| 1. |
- Nordgreen, T, et al.
(author)
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Guided self-help via internet for panic disorder: Dissemination across countries
- 2010
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In: COMPUTERS IN HUMAN BEHAVIOR. - : Elsevier Science B.V., Amsterdam.. - 0747-5632. ; 26:4, s. 592-596
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Journal article (peer-reviewed)abstract
- Guided self-help via Internet is a promising way of treating panic disorder (PD). The present study examined the effects of a self-help program via Internet with weekly therapist contact for PD after disseminated to a new country. Predictors of outcome were also examined. The study was an open trial with 27 participants with PD with or without agoraphobia as their primary diagnose. Medium to large effects on PD-symptoms were reported after treatment and at 6 months follow-up, with smaller effects on secondary outcome measures, i.e. depression, interpersonal problems, and sleep problem. The attrition rate of 30% in present study was higher than in Swedish studies. Predictor analysis showed that participants with longer duration of PD-symptoms had less improvement on all outcome measurers, whereas higher age predicted more improvement. The guided self-help program remained effective when disseminated to a new country, but the high attrition rate needs to be addressed in future studies.
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| 2. |
- Obel, C., et al.
(author)
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Is maternal smoking during pregnancy a risk factor for Hyperkinetic disorder? : Findings from a sibling design
- 2011
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In: International Journal of Epidemiology. - : Oxford University Press (OUP). - 0300-5771 .- 1464-3685. ; 40:2, s. 338-345
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Journal article (peer-reviewed)abstract
- Background Studies have consistently shown that pregnancy smoking is associated with twice the risk of hyperactivity/inattention problems in the offspring. An association of this magnitude may indicate behavioural difficulties as one of the most important health effects related to smoking during pregnancy. However, social and genetic confounders may fully or partially account for these findings. Methods A cohort including all singletons born in Finland from 1 January 1987 through 31 December 2001 was followed until 1 January 2006 based on linkage of national registers. Data were available for 97% (N = 868 449) of the population. We followed singleton children of smoking and non-smoking mothers until they had an International Classification of Diseases, 10th revision, diagnosis of hyperkinetic disorder (HKD) or to the end of the observation period. We used sibling-matched Cox regression analyses to control for social and genetic confounding. Results We found a much smaller association between exposure to maternal smoking during pregnancy and risk of HKD in children using the sibling-matched analysis [hazards ratio (HR) = 1.20, 95% confidence interval (CI) 0.97-1.49] than was observed in the entire cohort (HR 2.01, 95% CI 1.90-2.12). Conclusions Our findings suggest that the strong association found in previous studies may be due to time-stable familial factors, such as environmental and genetic factors. If smoking is a causal factor, the effect is small and less important than what the previous studies indicate.
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| 3. |
- Obel, C, et al.
(author)
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The strengths and difficulties questionnaire in the Nordic countries
- 2004
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In: European Child Adolescent Psychiatry. ; 13:suppl 2, s. 1132-9
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Journal article (peer-reviewed)abstract
- BACKGROUND: The Strengths and Difficulties Questionnaire (SDQ) has been translated into the different Nordic languages between 1996 and 2003. During the past few years, SDQs have been completed for nearly 100,000 children and adolescents in population-based studies as well as in clinical samples. The largest studies have been performed in Norway and Denmark, and in these countries the diagnostic interview DAWBA has also been used in conjunction with the SDQ. AIMS: In addition to a brief overview of past and ongoing SDQ work in Sweden, Finland, Norway, Denmark, and Iceland, we present scale means and standard deviations from selected community studies with comparable age groups, including parental reports for 7, 9 and 11 year-old children and self-reports of 13 and 15 year-olds. CONCLUSIONS: The descriptive statistics suggest that the distributions of SDQ scores are very similar across the Nordic countries. Further collaborative efforts in establishing norms and evaluating the validity of the SDQ as a screening instrument are encouraged.
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| 4. |
- Rayner, C, et al.
