| 1. |
- Ebert, D. D., et al.
(författare)
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Does Internet-based guided-self-help for depression cause harm? An individual participant data meta-analysis on deterioration rates and its moderators in randomized controlled trials
- 2016
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Ingår i: Psychological Medicine. - : Cambridge University Press. - 0033-2917 .- 1469-8978. ; 46:13, s. 2679-2693
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Forskningsöversikt (refereegranskat)abstract
- Almost nothing is known about the potential negative effects of Internet-based psychological treatments for depression. This study aims at investigating deterioration and its moderators within randomized trials on Internet-based guided self-help for adult depression, using an individual patient data meta-analyses (IPDMA) approach.Studies were identified through systematic searches (PubMed, PsycINFO, EMBASE, Cochrane Library). Deterioration in participants was defined as a significant symptom increase according to the reliable change index (i.e. 7.68 points in the CES-D; 7.63 points in the BDI). Two-step IPDMA procedures, with a random-effects model were used to pool data.A total of 18 studies (21 comparisons, 2079 participants) contributed data to the analysis. The risk for a reliable deterioration from baseline to post-treatment was significantly lower in the intervention v. control conditions (3.36 v. 7.60; relative risk 0.47, 95% confidence interval 0.29–0.75). Education moderated effects on deterioration, with patients with low education displaying a higher risk for deterioration than patients with higher education. Deterioration rates for patients with low education did not differ statistically significantly between intervention and control groups. The benefit–risk ratio for patients with low education indicated that 9.38 patients achieve a treatment response for each patient experiencing a symptom deterioration.Internet-based guided self-help is associated with a mean reduced risk for a symptom deterioration compared to controls. Treatment and symptom progress of patients with low education should be closely monitored, as some patients might face an increased risk for symptom deterioration. Future studies should examine predictors of deterioration in patients with low education.
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| 4. |
- Karyotaki, Eirini, et al.
(författare)
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Do guided internet-based interventions result in clinically relevant changes for patients with depression? : An individual participant data meta-analysis
- 2018
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Ingår i: Clinical Psychology Review. - : Elsevier. - 0272-7358 .- 1873-7811. ; 63, s. 80-92
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Forskningsöversikt (refereegranskat)abstract
- Little is known about clinically relevant changes in guided Internet-based interventions for depression. Moreover, methodological and power limitations preclude the identification of patients' groups that may benefit more from these interventions. This study aimed to investigate response rates, remission rates, and their moderators in randomized controlled trials (RCTs) comparing the effect of guided Internet-based interventions for adult depression to control groups using an individual patient data meta-analysis approach. Literature searches in PubMed, Embase, PsycINFO and Cochrane Library resulted in 13,384 abstracts from database inception to January 1, 2016. Twenty-four RCTs (4889 participants) comparing a guided Internet-based intervention with a control group contributed data to the analysis. Missing data were multiply imputed. To examine treatment outcome on response and remission, mixed-effects models with participants nested within studies were used. Response and remission rates were calculated using the Reliable Change Index. The intervention group obtained significantly higher response rates (OR = 2.49, 95% CI 2.17-2.85) and remission rates compared to controls (OR = 2.41, 95% CI 2.07-2.79). The moderator analysis indicated that older participants (OR = 1.01) and native-born participants (1.66) were more likely to respond to treatment compared to younger participants and ethnic minorities respectively. Age (OR = 1.01) and ethnicity (1.73) also moderated the effects of treatment on remission.Moreover, adults with more severe depressive symptoms at baseline were more likely to remit after receiving intemet-based treatment (OR = 1.19). Guided Internet-based interventions lead to substantial positive treatment effects on treatment response and remission at post-treatment. Thus, such interventions may complement existing services for depression and potentially reduce the gap between the need and provision of evidence-based treatments.
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| 5. |
- Forsell, E., et al.
