| 1. |
- Jansson, Billy, 0063-
(författare)
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Does the way in which we perceive the world make us susceptible to anxiety?
- 2005
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- One major focus of anxiety research in recent years has been the identification of cognitive factors that promote increased vulnerability to anxiety. Cognitive formulations propose that anxiety is characterised by an increased tendency to attend to negatively valenced emotional information, and that this bias may play a causal role in the development and maintenance of clinical anxiety. Evidence suggests that this anxiety-linked processing bias occurs even in conditions in which the stimuli are masked in order to prevent awareness of the content (i.e., preattentive bias). The present thesis focused principally on the preferential processing of threat-related information that occurs outside awareness. Two different outcome measures were used to index preferential preattentive processing of threat-related information in non-clinical populations: The emotional Stroop task was used to index selective attention to masked presentation of threatening word stimuli, whereas skin conductance responses were used to index selective autonomic responses to masked presentation of threatening pictorial stimuli. The empirical studies in the present thesis showed that elevated levels of trait anxiety promote preferential preattentive processing of negatively valenced information, whereas elevated levels of social desirability (interpreted as defensiveness) generally prevent preferential preattentive processing of negatively valenced information, especially among those at higher levels of trait anxiety, irrespective of outcome measure used. Moreover, previous research has demonstrated that a person’s most common emotional reaction when encountering a stressful event is causally influenced by that person’s habitual tendency to selectively encode the most threatening aspects of all available information. Thus, preattentive bias (as measured with the emotional Stroop task) was used to predict the emotional responses (as seen on self-reported emotional distress and autonomic reactivity) following exposure to a laboratory stressor. This study showed that preattentive bias to negative information had significant effects on both self-reported and physiological measures in response to a laboratory stressor, but in diametrically opposite directions. Specifically, whereas preattentive bias was positively associated with self-reported negative emotional response, it was negatively associated with a physiological indicator of emotional response. The results were discussed in terms of an inability to automatically inhibit the processing of threatening cues, which seems to be a vulnerability marker for anxiety. Whether this bias is ultimately sufficient for the development of clinical anxiety remains to be examined in future research. Additionally, more information is needed before it can be established that the emotional Stroop task can be viewed as a reliable diagnostic tool for determining an individual’s anxiety status.
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| 2. |
- Lundh, Lars-Gunnar, et al.
(författare)
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Sömnstörningar
- 2006
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Ingår i: Kognitiv beteendeterapi inom psykiatrin. - 912710947X ; , s. 195-210
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- I kapitlet beskrivs kognitiva och beteendeinriktade behandlingsmetoder vid sömnstörningar, i första hand insomni. En översikt ges av diagnos och analys utifrån en KBT-modell. Beteendeanalys med hjälp av intervju, sömndagbok och självskattningsskalor beskrivs. En sammanfattning görs av vanliga behandlingsmetoder som avslappningsmetoder, paradoxal intention, stimuluskontroll, sömnrestriktion och kognitiva metoder. Även andra typer av sömnstörningar (sömnapné, narkolepsi, parasomnier och dygnsrytmstörningar) berörs kort.
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| 3. |
- Andersson, Gerhard, et al.
(författare)
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Internet-Based Self-Help Versus One-Session Exposure in the Treatment of Spider Phobia : A Randomized Controlled Trial
- 2009
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Ingår i: Cognitive Behaviour Therapy. - : Routledge. - 1650-6073 .- 1651-2316. ; 38:2, s. 114-120
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Tidskriftsartikel (refereegranskat)abstract
- The authors compared guided Internet-delivered self-help with one session of live-exposure treatment in a sample of spider-phobic patients. A total of 30 patients were included following screening on the Internet and a structured clinical interview. The Internet treatment consisted of five weekly text modules, which were presented on a web page, a video in which exposure was modelled, and support provided via Internet. The live-exposure treatment was delivered in a 3-hr session following a brief orientation session. The main outcome measure was the behavioural approach test (BAT), and as secondary measures the authors used questionnaires measuring anxiety symptoms and depression. Results showed that the groups did not differ at posttreatment or follow-up, with the exception of the proportion showing clinically significant change on the BAT. At posttreatment 46.2% of the Internet group and 85.7% in the live-exposure group achieved this change. At follow-up the corresponding figures were 66.7% for the Internet group and 72.7% for the live treatment. Within-group effect sizes for the spider phobia questionnaire were large (d = 1.84 and 2.58 for the Internet and live-exposure groups, respectively, at posttreatment). The authors conclude that guided Internet-delivered exposure treatment is a promising new approach in the treatment of spider phobia.
