Yan Leykin

Palo Alto University · Department of Psychology

Objective This study examines predictors of non-initiation of care and dropout in a blended care CBT intervention, with a focus on early digital engagement and sociodemographic and clinical factors. Methods This retrospective cohort analysis included 3566 US-based individuals who presented with clinical levels of anxiety and depression and enrolle...

The COVID-19 pandemic is a public health crisis that continues to impact individuals worldwide. While children may be less susceptible to severe medical complications, they are nonetheless vulnerable to stress and anxiety associated with the pandemic. However, current understanding of psychological functioning and potential strategies to mitigate d...

Suicide is the second leading cause of death for adolescents. Online interventions have the potential to reduce risk factors for suicide, such as hopelessness, social isolation, social rejection, and poor self-esteem. The present study aimed to analyze the impact of engagement with CATCH-IT, an Internet-based depression prevention intervention, on...

Background When screening for suicidality, clinicians usually ask questions in ascending order of severity. Clinicians often discontinue questioning after negative responses to the first question or questions, presuming that these individuals are unlikely to endorse any further suicidality. In this study, the accuracy of this presumption is evaluat...

Health officials recommended a number of COVID-19 infection control measures, such as social distancing and face covering. This study explores whether depression influences individuals' moral judgments regarding COVID-19 infection control behaviors and policies. In this study, participants (N = 340) were US residents, recruited via Amazon Mechanica...

Background: Depression and anxiety are leading causes of disability worldwide. Though effective treatments exist, depression and anxiety remain undertreated. Blended care psychotherapy, combining the scalability of online interventions with the personalization and engagement of a live therapist, is a promising approach for increasing access to evi...

This presentation provides an overview of the role of intolerance of uncertainty as an accelerator of health related anxieties and reactions to COVID-19 in youth and their families.

There is now substantial evidence that major depressive episodes can be prevented and treated effectively with psychological interventions administered by trained lay and professional providers. There is also evidence that depression can be prevented and treated using self-help digital interventions such as websites and apps, and that their effecti...

Objective: To explore the prevalence of recent (previous 2 weeks) suicide attempts and estimates of likelihood of future suicide attempts as well as demographic characteristics associated with such attempts among residents of the Arab region looking for depression information online. Methods: Google Ads were used to recruit 1,003 Arabic-speaking...

Objective To describe demographic and clinical characteristics of Spanish- and English-speaking visitors to a "Healthy Mood" website. Methods An online study intended to prevent depression by teaching users mood management skills recruited participants globally using primarily Google Ads. Those who consented responded to the Patient Health Questio...

Introduction : Core symptoms of depression are likely universal, however cultural groups differ in their experience of the condition. The purpose of this study was to examine differences and similarities of depression symptom groupings between broad cultural groups. Method : 6,982 adults took part in an online multilingual depression screening stu...

BACKGROUND Adherence to self-guided interventions tends to be very low, especially in people with depression. Prior studies have demonstrated that enhancements may increase adherence, but little is known about the efficacy of various enhancements in comparison to, or in combination with, one another. OBJECTIVE The objective of our study was to tes...

Background Adherence to self-guided interventions tends to be very low, especially in people with depression. Prior studies have demonstrated that enhancements may increase adherence, but little is known about the efficacy of various enhancements in comparison to, or in combination with, one another. Objective The aim of our study is to test wheth...

Background: Smoking cessation Internet interventions have been shown to be comparable in effectiveness to the nicotine patch. The aim of this study was to develop a Spanish/English smoking cessation web app using input from low-income smokers, and to evaluate modifications to the online intervention in terms of its ability to engage smokers. Meth...

Suicide is a public health crisis, yet few online resources that specifically target suicidality are available. The aim of the present study was to develop an automated, self-guided Internet-Based Safety Plan (IBSP) and to explore how intended users – members of the Internet community who endorsed past or current suicidality – utilized this resourc...

Depression rates are increasing among minors. Internet is central to the lives of many minors, and many of them look online for depression information. This report describes minors who attempted to screen themselves for depression in a worldwide online study. Google Ads were used to recruit individuals to a multilingual depression screening study t...

BACKGROUND Blended care psychotherapy, which combines the strengths of therapist-led and Internet interventions can be clinically effective and efficient but has been rarely evaluated outside of controlled research settings. OBJECTIVE This study evaluated the effectiveness of a blended care intervention (video-based CBT and Internet intervention)...

Background The past few decades saw considerable advances in research and dissemination of evidence-based psychotherapies, yet available treatment resources are not able to meet the high need for care for individuals suffering from depression or anxiety. Blended care psychotherapy, which combines the strengths of therapist-led and internet interven...

