU - van Amelsvoort, Therese
AU - Vaessen, Thomas
AU - Reininghaus, Ulrich
AU - Lafit, Ginette
AU - Myin-Germeys, Inez
PY - 2025/1/7
Y1 - 2025/1/7
N2 - ACT in Daily Life (ACT-DL) is a blended-care Ecological Momentary Intervention that extends ACT into the daily life of individuals, improving psychotic distress, negative symptoms, and global functioning. However, it remains unclear whether ACT-DL works equally for everyone. We investigated whether moderators (i.e., sociodemographic information, personality, and trauma history) determine clinical outcomes in individuals with early psychosis receiving ACT-DL. Seventy-one participants from the INTERACT trial, using ACT-DL, were analyzed. Outcomes included psychotic distress, negative symptoms, global functioning, and psychological flexibility. Using multivariate-multilevel models, we evaluated the effects of sociodemographics, personality, and childhood trauma across baseline, post-intervention, and six- and 12-month follow-ups. Sociodemographic characteristics and personality predicted clinical outcomes. Higher education demonstrated more substantial improvement in global functioning at 6- (B = 7.43, p = 0.04) and 12-FU (B = 10.74, p = 0.002) compared to lower education. Higher extraversion showed less improvement in negative symptoms at 12-FU (B = 1.24, p = 0.01) and more improvement in global functioning at post-intervention (B = 0.39, p = 0.046) and 6-FU (B = 1.40, p = 0.02) compared to lower extraversion. Higher negative affectivity showed more improvement in negative symptoms at 12-FU (B = -1.59, p = 0.001) and higher psychological flexibility at 12-FU (B = 8.38, p = 0.001) compared to lower negative affectivity. Our findings suggest that while ACT-DL improves clinical outcomes in individuals with early psychosis, the improvement rate is dissimilar for individuals and predictable by baseline characteristics. If replicated, these findings enable precision medicine approaches in allocating ACT-DL for early psychosis.
AB - ACT in Daily Life (ACT-DL) is a blended-care Ecological Momentary Intervention that extends ACT into the daily life of individuals, improving psychotic distress, negative symptoms, and global functioning. However, it remains unclear whether ACT-DL works equally for everyone. We investigated whether moderators (i.e., sociodemographic information, personality, and trauma history) determine clinical outcomes in individuals with early psychosis receiving ACT-DL. Seventy-one participants from the INTERACT trial, using ACT-DL, were analyzed. Outcomes included psychotic distress, negative symptoms, global functioning, and psychological flexibility. Using multivariate-multilevel models, we evaluated the effects of sociodemographics, personality, and childhood trauma across baseline, post-intervention, and six- and 12-month follow-ups. Sociodemographic characteristics and personality predicted clinical outcomes. Higher education demonstrated more substantial improvement in global functioning at 6- (B = 7.43, p = 0.04) and 12-FU (B = 10.74, p = 0.002) compared to lower education. Higher extraversion showed less improvement in negative symptoms at 12-FU (B = 1.24, p = 0.01) and more improvement in global functioning at post-intervention (B = 0.39, p = 0.046) and 6-FU (B = 1.40, p = 0.02) compared to lower extraversion. Higher negative affectivity showed more improvement in negative symptoms at 12-FU (B = -1.59, p = 0.001) and higher psychological flexibility at 12-FU (B = 8.38, p = 0.001) compared to lower negative affectivity. Our findings suggest that while ACT-DL improves clinical outcomes in individuals with early psychosis, the improvement rate is dissimilar for individuals and predictable by baseline characteristics. If replicated, these findings enable precision medicine approaches in allocating ACT-DL for early psychosis.
KW - NEGATIVE SYMPTOM SCALE
KW - COMPREHENSIVE ASSESSMENT
KW - PERSONALITY-TRAITS
KW - EPISODE PSYCHOSIS
KW - CHILDHOOD TRAUMA
KW - 5-FACTOR MODEL
KW - METAANALYSIS
KW - DROPOUT
KW - VERSION
U2 - 10.1038/s41398-024-03214-1
DO - 10.1038/s41398-024-03214-1
M3 - Article
SN - 2158-3188
VL - 15
JO - Translational Psychiatry
JF - Translational Psychiatry
IS - 1
M1 - 3
ER -