| 1. |
- Carlbring, Per, et al.
(författare)
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A randomized controlled trial of Internet-based CBT for perfectionism including an investigation of outcome predictors
- 2017
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Ingår i: Program Book. ; , s. 128-128
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Konferensbidrag (refereegranskat)abstract
- Being highly attentive to details can be a positive feature. However, for some individuals, perfectionism can lead to distress and is associated with many psychiatric disorders. Cognitive behavior therapy has been shown to yield many benefits for those experiencing problems with perfectionism, but the access to evidence-based care is limited. The current study investigated the efficacy of guided Internet-based Cognitive Behavior Therapy (ICBT) and predictors of treatment outcome. In total, 156 individuals were included and randomized to an eight-week treatment or wait-list control. Self-report measures of perfectionism, depression, anxiety, self-criticism, self-compassion, and quality of life were distributed during screening and at post-treatment. Intention-to-treat were used for all statistical analyses. Moderate to large between-group effect sizes were obtained for the primary outcome measures, Frost Multidimensional Perfectionism Scale, subscales Concerns over Mistakes and Personal Standards, Cohen’s d = 0.68-1.00, 95% Confidence Interval (CI) [0.36-1.33], with 35 (44.9%) of the patients in treatment being improved. Predictors were also explored, but none were related to treatment outcome. In sum, guided ICBT can be helpful for addressing problems with clinical perfectionism, but research of its long-term benefits is warranted.
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| 2. |
- Carlbring, Per, et al.
(författare)
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Internet-Based vs. Face-to-Face CBT : Systematic Review and Meta-Analysis
- 2018
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Konferensbidrag (refereegranskat)abstract
- During the last two decades, Internet-delivered cognitive behavior therapy (ICBT) has been tested in hundreds of randomized controlled trials, often with promising results. However, the control groups were often waitlist, care-as-usual or attention control. Hence, little is known about the relative efficacy of ICBT as compared to face-to-face cognitive behavior therapy (CBT). In addition, the long-term effects of ICBT is largely unknown.In this presentation a systematic review and meta-analysis, which included 1418 participants, will be presented. Out of the 2078 articles screened, a total of 20 studies met all inclusion criteria. These included studies on social anxiety disorder, panic disorder, depression, body dissatisfaction etc. Results showed a pooled effect size at post-treatment of Hedges g = 0.05 (95% CI, -0.09 to 0.20), indicating that ICBT and face-to-face treatment produced equivalent overall effects.We also reviewed studies in which the long-term effects of guided ICBT were investigated. Following a new set of literature searches in PubMed and other sources meta-analytic statistics were calculated for 14 studies involving a total of 902 participants, and an average follow-up period of three years. The duration of the actual treatments was usually short (8-15 weeks). The pre-to follow-up (>2 yrs) effect size was Hedge’s g = 1.52, but with a significant heterogeneity. The average symptom improvement across studies was 50%.While the overall results indicate equivalence, there have been few studies of the individual psychiatric and somatic conditions so far, and for the majority, guided ICBT has not been compared against face-to-face treatment. Thus, more research, preferably with larger sample sizes, is needed to establish the general equivalence of the two treatment formats. While effects may be overestimated, it is likely that therapist-supported ICBT can have enduring effects.
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| 3. |
- Rozental, Alexander, et al.
(författare)
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Reconsidering Perfect : A Qualitative Study of The Experiences of Undergoing Internet-Based Cognitive Behaviour Therapy for Perfectionism
- 2019
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Ingår i: Proceedings of the 9th World Congress of Behavioural & Cognitive Therapies. - Tübingen : dgvt-Verlag. - 9783871598517 ; , s. 233-233
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Internet-based cognitive behaviour therapy (ICBT) is a promising format for treating different psychiatric disorders. In addition, several clinical trials have found positive results for implementing transdiagnostic treatments via the Internet, as well as for using ICBT to target transdiagnostic processes, such as perfectionism. However, few qualitative studies have been conducted on the experiences of patients undergoing such treatments, making it unclear what aspects might facilitate or hinder their delivery. In the current study, patients completing twelve-week therapist-guided ICBT for perfectionism responded to open-ended questions at post-treatment. In total, 30 out of 62 (48.4%) rated the ease of understanding and completing the treatment program, as well as described their impressions of its content and the support provided by their therapist. The results were analysed qualitatively using thematic analysis. Overall, patients were satisfied, finding treatment easy to comprehend and use. Five themes were found in the responses; Learning how to do things differently, Noticing the positives, Feeling safe to be honest, A comfortable treatment format and Barriers to treatment. The results suggest that many patients were able to achieve a change in perspective in relation to their perfectionism and started facing their fears. They were also able to report the benefits of doing things differently as part of treatment, such as an improvement in their interpersonal relationships. Most patients were also positive about the treatment format, enjoying its flexibility and the encouragement offered by their therapist. However, obstacles such as conflicting commitments, personal difficulties, time-consuming and comprehensive modules, and a desire for more support were brought up by some, suggesting that there are aspects that could be considered in the future.
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| 4. |
- Rozental, Alexander, et al.
