Artículos Psicología

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A developmental evaluation approach to lesson study: exploring the impact of lesson study in London schools
(2019) Godfrey, David; Seleznyov, Sarah; Anders, Jake; Wollaston, Nicholas; Barrera, Fabián
This paper presents a methodology for the developmental evaluation of a lesson study programme in primary and secondary schools. Our approach combined the principles of, i) user-focused evaluation, in which as evaluators we acted as participatory members of the innovation team and sought to involve users in the design and implementation of evaluation tools, ii) a multi-level logical model to guide data collection and impact measurement, and iii) an ‘improving rather than proving’ approach to evaluation. The evaluation tools were used on a programme to promote lesson study in London schools involving 133 teachers and 33 schools. The evaluation methodology included outcomes at school leadership, teacher and student levels. Issues of internal and external validity are discussed and strengths and weaknesses are described. Findings showed promise in the use of our scale to measure changes in teacher pedagogical outcomes and in the recording of qualitative changes to both teachers and students as a result of the lesson study cycles. Suggestions for the future use and development of this methodology are proposed, including better use of control groups and quantitative measures to record changes in learning outcomes for students.
A methodological approach to couples therapy using a conjoint relational drawing process for the description of and intervention with relational patterns and meaning-attributions
(2019) Molina, María Elisa; Tapia Villanueva, Luis; Fossa, Pablo; Pereira, Ximena; Aspillaga H., Carolina; Puerta, Sofía de la
The consultants’ observation and understanding of relational patterns in couples therapy is a main therapeutic objective and a resource for change. The Conjoint Relational Drawing Process (CRDP) methodology uses a drawing technique to enable the display and efficient observation of relational patterns. It was designed to address the relational process in couples therapy. Two couples participated in making a conjoint drawing that was video-recorded and later observed and analysed by the couple and the therapist and the researchers. The relational pattern descriptions and meaning attributions about the video-recorded drawings were analysed in the therapeutic and research contexts. As a result, new perspectives regarding relational patterns and meaning attributions emerged, revealing modes of interaction that allowed new viewpoints about difficulties and ways forward. This approach for the clinical application of CRDP contributed to the evaluation and intervention in the couples’ therapy, and enabled issues to be defined early in the process
A Multi-Country Study of Harms to Children Because of Others’ Drinking
(2017) Laslett, Anne-Marie; Rankin, Georgia; Waleewong, Orratai; Callinan, Sarah; Hoangs, Hanh T. M.; Florenzano, Ramón; Hettige, Siri; Obot, Isidore; Siengsounthone, Latsamy; Ibanga, Akanidomo; Hope, Ann; Vu, Hanh T. M.; Thamarangsi, Thaksaphon; Rekve, Dag; Room, Robin
Objective: This study aims to ascertain and compare the prevalence and correlates of alcohol-related harms to children cross-nationally. Method: National and regional sample surveys of randomly selected households included 7,848 carers (4,223 women) from eight countries (Australia, Chile, Ireland, Lao People’s Democratic Republic [PDR], Nigeria, Sri Lanka, Thailand, and Vietnam). Country response rates ranged from 35% to 99%. Face-to-face or telephone surveys asking about harm from others’ drinking to children ages 0–17 years were conducted, including four specific harms: that because of others’ drinking in the past year children had been (a) physically hurt, (b) verbally abused, (c) exposed to domestic violence, or (d) left unsupervised. Results: The prevalence of alcohol-related harms to children varied from a low of 4% in Lao PDR to 14% in Vietnam. Alcohol-related harms to children were reported by a substantial minority of families in most countries, with only Lao PDR and Nigeria reporting significantly lower levels of harm. Alcohol-related harms to children were dispersed sociodemographically and were concentrated in families with heavy drinkers. Conclusions: Family-level drinking patterns were consistently identified as correlates of harm to children because of others’ drinking, whereas sociodemographic factors showed few obvious correlations.
