| 1. |
- Schäfer, Sarah K., et al.
(författare)
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To sleep or not to sleep, that is the question : A systematic review and meta-analysis on the effect of post-trauma sleep on intrusive memories of analog trauma
- 2023
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Ingår i: Behaviour Research and Therapy. - : Elsevier. - 0005-7967 .- 1873-622X. ; 167
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Forskningsöversikt (refereegranskat)abstract
- Distressing intrusive memories of a traumatic event are one of the hallmark symptoms of posttraumatic stress disorder. Thus, it is crucial to identify early interventions that prevent the occurrence of intrusive memories. Both, sleep and sleep deprivation have been discussed as such interventions, yet previous studies yielded contradicting effects. Our systematic review aims at evaluating existing evidence by means of traditional and individual participant data (IPD) meta-analyses to overcome power issues of sleep research. Until May 16th, 2022, six databases were searched for experimental analog studies examining the effect of post-trauma sleep versus wakefulness on intrusive memories. Nine studies were included in our traditional meta-analysis (8 in the IPD meta-analysis). Our analysis provided evidence for a small effect favoring sleep over wakefulness, log-ROM = 0.25, p < .001, suggesting that sleep is associated with a lower number of intrusions but unrelated to the occurrence of any versus no intrusions. We found no evidence for an effect of sleep on intrusion distress. Heterogeneity was low and certainty of evidence for our primary analysis was moderate. Our findings suggest that post-trauma sleep has the potential to be protective by reducing intrusion frequency. More research is needed to determine the impact following real-world trauma and the potential clinical significance.
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| 2. |
- Bergström, Gunnar, Professor, et al.
(författare)
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Long-term, non-specific spinal pain: reliable and valid subgroups of patients
- 2001
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Ingår i: Behaviour Research and Therapy. - : Elsevier. - 0005-7967 .- 1873-622X. ; 39:1, s. 75-87
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to identify reliable and valid subgroups of spinal pain patients, using data from the Swedish version of the Multidimensional Pain Inventory (MPI-S). A second aim was to test the generalisability of the three patient profiles described in earlier studies on the MPI (”adaptive coper”, ”dysfunctional” and ”interpersonally distressed” patients). The study base consisted of two samples of individuals suffering from long-term, non-specific spinal pain and the results were validated across these samples. Cluster analysis was used to detect distinct groups of patients and the validity of these subgroups was evaluated on variables not used to generate the cluster solution. One subgroup was characterised by lower pain severity, lower interference with everyday activities, lower affective distress and higher life control than the other two subgroups. This patient profile was similar to the MPI adaptive coper patients. A second subgroup resembled the dysfunctional patient profile, thus displaying a worse adjustment to chronic pain than the AC patients. The third patient group reported significantly lower levels of social support from “significant others” than the other subgroups. This patient profile was similar to that of the interpersonally distressed patient group. Taken together, the results support the reliability, validity and generalisability of three subgroups of chronic pain patients derived from the MPI-S.
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| 3. |
- Hedman, Erik, et al.
(författare)
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Clinical effectiveness and cost-effectiveness of Internet- vs. group-based cognitive behavior therapy for social anxiety disorder : 4-Year follow-up of a randomized trial
- 2014
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Ingår i: Behaviour Research and Therapy. - : Elsevier. - 0005-7967 .- 1873-622X. ; 59, s. 20-29
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Tidskriftsartikel (refereegranskat)abstract
- Social anxiety disorder (SAD) is common, debilitating and associated with high societal costs. The disorder can be effectively treated with Internet-based cognitive behavior therapy (ICBT), but no previous study has investigated the long-term clinical or health economic effects of ICBT for SAD in comparison to an evidence-based control treatment. The aim of the study was to investigate the clinical effectiveness and cost-effectiveness of ICBT compared to cognitive behavioral group therapy (CBGT) four years post-treatment. We conducted a 4-year follow-up study of participants who had received ICBT or CBGT for SAD within the context of a randomized controlled non-inferiority trial. The cost-effectiveness analyses were conducted taking a societal perspective. Participants in both treatment groups made large improvements from baseline to 4-year follow-up on the primary outcome measure (d = 1.34-1.48) and the 95% CI of the mean difference on the primary outcome was well within the non-inferiority margin. ICBT and CBGT were similarly cost-effective and both groups reduced their indirect costs. We conclude that ICBT for SAD yields large sustainable effects and is at least as long-term effective as CBGT. Intervention costs of both treatments are offset by net societal cost reductions in a short time. (C) 2014 Elsevier Ltd. All rights reserved.
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| 4. |
- Herz, Noa, et al.
