| 1. |
- Cristea, Ioana A, et al.
(författare)
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The effects of cognitive behavior therapy for adult depression on dysfunctional thinking : A meta-analysis.
- 2015
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Ingår i: Clinical Psychology Review. - : Elsevier BV. - 0272-7358 .- 1873-7811. ; 42, s. 62-71
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: It is not clear whether cognitive behavior therapy (CBT) works through changing dysfunctional thinking. Although several primary studies have examined the effects of CBT on dysfunctional thinking, no meta-analysis has yet been conducted.METHOD: We searched for randomized trials comparing CBT for adult depression with control groups or with other therapies and reporting outcomes on dysfunctional thinking. We calculated effect sizes for CBT versus control groups, and separately for CBT versus other psychotherapies and respectively, pharmacotherapy.RESULTS: 26 studies totalizing 2002 patients met inclusion criteria. The quality of the studies was less than optimal. We found a moderate effect of CBT compared to control groups on dysfunctional thinking at post-test (g=0.50; 95% CI: 0.38-0.62), with no differences between the measures used. This result was maintained at follow-up (g=0.46; 95% CI: 0.15-0.78). There was a strong association between the effects on dysfunctional thinking and those on depression. We found no significant differences between CBT and other psychotherapies (g=0.17; p=0.31), except when restrict in outcomes to the Dysfunctional Attitudes Scale (g=0.29). There also was no difference between CBT and pharmacotherapy (g=0.04), though this result was based on only 4 studies.DISCUSSION: While CBT had a robust and stable effect on dysfunctional thoughts, this was not significantly different from what other psychotherapies or pharmacotherapy achieved. This result can be interpreted as confirming the primacy of cognitive change in symptom change, irrespective of how it is attained, as well as supporting the idea that dysfunctional thoughts are simply another symptom that changes subsequent to treatment.
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| 2. |
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| 3. |
- Iyadurai, Lalitha, et al.
(författare)
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Intrusive memories of trauma : A target for research bridging cognitive science and its clinical application.
- 2019
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Ingår i: Clinical Psychology Review. - : Elsevier BV. - 0272-7358 .- 1873-7811. ; 69, s. 67-82
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Tidskriftsartikel (refereegranskat)abstract
- Intrusive memories of a traumatic event can be distressing and disruptive, and comprise a core clinical feature of post-traumatic stress disorder (PTSD). Intrusive memories involve mental imagery-based impressions that intrude into mind involuntarily, and are emotional. Here we consider how recent advances in cognitive science have fueled our understanding of the development and possible treatment of intrusive memories of trauma. We conducted a systematic literature search in PubMed, selecting articles published from 2008 to 2018 that used the terms "trauma" AND ("intrusive memories" OR "involuntary memories") in their abstract or title. First, we discuss studies that investigated internal (neural, hormonal, psychophysiological, and cognitive) processes that contribute to intrusive memory development. Second, we discuss studies that targeted these processes using behavioural/pharmacological interventions to reduce intrusive memories. Third, we consider possible clinical implications of this work and highlight some emerging research avenues for treatment and prevention, supplemented by new data to examine some unanswered questions. In conclusion, we raise the possibility that intrusive memories comprise an alternative, possibly more focused, target in translational research endeavours, rather than only targeting overall symptoms of disorders such as PTSD. If so, relatively simple approaches could help to address the need for easy-to-deliver, widely-scalable trauma interventions.
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| 4. |
- James, Ella L., et al.
(författare)
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The trauma film paradigm as an experimental psychopathology model of psychological trauma : intrusive memories and beyond
- 2016
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Ingår i: Clinical Psychology Review. - : PERGAMON-ELSEVIER SCIENCE LTD. - 0272-7358 .- 1873-7811. ; 47, s. 106-142
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Forskningsöversikt (refereegranskat)abstract
- A better understanding of psychological trauma is fundamental to clinical psychology. Following traumatic event(s), a clinically significant number of people develop symptoms, including those of Acute Stress Disorder and/or Post Traumatic Stress Disorder. The trauma film paradigm offers an experimental psychopathology model to study both exposure and reactions to psychological trauma, including the hallmark symptom of intrusive memories. We reviewed 74 articles that have used this paradigm since the earliest review (Holmes & Bourne, 2008) until July 2014. Highlighting the different stages of trauma processing, i.e. pre-, pert- and post-trauma, the studies are divided according to manipulations before, during and after film viewing, for experimental as well as correlational designs. While the majority of studies focussed on the frequency of intrusive memories, other reactions to trauma were also modelled. We discuss the strengths and weaknesses of the trauma film paradigm as an experimental psychopathology model of trauma, consider ethical issues, and suggest future directions. By understanding the basic mechanisms underlying trauma symptom development, we can begin to translate findings from the laboratory to the clinic, test innovative science-driven interventions, and in the future reduce the debilitating effects of psychopathology following stressful and/or traumatic events. (C) 2016 The Authors. Published by Elsevier Ltd.
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| 5. |
- 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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| 6. |
- Price, Rebecca B., et al.