A multi-country test of brief reappraisal interventions on emotions during the COVID-19 pandemic
(2021) Wang, Ke; Goldenberg, Amit; Dorison, Charles A.; Silva, Jaime; PSA Group
The COVID-19 pandemic has increased negative emotions and decreased positive emotions globally. Left unchecked, these emotional changes might have a wide array of adverse impacts. To reduce negative emotions and increase positive emotions, we tested the effectiveness of reappraisal, an emotion-regulation strategy that modifies how one thinks about a situation. Participants from 87 countries and regions (n= 21,644) were randomly assigned to one of two brief reappraisal interventions (reconstrual or repurposing) or one of two control conditions (active or passive). Results revealed that both reappraisal interventions (vesus both control conditions) consistently reduced negative emotions and increased positive emotions across different measures. Reconstrual and repurposing interventions had similar effects. Importantly, planned exploratory analyses indicated that reappraisal interventions did not reduce intentions to practice preventive health behaviours. The findings demonstrate the viability of creating scalable, low-cost interventions for use around the world.
A qualitative study of the experience of parents attending a psychoanalytic parent-toddler group
(2013) Barros, Maria; Kitson, Annabel; Midgley, Nick
A sense of community at school and the subjective well‐being of Chilean students
(2021) Villarroel, Alejandra; Alfaro Inzunza, Jaime; Reyes Reyes, Fernando; Carrillo, Gisela; Ditzel, Ana Loreto
Understand the degree to which a Sense of Community at School can predict the Life Satisfaction of Chilean students in the fifth and seventh grades. The classroom and school components will be presented separately. The research was designed as a descriptive study using a survey with a probabilistic sample made up of 1959 students (52.6% male and 47.4% female) in the fifth and seventh grades at elementary schools in the cities of Concepción and Santiago in Chile. A multiple linear regression analysis was done using the Multidimensional Scales of School Sense of Community (SOC‐S) and Classroom Sense of Community (SOC‐C) as predictors of life satisfaction measured with the Student Life Satisfaction Scale (SLSS). Multigroup analysis was conducted to make comparisons by sex and grade. The dimension of “sense of belonging and emotional connection” of the SOC‐C and the dimension of “belonging” of the SOC‐S predict life satisfaction for fifth grade students. The additional dimension of “emotional connection” of the SOC‐S scale was included for the seventh‐grade students. The sense that one is part of the school community is a dimension that affects childhood life satisfaction. Its level of contribution varies by age, with the sense of belonging and emotional connection variables being the relevant ones.
A systematic narrative review of subjective well-being promotion intervention programmes in the school setting
(2022) Chuecas, María Josefina; Alfaro, Jaime; Benavente, Maríavictoria; Ditzel, Loreto
Given the growing number of interventions aimed at promoting well-being in the school setting, this narrative review sought to synthesise available evidence about the characteristics of the interventions: theoretical components, evaluation designs and their reported results. Two electronic databases (EBSCO and Scopus) were searched, and articles published between 2015 and 2020 were included. A total of 1477 articles were identified from these search engines and based on the systematic scrutinising process a total of 55 articles were included in the review. Only one-third of the studies employed experimental, causal designs. Therefore, the review is unable to make conclusive statements about promising approaches, Nevertheless, the results show that the majority of interventions used to promote school children's well-being were based on positive psychology, most of which were focused on promoting positive emotions. The studies reviewed also suggest that longer interventions, with a higher number of sessions, which are targeted at multiple components of positive emotions are more likely to yield positive results. Almost all these studies were carried out in developed countries, with only one empirical work in Latin America. Therefore, more robust experimental studies using causal designs are needed, and more empirical work is needed in low-and middle-income countries on effective practices in developing children's subjective well-being.
