| 1. |
- Andersson, E, et al.
(författare)
-
Internet-based cognitive behaviour therapy for obsessive-compulsive disorder: a randomized controlled trial
- 2012
-
Ingår i: Psychological Medicine. - : Cambridge University Press (CUP). - 0033-2917 .- 1469-8978. ; 42:10, s. 2193-2203
-
Tidskriftsartikel (refereegranskat)abstract
- Background. Cognitive behaviour therapy (CBT) is an effective treatment for obsessive-compulsive disorder (OCD) but access to CBT is limited. Internet-based CBT (ICBT) with therapist support is potentially a more accessible treatment. There are no randomized controlled trials testing ICBT for OCD. The aim of this study was to investigate the efficacy of ICBT for OCD in a randomized controlled trial. less thanbrgreater than less thanbrgreater thanMethod. Participants (n=101) diagnosed with OCD were randomized to either 10 weeks of ICBT or to an attention control condition, consisting of online supportive therapy. The primary outcome measure was the Yale-Brown Obsessive Compulsive Scale (YBOCS) administered by blinded assessors. less thanbrgreater than less thanbrgreater thanResults. Both treatments lead to significant improvements in OCD symptoms, but ICBT resulted in larger improvements than the control condition on the YBOCS, with a significant between-group effect size (Cohens d) of 1.12 (95% CI 0.69-1.53) at post-treatment. The proportion of participants showing clinically significant improvement was 60% (95% CI 46-72) in the ICBT group compared to 6% (95% CI 1-17) in the control condition. The results were sustained at follow-up. less thanbrgreater than less thanbrgreater thanConclusions. ICBT is an efficacious treatment for OCD that could substantially increase access to CBT for OCD patients. Replication studies are warranted.
|
|
| 2. |
- Andersson, Gerhard, et al.
(författare)
-
Chronic Pain in Older Adults: A Controlled Pilot Trial of a Brief Cognitive-Behavioural Group Treatment
- 2012
-
Ingår i: Behavioural and Cognitive Psychotherapy. - : Cambridge University Press (CUP). - 1352-4658 .- 1469-1833. ; 40:2, s. 239-244
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Chronic pain is a common condition among older adults. While cognitive behaviour therapy (CBT) has been tested in numerous studies on adults and children there are fewer studies on older persons. The objective of this study was to investigate the effects of a six-session CBT group treatment for older persons with chronic pain. As a secondary aim we investigated whether treatment credibility was associated with outcome. Method: We included 21 persons (mean age = 72.0 years) who were randomly allocated to either a waitlist condition or treatment consisting of applied relaxation, with the addition of problem solving, assertiveness, communication strategies, sleep management, and relapse prevention. Results: Few statistically significant effects were found on measures of pain, mood, anxiety, and quality of life; however, a significant treatment effect with a between group effect size of d = 1.0 was observed with respect to perceived ability to function despite the discomfort of pain. Conclusion: The study provides some preliminary support for the use of group-based CBT with a focus on applied relaxation for older adults with chronic pain.
|
|
| 3. |
- Andersson, Gerhard
(författare)
-
Guided internet treatment for anxiety disorders. As effective as face-to-face therapies?
- 2012
-
Ingår i: Studies in Health Technology and Informatics. - 0926-9630 .- 1879-8365. ; 181, s. 3-7
-
Tidskriftsartikel (refereegranskat)abstract
- Introduction: Guided Internet-delivered treatments were developed in the late 1990s and have since been tested in numerous controlled trials. While promising, there are yet few direct comparisons between Internet treatments and traditional face-to-face treatments. The aim of the present study is to present an overview of the evidence in the field of anxiety disorders. Method: Studies were located, including unpublished trials from our research group in Sweden. Results: Results of direct comparative trials on panic disorder (n=3) and social anxiety disorder (n=3) show equivalent outcomes. One study on specific phobia did not show equivalent outcomes with an advantage for face-to-face treatment. However, a systematic review by Cuijpers et al. (2010) found equivalent outcomes across several self-help formats, suggesting that guided self-help overall can be as affective as face-to-face treatments. Conclusion: Overall, there are still few large-scale trials and statistical power is often limited. A preliminary conclusion is that guided Internet treatment can be as effective as face-to-face treatments, but there is a need to investigate moderators and mediators of the outcome.
|
|
| 4. |
|
|
| 5. |
- Andersson, Gerhard, et al.
