title: The efficacy of life-review as online-guided self-help for adults: a randomized trial.
abstract: OBJECTIVE
  The study used a randomized controlled trial to investigate the short-term and long-term effects of life-review as online-guided self-help in adults (40+) with moderate depressive symptomatology. We evaluated ego-integrity and rumination as mediators and assessed whether the effects of the intervention did not differ across middle-aged and older adults.
  
  
  METHODS
  Effects of life-review (n = 58) were compared with a waiting list group (n = 58) and an expressive writing intervention (n = 58) on depressive symptoms (primary outcome), anxiety, and well-being (secondary outcomes). Mediator and moderator analyses were also applied.
  
  
  RESULTS
  Compared with the waiting list, life-review reduced depressive symptoms (d = 0.35) and enhanced emotional (d = 0.16) and psychological well-being (d = 0.27). Life-review was not more effective than expressive writing. The effects on depressive symptoms were partly related with increases in ego-integrity and decreases in rumination. The intervention is applicable for middle-aged and older adults.
  
  
  CONCLUSIONS
  Life-review is effective as self-help for middle-aged and older adults with moderate depressive symptomatology compared with a waiting list group. Future research should investigate whether stimulating ego-integrity and reducing rumination enhance the effects of the intervention.
authors.affiliation: Department of Psychology, Health, and Technology, University of Twente, Enschede, The Netherlands. s.m.a.lamers@utwente.nl.
authors.forename: Sanne M A
authors.initials: SM
authors.lastname: Lamers
authors.affiliation: Department of Psychology, Health, and Technology, University of Twente, Enschede, The Netherlands.
authors.forename: Ernst T
authors.initials: ET
authors.lastname: Bohlmeijer
authors.affiliation: Department of Psychology, Health, and Technology, University of Twente, Enschede, The Netherlands.
authors.forename: Jojanneke
authors.initials: J
authors.lastname: Korte
authors.affiliation: Department of Psychology, Health, and Technology, University of Twente, Enschede, The Netherlands.
authors.forename: Gerben J
authors.initials: GJ
authors.lastname: Westerhof
mesh_terms: D000328:Adult; D000368:Aged; D001325:Autobiographies as Topic; D003376:Counseling / Q000379:methods*; D003863:Depression / Q000628:therapy*; D034742:Electronic Mail / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D033262:Narration; D012648:Self Care / Q000379:methods*; D016896:Treatment Outcome
keywords: Depression; Ego-integrity; Life-review; Randomized controlled trial; Rumination; Self-help.