Access to material resources and the subjective well-being of children in Brazil and Chile
(2021) Ditzel, Ana Loreto; Chuecas, María Josefina; Bedín, Lívia; Torres-Vallejos, Javier; Villarroel, Alejandra; Benavente, Mariavictoria; Alfaro Inzunza, Jaime; Castellá Sarriera, Jorge; Juarros-Basterretxea, Joel
This article analyzes the relationships between the material conditions and the subjective well-being of 3,716 children (50.5% girls) between 10 and 12 years of age (M = 11.4) in Chile and Brazil. These are the two Latin American countries that took part in the third wave of the Children’s Worlds research. The material conditions of the children were assessed using latent classes. A multivariate analysis of covariance was done next in order to test the influence of material conditions over the children's subjective well-being and interpersonal relationships. The association between gender and country variables of the children was also studied. The results showed that although the average subjective well-being scores of the children were high in general, the class analysis showed significant differences between the results for children with better material conditions than those with poorer material conditions. The latter group presented lower subjective well-being levels. MANCOVA was used to analyze the mean differences in subjective well-being levels and interpersonal relationships controlling variables of gender and country of residence. This showed that children with greater access to better material conditions showed significantly higher levels of subjective well-being levels and had a more positive view of their interpersonal relationships in all areas assessed compared to those who reported worse material conditions. These results are discussed in view of the high indices of material deprivation that exist in Latin America during childhood as well as how these findings may help better understand the well-being of children living in Latin American countries
Acoso Escolar y su Relación con el Consumo de Drogas y Trastornos Alimentarios: Comparación entre Adolescentes de Chile y España.
(2015) Carmona-Torres, José A; Cangas, Adolfo J.; Langer, Álvaro I.; Aguilar-Parra, José M.; Gallego, José
El objetivo de este trabajo fue analizar la asociación entre acoso escolar, trastornos alimentarios y consumo de drogas en adolescentes de España y Chile. Participaron estudiantes de Educación Secundaria y Bachillerato procedentes de Chile (n= 666) y España (n= 294). Los resultados muestran que los estudiantes de ambos países que actúan como acosadores presentan un consumo de drogas significativamente mayor que los no acosadores. Por su parte, las víctimas muestran un mayor riesgo de trastornos alimentarios. Siendo la fuerza de dichas asociaciones grandes y medias con base en el estimador del tamaño de efecto. Por el contrario, ser acosador no se ha asociado con trastornos alimentarios, ni ser víctima con consumo de drogas, salvo para el consumo de tabaco. Por su parte, mientras que los valores medios de acoso escolar son similares en ambas submuestras, los estudiantes españoles presentan un consumo mayor de sustancias y mayor riesgo de trastornos alimentarios. En conclusión, este estudio evidencia la vinculación entre ser acosador con consumo de drogas y ser víctima de acoso escolar con trastornos alimentarios.
Actitudes hacia la paz y la guerra, identidad social e ideología en universitarios peruanos
(2016) León, Ramón; Sirlopú, David
Finalizada la Guerra del Pacífico (1879-1884), las relaciones entre Chile y Perú han atravesado por etapas de animosidad o indiferencia a lo largo del tiempo. A fines del siglo XX, sin embargo, se gestó un mayor acercamiento entre los gobiernos y ciudadanos de ambos países. Una muestra de esto lo representa el actual dinamismo de los flujos comerciales bilaterales. Pero este periodo de integración podría enfrentar un retroceso, una vez que se conozca el fallo que entregará la Corte Internacional de La Haya sobre un diferendo marítimo entre estos países. Este fue el telón de fondo donde se desarrolló la presente investigación, cuyo propósito general fue explorar las actitudes hacia la paz y la guerra, entendidas como dos dimensiones independientes. Para tal fin, se utilizó la Escala de Actitudes hacia la Paz y la Guerra (EAPG) elaborada por Bizumic et al. (2013), la que fue aplicada a 449 universitarios de Lima (Perú). Se analizó la estructura factorial de la EAPG así como el papel predictor de la identidad nacional, la identidad latinoamericana, el nacionalismo y la Orientación a la Dominancia Social sobre las actitudes hacia la paz y la guerra. Los resultados muestran una solución de cuatro factores de la EAPG, además de una marcada tendencia al pacifismo entre los participantes. La identidad nacional y la Orientación a la Dominancia Social fueron los predictores más importantes. Estos hallazgos son discutidos a la luz de sus implicancias teóricas y socio-políticas.
