| 1. |
|
|
| 2. |
- Hesser, Hugo, 1982-, et al.
(författare)
-
Behavioral avoidance moderates the effect of exposure therapy for irritable bowel syndrome: A secondary analysis of results from a randomized component trial
- 2021
-
Ingår i: Behaviour Research and Therapy. - : Elsevier BV. - 0005-7967 .- 1873-622X. ; 141
-
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.
|
|
| 3. |
- Ljótsson, B., et al.
(författare)
-
Provoking symptoms to relieve symptoms : A randomized controlled dismantling study of exposure therapy in irritable bowel syndrome
- 2014
-
Ingår i: Behaviour Research and Therapy. - : Elsevier. - 0005-7967 .- 1873-622X. ; 55:1, s. 27-39
-
Tidskriftsartikel (refereegranskat)abstract
- An internet-delivered cognitive behavioral treatment (ICBT) based on systematic exposure exercises has previously shown beneficial effects for patients with irritable bowel syndrome (IBS). Exposure exercises may be perceived as difficult for patients to perform because of the elicited short-term distress and clinicians may be reluctant to use these interventions. The aim of this study was to compare ICBT with the same protocol without systematic exposure (ICBT-WE) to assess if exposure had any incremental value. This randomized controlled dismantling study included 309 participants diagnosed with IBS. The treatment interventions lasted for 10 weeks and included online therapist contact. ICBT-WE comprised mindfulness, work with life values, acceptance, and encouraged reduced avoidance behaviors, while ICBT also included systematic exposure to IBS symptoms and related situations. Severity of IBS symptoms was measured with the Gastrointestinal Symptom Rating Scale-IBS version (GSRS-IBS). The between-group Cohen's don GSRS-IBS was 0.47(95% CI: 0.23-0.70) at post-treatment and 0.48 (95% CI: 0.20-0.76) at 6-month follow-up, favoring ICBT. We conclude that the systematic exposure included in the ICBT protocol has incremental effects over the other components in the protocol. This study provides evidence for the utility of exposure exercises in psychological treatments for IBS.
|
|