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| 4. |
- Andersson, Gerhard, 1966-, et al.
(författare)
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Lovande behandling vid borderlinestörning
- 2006
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Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 103, s. 3188-3190
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Tidskriftsartikel (refereegranskat)abstract
- Borderline personlighetsstörning (BPD) kännetecknas av ett genomgående mönster av instabilitet i regleringen av känslor, bristande impulskontroll, relationsproblem och låg självkänsla. Självskadande beteenden och självmordsförsök är vanliga. Dialektisk beteendeterapi (DBT) är en form av kognitiv beteendeterapi som utvecklats för självmordsbenägna patienter med BPD. I DBT ingår beteendeförändrande tekniker och metoder för att lära sig acceptera känslor. Behandlingen ges i form av individualterapi med telefonstöd och gruppterapi samt genomförs i flera steg, där självskadande och terapistörande beteenden prioriteras. Enligt SBUs granskning är det vetenskapliga stödet DBT begränsat (Evidensstyrka 3) och främst avgränsat till minskning av självskadande beteende.
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| 5. |
- Carlbring, Per, 1972-, et al.
(författare)
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Internet vs. paper and pencil administration of questionnaires commonly used in panic/agoraphobia research
- 2007
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Ingår i: Computers in human behavior. - : Elsevier BV. - 0747-5632 .- 1873-7692. ; 23:3, s. 1421-1434
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to investigate the psychometric properties of Internet administered questionnaires used in panic research. Included were 494 people who had registered for an Internet-based treatment program for panic disorder (PD). Participants were randomly assigned to fill in the questionnaires either on the Internet or the paper-and-pencil versions, and then to fill in the same questionnaires again the next day using the other format. The questionnaires were the body sensations questionnaire [BSQ; Chambless, D. L., Caputo, G. C., Bright, P., & Gallagher, R. (1984). Assessment of fear of fear in agoraphobics: the body sensations questionnaire and the agoraphobic cognitions questionnaire. Journal of Consulting and Clinical Psychology, 52, 1090-1097], agoraphobic cognitions questionnaire [ACQ; Chambless, D. L., Caputo, G. C., Bright, P., & Gallagher, R. (1984). Assessment of fear of fear in agoraphobics: the body sensations questionnaire and the agoraphobic cognitions questionnaire. Journal of Consulting and Clinical Psychology, 52, 1090-1097], mobility inventory [MI; Chambless, D. L., Caputo, G., Jasin, S., Gracely, E. J., & Williams, C. (1985). The mobility inventory for agoraphobia. Behaviour Research and Therapy, 23, 35-44], beck anxiety inventory [BAI; Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988). An inventory for measuring clinical anxiety: psychometric properties. Journal of Consulting and Clinical Psychology, 56, 893-897], beck depression inventory 11 [Beck, A. T., & Steer, R. A. (1996). Beck Depression Inventory, Manual, Svensk version (Swedish version). Fagernes, Norway: Psykologiforlaget, AB], quality of life inventory [QOLI; Frisch, M. B., Cornell, J., Villanueva, M., & Retzlaff, P. J. (1992). Clinical validation of the quality of life inventory. A measure of life satisfaction for use in treatment planning and outcome assessment. Psychological Assessment, 4, 92-101], and montgomery angstrom sberg depression rating scale [MADRS; Svanborg, P., & angstrom sberg, M. (1994). A new self-rating scale for depression and anxiety states based on the comprehensive psychopathological rating scale. ACTA Psychiatrica Scandinavica, 89, 21-28]. Results showed largely equivalent psychometric properties for the two administration formats (Cronbach's alpha between 0.79 and 0.95). The results also showed high and significant correlations between the Internet and the paper-and-pencil versions. Analyses of order effects showed an interaction effect for the BSQ and the MI (subscale Accompanied), a main effect was identified for ACQ, MI-Alone, BAI and BDIII. However, in contrast to previous research, the Internet version did not consistently generate higher scores and effect sizes for the differences were generally low. Given the presence of an interaction effect, we recommend that the administration format should be stable in research across measurement points. Finally, the findings suggest that Internet versions of questionnaires used in PD research can be used with confidence.