Objective To understand reasons individuals with high depressive symptoms offer for trying to improve their state or for not doing so. Method Participants (N = 227) in an online depression intervention study were asked, in a free response format, about their reasons for “getting better” (200 responses were collected), and, separately, about their...

Objective: The aim of this study was to examine whether people who screened positive for depression were more likely to have sought treatment if they had personal knowledge of other individuals with emotional or mental problems or of individuals who have sought treatment for them. Methods: Participants who screened positive for current major dep...

Individuals with depressive symptoms frequently experience stigma, which may lower self‐esteem and increase social withdrawal, further exacerbating symptoms. The association between depressive symptoms and subjective social status (SSS; perceived standing within one's community) have previously been identified. However, no work has connected the co...

Individuals with obsessive-compulsive disorder (OCD) and hoarding disorder (HD) struggle with decision-making. One potentially important aspect of decision-making that has yet to be studied in relation to OCD and HD is decision-making style, a trait-like pattern of responding that is relatively stable across a variety of decision-making situations....

Background: This manuscript describes the first two phases of pilot testing MARIGOLD, an online self-guided positive emotion skills intervention for adults with elevated depressive symptoms, along with enhancements to overcome retention and adherence problems reported in previous research. Methods: Adults with elevated depressive symptoms were r...

Background: The Internet may offer resources for individuals who struggle with suicidality but have no access to other resources or fail to use them. Aims: To develop an automated, self-guided Internet-based safety plan (IBSP), and to evaluate its use and perceived utility among individuals who report suicidality online. Method: Participants (N = 1...

Background: Adolescent death by suicide is an emergent health crisis in the United States of America. Although many suicide prevention programs have been created to address suicide in this population, rates continue to increase. Online interventions can disseminate treatments world-wide and reach large numbers of users. Thus, the purpose of the pr...

Background To address limitations in recruitment and enrollment of diverse, low-literacy patients into prostate cancer clinical trials, we evaluated the feasibility, acceptability, and efficacy of an English and Spanish, Internet-based, multilevel recruitment intervention. Methods Intervention components included (1) a low-literacy, bilingual, aut...

Internet interventions face significant challenges in recruitment and attrition rates are typically high and problematic. Finding innovative yet scientifically valid avenues for attaining and retaining participants is therefore of considerable importance. The main goal of this study was to compare recruitment process and participants characteristic...

Background: Living with elevated symptoms of depression can have debilitating consequences for an individual’s psychosocial and physical functioning, quality of life, and health care utilization. A growing body of evidence demonstrates that skills for increasing positive emotion can be helpful to individuals with depression. Although Web-based inte...

Background: Individuals suffering from mental as well as physical conditions often face stigma, which can adversely affect functioning, treatment seeking, and emotional health. We compared levels of stigma experienced by individuals with depression and/or chronic pain, to contrast the perception of stigma experienced by the sufferers with that of...

Background and aims: Suicidality research in developing countries, including India, faces logistical and cultural challenges. Technology may help address these challenges and offer data to providers treating a diverse clientele. Method: The relationship between perceived stress and suicide-related beliefs was examined in two populations: Indians...

This randomized controlled trial investigated the effect of a brief unsupported behavioral activation Internet intervention (BAII) designed to improve mood. A total of 671 participants were recruited through Amazon’s Mechanical Turk (AMT) (Mage = 35.71 years; SD = 12.34, 32.3% male) and 187 (27.9%) individuals completed the 1-week follow-up survey....

Untreated depression remains one of the largest public health concerns. However, barriers such as unavailability of mental health providers and high cost of services limit the number of people able to benefit from traditional treatments. Though unsupported Internet interventions have proven effective at bypassing many of these barriers given their...

Background: Automated Internet intervention studies have generally had large dropout rates for follow-up assessments. Live phone follow-ups have been often used to increase follow-up completion rates. Objective: To compare, via a randomized study, whether receiving phone calls improves follow-up rates beyond email reminders and financial incentives...

Objective: Clinical trials are necessary for evaluation of novel treatments. However, concerns have been raised about the vulnerability of depressed individuals when joining clinical trials, that is, about their abilities to make good decisions about clinical trial participation. The purpose of this study was to determine whether depression compro...

Background: Most users of unsupported Internet interventions visit that site only once, therefore there is a need to create interventions that can be offered as a single brief interaction with the user. Objective: The main goal of this study was to compare the effect of a one-session unsupported Internet intervention on participants' clinical sympt...