(författare)
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Intrusive memories : A mechanistic signature for emotional memory persistence
- 2020
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Ingår i: Behaviour Research and Therapy. - : Elsevier BV. - 0005-7967 .- 1873-622X. ; 135
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Tidskriftsartikel (refereegranskat)abstract
- Memories of negative emotional events persist more over time relative to memories for neutral information. Such persistence has been attributed to heightened encoding and consolidation processes. However, reactivation of the encoded information may also lead to reduced memory decay through rehearsal or a reconsolidation processes. Here, we tested whether involuntary intrusive memories, spontaneously arising following a stressful event and reactivating its memory, function to prevent memory decay, enhancing its persistence. Participants watched a stressful film containing scenes of aversive material. Memory for the film contents was tested immediately post film using a visual recognition test. In the following five days, participants recorded intrusive memories of the film using a digitized diary. After 5-days, memory for the film contents was retested. Results indicate that in the immediate aftermath of film watching, participant's memory scores were similarly high for scenes that were later experienced as intrusions and scenes that did not intrude, suggesting effective encoding for all scenes. However, persistence of memory for scenes that intruded was preserved relative to memory for scenes that did not intrude, pointing to a mechanism through which negative intrusive memories persist over time. Implications for memory modification interventions in trauma-related psychopathology are discussed.
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| 5. |
- Jüris, Linda, et al.
(författare)
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Cognitive Behaviour Therapy for Hyperacusis : A Randomized Controlled Trial
- 2014
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Ingår i: Behaviour Research and Therapy. - : Elsevier BV. - 0005-7967 .- 1873-622X. ; 54, s. 30-37
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Tidskriftsartikel (refereegranskat)abstract
- Hyperacusis, defined as unusual intolerance to ordinary environmental sounds, is a common problem for which there are no controlled trials on psychological treatment. Given the avoidance strategies present in hyperacusis, and similarities with problems such as tinnitus and chronic pain, cognitive behaviour therapy (CBT) is hypothesized to be helpful for patients with hyperacusis. In this randomized controlled study of 60 patients with hyperacusis, CBT was compared with a waiting list control group using the Loudness Discomfort Level test (LDL), the Hyperacusis Questionnaire, the Hospital Anxiety and Depression Scales, the Quality of Life Inventory and an adapted version of the Tampa Scale of Kinesiophobia. There were significant between-group effects in favour of the CBT group on all measures except for the HADS anxiety scale. Between-group effect sizes were moderate to high, with Cohen's d = 0.67 and 0.69 per ear, respectively, for the primary measure LDL, and ranging from d = 0.32 to 1.36 for the secondary measures. The differences between groups ceased to exist when the waiting list group was treated later with CBT, and the treatment results were largely maintained after 12 months. In conclusion, CBT is a promising treatment for hyperacusis, although more research is necessary.
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| 6. |
- Soares, Joaquim, 1947-, et al.
(författare)
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Preattentive processing, preparedness and phobias: Effects of instructions on conditioned electrodermal responses to masked and non-masked fear-relevant stimuli
- 1993
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Ingår i: Behaviour Research and Therapy. - 0005-7967 .- 1873-622X. ; 31:1, s. 87-95
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Tidskriftsartikel (refereegranskat)abstract
- We hypothetized that autonomic responses conditioned to fear-relevant stimuli, in contrast to responses conditioned to neutral stimuli, can be elicited after only an automatic, non-conscious analysis of the stimulus. Consequently, they may be expected to be insensitive to verbal instructions. Normal subjects were conditioned to either fear-relevant stimuli (snakes or spiders) or neutral stimuli (flowers or mushrooms) in a differential conditioning paradigm with shock as the unconditioned stimulus. In a subsequent extinction series, half of the subjects were shown the conditioned stimuli under masking conditions preventing their conscious recognition, whereas the other half were exposed to non-masked stimuli. Then half of the subjects in each of the masking conditions were verbally instructed that no more shocks would be delivered and then the extinction trials followed. Consistent with our hypothesis, differential responses to the fear-relevant CSs+ and CSs− remained unaffected by both masking and instruction, whereas differential responding to neutral stimuli was wiped out by the masking procedure and the verbal instruction.
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| 7. |
- Dahlin, Mats, et al.
(författare)
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Internet-delivered acceptance-based behaviour therapy for generalized anxiety disorder : A randomized controlled trial
- 2016
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Ingår i: Behaviour Research and Therapy. - : Elsevier BV. - 0005-7967 .- 1873-622X. ; 77, s. 86-95
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Tidskriftsartikel (refereegranskat)abstract
- Generalized anxiety disorder (GAD) is a disabling condition which can be treated with cognitive behaviour therapy (CBT). The present study tested the effects of therapist-guided internet-delivered acceptance-based behaviour therapy on symptoms of GAD and quality of life. An audio CD with acceptance and mindfulness exercises and a separate workbook were also included in the treatment. Participants diagnosed with GAD (N = 103) were randomly allocated to immediate therapist-guided internet-delivered acceptance-based behaviour therapy or to a waiting-list control condition. A six month follow-up was also included. Results using hierarchical linear modelling showed moderate to large effects on symptoms of GAD (Cohen's d = 0.70 to 0.98), moderate effects on depressive symptoms (Cohen's d = 0.51 to 0.56), and no effect on quality of life. Follow-up data showed maintained effects. While there was a 20% dropout rate, sensitivity analyses showed that dropouts did not differ in their degree of change during treatment. To conclude, our study suggests that internet-delivered acceptance-based behaviour therapy can be effective in reducing the symptoms of GAD.