(författare)
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Targeting Procrastination Using Psychological Treatments : A Systematic Review and Meta-Analysis
- 2019
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Ingår i: Proceedings of the 9th World Congress of Behavioural & Cognitive Therapies. - Tübingen : dgvt-Verlag. - 9783871598524 ; , s. 310-310
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Konferensbidrag (refereegranskat)abstract
- Introduction: Procrastination can be stressful and frustrating, but it seldom causes any major distress. However, for some people, it can become problematic, resulting in anxiety, lowered mood, physical complaints, and decreased well-being. Still, few studies have investigated the benefits of targeting procrastination. In addition, no attempt has previously been made to determine the overall efficacy of providing psychological treatments.Method: A systematic review and meta-analysis was conducted by searching for eligible records in Scopus, Proquest, and Google Scholar. Only randomized controlled trials comparing psychological treatments for procrastination to an inactive comparator and assessing the outcomes by a self-report measure were included. A random effects model was used to determine the standardized mean difference Hedge’s g at post- treatment. Furthermore, test for heterogeneity was performed, fail-safe N was calculated, and the risk of bias was explored. The study was pre-registered at Prospero: CRD42017069981.Results: A total of 1639 records were identified, with twelve studies (21 comparisons, N = 718) being included in the quantitative synthesis. Overall effect size g when comparing treatment to control was 0.34, 95% Confidence Interval [0.11, 0.56], but revealing significant heterogeneity, Q(20) = 46.99, p < .00, and I2 = 61.14%, 95% CI [32.83, 84.24]. Conducting a subgroup analysis of three out of four studies using cognitive behavior therapy (CBT) found an effect size g of 0.55, 95% CI [0.32, 0.77], and no longer showing any heterogeneity, Q(4) = 3.92, p = 0.42, I2 = 0.00%, 95% CI [0.00, 91.02] (N = 236). Risk of publication bias, as assessed by the Egger’s test was not significant, z = -1.05, p = 0.30, fail-safe N was 370 studies, and there was some risk of bias as rated by two independent researchers. In terms of secondary outcomes, the self-report measures were too varied to present an aggregated estimate.Discussion: Psychological treatments seem to have small benefits on procrastination, but the studies displayed significant between-study variation. Meanwhile, CBT was associated with a moderate benefit, but consisted of only three studies. Recommendations for future research are provided, including the use of more valid and reliable outcomes and a screening interview at intake.
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| 5. |
- Rozental, Alexander, et al.
(författare)
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Treating perfectionism using internet-based cognitive behavior therapy : Comparing two types of treatment
- 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. 11-11
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Konferensbidrag (refereegranskat)abstract
- Introduction: Perfectionism is characterized by setting high standards and being concerned about performance, which can have a negative impact on interpersonal relationships and psychological wellbeing. Cognitive behavior therapy (CBT), administered in a face-to-face setting and via the Internet, has previously demonstrated promising effects with regard to symptoms of perfectionism and related problems, for example depression. However, no clinical trial has used an active comparator. In the current study, Internet-based CBT (iCBT) was compared to Internet-based Unified Protocol (iUP) for self-referred participants seeking treatment for perfectionism.Methods: In total, 138 participants were deemed eligible and randomized to receive two types of treatment via the Internet, iCBT and iUP. Eight modules over eight weeks were distributed, containing both psychoeducation and homework assignments. If needed, participants could also receive support on demand from three therapists. A number of self-report measures were administered prior to and after the treatment period. At the time of the conference, the results of both conditions will be analyzed using an intention-to-treat, mixed model-analysis, applying maximum likelihood estimation to account for missing data.Results: Results from the post-treatment assessment showed that half of the participants (52.9%) had opened all of the eight modules, with no difference between the conditions. For the main outcome measure, the Clinical Perfectionism Questionnaire, the within-group effect size Cohen’s d was 1.61 for iCBT and 1.83 for iUP. For the secondary outcome measures, effects ranged from d 0.33 to 0.67. At the time of the conference, additional results from two follow-up assessments, six- and 12-months, will also be presented.Conclusion: Perfectionism can lead to significant difficulties and sometimes warrant treatment. CBT has been shown to benefit those affected by helping them change inflexible standards, refute cognitive biases, experiment with more flexible behaviors, and basing one’s self-worth on more than performance. The current study replicates prior research findings that CBT for perfectionism can successfully be delivered via the Internet, which could help disseminate an effective treatment to those in need.
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| 6. |
- Wade, Tracey, et al.
(författare)
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Internet-Based Cognitive Behaviour Therapy for Perfectionism : More is Better but no Need to Be Prescriptive
- 2019
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Ingår i: Proceedings of the 9th World Congress of Behavioural & Cognitive Therapies. - Tübingen : dgvt-Verlag. - 9783871598517 ; , s. 233-233
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Two sequential randomized internet ICBT for perfectionism (ICBT-P) studies were conducted with participants who self-identified as having difficulties with perfectionism; in the first participants (N=51) received 3-module ICBT-P or wait-list, and in the second participants (N=55) received fixed (asked to complete all 8 modules two per week over 4-weeks) or flexible format (after completing the first psychoeducational module, participants decided how many/in what order they completed the modules). We examined impact on our primary variables, perfectionistic concerns and standards, and secondary outcomes of negative affect, body image flexibility, and self-efficacy. First, while use of a 3 to 8 module intervention reliably decreased perfectionism, it appears that more modules are required in order to impact secondary outcomes, such as negative affect and body image. Second, there is no difference in impact when a fixed or flexible approach to the intervention (i.e., order and number of modules to be completed) is adopted. This suggests we can offer a patient-centred approach to ICBTP that is effective, while suggesting completion of more modules can result in larger, more pervasive improvements.
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