Actitudes implícitas y explícitas hacia personas con síndrome de Down: un estudio en colegios con y sin programas de integración de Chile
(2012) Sirlopú, David; González, Roberto; Bohner, Gerd; Siebler, Frank; Millar, Andrés; Ordóñez, Gabriela; Torres, David; Tezanos-Pinto, Pablo de
La integración escolar puede disminuir el prejuicio entre sus miembros a través del contacto. En esta área, las investigaciones suelen utilizar medidas explícitaspero son escasas las que han usado mediciones implícitas. En este artículo sepretende evaluar ambos tipos de actitudes hacia las personas con síndrome de Down (PCSD). Ochenta estudiantes chilenos entre los 11 y 15 años,pertenecientes a colegios con ysin programas de integración,participaron de este estudio. Las actitudes implícitas fueron medidas a través del Test de Asociación Implícita (IAT). Los resultados mostraron que los estudiantes, independiente del sistema escolar, mostraron sesgo implícito hacia las PCSD. En las actitudes explícitas, si bien ambas muestras exhibieron bajos niveles de prejuicio, en los colegios integrados se expresó menos ansiedad hacia las PCSD. Finalmente, la calidad, cantidad ysaliencia se asociaron con menor ansiedad y más estereotipospositivos hacia las PCSD.
Adaptación del índice de bienestar personal para adolescentes en lengua española y portuguesa
(2014) Alfaro Inzunza, Jaime; Castellá Sarriera, Jorge; Casas, Ferran; Valdenegro, Boris; Abs, Daniel; Oyarzún, Denise; Bedin, Lívia
Se analizaron las propiedades psicométricas del Índice de Bienestar Personal en una muestra de adolescentes chilenos y brasileños. Se examinó la fiabilidad de la escala mediante el alfa de Cronbach, complementándose con un análisis de las correlaciones ítem-total de los distintos ámbitos de bienestar que la componen. Se realizó un análisis factorial exploratorio (componentes principales) y un análisis factorial confirmatorio multigrupo. Los resultados arrojan un alfa de Cronbach de 0.79 para la versión chilena y de 0.78 para la versión brasileña, que confirman niveles adecuados de fiabilidad encontrados en anteriores estudios. Las correlaciones entre ámbitos de bienestar arroja valores que van entre 0.224 y 0.496 para Chile y 0.24 a 0.46 para Brasil, similares a resultados obtenidos en otros países. Se confirman la estructura monofactorial de la escala, la adecuación de la estructura de la escala para los datos de las dos muestras y la comparabilidad de las medias de sus índices globales. Los resultados permiten suponer la existencia de otros ámbitos del bienestar de los sujetos que no fueron considerados en la propuesta original de la escala.
Adaptación y Análisis Psicométrico de la Versión Española del Índice Internacional de Función Eréctil (IIEF) en Población Chilena
(2017) Hernández, Rodolfo; Thieme, Tatiana; Araos, Fernando
Contar con instrumentos validados en Chile para Disfunción Eréctil (DE), motivó el validar la versión española del Índice Internacional de Función Eréctil (IIEF), en población chilena. Se realizó un estudio cuantitativo no experimental transversal, de muestra no probabilística por conveniencia, con 95 varones adultos de tres centros de salud (Concepción, Talcahuano y Santiago), durante Noviembre 2012 y Junio 2013. Expertos ciegos realizaron entrevista clínica utilizando criterios DSM-V y causas médico-quirúrgicas de DE. Luego de aplicación piloto y adaptación del IIEF, se logró la versión IIEF-Ch aplicándola a toda la muestra. Se analizaron los resultados con SPSS 15.0, obteniéndose alta correlación entre variables (X2: 956.533) y alta adecuación muestral (0,893); dos factores que explican el 81.59% de la varianza del instrumento, con alta confiabilidad (.971) y adecuada validez de criterio, alta sensibilidad (84.5%) y especificidad aceptable (91.9%). La IIEF-Ch es un instrumento válido y confiable para estudios sobre DE en Chile.