(författare)
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Pooled patient-level meta-analysis of children and adults completing a computer-based anxiety intervention targeting attentional bias
- 2016
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Ingår i: Clinical Psychology Review. - : Elsevier BV. - 0272-7358 .- 1873-7811. ; 50, s. 37-49
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Forskningsöversikt (refereegranskat)abstract
- Computer-based approaches, such as Attention Bias Modification (ABM), could help improve access to care for anxiety. Study-level meta-analyses of ABM have produced conflicting findings and leave critical questions unresolved regarding ABM's mechanisms of action and clinical potential. We pooled patient-level datasets from randomized controlled trials of children and adults with high-anxiety. Attentional bias (AB) towards threat, the target mechanism of ABM, was tested as an outcome and a mechanistic mediator and moderator of anxiety reduction. Diagnostic remission and Liebowitz Social Anxiety Scale (LSAS) were clinical outcomes available in enough studies to enable pooling. Per-patient data were obtained on at least one outcome from 13/16 eligible studies [86% of eligible participants; n = 778]. Significant main effects of ABM on diagnostic remission (ABM—22.6%, control—10.8%; OR = 2.57; p = 0.006) and AB (β* (95%CI) = − 0.63 (− 0.83, − 0.42); p < 0.00005) were observed. There was no main effect of ABM on LSAS. However, moderator analyses suggested ABM was effective for patients who were younger (≤ 37 y), trained in the lab, and/or assessed by clinicians. Under the same conditions where ABM was effective, mechanistic links between AB and anxiety reduction were supported. Under these specific circumstances, ABM reduces anxiety and acts through its target mechanism, supporting ABM's theoretical basis while simultaneously suggesting clinical indications and refinements to improve its currently limited clinical potential.
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| 7. |
- Stratford, Hannah J., et al.
(författare)
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Psychological therapy for anxiety in bipolar spectrum disorders : A systematic review
- 2015
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Ingår i: Clinical Psychology Review. - : PERGAMON-ELSEVIER SCIENCE LTD. - 0272-7358 .- 1873-7811. ; 35, s. 19-34
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Tidskriftsartikel (refereegranskat)abstract
- Comorbid anxiety is common in bipolar spectrum disorders [BPSD], and is associated with poor outcomes. Its clinical relevance is highlighted by the "anxious distress specifier" in the revised criteria for Bipolar Disorders in the Diagnostic and Statistical Manual 5th Edition [DSM-5]. This article reviews evidence for the effectiveness cif psychological therapy for anxiety in adults. with BPSD (bipolar I, II, not otherwise specified, cyclothymia, and rapid cycling disorders). A systematic search yielded 22 treatment studies that included an anxiety-related outcome measure. Cognitive behavioural therapy [CBT] for BPSD incorporating an anxiety component reduces anxiety symptoms in cyclothymia, "refractory" and rapid cycling BPSD, whereas standard bipolar treatments have only a modest effect on anxiety. Preliminary evidence is promising for CBT for post-traumatic stress disorder and generalised anxiety disorder in BPSD. Psychoeducation alone does not appear to reduce anxiety, and data for mindfulness-based cognitive therapy [MBCT] appear equivocal. CBT during euthymic phases has the greatest weight of evidence. Where reported, psychological therapy appears acceptable and safe, but more systematic collection and reporting of safety and acceptability information is needed. Development of psychological models and treatment protocols for anxiety in BPSD may help improve outcomes. (C) 2014 The Authors. Published by Elsevier Ltd.
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| 8. |
- Vigerland, Sarah, et al.
(författare)
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Internet-delivered cognitive behavior therapy for children and adolescents : A systematic review and meta-analysis
- 2016
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Ingår i: Clinical Psychology Review. - : Elsevier BV. - 0272-7358 .- 1873-7811. ; 50, s. 1-10
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Forskningsöversikt (refereegranskat)abstract
- Internet-delivered cognitive behavior therapy (ICBT) is a relatively novel treatment format with the potential to increase accessibility of evidence-based care. However, little is known about the feasibility and efficacy of ICBT in children and adolescents. We conducted a comprehensive systematic review and meta-analysis of ICBT for children and adolescents to provide an overview of the field and assess the efficacy of these interventions. A systematic literature search of six electronic databases was performed to identify ICBT intervention studies for children with a psychiatric condition, such as social anxiety disorder, or a somatic condition, such as chronic pain. Two reviewers independently rated study quality. Twenty-five studies, targeting 11 different disorders, were included in the review. Study quality and presentation of treatment variables, such as therapist time and treatment adherence, varied largely. Twenty-four studies (N = 1882) were included in the meta-analysis and ICBT yielded moderate between-group effect sizes when compared with waitlist, g = 0.62, 95% CI [0.41, 0.84]. The results suggest that CBT for psychiatric and somatic conditions in children and adolescents can be successfully adapted to an intemet-delivered format.
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| 9. |
- Öst, Lars-Göran, et al.
(författare)
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Cognitive behavioral treatments of obsessive-compulsive disorder. A systematic review and meta-analysis of studies published 1993-2014
- 2015
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Ingår i: Clinical Psychology Review. - : Elsevier BV. - 0272-7358 .- 1873-7811. ; 40, s. 156-169
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Forskningsöversikt (refereegranskat)abstract
- Obsessive-compulsive disorder is ranked by the WHO as among the 10 most debilitating disorders and tends to be chronic without adequate treatment. The only psychological treatment that has been found effective is cognitive behavior therapy (CBT). This meta-analysis includes all RCTs (N = 37) of CBT for OCD using the interview-based Yale-Brown Obsessive Compulsive Scale, published 1993 to 2014. The effect sizes for comparisons of CBT with waiting-list (1.31), and placebo conditions (1.33) were very large, whereas those for comparisons between individual and group treatment (0.17), and exposure and response prevention vs. cognitive therapy (0.07) were small and non-significant. CBT was significantly better than antidepressant medication (0.55), but the combination of CBT and medication was not significantly better than CBT plus placebo (0.25). The RCTs have a number of methodological problems and recommendations for improving the methodological rigor are discussed as well as clinical implications of the findings.
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