Background: Prior research has found higher rates of mental health problems among sexual minority individuals. We examine treatment-seeking for depression, as well as its relationship with sexual orientation, in a large, multilingual, international sample. Method: Participants in an automated, quintilingual internet-based depression screening to...

Background Most users of unsupported Internet interventions visit that site only once, therefore there is a need to create interventions that can be offered as a single brief interaction with the user. Objective The main goal of this study was to compare the effect of a one-session unsupported Internet intervention on participants' clinical sympto...

Background Patients at risk for or diagnosed with breast cancer have many symptoms and need for supportive care services. As part of the Athena Breast Health Network (a University of California-wide collaboration), the UCSF Breast Care Center (BCC) has incorporated an electronic health questionnaire system (HQS) prior to new patient and follow-up c...

226 Background: Psychological wellbeing and lifestyle changes are important factors in long-term health of cancer survivors. As part of the Athena Breast Health Network, the UCSF Breast Care Center (BCC) incorporated an electronic health questionnaire system (HQS) that collects patient-reported data on physical and psychological symptoms, medical c...

Background: Enrollment of minorities in clinical trials remains low. Through a California population-based study of men with early stage prostate cancer, we examined the relationships between race/ethnicity and 1) attitudes, 2) knowledge and 3) willingness to participate in clinical trials. Methods: From November 2011-November 2012, we identifie...

Mobile and automated technologies are increasingly becoming integrated into mental health care and assessment. The purpose of this study was to determine how automated daily mood ratings are related to the Patient Health Questionnaire-9 (PHQ-9), a standard measure in the screening and tracking of depressive symptoms. There was a significant relatio...

Internet interventions provide an option for those who either cannot or choose not to engage with traditional treatments. Most research on internet interventions involves guided or supported interventions. However, unsupported interventions offer considerably more scalability and cost-effectiveness, which makes them attractive for large-scale imple...

Background: In populations where mental health resources are scarce or unavailable, or where stigma prevents help-seeking, the Internet may be a way to identify and reach at-risk persons using self-report validated screening tools as well as to characterize individuals seeking health information online. Aims: We examined the feasibility of deliv...

Internet-based mental health resources often suffer from low engagement and retention. An increased understanding of engagement and attrition is needed to realize the potential of such resources. In this study, 45,142 individuals were screened for depression by an automated online screener, with 2,539 enrolling in a year-long monthly rescreening st...

Google AdWords, the placement of sponsored links in Google search results, is a potent method of recruitment to Internet-based health studies and interventions. However, the performance of Google AdWords varies considerably depending on the language and the location of the target audience. Our goal was to describe differences in AdWords performance...

Clinical psychology training for research-oriented scientist-practitioners tends to have a gap in research training during the predoctoral internship year. In 1982, the Clinical Psychology Training Program (CPTP) at the University of California, San Francisco (UCSF) began a 2-year clinical and clinical research training program combining an America...

Websites containing information and advice about health are increasingly common and popular. It is important to understand whether the material these sites contain can positively influence individual behavior, and whether populations differ in their response to that material. Participants in an international web-based stop smoking randomized contr...

To address health problems that have a major impact on global health requires research designs that go beyond randomized controlled trials. One such design, the participant preference trial, provides additional information in an ecologically valid manner, once intervention efficacy has been demonstrated. The current study presents illustrative data...

Too few cancer patients and survivors receive evidence-based interventions for mental health symptoms. This review examines the potential for Internet interventions to help fill treatment gaps in psychosocial oncology and presents evidence regarding the likely utility of Internet interventions for cancer patients. The authors examined available lit...

Research on deep brain stimulation (DBS) for treatment-resistant depression appears promising, but concerns have been raised about the decisional capacity of severely depressed patients and their potential misconceptions about the research. We assessed 31 DBS research participants with the MacArthur Competence Assessment Tool for Clinical Research...

Worldwide automated Internet health interventions have the potential to greatly reduce health disparities. High attrition from automated Internet interventions is ubiquitous, and presents a challenge in the evaluation of their effectiveness. Our objective was to evaluate variables hypothesized to be related to attrition, by modeling predictors of a...

Internet interventions have the potential to address many of the health problems that produce the greatest global burden of disease. We present a study illustrating this potential. The Spanish/English San Francisco Stop Smoking Internet site, which yielded quit rates of 20% or more at 12 months in published randomized controlled trials (RCTs), was...

The 2009 Institute of Medicine report on prevention of mental, emotional, and behavioral disorders (National Research Council & Institute of Medicine, 2009b) presented evidence that major depression can be prevented. In this article, we highlight the implications of the report for public policy and research. Randomized controlled trials have shown...