Adaptación y validación de la versión chilena de la escala de impacto de evento-revisada (EIE-R)
(2011) Caamano W., Liliana; Fuentes M., Diego; González B., Luis; Melipillán Araneda, Roberto; Sepúlveda C., Marcelo; Valenzuela G., Elizabeth
Background: Impact of Event Scale Revised (IES-R), that evaluates the subjective perception of stress, is used to assess post traumatic stress disorder simptoms. Aim: To adapt and validate IES-R to the Chilean population. Material and Methods: Two hundred seventy eight subjects exposed to stressful life events of varying magnitude were assessed using the IES-R, the Beck Depression Inventory, the anxiety and somatoform subscales of the Depressive, Anxiety and Somatoform Disorders Scale and the AUDIT Questionnaire. Results: IES-R had adequate psychometric properties in terms of internal consistency, test-retest reliability, convergent and discriminating validity. It identified a principal factor, explaining 67% of the variance. Conclusions: The IES-R can be used in the Chilean population to assess the degree of suffering produced by a traumatic event. (Rev Med Chile 2011; 139: 1163-1168).
Adaptación y validación de la versión en español de la Escala de Respeto Incondicional hacia las personas en una muestra de escolares chilenos*
(2019) Sirlopú, David; Pérez-Salas, Claudia; Villarroel, Verónica; García, Catalina; Barrera, Kiyomi; Fierro, Eugenio; Castillo, Isidora
La Escala de Respeto Incondicional hacia las Personas (ERIP) mide las actitudes positivas hacia la autonomía, la igualdad y la integridad de los seres humanos. Esta investigación validó y analizó algunas propiedades psicométricas de la versión en español de la ERIP, en una muestra de 947 escolares chilenos entre 12 y 19 años (M = 15.47, DE = 1.49). Mediante análisis factoriales, exploratorio y confirmatorio, emergieron dos factores: Desprecio hacia los demás (F1) y Respeto hacia los demás (F2). La consistencia interna (F1: Omega = 0.82; F2: Omega = 0.78) así como la validez convergente y discriminante de la ERIP fueron adecuadas. Estos resultados indican que la ERIP es un instrumento válido y confiable para ser aplicado en adolescentes y jóvenes.
Adapting to Adversity: Effects of COVID-19 on Parenting in Chile
(2022) Perez Ewert, J. Carola; Aldoney, Daniela; Vivanco-Carlevari, Anastassia; Coo, Soledad; Guzmán, Eugenio J.; Silva, Jaime R.
The pandemic outbreak in March 2020 and its associated sanitary regulations and restrictions triggered an abrupt and significant change for society in general and for families’ organization in particular. In Chile, the Santiago Metropolitan District was under a strict lockdown that involved the closure of the entire educational system. From a systemic-family stress perspective, the impact of these changes might have consequences not only for each individual family member, but for the parental dynamic and, consequently, for children’s well-being. This paper presents the results of a followup study showing changes in self-reported parental depression and the perceived home organization of mothers and fathers assessed at three different moments: before the pandemic, at the initial outbreak, and after 1 month of strict lockdown. Relevant moderators were explored using linear mixed models to understand the within-subject changes in mothers’ and fathers’ self-reports across the different assessment times. Financial strain, personality traits of self-criticism and dependency, previous parent– child quality interaction, recent major stressful events, and number of children are highlighted as relevant factors that moderate changes in home chaos and parental mental health perception. Significant risks and protective factors are described for fathers and mothers. The use of pre-pandemic measures as baseline levels enabled the identification of personal and family characteristics that were related to better outcomes. The results help increase our understanding of the sanitary regulations’ impacts on the family system and identify vulnerability indicators that should be considered.
