title: BEAT-IT: Comparing a behavioural activation treatment for depression in adults with intellectual disabilities with an attention control: study protocol for a randomised controlled trial.
abstract: BACKGROUND
  Depression appears to be more enduring amongst people with intellectual disabilities, suggesting that it is a more chronic problem or more poorly managed in this population. This is not helped by a lack of evidence about the effectiveness of psychological therapies for people who have intellectual disabilities and depression. Behavioural activation, which aims to counteract depression by increasing individuals' level of meaningful activity and their exposure to positive reinforcers, has proven to be as effective as cognitive behavioural therapy in the general population. Given that this therapy makes fewer communicative demands and focuses on activity, it was thought that behavioural activation would be both accessible and apt for people with intellectual disabilities, who are often socially marginalised.
  
  
  METHODS
  This study is a multi-centre single-blind randomised controlled trial of behavioural activation versus a self-help attention control intervention for depression in adults with mild/moderate intellectual disabilities. The study has an internal pilot in one centre, to establish that recruitment can be built up and sustained at the required level, before being rolled out across the other sites. One hundred sixty-six participants will be randomly assigned to the behavioural activation or self-help interventions, which will be delivered to individuals with mild to moderate intellectual disabilities, accompanied by someone who provides them with regular support. Both interventions are manualised and will be delivered over a period of approximately 4 months. The primary outcome measure will be the Glasgow Depression Scale, a self-report measure which is completed at baseline and 4 and 12 months post-randomisation. Secondary outcomes include measures of participants' activity levels, proxy reports of depressive symptoms, and cost-effectiveness.
  
  
  CONCLUSIONS
  The study will provide evidence about the effectiveness of behavioural activation for depression, adapted for people who have mild/moderate intellectual disabilities, and will inform the delivery of psychological therapies to people with intellectual disabilities in practice.
  
  
  BACKGROUND
  Date trial registered: Nov. 13, 2012; trial registration number: ISRCTN 09753005.
authors.affiliation: Institute of Health and Wellbeing, University of Glasgow, Academic Centre, Gartnavel Royal Hospital, 1055 Great Western Road, Glasgow, G12OXH, UK. andrew.jahoda@glasgow.ac.uk.
authors.forename: Andrew
authors.initials: A
authors.lastname: Jahoda
authors.affiliation: Institute of Health and Wellbeing, University of Glasgow, Academic Centre, Gartnavel Royal Hospital, 1055 Great Western Road, Glasgow, G12OXH, UK. craig.melville@glasgow.ac.uk.
authors.forename: Craig
authors.initials: C
authors.lastname: Melville
authors.affiliation: Institute of Health and Wellbeing, University of Glasgow, Academic Centre, Gartnavel Royal Hospital, 1055 Great Western Road, Glasgow, G12OXH, UK. sally-ann.cooper@glasgow.ac.uk.
authors.forename: Sally-Ann
authors.initials: SA
authors.lastname: Cooper
authors.affiliation: CEDAR, University of Warwick, Kirby Corner Road, Coventry, CV4 8UW, UK. r.hastings@warwick.ac.uk.
authors.forename: Richard
authors.initials: R
authors.lastname: Hastings
authors.affiliation: HETA, Institute of Health and Wellbeing, University of Glasgow, 1 Lilybank Gardens, Glasgow, G12 8RZ, UK. andrew.briggs@glasgow.ac.uk.
authors.forename: Andrew
authors.initials: A
authors.lastname: Briggs
authors.affiliation: Cumbria Partnership NHS Foundation Trust, Penrith CA11, Portland PI, UK. dave.dagnan@cumbria.nhs.uk.
authors.forename: Dave
authors.initials: D
authors.lastname: Dagnan
authors.affiliation: CeDR, Faculty of Health and Medicine, Furness College, Lancaster University, Lancaster, LA14YG, UK. chris.hatton@lancaster.ac.uk.
authors.forename: Chris
authors.initials: C
authors.lastname: Hatton
authors.affiliation: Robertson Centre, University of Glasgow, Boyd Orr Building, Glasgow, G12 ORR, UK. alex.mcconnachie@glasgow.ac.uk.
authors.forename: Alex
authors.initials: A
authors.lastname: McConnachie
authors.affiliation: Institute of Health and Wellbeing, University of Glasgow, Academic Centre, Gartnavel Royal Hospital, 1055 Great Western Road, Glasgow, G12OXH, UK. chris.williams@glasgow.ac.uk.
authors.forename: Chris
authors.initials: C
authors.lastname: Williams
authors.affiliation: School of Psychology, Bangor University, Brigantia Building, Bangor, Gwynedd, North Wales, LL57 2DG, UK. r.s.jones@bangor.ac.uk.
authors.forename: Robert S P
authors.initials: RS
authors.lastname: Jones
mesh_terms: D000328:Adult; D001288:Attention; D001521:Behavior Therapy / Q000191:economics / Q000379:methods*; D002985:Clinical Protocols; D003362:Cost-Benefit Analysis; D003863:Depression / Q000175:diagnosis / Q000191:economics / Q000523:psychology / Q000628:therapy*; D017048:Health Care Costs; D006801:Humans; D008607:Intellectual Disability / Q000175:diagnosis / Q000523:psychology*; D019989:Persons with Intellectual Disabilities / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D012107:Research Design; D016037:Single-Blind Method; D013997:Time Factors; D016896:Treatment Outcome; D006113:United Kingdom