Adaptive actions as a mechanism of change in transdiagnostic internet-delivered cognitive behavioral therapy: Comparison with homework engagement
Why this work is in the frame
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Bibliographic record
Abstract
= 625) received a transdiagnostic ICBT program in routine care. Outcomes included depression, generalized anxiety, posttraumatic stress, panic, social anxiety, insomnia, functional impairment, and wellbeing. Adaptive actions were assessed with the Things You Do Questionnaire-15 Item (TYDQ-15) and homework engagement with the Homework Reflection Questionnaire (HWRQ). TYDQ-15 scores improved from pre- to post-treatment and were maintained at follow-up. Although correlated, mid-treatment TYDQ-15 scores more consistently predicted outcomes than homework engagement and partially mediated changes across all assessed outcomes. Reciprocal analyses revealed bidirectional relationships between adaptive actions and anxiety and wellbeing, and partially bidirectional associations with depression. Overall, mid-treatment adaptive actions emerged as a stronger and more consistent mechanism of change than homework engagement across diverse outcomes. Findings underscore the importance of research on the benefits of encouraging adaptive actions early in treatment.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it