(författare)
-
Internet-based psychodynamic versus cognitive behavioral guided self-help for generalized anxiety disorder : A randomized controlled trial
- 2012
-
Ingår i: Psychotherapy and Psychosomatics. - Basel, Switzerland : Karger. - 0033-3190 .- 1423-0348. ; 81:6, s. 344-355
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Guided Internet-based cognitive behavior therapy (ICBT) has been tested in many trials and found to be effective in the treatment of anxiety and mood disorders. Generalized anxiety disorder (GAD) has also been treated with ICBT, but there are no controlled trials on guided Internet-based psychodynamic treatment (IPDT). Since there is preliminary support for psychodynamic treatment for GAD, we decided to test if a psychodynamically informed self-help treatment could be delivered via the Internet. The aim of the study was to investigate the efficacy of IPDT for GAD and to compare against ICBT and a waiting list control group.Method: A randomized controlled superiority trial with individuals diagnosed with GAD comparing guided ICBT (n = 27) and IPDT (n = 27) against a no treatment waiting list control group (n = 27). The primary outcome measure was the Penn State Worry Questionnaire.Results: While there were no significant between-group differences immediately after treatment on the main outcome measure, both IPDT and ICBT resulted in improvements with moderate to large within-group effect sizes at 3 and 18 months follow-up on the primary measure in the completer analyses. The differences against the control group, although smaller, were still significant for both PDT and CBT when conforming to the criteria of clinically significant improvement. The active treatments did not differ significantly. There was a significant group by time interaction regarding GAD symptoms, but not immediately after treatment.Conclusions: IPDT and ICBT both led to modest symptom reduction in GAD, and more research is needed.Copyright (C) 2012 S. Karger AG, Basel
|
|
| 6. |
- Andersson, Gerhard, 1966-
(författare)
-
Psykologisk behandling vid depression : teorier, terapimetoder och forskning
- 2012. - 1
-
Bok (övrigt vetenskapligt/konstnärligt)abstract
- Unikt för depressionsområdet är att flera psykologiska behandlingsmetoder visat sig hjälpsamma. Den här boken ger en fördjupning i de mest etablerade psykoterapiformerna psykodynamisk, humanistisk och interpersonell psykoterapi, samt kognitiv beteendeterapi. För varje metod beskrivs teoribakgrund, behandlingens upplägg, forskningseffekter och vem metoden passar för. Boken är skriven för studenter på vårdutbildningar, de som arbetar med depressionsbehandling och alla med intresse för psykoterapiforskning.
|
|
| 7. |
- Andersson, Gerhard, et al.
(författare)
-
Therapeutic alliance in guided internet-delivered cognitive behavioural treatment of depression, generalized anxiety disorder and social anxiety disorder
- 2012
-
Ingår i: Behaviour Research and Therapy. - : Elsevier. - 0005-7967 .- 1873-622X. ; 50:9, s. 544-550
-
Tidskriftsartikel (refereegranskat)abstract
- Guided internet-delivered cognitive behaviour therapy (ICBT) has been found to be effective in several controlled trials, but the mechanisms of change are largely unknown. Therapeutic alliance is a factor that has been studied in many psychotherapy trials, but the role of therapeutic alliance in ICBT is less well known. The present study investigated early alliance ratings in three separate samples. Participants from one sample of depressed individuals (N = 49), one sample of individuals with generalized anxiety disorder (N = 35), and one sample with social anxiety disorder (N = 90) completed the Working Alliance Inventory (WAI) modified for ICBT early in the treatment (weeks 3-4) when they took part in guided ICBT for their conditions. Results showed that alliance ratings were high in all three samples and that the WAI including the subscales of Task, Goal and Bond had high internal consistencies. Overall, correlations between the WAI and residualized change scores on the primary outcome measures were small and not statistically significant. We conclude that even if alliance ratings are in line with face-to-face studies, therapeutic alliance as measured by the WAI is probably less important in ICBT than in regular face-to-face psychotherapy.
|
|
| 8. |
- Andersson, Gerhard, et al.
