Using an online CBT-based intervention to improve academic performance in students with low mood: A pre-post study with historical control

Abstract

Abstract Background Online CBT-based interventions have shown potential to improve mental health in university students. However, their impacts in West Asian cultures and on educational achievement have yet to be fully investigated. This study aims to explore the feasibility, acceptability and potential effectiveness of a self-directed, internet-delivered, cognitive-behavioural skills training program (MoodGYM) in reducing depression and improving academic performance in university students in the United Arab Emirates (UAE). Methods This exploratory pre-post intervention study with an historic control group recruited 50 students from one UAE university, with GPA < 2 and self-reporting at least one of two key depressive symptoms. Pre-intervention, participants completed an online survey including most recent grade point average (GPA), number of attendance warnings and the Hospital Anxiety and Depression Scale (HADS). Participants were then sent a link to MoodGYM. After eight weeks, 44 participants repeated the survey and provided feedback on MoodGYM (88% follow-up). A subgroup of 19 students with GPA scores < 2 at baseline formed an historical control group for change in GPA and attendance warnings. Results Total HADS-Depression scores fell at post intervention (P = 0.004) and the proportion of participants scoring above the cut-off for depression (HADS-D ≥ 8) fell from 77.2–27.3% (p < 0.001). There was also a substantial fall in HADS-Anxiety scores (p < 0.001) and the proportion of participants above the cut-off for anxiety (HADS-A ≥ 8) fell from 50% to 11.4 % (p = 0.001). GPA scores improved substantially over time (p < 0.001, d = 1.3) and attendance warnings reduced (p = 0.008, d = 0.6). Compared to historic control, the intervention group had higher GPA at follow-up (p < 0.030 d = 0.6) fewer attendance warnings (p = 0.036 d = 0.7). Most students (79.6%) evaluated MoodGYM as useful and all students completed at least 2 MoodGYM modules. More modules completed (p = 0.005) and greater reduction in attendance warnings (p = 0.007) were independently associated with greater improvement in GPA scores at follow-up. Conclusions This study provides support for a web based mental health promotion intervention (MoodGYM) to improve academic achievement in university students with depressive symptoms. Further research is needed to explore how MoodGYM can be best implemented within University settings.