(author)
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A genome-wide association meta-analysis of prognostic outcomes following cognitive behavioural therapy in individuals with anxiety and depressive disorders
- 2019
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In: Translational psychiatry. - : Springer Science and Business Media LLC. - 2158-3188. ; 9:1, s. 150-
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Journal article (peer-reviewed)abstract
- Major depressive disorder and the anxiety disorders are highly prevalent, disabling and moderately heritable. Depression and anxiety are also highly comorbid and have a strong genetic correlation (rg ≈ 1). Cognitive behavioural therapy is a leading evidence-based treatment but has variable outcomes. Currently, there are no strong predictors of outcome. Therapygenetics research aims to identify genetic predictors of prognosis following therapy. We performed genome-wide association meta-analyses of symptoms following cognitive behavioural therapy in adults with anxiety disorders (n = 972), adults with major depressive disorder (n = 832) and children with anxiety disorders (n = 920; meta-analysis n = 2724). We estimated the variance in therapy outcomes that could be explained by common genetic variants (h2SNP) and polygenic scoring was used to examine genetic associations between therapy outcomes and psychopathology, personality and learning. No single nucleotide polymorphisms were strongly associated with treatment outcomes. No significant estimate of h2SNP could be obtained, suggesting the heritability of therapy outcome is smaller than our analysis was powered to detect. Polygenic scoring failed to detect genetic overlap between therapy outcome and psychopathology, personality or learning. This study is the largest therapygenetics study to date. Results are consistent with previous, similarly powered genome-wide association studies of complex traits.
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| 5. |
- Wergeland, Gro Janne H., et al.
(author)
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An effectiveness study of individual vs. group cognitive behavioral therapy for anxiety disorders in youth
- 2014
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In: Behaviour Research and Therapy. - : Elsevier BV. - 0005-7967 .- 1873-622X. ; 57, s. 1-12
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Journal article (peer-reviewed)abstract
- Objective: Conducted a randomized controlled trial to investigate the effectiveness of cognitive behavioral therapy (CBT), and compared the relative effectiveness of individual (ICBT) and group (GCBT) treatment approaches for anxiety disorders in children and adolescents.Methods: Referred youth (N = 182, M age = 11.5 years, range 8-15 years, 53% girls) with separation anxiety, social phobia, or generalized anxiety disorder were randomly assigned to ICBT, GCBT or a waitlist control (WLC) in community clinics. Pre-, post-, and one year follow-up assessments included youth and parent completed diagnostic interview and symptom measures. After comparing CBT (ICBT and GCBT combined) to WLC, ICBT and GCBT were compared along diagnostic recovery rates, clinically significant improvement, and symptom measures scores using traditional hypothesis tests, as well as statistical equivalence tests.Results: Significantly more youth lost all anxiety disorders after CBT compared to WLC. Full diagnostic recovery rate was 25.3% for ICBT and 20.5% in GCBT, which was not significantly different. There was continued lack of significant differences between ICBT and GCBT at one year follow-up. However, equivalence between GCBT and ICBT could only be demonstrated for clinical severity rating of the principal anxiety disorder and child reported anxiety symptoms post-treatment.Conclusion: Findings support the effectiveness of CBT compared to no intervention for youth with anxiety disorders, with no significant differences between ICBT and GCBT. However, the relatively low recovery rates highlight the need for further improvement of CBT programs and their transportability from university to community settings.
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| 6. |
- Wergeland, Gro Janne H., et al.