(författare)
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Overcoming procrastination : One-year follow-up and predictors of change in a randomized controlled trial of Internet-based cognitive behavior therapy
- 2016
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Konferensbidrag (refereegranskat)abstract
- Procrastination; the purposeful delay of an intended course of action is, for many, a persistent behavior associated with reduced mood, increased stress, and poorer performance. 20 % of adults and 50 % of students experience significant difficulties with procrastination. Internet- based cognitive behavior therapy (ICBT) shows promise for several conditions, but has never been applied to procrastination. The current study examined the efficacy of ICBT for procrastination at post treatment and one-year follow-up, and investigated predictors of change.Method: Participants (N = 150) were randomized to 10 weeks of either guided self-help, unguided self-help, or wait-list control (receiving unguided self-help after the first treatment period). Outcome measures were the Pure Procrastination Scale (PPS), the Irrational Procrastination Scale (IPS), the Susceptibility to Temptation Scale, the Montgomery Åsberg Depression Rating Scale, the Generalized Anxiety Disorder Assessment, and the Quality of Life Inventory. Intention-to-treat was used for all statistical analyses, with mixed-effects models to assess the effect of time and group.Results: Moderate to large effect sizes were obtained post treatment comparing guided and unguided self-help with wait-list control, the PPS, Cohen’s d = 0.70, 95% confidence interval (CI) [0.29, 1.10], and d = 0.50, 95% CI [0.10, 0.90], and the IPS, d = 0.81 95% CI [0.40, 1.22], and d = 0.69 95% CI [0.29, 1.09]. Clinically significant change was achieved among 31.3–40.0% for guided self-help and 24.0–36.0% for unguided self-help. Neither treatment condition was superior on any outcome measure, Fs (98, 65.17-72.55) < 1.70, p > .19. One-year follow-up data has been collected and the results will be available at the time of the conference, including predictors of change.Conclusion: ICBT could be useful for self-reported problems of procrastination, with results at one-year follow-up and predictors of change revealing the long-term benefit and variables associated with successful treatment outcome.
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| 6. |
- Forsström, David, et al.
(författare)
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Group versus Internet-based cognitive-behavioral therapy for procrastination : Study protocol for a randomized controlled trial
- 2015
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Ingår i: Abstracts from the 7th Swedish Congress on internet interventions (SWEsrii). - Linköping : Linköping University Press. ; , s. 20-20
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Konferensbidrag (refereegranskat)abstract
- Procrastination can be defined as a voluntarily delay of an intended course of action despite expecting to be worse-off for the delay, and is considered a persistent behavior pattern that can result in major psychological suffering, which in turn can constitute a major problem for many individuals. There a not many studies available on treating procrastination. A previous Internet based RCT with guided and unguided treatment aimed to decrease procrastination yielded positive results for individuals who volunteered to receive treatment. This current study has the aim to further increase the knowledge regarding treatment for procrastination. It is a RCT comparing unguided and group treatment aimed to decrease procrastination in a student population. Demographic data from the included participants and preliminary outcome data is presented. These results are discussed and compared to the previous RCT and other studies evaluating the effect of treatment aimed to decrease procrastination.
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| 7. |
- Oscarsson, Martin, et al.
(författare)
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Developing an internet-based stress-management program for working adults with ADHD
- 2022
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Ingår i: Abstracts from the 11th Swedish Congress on internet interventions (SWEsrii), Gothenburg, Sweden, 23-24 May 2022. - Linköping : Linköping University Electronic Press. ; , s. 9-9
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Konferensbidrag (refereegranskat)abstract
- Introduction: The proportion of sickness absence due to psychiatric diagnoses has increased drastically. It is reasonable to assume that ADHD adults are overly represented in these cases. Thus, it is urgent to manage and prevent work-related mental illness in this population. Yet, the possibilities of doing so have not been studied extensively. Therefore, this project evaluates the feasibility, acceptability, and effects of an internet-based stress-management program developed specifically for this at-risk population. In this presentation, the protocol for developing and assessing the program is presented, including ADHD adults’ attitudes toward the program and comparing current interventions.Methods: To assess attitudes toward the program, transcripts from 20 interviews with ADHD adults were explored using descriptive thematic analysis. The interviews focused on the scope, content, and duration of the proposed intervention and the design and possible inclusion of therapist support. The program will be based on existing support and interventions for ADHD adults. The development will include a thorough assessment of previous research, including quantitative and qualitative studies, meta-analyses, and literature reviews. The most relevant and effective material will be adapted to the internet format and the ADHD-adult population.Results and discussion: This project will further the knowledge of possible ways to manage and prevent work-related mental illness among ADHD adults, including related sickness absence. If the proposed program shows promising results, it could quickly be made available to caregivers and/or the public, conceivably conserving considerable resources for individuals, employers, and society.
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| 8. |
- Rozental, Alexander, et al.