Admisibilidad en contextos forenses de indicadores clínicos para la detección del abuso sexual infantil
(2014) Scott, María Teresa; Manzanero, Antonio L.; Muñoz, José M.; Köhnken, Günter
El presente trabajo trata de poner de manifiesto el riesgo, para jueces y tribunales, de valorar de forma acrítica los informes periciales psicológicos referidos a la valoración del daño psíquico en supuestos de abuso sexual infantil (ASI). Desde la revisión bibliográfica realizada se han detectado serias limitaciones para detectar ASI en la utilización de indicadores clínicos que han surgido del contexto sanitario y asistencial. Se cuestiona el modelo teórico subyacente y la rigurosidad de los estudios sobre las consecuencias psicológicas asociadas al ASI. Igualmente, son debatidos algunos métodos de exploración clínica, extrapolados al contexto forense, y desaconsejados debido a su baja fiabilidad y validez. Se concluye señalando lo inadecuado de trasladar modelos y procedimientos del contexto clínico-asistencial al pericial, y la necesidad de exigir requisitos técnicos a los informes forenses.
Affective Style and Eating Disorders: a Field Study
(2011) Silva, Jaime R.; Ortiz, Manuel; Quiñones, Álvaro; Vera-Villarroel, Pablo; Slachevsky, Andrea
Eating disorders (ED) are a heterogeneous group of problems related to restraint and/or overeating. It is proposed that individual differences in affective reactivity and moods (affective style) might be related to these behaviours. Variations in affective style are expressed by differing levels of sensitivity to the motivation systems of approach and avoidance. The present study tested whether a relation exists between ED and variations in the sensitivity of motivational systems as well as mood dispositions. A total of 2020 undergraduate students completed the Eating Disorder Diagnostic Scale (EDDS), the Behavioural Inhibition System and Behavioural Activation System Scales (BIS/BAS), and the Positive and Negative Affect Schedule (PANAS). The results showed a significant within-subject interaction of Alimentary group x Motivation (F=4.056; p<0.007). It was also observed that the Overeating group had lower levels of motivation asymmetry than the Normal (p<0.01) and Restrictive (p<0.005) groups and marginally lower levels than the Purgative group (p<0.07). The study results suggest mainly that the avoidance/inhibition motivational system is related to eating problems connected with overeating, including chronic alimentary restraint (chronic dieters). The theoretical and clinical implications of these findings are discussed. (Eating Weight Disord. 16: e73-e80, 2011). (C)2011, Editrice Kurtis
Alcohol’s harm to others: An international collaborative project
(2016) Callinan, Sarah; Laslett, Anne-Marie; Rekve, Dag; Room, Robin; Waleewong, Orratai; Benegal, Vivek; Huckle, Taisia; Florenzano, Ramón; Casswell, Sally; Hanh, Hoang Thi My; Hettige, Siri; Ibanga, Akanidomo; Obot, Isidore; Rao, Girish; Siengsounthone, Latsamy; Ranki, Georgia; Thamarangsi, Thaksaphon
Abstract Aims: This paper outlines the methods of a collaborative population survey project measuring the range and magnitude of alcohol’s harm to others internationally. Setting: Seven countries participating in the World Health Organization (WHO) and ThaiHealth Promotion Foundation (ThaiHealth) research project titled “The Harm to Others from Drinking,” along with two other countries with similar studies, will form the core of a database which will incorporate data from other countries in the future. Measures: The WHO-ThaiHealth research project developed two comparable versions of a survey instrument, both measuring harm from others’ drinking to the respondent and the respondent’s children. Design: Surveys were administered via face-to-face methods in seven countries, while similar surveys were administered via computer-assisted telephone interviews in two additional countries. Responses from all surveys will be compiled in an international database for the purpose of international comparisons. Discussion: Harms from the alcohol consumption of others are intertwined with the cultural norms where consumption occurs. The development of this database will make it possible to look beyond reports and analyses at national levels, and illuminate the relationships between consumption, harms, and culture. Conclusions: This database will facilitate work describing the prevalence, patterning, and predictors of personal reports of harm from others’ drinking cross-nationally.