(author)
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Predictors of dropout from community clinic child CBT for anxiety disorders
- 2015
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In: Journal of Anxiety Disorders. - : Elsevier BV. - 0887-6185 .- 1873-7897. ; 31, s. 1-10
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Journal article (peer-reviewed)abstract
- The aim was to investigate predictors of treatment dropout among 182 children (aged 8-15 years) participating in an effectiveness trial of manual-based 10-session individual and group cognitive behavior therapy (CBT) for anxiety disorders in community clinics. The dropout rate was 14.4%, with no significant difference between the two treatment conditions. We examined predictors for overall dropout (n=26), early (<= session 4, n = 15), and late dropout (>= session 5, n = 11). Overall dropout was predicted bylaw child and parent rated treatment credibility, and high parent self-rated internalizing symptoms. Low child rated treatment credibility predicted both early and late dropout. High parent self-rated internalizing symptoms predicted early dropout, whereas low parent rated treatment credibility predicted late dropout. These results highlight the importance of addressing treatment credibility, and to offer support for parents with internalizing symptoms, to help children and families remain in treatment.
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| 7. |
- Wergeland, Gro Janne H., et al.
(author)
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Predictors of treatment outcome in an effectiveness trial of cognitive behavioral therapy for children with anxiety disorders
- 2016
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In: Behaviour Research and Therapy. - : Elsevier BV. - 0005-7967 .- 1873-622X. ; 76, s. 1-12
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Journal article (peer-reviewed)abstract
- A substantial number of children with anxiety disorders do not improve following cognitive behavioral therapy (CBT). Recent effectiveness studies have found poorer outcome for CBT programs than what is typically found in efficacy studies. The present study examined predictors of treatment outcome among 181 children (aged 8–15 years), with separation anxiety, social phobia, or generalized anxiety disorder, who participated in a randomized, controlled effectiveness trial of a 10-session CBT program in community clinics. Potential predictors included baseline demographic, child, and parent factors. Outcomes were as follows: a) remission from all inclusion anxiety disorders; b) remission from the primary anxiety disorder; and c) child- and parent-rated reduction of anxiety symptoms at post-treatment and at 1-year follow-up. The most consistent findings across outcome measures and informants were that child-rated anxiety symptoms, functional impairment, a primary diagnosis of social phobia or separation anxiety disorder, and parent internalizing symptoms predicted poorer outcome at post-treatment. Child-rated anxiety symptoms, lower family social class, lower pretreatment child motivation, and parent internalizing symptoms predicted poorer outcome at 1-year follow-up. These results suggest that anxious children with more severe problems, and children of parents with elevated internalizing symptom levels, may be in need of modified, additional, or alternative interventions to achieve a positive treatment outcome.
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| 8. |
- Bjaastad, Jon Fauskanger, et al.
(author)
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Competence and Adherence Scale for Cognitive Behavioral Therapy (CAS-CBT) for Anxiety Disorders in Youth : Psychometric Properties
- 2016
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In: Psychological Assessment. - : American Psychological Association (APA). - 1040-3590 .- 1939-134X. ; 28:8, s. 908-916
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Journal article (peer-reviewed)abstract
- The aim of the present study was to evaluate the psychometric properties of the Competence and Adherence Scale for Cognitive Behavioral Therapy (CAS-CBT). The CAS-CBT is an 11-item scale developed to measure adherence and competence in cognitive-behavioral therapy (CBT) for anxiety disorders in youth. A total of 181 videotapes from the treatment sessions in a randomized controlled effectiveness trial (Wergeland et al., 2014) comprising youth (N = 182, M age = 11.5 years, SD = 2.1, range 8-15 years, 53% girls, 90.7% Caucasian) with mixed anxiety disorders were assessed with the CAS-CBT to investigate interitem correlations, internal consistency, and factor structure. Internal consistency was good (Cronbach's alpha = .87). Factor analysis suggested a 2-factor solution with Factor 1 representing CBT structure and session goals (explaining 46.9% of the variance) and Factor 2 representing process and relational skills (explaining 19.7% of the variance). The sum-score for adherence and competence was strongly intercorrelated, r = .79, p < .001. Novice raters (graduate psychology students) obtained satisfactory accuracy (ICC > .40, n = 10 videotapes) and also good to excellent interrater reliability when compared to expert raters (ICC = .83 for adherence and .64 for competence, n = 26 videotapes). High rater stability was also found (n = 15 videotapes). The findings suggest that the CAS-CBT is a reliable measure of adherence and competence in manualized CBT for anxiety disorders in youth. Further research is needed to investigate the validity of the scale and psychometric properties when used with other treatment programs, disorders and treatment formats.