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| 8. |
- Haug, Thomas, et al.
(författare)
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Stepped care versus face-to–face cognitive behavior therapy for panic disorder and social anxiety disorder : Predictors and moderators of outcome
- 2015
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Ingår i: Behaviour Research and Therapy. - : Elsevier. - 0005-7967 .- 1873-622X. ; 71, s. 76-89
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate predictors and moderators of treatment outcome by comparing immediate face-to-face cognitive behavioral therapy (FtF-CBT) to a Stepped Care treatment model comprising three steps: Psychoeducation, Internet-delivered CBT, and FtF-CBT for panic disorder (PD) and social anxiety disorder (SAD).Method: Patients (N = 173) were recruited from nine public mental health out-patient clinics and randomized to immediate FtF-CBT or Stepped Care treatment. Characteristics related to social functioning, impairment from the anxiety disorder, and comorbidity was investigated as predictors and moderators by treatment format and diagnosis in multiple regression analyses.Results: Lower social functioning, higher impairment from the anxiety disorder, and a comorbidcluster C personality disorder were associated with significantly less improvement, particularly among patients with PD. Furthermore, having a comorbid anxiety disorder was associated with a better treatment outcome among patients with PD but not patients with SAD. Patients with a comorbid depression had similar outcomes from the different treatments, but patients without comorbid depression had better outcomes from immediate FtF-CBT compared to guided self-help.Conclusions: In general, the same patient characteristics appear to be associated with the treatment outcome for CBT provided in low- and high-intensity formats when treated in public mental health care clinics. The findings suggest that patients with lower social functioning and higher impairment from their anxiety disorder benefit less from these treatments and may require more adapted and extensive treatment.ClinicalTrials.govIdentifier: NCT00619138.
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| 9. |
- Hedman, Erik, et al.
(författare)
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Predictors in Internet-delivered cognitive behavior therapy and behavioral stress management for severe health anxiety
- 2015
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Ingår i: Behaviour Research and Therapy. - : Elsevier BV. - 0005-7967 .- 1873-622X. ; 64, s. 49-55
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Tidskriftsartikel (refereegranskat)abstract
- Severe health anxiety can be effectively treated with exposure-based Internet-delivered cognitive behavior therapy (ICBT), but information about which factors that predict outcome is scarce. Using data from a recently conducted RCT comparing ICBT (n = 79) with Internet-delivered behavioral stress management (IBSM) (n = 79) the presented study investigated predictors of treatment outcome. Analyses were conducted using a two-step linear regression approach and the dependent variable was operationalized both as end state health anxiety at post-treatment and as baseline-to post-treatment improvement. A hypothesis driven approach was used where predictors expected to influence outcome were based on a previous predictor study by our research group. As hypothesized, the results showed that baseline health anxiety and treatment adherence predicted both end state health anxiety and improvement. In addition, anxiety sensitivity, treatment credibility, and working alliance were significant predictors of health anxiety improvement. Demographic variables, i.e. age, gender, marital status, computer skills, educational level, and having children, had no significant predictive value. We conclude that it is possible to predict a substantial proportion of the outcome variance in ICBT and IBSM for severe health anxiety. The findings of the present study can be of high clinical value as they provide information about factors of importance for outcome in the treatment of severe health anxiety.
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| 10. |
- Hesser, Hugo, 1982-, et al.
(författare)
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Behavioral avoidance moderates the effect of exposure therapy for irritable bowel syndrome: A secondary analysis of results from a randomized component trial
- 2021
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Ingår i: Behaviour Research and Therapy. - : Elsevier BV. - 0005-7967 .- 1873-622X. ; 141
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Tidskriftsartikel (refereegranskat)abstract
- Past research has failed to identify consistent moderators of outcomes in psychological treatments for irritable bowel syndrome (IBS). The aim of this study was to test previously identified mediators as potential moderators of the effects of exposure therapy on IBS symptoms in a previously published randomized component trial. In total, 309 participants with IBS were randomized to internet-delivered cognitive behavioral treatment that included exposure (ICBT) or to the same treatment protocol without exposure (ICBT-WE) and were asked to report on gastrointestinal symptoms at pretreatment, posttreatment and weekly during the treatment. Pretreatment scores of The Visceral Sensitivity Index (VSI) and The Irritable Bowel Syndrome Behavioral Responses Questionnaire (IBS-BRQ) (i.e., gastrointestinal anxiety and avoidance behavior) were evaluated as predictors and moderators. Piecewise latent growth curve models were employed to evaluate moderators during distinct phases of the trial, prior to and following the onset of exposure in ICBT. Results revealed that pretreatment scores on IBS-BRQ (avoidance) moderated the effect of exposure therapy during the specific phase in which exposure was implemented in ICBT, with higher avoidance scores linked to stronger positive effects of exposure. VSI did not serve as predictor nor moderator. Adding exposure to CBT seems to be especially important for persons with moderate to high levels of avoidance behaviors in order to reduce gastrointestinal symptoms.
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