| 41. |
- Boettcher, Johanna, et al.
(författare)
-
Internet-Based Interventions for Social Anxiety Disorder - an Overview
- 2013
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Ingår i: Verhaltenstherapie (Basel). - : S. Karger AG. - 1016-6262 .- 1423-0402. ; 23:3, s. 160-168
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Forskningsöversikt (refereegranskat)abstract
- Internet-based interventions hold specific advantages and disadvantages in the treatment of social anxiety disorder (SAD). The present review examines different approaches in the internet-based treatment of SAD and reviews their efficacy and effectiveness. 21 studies investigated the potential of guided and unguided internet-based cognitive-behavioral treatments (ICBT) for SAD, comprising a total of N = 1,801 socially anxious individuals. The large majority of these trials reported substantial reductions of social anxiety symptoms through ICBT programs. Within effect sizes were mostly large and comparisons to waitlist and more active control groups were positive. Treatment gains were stable from 3 months to 5 years after treatment termination. In conclusion, ICBT is effective in the reduction of social anxiety symptoms. At the same time, not all participants benefit from these treatments to a sufficient degree. Future research should focus on what makes these interventions work in which patient populations, and at the same time, examine ways to implement internet-based treatment in the routine care for socially anxious patients.
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| 42. |
- Boettcher, Johanna, et al.
(författare)
-
Internet-Based Mindfulness Treatment for Anxiety Disorders : A Randomized Controlled Trial
- 2014
-
Ingår i: Behavior Therapy. - : Elsevier BV. - 0005-7894 .- 1878-1888. ; 45:2, s. 241-253
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Tidskriftsartikel (refereegranskat)abstract
- Mindfulness-based interventions have proven effective for the trans diagnostic treatment of heterogeneous anxiety disorders. So far, no study has investigated the potential of mindfulness-based treatments when delivered remotely via the Internet. The current trial aims at evaluating the efficacy of a stand-alone, unguided, Internet-based mindfulness treatment program for anxiety. Ninety-one participants diagnosed with social anxiety disorder, generalized anxiety disorder, panic disorder, or anxiety disorder not otherwise specified were randomly assigned to a mindfulness treatment group (MTG) or to an online discussion forum control group (CG). Mindfulness treatment consisted of 96 audio files with instructions for various mindfulness meditation exercises. Primary and secondary outcome measures were assessed at pre-, post-treatment, and at 6-months follow-up. Participants of the MTG showed a larger decrease of symptoms of anxiety, depression, and insomnia from pre- to postassessment than participants of the CG (Cohen's d(between) = 0.36-0.99). Within effect sizes were large in the MTG (d = 0.82-1.58) and small to moderate in the CG (d = 0.45-0.76). In contrast to participants of the CG, participants of the MTG also achieved a moderate improvement in their quality of life. The study provided encouraging results for an Internet-based mindfulness protocol in the treatment of primary anxiety disorders. Future replications of these results will show whether Web-based mindfulness meditation can constitute a valid alternative to existing, evidence-based cognitive-behavioural Internet treatments.
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| 43. |
- Boettcher, Johanna, et al.
(författare)
-
Internet-Based Mindfulness Treatment for Anxiety Disorders : A Randomized Controlled Trial
- 2014
-
Ingår i: Behavior Therapy. - New York : Association for advanced behavior therapy. - 0005-7894 .- 1878-1888. ; 45:2, s. 241-253
-
Tidskriftsartikel (refereegranskat)abstract
- Mindfulness-based interventions have proven effective for the trans diagnostic treatment of heterogeneous anxiety disorders. So far, no study has investigated the potential of mindfulness-based treatments when delivered remotely via the Internet. The current trial aims at evaluating the efficacy of a stand-alone, unguided, Internet-based mindfulness treatment program for anxiety. Ninety-one participants diagnosed with social anxiety disorder, generalized anxiety disorder, panic disorder, or anxiety disorder not otherwise specified were randomly assigned to a mindfulness treatment group (MTG) or to an online discussion forum control group (CG). Mindfulness treatment consisted of 96 audio files with instructions for various mindfulness meditation exercises. Primary and secondary outcome measures were assessed at pre-, post-treatment, and at 6-months follow-up. Participants of the MTG showed a larger decrease of symptoms of anxiety, depression, and insomnia from pre- to postassessment than participants of the CG (Cohen's d(between) = 0.36-0.99). Within effect sizes were large in the MTG (d = 0.82-1.58) and small to moderate in the CG (d = 0.45-0.76). In contrast to participants of the CG, participants of the MTG also achieved a moderate improvement in their quality of life. The study provided encouraging results for an Internet-based mindfulness protocol in the treatment of primary anxiety disorders. Future replications of these results will show whether Web-based mindfulness meditation can constitute a valid alternative to existing, evidence-based cognitive-behavioural Internet treatments.