(författare)
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Overcoming procrastination : One-year follow-up and predictors of change in a randomized controlled trial of Internet-based cognitive behavior therapy
- 2016
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Konferensbidrag (refereegranskat)abstract
- Aim: Procrastination refers to the purposeful delay of an intended course of action and can become a persistent behavioral pattern associated with reduced mood, increased stress, and poorer performance. One-fifth of the adult population and half of the student population experience significant difficulties due to procrastination, but has received little attention in clinical research. Meanwhile, Internet-based cognitive behavior therapy (ICBT) has been found promising for several conditions, but has not yet been used in relation to procrastination. The current study thus aimed to examine the efficacy of ICBT for procrastination at post treatment and one-year follow-up, as well as to investigate predictors of change.Method: Participants (N = 150) were randomized to a ten-week treatment programme; guided self-help, unguided self-help, and wait-list control (receiving unguided self-help after the first treatment period). Outcome measures were administered at screening, post treatment, one-year follow-up, or weekly, consisting of the Pure Procrastination Scale (PPS), the Irrational Procrastination Scale (IPS), the Susceptibility to Temptation Scale, the Montgomery Åsberg Depression Rating Scale, the Generalized Anxiety Disorder Assessment, and the Quality of Life Inventory. Intention-to-treat was used for all statistical analyses, with mixed-effects models to assess the effect of time and group.Results: Moderate to large effect sizes were obtained at post treatment comparing guided and unguided self-help with wait-list control, the PPS, Cohen’s d = 0.70, 95% confidence interval (CI) [0.29, 1.10], and d = 0.50, 95% CI [0.10, 0.90], and the IPS, d = 0.81 95% CI [0.40, 1.22], and d = 0.69 95% CI [0.29, 1.09]. Clinically significant change was achieved among 31.3–40.0% for guided self-help, compared with 24.0–36.0% for unguided self-help. Neither of the treatment conditions was found to be superior on any of the outcome measures, Fs (98, 65.17-72.55) < 1.70, p > .19. One-year follow-up data has just been collected and the results of will be available at the time of the conference, including predictors of change.Conclusion: ICBT could be useful for managing self-reported problems of procrastination, with results at one-year follow-up and predictors of change revealing the long-term benefit and possible variables responsible for a successful treatment outcome.
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| 9. |
- Rozental, Alexander, et al.
(författare)
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Treating procrastination using cognitive behavior therapy : A pragmatic randomized controlled trial comparing treatment delivered via the Internet or in groups
- 2017
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Ingår i: BABCP Manchester 2017. ; , s. 60-60
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Konferensbidrag (refereegranskat)abstract
- Introduction: Procrastination is a common problem among university students, with at least half of the population reporting great difficulties initiating or completing certain tasks and assignments. Procrastination can have a negative impact on course grades and the ability to achieve a university degree, but can also lead to psychological distress, such as, stress and anxiety. Cognitive Behavior Therapy (CBT) is often considered treatment of choice, but few studies have investigated its effectiveness in regular clinical settings. The current study explored its treatment effects using a pragmatic randomized controlled trial comparing treatment delivered during eight weeks as unguided self-help via the Internet (ICBT) or as group CBT. Methods: In total, 92 university students with severe procrastination were included in the study (registered as a clinical trial on Clinicaltrials.gov: NCT02112383). Outcome measures included self-reported procrastination, depression, anxiety, and physical and psychological well-being, which were distributed at pre- and post-treatment, as well as six-month follow-up. An outcome measure of procrastination was also administered weekly. Results: Linear mixed and fixed effects models were calculated, along with improvement and deterioration rates. The results showed that both unguided ICBT and group CBT yielded large within-group effect sizes on procrastination, Cohen’s d = 1.24-1.29, 95% Confidence Interval (CI) [0.76-1.74], and small to moderate benefits for depression, anxiety, and well-being, d = 0.37-0.68, 95% CI [-0.06-1.12]. In total, 32.6% were improved at post-treatment and 45.6% at follow-up. No differences between conditions were observed directly after the treatment period, however, participants in group CBT continued or maintained their improvement at follow-up, while participants in unguided ICBT showed signs of deterioration. Discussion: The findings from the current study suggest that CBT might be an effective treatment for students with problems of procrastination, but that a group format may be better for some in order to sustain their benefits over time.
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| 10. |
- Rozental, Alexander, et al.
(författare)
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Understanding and treating procrastination
- 2015
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Prokrastinering definieras som beteendet att medvetet förhala ett tilltänkt handlingsförlopp, trots medvetenhet om att det kan medföra negativa konsekvenser. Utöver att påverka prestationen på en given uppgift eller aktivitet har prokrastinering även visat sig vara associerat med sämre psykisk och fysisk hälsa. Trots detta är forskning på effektiva behandlingsinterventioner för prokrastinering ytterst begränsat. Aktuellt symposium syftar till att delge resultaten från två kliniska studier där kognitiv beteendeterapi har använts i behandling av personer med svåra problem av prokrastinering, dels i form av Internetbaserad självhjälpsbehandling, dels i form av gruppbehandling. Utöver en presentation av utfallet ges dessutom en genomgång av en klusteranalys av de deltagare som har sökt hjälp för prokrastinering, vilken visar på behovet av noggrann screening och god differentialdiagnostik inför en behandling.
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