(författare)
-
Therapist experience and knowledge acquisition in internet-delivered CBT for social anxiety disorder : a randomized controlled trial
- 2012
-
Ingår i: PLOS ONE. - : PLoS. - 1932-6203. ; 7:5, s. e37411-
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Guided internet-delivered cognitive behavior therapy (ICBT) has been tested in several trials on social anxiety disorder (SAD) with moderate to large effects. The aims of this study were threefold. First, to compare the effects of ICBT including online discussion forum with a moderated online discussion forum only. Second, to investigate if knowledge about SAD increased following treatment and third to compare the effects of inexperienced versus experienced therapists on patient outcomes. Methods: A total of 204 participants with a primary diagnosis of SAD were included and randomized to either guided ICBT or the control condition. ICBT consisted of a 9-week treatment program which was guided by either psychology students at MSc level (n = 6) or by licensed psychologists with previous experience of ICBT (n = 7). A knowledge test dealing with social anxiety was administered before and after treatment. Measures of social anxiety and secondary outcomes dealing with general anxiety, depression, and quality of life were administered before and after treatment. In addition, a 1-year follow-up was conducted on the treated individuals. Results: Immediately following treatment, the ICBT group showed superior outcome on the Liebowitz Social Anxiety Scale self-report version with a between group posttreatment Hedges geffect size ofg = 0.75. In addition, significant differences on all the secondary outcomes were observed. Gains were well maintained one year later. Knowledge, as assessed by the knowledge test, increased following treatment with little gain in the control group. Therapist experience did not result in different outcomes, but experienced therapists logged in less frequently compared to the inexperienced therapists, suggesting that they needed less time to support patients. Discussion: We conclude that guided ICBT reduce symptoms of SAD, increase knowledge about SAD and that therapist experience does not make a difference apart from the finding that experienced therapist may require less time to guide patients. Trial Registration: UMIN.ac.jp UMIN000001383
|
|
| 9. |
- Bergman Nordgren, Lise, 1983-, et al.
(författare)
-
Tailored internet-administered treatment of anxiety disorders for primary care patients : study protocol for a randomised controlled trial
- 2012
-
Ingår i: Trials. - : BioMed Central (BMC). - 1745-6215. ; 13, s. 16-
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Internet-administered cognitive behavioural therapy (ICBT) has been found to be effective for a range of anxiety disorders. However, most studies have focused on one specific primary diagnosis and comorbidity has not been considered. In primary care settings, patients with anxiety often suffer from more than one psychiatric condition, making it difficult to disseminate ICBT for specific conditions. The aim of this study will be to investigate if ICBT tailored according to symptom profile can be a feasible treatment for primary care patients with anxiety disorders. It is a randomised controlled trial aimed to evaluate the treatment against an active control group.Methods: Participants with anxiety disorders and co-morbid conditions (N = 128), will be recruited from a primary care population. The Clinical Outcome in Routine Evaluation (CORE-OM) will serve as the primary outcome measure. Secondary measures include self-reported depression, anxiety, quality of life and loss of production and the use of health care. All assessments will be collected via the Internet and measure points will be baseline, post treatment and 12 months post treatment.Discussion: This trial will add to the body of knowledge on the effectiveness of ICBT for anxiety disorders in primary care. The trial will also add knowledge on the long term effects of ICBT when delivered for regular clinic patients Trial Registration: ClinicalTrials.gov: NCT01390168
|
|
| 10. |
- Carlbring, Per, 1967-, et al.
(författare)
-
Internet-delivered attention bias modification training in individuals with social anxiety disorder : a double blind randomized controlled trial
- 2012
-
Ingår i: BMC Psychiatry. - : BioMed Central (BMC). - 1471-244X. ; 12, s. 66-
-
Tidskriftsartikel (refereegranskat)abstract
- Background:Computerized cognitive bias modification for social anxiety disorder has in several well conducted trials shown great promise with as many as 72% no longer fulfilling diagnostic criteria after a 4 week training program. To test if the same program can be transferred from a clinical setting to an internet delivered home based treatment the authors conducted a randomized, double-blind placebo-controlled trial.Methods:After a diagnostic interview 79 participants were randomized to one of two attention training programs using a probe detection task. In the active condition the participant was trained to direct attention away from threat, whereas in the placebo condition the probe appeared with equal frequency in the position of the threatening and neutral faces.Results:Results were analyzed on an intention-to-treat basis, including all randomized participants. Immediate and 4-month follow-up results revealed a significant time effect on all measured dimensions (social anxiety scales, general anxiety and depression levels, quality of life). However, there were no time x group interactions. The lack of differences in the two groups was also mirrored by the infinitesimal between group effect size both at post test and at 4-month follow-up.Conclusion:We conclude that computerized attention bias modification may need to be altered before dissemination for the Internet.Trial registration:ISRCTN01715124
|
|