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| 44. |
- Boettcher, Johanna, et al.
(författare)
-
Side effects in Internet-based interventions for social anxiety disorder
- 2014
-
Ingår i: Internet Interventions. - : Elsevier BV. - 2214-7829. ; 1:1, s. 3-11
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Tidskriftsartikel (refereegranskat)abstract
- Internet-based interventions are effective in the treatment of various mental disorders and have already been integrated in routine health care in some countries. Empirical data on potential negative effects of these interventions is lacking. This study investigated side effects in an Internet-based treatment for Social Anxiety Disorder (SAD).A total of 133 individuals diagnosed with SAD took part in an 11-week guided treatment. Side effects were assessed as open formatted questions after week 2 and at post-treatment after week 11. Answers were independently rated by two coders. In addition, rates of deterioration and non-response were calculated for primary social anxiety and secondary outcome measures (depression and quality of life).In total, 19 participants (14%) described unwanted negative events that they related to treatment. The emergence of new symptoms was the most commonly experienced side effect, followed by the deterioration of social anxiety symptoms and negative well-being. The large majority of the described side effects had a temporary but no enduring negative effect on participants' well-being. At post-treatment, none of the participants reported deterioration on social anxiety measures and 0–7% deteriorated on secondary outcome measures. Non-response was frequent with 32–50% for social anxiety measures and 57–90% for secondary outcomes at post-assessment.Results suggest that a small proportion of participants in Internet-based interventions experiences negative effects during treatment. Information about potential side effects should be integrated in patient education in the practice of Internet-based treatments.
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| 45. |
- Bystedt, Samuel, et al.
(författare)
-
Clinicians' perspectives on negative effects of psychological treatments
- 2014
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Ingår i: Cognitive Behaviour Therapy. - : Informa UK Limited. - 1650-6073 .- 1651-2316. ; 43:4, s. 319-331
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Tidskriftsartikel (refereegranskat)abstract
- Negative effects of psychological treatments is a fairly unexplored area of clinical research. Previous investigations have indicated that a portion of all patients experience negative effects in terms of deterioration and various adverse events. Meanwhile, evidence suggests that many clinicians are untrained in identifying negative effects and unaware of the current research findings. The objective of the current study is thus to investigate clinicians' own perspectives and experiences of possible negative effects of psychological treatments. An invitation to participate in an anonymous online survey consisting of 14 open-ended questions was distributed via three mailing lists used by clinicians that primarily identify themselves as cognitive behavior therapists. The responses were analyzed using a qualitative method based on thematic analysis. In total, 74 participants completed the survey. A majority agreed that negative effects of psychological treatments exist and pose a problem, and many reported having experienced both deterioration and adverse events among patients in their own practice. The thematic analysis resulted in three core themes: characteristics of negative effects, causal factors, as well as methods and criteria for evaluating negative effects. The clinicians recognize that negative effects exist, but many are unaware of the current research findings and are unfamiliar with methods and criteria for identifying and preventing deterioration and adverse events. The results provide evidence for further dissemination of the present knowledge regarding negative effects, particularly during basic clinical training, as well as the need for raising awareness of the available methods for identifying and preventing negative effects.
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| 46. |
- Carlbring, Per
(författare)
-
15 Years of Internet Interventions Research : ANXIETY
- 2014
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Ingår i: Oral Abstracts from the 7th Scientific Meeting of the International Society for Research on Internet Interventions. - : International Society for Research on Internet Interventions (ISRII). ; , s. 128-128
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Konferensbidrag (refereegranskat)abstract
- Sweden conduced its first randomized controlled trial on an anxiety disorder in the year 1999. Since then numerous trials and programs have been developed including problems such as panic disorder, social anxiety disorder, generalized anxiety disorder, severe health anxiety, post-traumatic stress disorder, obsessive compulsive disorder, specific phobia, and mixed anxiety-depression. Moreover, there are studies on specific problems such as procrastination. With the exception of cognitive bias modification training most studies show effects in line with face-to-face cognitive behavior therapy. In addition to cognitive behavior therapy there are Swedish trials on mindfulness-based internet treatment, interpersonal psychotherapy, and psychodynamic internet treatment. This presentation will take the listener on a journey from the past, via the present and a place where the bright future can be seen.
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| 47. |
- Carlbring, Per, et al.
