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- Wittchen, Hans-Ulrich, et al.
(författare)
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The need for a behavioural science focus in research on mental health and mental disorders
- 2014
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Ingår i: International Journal of Methods in Psychiatric Research. - : Wiley-Blackwell. - 1049-8931 .- 1557-0657. ; 23, s. 28-40
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Tidskriftsartikel (refereegranskat)abstract
- Psychology as a science offers an enormous diversity of theories, principles, and methodological approaches to understand mental health, abnormal functions and behaviours and mental disorders. A selected overview of the scope, current topics as well as strength and gaps in Psychological Science may help to depict the advances needed to inform future research agendas specifically on mental health and mental disorders. From an integrative psychological perspective, most maladaptive health behaviours and mental disorders can be conceptualized as the result of developmental dysfunctions of psychological functions and processes as well as neurobiological and genetic processes that interact with the environment. The paper presents and discusses an integrative translational model, linking basic and experimental research with clinical research as well as population-based prospective-longitudinal studies. This model provides a conceptual framework to identify how individual vulnerabilities interact with environment over time, and promote critical behaviours that might act as proximal risk factors for ill-health and mental disorders. Within the models framework, such improved knowledge is also expected to better delineate targeted preventive and therapeutic interventions that prevent further escalation in early stages before the full disorder and further complications thereof develop. In contrast to conventional personalized medicine that typically targets individual (genetic) variation of patients who already have developed a disease to improve medical treatment, the proposed framework model, linked to a concerted funding programme of the Science of Behaviour Change, carries the promise of improved diagnosis, treatment and prevention of health-risk behaviour constellations as well as mental disorders.
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| 3. |
- Almlöv, Jonas, et al.
(författare)
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Therapist effects in guided internet-delivered CBT for Anxiety Disorders
- 2011
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Ingår i: Behavioural and Cognitive Psychotherapy. - London : Wisepress. - 1352-4658 .- 1469-1833. ; 39:3, s. 311-322
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Tidskriftsartikel (refereegranskat)abstract
- Background: Guided internet-delivered CBT for anxiety disorders has received increasing empirical support, but little is known regarding the role of the therapist. Aims: This study addressed therapist factors in guided internet-delivered cognitive behavioural therapy for anxiety disorders. Method: Data from three controlled trials with a total N of 119 were analyzed with attention to differences between eight therapists. Results: No significant mean level differences between therapists appeared in the dataset. However, one significant intraclass correlation between participants was found, suggesting that the outcome on the Beck Anxiety Inventory might have been influenced by the impact of the individual therapists. Conclusion: The therapist can possibly have some influence on the outcome of guided internet-delivered CBT for anxiety disorders, but studies with more statistical power are needed to establish whether therapist effects are present in this modality of psychological treatment. The present study was underpowered to detect minor therapist effects.
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| 4. |
- Andersson, Erik, et al.
(författare)
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A Randomized Controlled Trial of Guided Internet-delivered Cognitive Behavioral Therapy for Erectile Dysfunction
- 2011
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Ingår i: Journal of Sexual Medicine. - : Wiley-Blackwell. - 1743-6095 .- 1743-6109. ; 8:10, s. 2800-2809
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Tidskriftsartikel (refereegranskat)abstract
- Introduction. Men with erectile dysfunction are often worried about their condition, have interpersonal difficulties, and have a reduced quality of life. Internet-delivered cognitive behavior therapy (ICBT) has been shown effective for a number of health problems but evidence is limited concerning the treatment of erectile dysfunction. less thanbrgreater than less thanbrgreater thanAim. The study investigated the effects of ICBT for erectile dysfunction. less thanbrgreater than less thanbrgreater thanMethods. Seventy-eight men were included in the study and randomized to either ICBT or to a control group, which was an online discussion group. Treatment consisted of a 7-week Web-based program with e-mail-based therapist support. Each therapist spent an average of 55 minutes per participant. less thanbrgreater than less thanbrgreater thanMain Outcome Measure. The International Index of Erectile Functioning five-item version was administered via the telephone at pretreatment, post-treatment, and 6 months after receiving ICBT. less thanbrgreater than less thanbrgreater thanResults. At post-treatment, the treatment group had significantly greater improvements with regard to erectile performance compared with the control group. Between-group differences at post-treatment were small (d = 0.1), but increased at the 6-month follow-up (d = 0.88). less thanbrgreater than less thanbrgreater thanConclusions. This study provides support for the use of ICBT as a possible treatment format for erectile dysfunction.
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| 5. |
- Andersson, Evelyn, et al.