An Adjunctive Internet-Based Intervention to Enhance Treatment for Depression in Adults: Randomized Controlled Trial
(2021) Pérez Ewert, J. Carola; Fernández, Olga; Cáceres, Cristián; Carrasco, Álvaro E.; Moessner, Markus; Bauer, Stephanie; Espinosa-Duque, Daniel; Gloger, Sergio; Krause, Mariane
Background: Internet-based interventions promise to enhance the accessibility of mental health care for a greater number of people and in more remote places. Their effectiveness has been shown for the prevention and treatment of various mental disorders. However, their potential when delivered as add-on to conventional treatment (ie, blended care) is less clear. Objective: The aim of this study is to study the effectiveness of an internet intervention (ASCENSO) implemented in addition to face-to-face treatment as usual (TAU) for depression. Methods: A 2-arm, parallel-group, randomized controlled trial was conducted in an outpatient private mental health care center in Chile. In all, 167 adults, diagnosed with major depressive disorder, without severe comorbidities, and with internet access, were included. Eighty-four participants were assigned to the intervention group and received medical and psychological TAU from the mental health center plus access to the ASCENSO online platform. The control group (n=83) received only TAU. The ASCENSO platform includes psycho-educational information, depressive symptom monitoring and feedback, and managing emergencies based on the principles of cognitive behavioral therapy. Emergency management was mental health provider–assisted. TAU includes access to primary care physicians and psychiatrists, to a brief individual psychotherapy, and to medication when needed. The baseline questionnaires were administered in person, and 6- and 9-months assessments were conducted online. Depression symptoms and quality of life were measured by self-administered questionnaires, and treatment adherence was determined via the Mental Health Center’s internal records. The usage of ASCENSO was assessed by server logs. Reduction on depressive symptomatology was considered as the primary outcome of the intervention and quality of life as a secondary outcome. Results: Of the 84 participants in the intervention group, 5 participants (6%) never accessed the online platform. Of the remaining 79 participants who accessed ASCENSO, 1 (1%, 1/79) did not answer any of the symptom questionnaire, and most participants (72/79, 91%) answered the monitoring questionnaires irregularly. The ASCENSO intervention implemented in addition to face-to-face care did not improve the outcome of the usual care delivered at the mental health center, either in terms of reduction of depressive symptoms (F2,6087= 0.48; P=.62) or in the improvement of quality of life (EQ-5D-3L: F2,7678=0.24; P=.79 and EQ-VAS: F2,6670= 0.13; P=.88). In contrast, for the primary (F2,850=78.25; P<.001) and secondary outcomes (EQ-5D-3L: F2,1067=37.87; EQ-VAS: F2,4390= 51.69; P<.001) in both groups, there was an improvement from baseline to 6 months (P<.001), but there was no change at 9 months. In addition, no effects on adherence to or use of TAU were found. Finally, the dropout rate for the face-to-face treatment component was 54% (45/84) for the intervention group versus 39% (32/83) for the control group (P=.07). Conclusions: The fact that the adjunctive access to ASCENSO did not improve outcome could be due to both the rather high effectiveness of TAU and to patients’ limited use of the online platform. Trial Registration: ClinicalTrials.gov NCT03093467; https://clinicaltrials.gov/ct2/show/NCT03093467

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