(författare)
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All at once or one at a time? : a randomized controlled trial comparing two ways to deliver bibliotherapy for panic Disorder
- 2011
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Ingår i: Cognitive Behaviour Therapy. - Routledge : Routledge, Taylor and Francis Group. - 1650-6073 .- 1651-2316. ; 40:33, s. 228-235
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Tidskriftsartikel (refereegranskat)abstract
- Bibliotherapy is potentially effective in the treatment of panic disorder (PD). A still unanswered question is whether pacing is important. This study was designed to test whether there is a difference between being assigned a full book as therapy and receiving one individual chapter every week (i.e. pacing). A total of 28 participants were randomized to either 10 paced chapters or one book with 10 chapters. To maximize compliance, short weekly telephone calls were added in both conditions ( M¼17.8 min,SD¼4.2). Both treatments showed promising results, with effects maintained up to 2 years and with within-group effect sizes (Cohen’s d) between 0.95 and 1.11. Pretreatment ratings of credibility were positively correlated with the change scores at both posttest and 2-year follow-up for three panic measures. Pacing of text material in bibliotherapy for PD is not needed, and all material can be provided at once when the treatment is guided by a therapist.
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| 48. |
- Carlbring, Per, et al.
(författare)
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Challenger - the Development and Initial Evaluation of a Smartphone Application for Social Anxiety Disorder
- 2014
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Ingår i: Poster Abstracts from the 7th Scientific Meeting of the International Society for Research on Internet Interventions. - : International Society for Research on Internet Interventions (ISRII). ; , s. 40-40
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Konferensbidrag (refereegranskat)abstract
- Challenger, a newly developed smartphone application from Stockholm University, provides users with customized challenges. Based on the goals the user chooses, and the answers to questions regarding that goal, an appropriate challenge is created by the app. The user can follow their progress and history on a board game, where they move forward for each challenge they complete. They can also fill their own board with rewards that they find appealing and motivating. After a challenge completion, the user is prompted to write a note reflecting on the experience, and to report their anxiety level during the challenge. If the user so chooses, the note can then be sent anonymously, much like a message in a bottle, to another randomly selected user to provide supportive feedback. That feedback is sent back to the challangee which can then choose to "like", be indifferent to, or dislike (report abuse) the feedback. In summary, "Challenger" generates customized behavioral experiments, and exposure exercises which are performed in the patients vicinity, and provides the means to reflect on the experience and to also receive anonymous social community support. A set of valid and commonly used questionnaires were used in the study. Level of social anxiety symptoms was assessed using MINI-SPIN every other day. In addition, once a week PHQ9 and GAD7 were administered in the smartphone application in order to get a general level of depression and anxiety respectively. Preliminary results indicate that using Challenger decreases social anxiety and depressive symptoms, but data collection is still at an early stage, and we will know much more at the time of the conference. The app can be found at www.mobilKBT.se
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| 49. |
- Carlbring, Per, et al.
(författare)
-
Consensus statement on defining and measuring negative effects of Internet interventions
- 2014
-
Konferensbidrag (refereegranskat)abstract
- Background: Internet interventions have great potential for alleviating emotional distress, promoting mental health, and enhancing well-being. Numerous clinical trials have demonstrated their effectiveness for a number of psychiatric conditions, and interventions delivered via the Internet will likely become a common alternative to face-to-face treatment. Meanwhile, research has paid little attention to the negative effects associated with treatment, warranting further investigation of the possibility that some patients might deteriorate or encounter adverse events despite receiving best available care. Evidence from research of face-to-face treatment suggests that negative effects afflict 5-10% of all patients undergoing treatment in terms of deterioration.Objective: There is currently a lack of consensus on how to define and measure negative effects in psychotherapy research in general, leaving researchers without practical guidelines for monitoring and reporting negative effects in clinical trials. The current study therefore sought out to provide recommendations that could promote the study of negative effects in Internet interventions with the aim of increasing the knowledge of its occurrence and characteristics.Methods: Ten experts in the field of Internet interventions were invited to participate and share their perspective on how to explore negative effects, using the Delphi technique to facilitate a dialogue and reach an agreement. The authors discuss the importance of conducting research on negative effects in order to further the understanding of its incidence and different features.Results: Suggestions on how to classify and measure negative effects in Internet interventions are proposed, involving methods from both quantitative and qualitative research. Potential mechanisms underlying negative effects are also discussed, differentiating common factors shared with face-to-face treatments from those unique to treatments delivered via the Internet.Conclusions: We conclude that negative effects are to be expected and need to be acknowledged to a greater extent, advising researchers to systematically probe for negative effects whenever conducting clinical trials involving Internet interventions, as well as to share their findings in scientific journals.
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| 50. |
- Carlbring, Per
(författare)
-
Förord
- 2013. - 1
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Ingår i: Kort om ångest. - Stockholm : Fri tanke. - 9789186061692 ; , s. 7-8
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Bokkapitel (populärvet., debatt m.m.)abstract
- Ur förordet: "I boken beskrivs fobier, social fobi, paniksyndrom, generaliserat ångestsyndrom, tvångssyndrom och posttraumatiskt stressyndrom. Du får ta del av modern forskning och medryckande redogörelser för hur olika teoretiska skolbildningar ser på uppkomst och vidmakthållande. […] Jag hoppas att denna bok hjälper till att skapa en medvetenhet om ångestproblemen och därmed gör dem mindre tabubelagda."
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