title: Targeted prevention of common mental health disorders in university students: randomised controlled trial of a transdiagnostic trait-focused web-based intervention.
abstract: BACKGROUND
  A large proportion of university students show symptoms of common mental disorders, such as depression, anxiety, substance use disorders and eating disorders. Novel interventions are required that target underlying factors of multiple disorders.
  
  
  OBJECTIVE
  To evaluate the efficacy of a transdiagnostic trait-focused web-based intervention aimed at reducing symptoms of common mental disorders in university students.
  
  
  METHODS
  Students were recruited online (n=1047, age: M=21.8, SD=4.2) and categorised into being at high or low risk for mental disorders based on their personality traits. Participants were allocated to a cognitive-behavioural trait-focused (n=519) or a control intervention (n=528) using computerised simple randomisation. Both interventions were fully automated and delivered online (trial registration: ISRCTN14342225). Participants were blinded and outcomes were self-assessed at baseline, at 6 weeks and at 12 weeks after registration. Primary outcomes were current depression and anxiety, assessed on the Patient Health Questionnaire (PHQ9) and Generalised Anxiety Disorder Scale (GAD7). Secondary outcome measures focused on alcohol use, disordered eating, and other outcomes.
  
  
  RESULTS
  Students at high risk were successfully identified using personality indicators and reported poorer mental health. A total of 520 students completed the 6-week follow-up and 401 students completed the 12-week follow-up. Attrition was high across intervention groups, but comparable to other web-based interventions. Mixed effects analyses revealed that at 12-week follow up the trait-focused intervention reduced depression scores by 3.58 (p<.001, 95%CI [5.19, 1.98]) and anxiety scores by 2.87 (p=.018, 95%CI [1.31, 4.43]) in students at high risk. In high-risk students, between group effect sizes were 0.58 (depression) and 0.42 (anxiety). In addition, self-esteem was improved. No changes were observed regarding the use of alcohol or disordered eating.
  
  
  CONCLUSIONS
  This study suggests that a transdiagnostic web-based intervention for university students targeting underlying personality risk factors may be a promising way of preventing common mental disorders with a low-intensity intervention.
  
  
  BACKGROUND
  ControlledTrials.com ISRCTN14342225.
authors.affiliation: Department of Psychology, King's College London, Institute of Psychiatry, London, United Kingdom.
authors.forename: Peter
authors.initials: P
authors.lastname: Musiat
authors.affiliation: Centre hospitalier universitaire Sainte-Justine, Université de Montréal, Montréal, Canada.
authors.forename: Patricia
authors.initials: P
authors.lastname: Conrod
authors.affiliation: Department of Psychological Medicine, King's College London, Institute of Psychiatry, London, United Kingdom.
authors.forename: Janet
authors.initials: J
authors.lastname: Treasure
authors.affiliation: Department of Health Service and Population Research, King's College London, Institute of Psychiatry, London, United Kingdom.
authors.forename: Andre
authors.initials: A
authors.lastname: Tylee
authors.affiliation: Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom.
authors.forename: Chris
authors.initials: C
authors.lastname: Williams
authors.affiliation: Department of Psychological Medicine, King's College London, Institute of Psychiatry, London, United Kingdom.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Schmidt
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000517:prevention & control*; D008603:Mental Health; D008875:Middle Aged; D010549:Personal Satisfaction; D019655:Quantitative Trait, Heritable; D012647:Self-Assessment; D013334:Students / Q000523:psychology*; D011795:Surveys and Questionnaires; D014495:Universities; D055815:Young Adult
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