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- Andersson, G., et al.
(författare)
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Psychological treatments for depression delivered via the internet and supported by a clinician: An pdate : [Tratamientos psicológicos para la depresión aplicados a través de Internet y con el apoyo de un clínico: Una actualización]
- 2014
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Ingår i: Revista de Psicopatologia y Psicologia Clinica. - : Asociación de Análisis del Comportamiento. - 1136-5420 .- 2254-6057. ; 19:3, s. 217-225
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Forskningsöversikt (refereegranskat)abstract
- Guided internet-delivered cognitive behaviour therapy (ICBT) has been tested in many trials since the early studies dating back to the late 1990s. The aim of this review was to investigate the most recent literature on guided ICBT for depression. We identified 11 controlled studies published between January 2013 and September 2014. Overall, large treatment effects were observed with a few exceptions. A majority (7 studies) provided some information regarding unwanted effects such as deterioration. Three studies directly compared guided ICBT against face-to-face CBT. We added an earlier study and calculated meta-analytic summary statistics for the four studies involving a total of 336 participants. The average effect size difference was Hedges g = 0.12 (95% CI: -0.08∼0.32) in the direction of favouring guided ICBT, but with no practical importance. We conclude that guided ICBT is a promising treatment for depression and mood disorders and that the research is rapidly expanding.
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- Clason van de Leur, Jakob, et al.
(författare)
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Mediators during a multimodal intervention for stress-induced exhaustion disorder
- 2024
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Ingår i: Cognitive Behaviour Therapy. - : Routledge. - 1650-6073 .- 1651-2316. ; 53:3, s. 235-253
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Tidskriftsartikel (refereegranskat)abstract
- Our understanding of the underlying psychological processes of development, maintenance, and treatments for stress-induced exhaustion disorder (ED) remains limited. Therefore, the current study aimed to explore whether sleep concerns, pathological worry, perfectionistic concerns, and psychological flexibility mediate change in exhaustion symptoms during a Multimodal intervention for ED based on Cognitive behavioral therapy principles. Participants (N = 913) were assessed at three time points, and mediation was explored using a two-criteria analytical model with linear mixed-effects models (criterion one) and random intercepts cross-lagged panel modeling (criterion 2). Criterion one for mediation was successfully met, as the findings indicated significant associations between time in treatment, with all suggested mediators, and exhaustion symptoms (significant ab-products). However, criterion two was not satisfied as changes in the mediators did not precede changes in exhaustion symptoms. Therefore, mediation could not be established. Instead, changes in the suggested mediators appeared to result from changes in exhaustion symptoms. Consequently, sleep concerns, pathological worry, perfectionistic concerns, and psychological flexibility appear to improve in conjunction with exhaustion symptoms during treatment, where improvement in exhaustion is indicated as the main driving factor, based on this exploratory analysis. The implications of these findings are contextualized within a broader framework of process-based therapy.
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- Clason van de Leur, Jakob, et al.
(författare)
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Psychological Treatment of Exhaustion Due to Persistent Non-Traumatic Stress : A Scoping Review
- 2024
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Ingår i: International Journal of Behavioral Medicine. - : Springer. - 1070-5503 .- 1532-7558. ; 31:2, s. 175-191
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Forskningsöversikt (refereegranskat)abstract
- BackgroundExhaustion due to persistent non-traumatic stress (ENTS) is a significant health problem with substantial personal, social, and economic impact. While there are increasing studies of ENTS, there is no international agreement on how it should be diagnosed and treated. This scoping review aimed to map definitions, diagnoses, treatments, outcome measures, and outcomes in psychological treatment studies of ENTS. A further aim was to assess the quality of the treatments and map what change processes are described within ENTS interventions.MethodsA PRISMA-guided scoping review of psychological treatment studies delivered in a clinical setting for ENTS was conducted using the databases of PubMed, PsycINFO, and CINAHL.ResultsOf the 60 studies included, the majority (87%) stemmed from Europe. The most recurrent term for ENTS was burnout, and the diagnosis most often utilized was exhaustion disorder. Several treatments were reported, the most frequent being cognitive behavioral therapy (CBT) (68%). Statistically significant outcomes relevant to ENTS were reported in 65% (n = 39) of the studies, with effect sizes between 0.13 and 1.80. In addition, 28% of the treatments were rated as high quality. The most frequent change processes described were dysfunctional sleep, avoidance, behavioral activation, irrational thoughts and beliefs, worry, perceived competence/positive management, psychological flexibility, and recuperation.ConclusionsWhile several treatments based on CBT show promising results for ENTS, there do not seem to be any uniformly established methods, theoretical models, or change processes. Instead of adopting a monocausal, syndromal, and potentially bio-reductionist perspective on ENTS, a process-based approach to treatment is encouraged.
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- Lavefjord, Amani, et al.
