| 1. |
- Andersson, Gerhard, et al.
(författare)
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Factorial Trial Design in Internet Intervention Research
- 2019
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Ingår i: Proceedings of the 9th World Congress of Behavioural & Cognitive Therapies. - Tübingen : dgvt-Verlag. - 9783871598517 ; , s. 155-156
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Numerous controlled trials have been published on the effects of internet-delivered psychological treatments for a range of problems and disorders. Generally, trials adhere to the CONSORT statement and include control groups. Often this is attention control, waitlist but also alternative treatments. In experimental psychology factorial designs is the common way to investigate research questions but in psychotherapy research this is rare given the need for large samples in order to have sufficient power to detect differntial effects of independent variables (like for example different versions of a treatment). With the advent of internet-delivered CBT (ICBT) this has changes and it is now possible to run trials with larger samples. At the same time there is really no need for more studies showing that a treatment is better than just waiting (for some areas at least like depression). In this talk we will present result from three completed factorial design trials in which we have manipulated support form (on demand versus scheduled in one trial and chat-support versus just email in another), and also other aspects like learning support and choice of treatment. The talk will end with a discussion on future directions of ICBT research with regards to design of trials.
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| 2. |
- Lindner, Philip
(författare)
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The Next Generation of Virtual Reality Interventions for Mental Health
- 2019
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Ingår i: Proceedings of the 9th World Congress of Behavioural & Cognitive Therapies. - Tübingen : dgvt-Verlag. - 9783871598517 ; , s. 174-174
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Decades of research have shown that Virtual Reality (VR) technology can be used efficaciously to treat anxiety disorders, and for pain management, stress reduction, and other mental health purposes. Yet it is only with the recently advent of consumer VR platforms that widespread clinical implementation and scalable dissemination of self-help application have become possible. The time is thus ripe to move VR interventions out from university labs and into clinics and the hands of regular patients. This talk will present recent research on the efficacy, effectiveness and real-world usage of automated, gamified VR self-help applications, as well as three on-going effectiveness studies in regular healthcare: VR pain-distraction at a post-operative ward, VR relaxation at a psychiatric inpatient clinic, and VR exposure therapy for public speaking anxiety at a general mental health clinic. The unique and inherent clinical capabilities of VR technology will be discussed, as will lessons learned from implementation and dissemination efforts.
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| 3. |
- Månsson, Kristoffer, et al.
(författare)
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Brain Signal Variability and Indices of Cellular Protection Predicts Social Anxiety Disorder Treatment Outcome
- 2019
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Ingår i: Proceedings of the 9th World Congress of Behavioural & Cognitive Therapies. - Tübingen : dgvt-Verlag. - 9783871598517 ; , s. 158-158
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- We are currently lacking clinically useful predictors of treatment response in common psychiatric disorders. Non-invasive and increasingly accessible neuroimaging techniques like functional magnetic resonance imaging (fMRI) could be a useful tool. In contrast to the conventional approach investigating the brain’s average responses, the brain’s signal variability could be a better estimate of the brain’s dynamic operations (Garrett et al., 2010, 2015). In addition, telomere attrition is a hallmark of cellular aging and shorter telomeres have been reported in mood and anxiety disorders. Telomere shortening is counteracted by the enzyme telomerase and cellular protection is also provided by the antioxidant enzyme glutathione peroxidase (GPx). Here, we investigate if baseline BOLD-fMRI signal variability, and indices of cellular protection, predicts social anxiety disorder patient’s response to internet-delivered cognitive behavior therapy. Forty-six patients with social anxiety disorder (SAD) were scanned twice with a 3 Tesla fMRI before initiating CBT. Treatment outcome was assessed the Liebowitz Social Anxiety Scale (self-report). 1) BOLD-fMRI acquisition was performed while passively viewing emotional faces flashing on the screen for 80 seconds. Raw BOLD-fMRI data was implemented in an Independent Component Analysis in order to manually denoise images by carefully remove noise from neural signal. Across time, each voxel’s standard deviation was calculated and used as an index of variability. Multivariate partial least squares regression models were used for second level analysis. 2) Telomerase activity and telomere length were measured in peripheral blood mononuclear cells and GPx activity in plasma. Significant latent level brain scores, and baseline analytes were implemented in linear regressions with LSAS-SR change score as the outcome. Results will be presented and discussed.
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| 4. |
- 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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| 5. |
- Rozental, Alexander, et al.
(författare)
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The Negative Effects Questionnaire : Psychometric Properties of an Instrument for Assessing Negative Effects in Psychological Treatments
- 2019
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Ingår i: Proceedings of the 9th World Congress of Behavioural & Cognitive Therapies. - Tübingen : dgvt-Verlag. - 9783871598517 ; 47:5, s. 559-572
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: Psychological treatments provide many benefits for patients with psychiatric disorders, but research also suggest that negative effects might occur from the interventions involved. The Negative Effects Questionnaire (NEQ) has previously been developed as a way of determining the occurrence and characteristics of such incidents, consisting of 32 items and six factors. However, the NEQ has yet to be examined using modern test theory, which could help to improve the understanding of how well the instrument works psychometrically. Aims: The current study investigated the reliability and validity of the NEQ from both a person and item perspective, establishing goodness-of-fit, item bias, and scale precision. Method: The NEQ was distributed to 564 patients in five clinical trials at post-treatment. Data was analyzed using Rasch analysis, i.e., a modern test theory application. Results: 1) the NEQ exhibits fairness in testing across sociodemographics, 2) shows comparable validity for a final and condensed scale of 20 instead of 32 items, 3) uses a rating scale that advances monotonically in steps of 0-4, and 4) is suitable for monitoring negative effects on an item-level. Conclusion: The NEQ is proposed as a useful instrument for investigating negative effects in psychological treatments, and its newer shorter format could facilitate its use in clinical and research settings. However, further research is needed to explore the relationship between negative effects and treatment outcome, as well as to test it in more diverse patient populations
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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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