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| 9. |
- Fauskanger Bjaastad, Jon, et al.
(author)
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Do clinical experience, formal cognitive behavioural therapy training, adherence, and competence predict outcome in cognitive behavioural therapy for anxiety disorders in youth?
- 2018
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In: Clinical Psychology and Psychotherapy. - : Wiley. - 1063-3995 .- 1099-0879. ; 25:6, s. 865-877
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Journal article (peer-reviewed)abstract
- Objective The aim was to investigate whether clinical experience, formal cognitive behavioural therapy (CBT) training, adherence, and competence predict outcome in CBT for anxiety disorders in youth. Method Videotapes (N = 181) from the sessions in a randomized controlled effectiveness trial (Wergeland et al., 2014, Behaviour Research and Therapy, 57, 1-12) comprising youth (N = 182, M age = 11.5 years) with mixed anxiety disorders were assessed for treatment adherence and competence using the Competence and Adherence Scale for CBT for anxiety disorders in youth (Bjaastad et al., 2016, Psychological Assessment, 28, 908-916). Therapists' (N = 17) clinical experience and educational background were assessed. Participants completed a diagnostic interview (Anxiety Disorders Interview Schedule, child and parent versions) and an anxiety symptom measure (Spence Children's Anxiety Scale, child and parent versions) at pretreatment, posttreatment, and 1-year follow-up. Results Higher therapist adherence was related to better treatment outcomes, whereas number of years of clinical experience and competence was related to worse outcomes. However, these findings were not consistent across informants and the time points for the assessments. Interaction effects suggested that competence among therapists with formal CBT training was related to better patient outcomes. Conclusions Therapist adherence, competence, and clinical experience are associated with outcomes of manualized CBT for youth anxiety disorders, but mixed findings indicate the need for more research in this area.
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| 10. |
- Fjermestad, Krister W., et al.
(author)
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Factor Structure and Validity of the Therapy Process Observational Coding System for Child Psychotherapy-Alliance Scale
- 2012
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In: Journal of clinical child and adolescent psychology (Print). - : Informa UK Limited. - 1537-4416 .- 1537-4424. ; 41:2, s. 246-254
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Journal article (peer-reviewed)abstract
- The aim of this study was to examine the factor structure and psychometric properties of an observer-rated youth alliance measure, the Therapy Process Observational Coding System for Child Psychotherapy-Alliance scale (TPOCS-A). The sample was 52 youth diagnosed with anxiety disorders (M age = 12.43, SD = 2.23, range = 8-15; 56% boys; 98% Caucasian) drawn from a randomized controlled trial. Participants received a manualized individual cognitive behavioral treatment, the FRIENDS for life program, in public community clinics in Norway. Diagnostic status, treatment motivation, and perceived treatment credibility were assessed at pretreatment. Using the TPOCS-A, independent observers rated child-therapist alliance from the third therapy session. Child-and therapist-reported alliance measures were collected from the same session. An exploratory factor analysis supported a one-factor solution, which is consistent with previous studies of self-and observer-rated youth alliance scales. Psychometric analyses supported the interrater reliability, internal consistency, and convergent/divergent validity of the TPOCS-A. Accumulating psychometric evidence indicate that the TPOCS-A has the potential to fill a measurement gap in the youth psychotherapy field. In youth psychotherapy, alliance may be unidimensional, so establishing a strong bond and engaging the child in therapeutic activities may both be instrumental to establishing good alliance early in treatment. However, it is important to be cautious when interpreting the factor analytic findings, because the sample size may have been too small to identify additional factors. Future research can build upon these findings by examining the factor structure of youth alliance measures with larger, more diverse samples.
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