(författare)
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Assessment methods in single case design studies of psychological treatments for chronic pain : A scoping review
- 2021
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Ingår i: Journal of Contextual Behavioral Science. - : Elsevier. - 2212-1447. ; 21, s. 121-135
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Forskningsöversikt (refereegranskat)abstract
- Single case designs (SCDs) represent an excellent approach for developing and testing treatments, and for generating general knowledge of treatment mechanisms and outcomes. Their ability to generate knowledge, however, will depend on their methods being reliable, valid, clearly described, and replicable. This scoping review aims to map assessment methods in SCD studies of psychological treatments for chronic pain. The particular aims were to review the specific measures used, their modes of administration, their adequacy as measures, and opportunities for improvement. PubMed, PsycINFO, CINAHL and OpenGrey were searched for SCD studies of psychological treatments for chronic pain in adults. Two reviewers independently assessed eligibility, with input from two additional reviewers, and then extracted relevant data from the 55 included studies. The most common outcome domains were “pain”, “physical functioning” and “psychological processes.” Non-behavioral measures were more common than behavioral or physiological measures. Measures were often standardized. Measures in each domain were highly varied, and administration information was lacking. Evi dence for adequacy of measures was based on psychometric analyses of aggregated group data for nonbehavioral measures and agreement for behavioral and physiological measures, but was frequently not re ported. Non-behavioral idiographic measures were often inadequate in that adapted measures were often used but validation was reported for original versions. Outcome domains did not correspond with currently available guidelines for measures employed in clinical trials in pain. A new set of guidelines, that is more suited to psy chological treatments and to SCDs, is needed. Researchers should consider following an idiographic framework by using individualized measures more often. When measures are individually applied, it is recommended that their adequacy is not based on nomothetic psychometric approaches. Rather, behavioral assessment principles should be employed. Overall, adequacy reporting, usage of SCD consistent terminology, and information on how measures are administered need improvement.
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- Lavefjord, Amani, et al.
(författare)
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The role of stigma in health and functioning in chronic pain : Not just catastrophizing
- 2024
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Ingår i: European Journal of Pain. - : John Wiley & Sons. - 1090-3801 .- 1532-2149. ; 28:4, s. 620-632
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundPeople with chronic pain are frequently exposed to stigma, which is typically distressing and may lead to internal stigmatizing thoughts. The thought content associated with stigma has similarities to pain catastrophizing, although these concepts differ in that stigma is arguably more social in origin. Stigma can be measured by the Stigma Scale for Chronic Illness – 8-item version (SSCI-8). In this study, we first demonstrate the validity of this measure in Swedish. We then examine the role of stigma in the health and functioning of people with chronic pain, particularly beyond the role played by pain catastrophizing.MethodsAdult participants (N = 404) with chronic pain recruited online completed measures of pain, stigma, catastrophizing, pain interference, work and social adjustment and depression on two occasions.ResultsA one-factor solution had an overall good model fit as long as residuals were allowed to covary, indicating some redundancy in the items. The SSCI-8 demonstrated good internal consistency and moderate temporal stability, and SSCI-8 scores demonstrated medium-to-large correlations with the measures of health and functioning. Furthermore, stigma was found to significantly contribute to explained variance in pain interference, work and social adjustment and depression, uniquely adding to the explained variance in these outcomes even after accounting for pain catastrophizing.ConclusionsThe SSCI-8 provides an adequate measure to capture stigma experiences. Stigma is uniquely associated with pain-related outcomes and should be further considered in pain research and clinical practice in the future.SignificanceThis study points to the importance of a social perspective on pain-related outcomes. We may need to more fully appreciate the way that people with chronic pain are treated by both health care providers and others can have an impact on their well-being. Potential negative impacts of stigmatizing responses to people with chronic pain are highlighted by the current results.
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- McCracken, Lance M., 1962-, et al.
(författare)
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COVID-19 and processes of adjustment in people with persistent pain : the role of psychological flexibility
- 2023
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Ingår i: Scandinavian Journal of Pain. - : Walter de Gruyter. - 1877-8860 .- 1877-8879. ; 23:3, s. 539-545
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Tidskriftsartikel (refereegranskat)abstract
- ObjectivesThe purpose of the current study was to investigate facets of Psychological Flexibility (PF) and Psychological Inflexibility (PI) and their relations with depression, anxiety, and insomnia in people with chronic pain during the COVID-19 pandemic. It was predicted that the full set of facets would significantly predict all three outcomes. The relative contributions of differing facets and dimensions was explored.MethodsParticipants with pain were selected from a sample of 1,657 Swedish adults responding to an online survey of health and COVID-19. Persistent pain was defined as pain on most days, present for three months or more. A total of 560, 33.8% of the total sample, were included in the analyses. Standardized and validated measures were used to measure depression, anxiety, and insomnia, and the Multidimensional Psychological Flexibility Inventory (MPFI) was used to measure both PF and PI.ResultsSignificant rates of depression, anxiety, and insomnia, at 43.1, 26.4, and 64.2%, respectively, were found in this sample. These rates appear higher than those found in a general sample in Sweden. PF was negatively associated with these problems while PI was positively associated with them. Better prediction of outcome was obtained by PI compared to PF.ConclusionsPF and especially PI appear to have played a role in relation to health outcomes in people with persistent pain during the COVID-19 pandemic. This group of people appears to have been especially vulnerable to the impacts of the pandemic. This study motivates further investigation and development of treatment approaches, possibly focusing on training PF, for people with persistent pain in the current pandemic context and in the future.
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