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Background Major depressive disorder (MDD) is highly prevalent and burdensome for individuals and society. While there are psychological interventions able to prevent and treat MDD, uptake remains low. To overcome structural and attitudinal barriers, an indirect approach of using online insomnia interventions seems promising because insomnia is less stigmatized, predicts MDD onset, is often comorbid and can outlast MDD treatment. This individual-participant-data meta-analysis evaluated the potential of the online insomnia intervention GET.ON Recovery as an indirect treatment to reduce depressive symptom severity (DSS) and potential MDD onset across a range of participant characteristics. Methods Efficacy on depressive symptom outcomes was evaluated using multilevel regression models controlling for baseline severity. To identify potential effect moderators, clinical, sociodemographic, and work-related variables were investigated using univariable moderation and random-forest methodology before developing a multivariable decision tree. Results IPD were obtained from four of seven eligible studies (N = 561); concentrating on workers with high work-stress. DSS was significantly lower in the intervention group both at post-assessment (d = −0.71 [95% CI−0.92 to −0.51]) and at follow-up (d = −0.84 [95% CI −1.11 to −0.57]). In the subsample (n = 121) without potential MDD at baseline, there were no significant group differences in onset of potential MDD. Moderation analyses revealed that effects on DSS differed significantly across baseline severity groups with effect sizes between d = −0.48 and −0.87 (post) and d = − 0.66 to −0.99 (follow-up), while no other sociodemographic, clinical, or work-related characteristics were significant moderators. Conclusions An online insomnia intervention is a promising approach to effectively reduce DSS in a preventive and treatment setting. [ABSTRACT FROM AUTHOR]

Imaginal retraining (IR) is an approach‐avoidance procedure that has shown promising results in previous studies. The aim of the present study was to dismantle the efficacy of IR's components in a randomized controlled trial (RCT). We conducted a RCT with nine conditions comprising eight intervention groups and a waitlist control group (WLC). Alcohol craving (primary outcome), consumption, depressive symptoms, quality of life, subjective appraisal, and side effects were assessed online at baseline, post intervention (6 weeks), and follow‐up (12 weeks). The sample consisted of 426 participants (age: M = 47.22, SD = 11.82, women: 50.5%). The intervention groups received instructions for four different components of IR (mood induction, mental avoidance of unhealthy stimuli, motor avoidance of unhealthy stimuli, approach to healthy stimuli) that were each conveyed with or without prior psychoeducation (PE). The intervention was delivered online. At total of 163 individuals (42.9%) used the intervention at least once. No group differences were found for any primary or secondary outcome after Šidák correction. Uncorrected statistics showed effects of significantly decreased alcohol consumption for the approach + PE group in the intention‐to‐treat and the merged motor avoidance group in the per‐protocol analyses at post assessment compared with the WLC. Exploratory moderation analyses revealed that individuals with high visualization skills benefited most. The authors conclude that visualization training and motivational components may increase the efficacy and adherence of IR. [ABSTRACT FROM AUTHOR]