Personal health records (PHR) may improve patients' health by providing access to and context for health information. Among patients receiving care at a safety-net HIV/AIDS clinic, we examined the hypothesis that a mental health (MH) or substance use (SU) condition represents a barrier to engagement with web-based health information, as measured by...

Smoking is one of the largest contributors to the global burden of disease. Internet interventions have been shown to reduce smoking rates successfully. However, improved methods of evaluating effectiveness need to be developed for large-scale Internet intervention trials. To illustrate a method to interpret outcomes of large-scale, fully automated...

Ethical concerns regarding early-phase clinical trials of DBS for treatment-resistant depression (TRD) include the possibility that participants' decisions to enroll might be motivated by unrealistic expectations of personal benefit or minimization of risks. Thematic analyses were conducted on a sample of 26 adults considering participation in two...

We tested two competing hypotheses-relative social position and community resources-in regards to their effect on two co-occurring health problems (depression, and obesity) in a sample of smokers participating in an online smoking cessation intervention. Income and education data at the zip code level from the 2000 Census was linked with individual...

The number of individuals looking for health information on the Internet continues to expand. The purpose of this study was to understand the prevalence of major depression among English-speaking individuals worldwide looking for information on depression online. An automated online Mood Screener website was created and advertised via Google AdWord...

Deep brain stimulation (DBS) for treatment-resistant depression (TRD) is the focus of great interest and numerous studies. Given the state of this research, the risks of DBS, the uncertainty of direct benefits, and the potential for therapeutic misconception (TM), examination of research participants' perspectives is critical to addressing concerns...

Difficulty making decisions is a core symptom of depressive illness, but the nature of these difficulties has not been well characterized. The two studies presented herein use the same hypothetical scenarios that call for a decision. In Study 1, participants were asked to make and explain their decisions in a free-response format, as well as to des...

Research on the Center for Epidemiological Studies-Depression Scale's (CES-D; Radloff, 1977) factor structure is mixed across diverse and international populations that differ from the one on which the scale was developed. This study examined the CES-D's factor structure in a large international sample of English (n=3827) and Spanish-speaking (n=13...

Difficulty making decisions is one of the symptoms of the depressive illness. Previous research suggests that depressed individuals may make decisions that differ from those made by the non-depressed, and that they use sub-optimal decision-making strategies. For this study we constructed an instrument that aims to measure a variety of decision-maki...

High voluntary turnover of substance abuse counsellors is a recognised and pervasive problem, likely due in large part to job-related burnout experienced by providers. This article explores the influence of the type of training on three facets of burnout (emotional exhaustion, depersonalisation and a reduced perception of personal accomplishments)...

Before the 1980s, no randomized controlled trials had been carried out to test whether major depressive episodes could be prevented. In the past 30 years, several trials have reported success in reducing the incidence (the number of new cases) of major depressive episodes. These studies suggest that major depression can be prevented. Given the larg...

Concern about the contamination of psychotherapy outcome studies by “allegiance bias”—distortion of findings because of investigators’ preferences—has led to the proposal that findings to date should not be used to make inferences about the relative efficacies of psychotherapies. It has also been proposed that results from all such studies should b...

Difficulty with making decisions is one of the features of depressive illness. However, the particulars of decision-making in individuals suffering from depression are poorly understood. In this thesis, the relationship between depression and decision-making was explored in three studies, conducted both on the Internet, with participants recruited...

Randomization procedures are performed in order to maximize the internal validity of treatment outcome studies. Objections have been made that this practice undermines the external validity of these studies because it ignores patients' treatment preferences, thereby precluding the self-selection of treatment that can occur in the community. This st...

Research suggests that depressed patients’ beliefs about the causes of their depression affect the course and outcomes of treatment. However, changes in such beliefs during treatment have not been investigated. Before and after treatment, participants in a randomized control trial comparing cognitive therapy (CT) with antidepressant medication (ADM...

Recent research suggests that there may be a reduction in therapeutic response after multiple administrations of antidepressant drug (AD) therapy in patients with major depressive disorder. This study assessed the response to AD therapy and cognitive therapy (CT) of patients with a history of prior AD exposures. A sample of 240 patients with modera...

This study assesses the efficacy of nefazodone treatment (target dose of 400-600 mg/day) on objective and subjective sleep quality in Vietnam combat veterans with chronic DSM-IV posttraumatic stress disorder (PTSD). Medically healthy male Vietnam theater combat veterans with DSM-IV PTSD (N = 10) completed a 12-week open-label trial. Two nights of a...