(författare)
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Genetic Polymorphisms in Monoamine Systems and Outcome of Cognitive Behavior Therapy for Social Anxiety Disorder
- 2013
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 8:11
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveThe role of genetics for predicting the response to cognitive behavior therapy (CBT) for social anxiety disorder (SAD) has only been studied in one previous investigation. The serotonin transporter (5-HTTLPR), the catechol-o-methyltransferase (COMT) val158met, and the tryptophan hydroxylase-2 (TPH2) G-703Tpolymorphisms are implicated in the regulation of amygdala reactivity and fear extinction and therefore might be of relevance for CBT outcome. The aim of the present study was to investigate if these three gene variants predicted response to CBT in a large sample of SAD patients.MethodParticipants were recruited from two separate randomized controlled CBT trials (trial 1: n = 112, trial 2: n = 202). Genotyping were performed on DNA extracted from blood or saliva samples. Effects were analyzed at follow-up (6 or 12 months after treatment) for both groups and for each group separately at post-treatment. The main outcome measure was the Liebowitz Social Anxiety Scale Self-Report.ResultsAt long-term follow-up, there was no effect of any genotype, or gene × gene interactions, on treatment response. In the subsamples, there was time by genotype interaction effects indicating an influence of the TPH2 G-703T-polymorphism on CBT short-term response, however the direction of the effect was not consistent across trials.ConclusionsNone of the three gene variants, 5-HTTLPR, COMTval158met and TPH2 G-703T, was associated with long-term response to CBT for SAD.
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| 6. |
- Andersson, Gerhard, et al.
(författare)
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A 3.5-year follow-up of Internet-delivered cognitive behavior therapy for major depression
- 2013
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Ingår i: Journal of Mental Health. - London, UK : Informa Healthcare. - 0963-8237 .- 1360-0567. ; 22:2, s. 155-164
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundInternet-delivered cognitive behavior therapy (ICBT) for major depression has been tested in several trials, but only with follow-ups up to 1.5 years.AimThe aim of this study was to evaluate the outcome of ICBT 3.5 years after treatment completion.MethodsA total of 88 people with major depression were randomized to either guided self-help or e-mail therapy in the original trial. One-third was initially on a waiting-list. Treatment was provided for eight weeks and in this report long-term follow-up data were collected. Also included were data from post-treatment and six-month follow-up. A total of 58% (51/88) completed the 3.5-year follow-up. Analyses were performed using a random effects repeated measures piecewise growth model to estimate trajectory shape over time and account for missing data.ResultsResults showed continued lowered scores on the Beck Depression Inventory (BDI). No differences were found between the treatment conditions. A large proportion of participants (55%) had sought and received additional treatments in the follow-up period. A majority (56.9%) of participants had a BDI score lower than 10 at the 3.5-year follow-up.ConclusionsPeople with mild to moderate major depression may benefit from ICBT 3.5-years after treatment completion.
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| 7. |
- Andersson, Gerhard, et al.
(författare)
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Can the patient decide which modules to endorse? : an open trial of tailored internet treatment of anxiety disorders
- 2011
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Ingår i: Cognitive Behaviour Therapy. - : Routledge, Taylor and Francis Group. - 1650-6073 .- 1651-2316. ; 1:40, s. 57-64
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Tidskriftsartikel (refereegranskat)abstract
- Internet-delivered cognitive behaviour therapy commonly consists of disorder-specific modules that are based on face-to-face manuals. A recent development in the field is to tailor the treatment according to patient profile, which has the potential to cover comorbid conditions in association with anxiety and mood disorders. However, it could be that the patients themselves are able to decide what modules to use. The authors tested this in an open pilot trial with 27 patients with mixed anxiety disorders. Modules were introduced with a brief description, and patients could choose which modules to use. The exception was the two first modules and the last, which involved psychoeducation and relapse prevention. The treatment period lasted for 10 weeks. Results showed large within-group effect sizes, with an average Cohen’s d of 0.88. In a structured clinical interview, a majority (54%) had significantly improved 10 weeks after commencing treatment. Only one person dropped out. On the basis of results of this preliminary study, the authors suggest that the role of choice and tailoring should be further explored in controlled trials and that patient choice could be incorporated into Internet-delivered treatment packages.
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| 10. |
- Andersson, Gerhard, et al.
(författare)
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Förord
- 2013
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Ingår i: Internetbehandling med KBT. - Stockholm : Natur och kultur. - 9789127132771
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Internetbaserad KBT ger tillgång till fungerande behandling för psykisk ohälsa på patientens villkor. Metoden har utvecklats i snabb takt genom utbredda forskningsinsatser, där Sverige kan betraktas som världsledande inom området.Internetbehandling med KBT ger en grundlig genomgång av behandlingsarbetet med betoning på praktiska aspekter och tillämpningen i olika verksamheter. Särskilt fokus ligger på att skapa ett fungerande behandlingsupplägg, praktiska förberedelser, behandlarens roll och viktiga terapeutfärdigheter samt hur vanliga svårigheter hanteras. Läsaren får också en teoretisk orientering, kunskap om befintligt forskningsstöd och vilka fördelar metoden har för patienter, behandlare och verksamheter. Fallexempel, checklistor och annat praktiskt material gör boken till ett mycket användbart hjälpmedel.
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