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| 6. |
- Davis III, Thompson E., et al.
(författare)
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Intensive Treatment of Specific Phobias in Children and Adolescents
- 2009
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Ingår i: Cognitive and Behavioral Practice. - : Elsevier. - 1077-7229 .- 1878-187X. ; 16:3, s. 294-303
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Tidskriftsartikel (refereegranskat)abstract
- One-session treatment (OST), a variant of cognitive-behavioral therapy, combines graduated in vivo exposure, participant modeling, reinforcement, psychoeducation, cognitive challenges, and skills training in an intensive treatment model. Treatment is maximized to one 3-hour session. In this paper, we review the application of OST for specific phobia in youth and highlight practical matters related to OST and its use in a clinical setting. We also briefly review results of treatment outcome studies and suggest future directions for clinical research and practice. We conclude that OST is an efficient and efficacious treatment.
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| 7. |
- Fjermestad, Krister W., et al.
(författare)
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Relationship Factors and Outcome in Child Anxiety Treatment Studies
- 2009
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Ingår i: Clinical Child Psychology and Psychiatry. - : Sage. - 1359-1045 .- 1461-7021. ; 14:2, s. 195-214
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Forskningsöversikt (refereegranskat)abstract
- This study reviews 19 randomized controlled trials examiningthe association between three relationship factors — participation,treatment involvement, and therapeutic relationship —and outcome of cognitive-behavioral anxiety treatments for childrenand adolescents. In 12 studies, parent participation was consideredas an independent variable compared to child-only participation.In three studies, parental involvement was measured. Child involvementwas measured in one study. The child's perception of the therapeuticrelationship was considered in three studies. Six studies founda significant positive effect of parent participation on diagnosticstatus, symptom level, or global functioning outcome measures.One study found a significant effect of parental involvementon global outcome measures. Another study found a significantpositive association between child involvement and symptom measuresand global functioning measures. No association was found betweenthe quality of the child's perception of the therapeutic relationshipand treatment outcome. Clinical implications are discussed.
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| 8. |
- Fredrikson, Mats, et al.
(författare)
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Forskningsresultaten inom KBT är otvetydiga : Replik
- 2009
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Ingår i: Läkartidningen. - Stockholm : Sveriges läkarförbund. - 0023-7205 .- 1652-7518. ; 106:18-19, s. 1294-1296
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 9. |
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| 10. |
- Fredrikson, Mats, et al.
(författare)
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Regeringens storsatsning mot psykisk ohälsa äventyrar patientsäkerheten
- 2009
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Ingår i: Läkartidningen. - Stockholm : Sveriges läkarförbund. - 0023-7205 .- 1652-7518. ; 106:13, s. 946-947
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Regeringens rehabiliteringsgaranti kan få förödande konsekvenser för tilltron till kognitiv beteendeterapi som behandlingsmetod och för den enskilda patienten som tror sig få KBT av en kompetent behandlare. Orsaken är regeringens lågt ställda krav på behandlarnas kompetens. Rehabiliteringsgarantin bör omformuleras, anser nio KBT-företrädare.
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| 11. |
- Haukebø, Kristin, et al.
(författare)
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One- vs. five-session treatment of dental phobia : A randomized controlled study
- 2008
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Ingår i: Journal of Behavior Therapy and Experimental Psychiatry. - : Elsevier BV. - 0005-7916 .- 1873-7943. ; 39:3, s. 381-390
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Tidskriftsartikel (refereegranskat)abstract
- Forty participants fulfilling the DSM-IV criteria for dental phobia were randomly assigned to a waitlist group, one-session or five-session exposure treatment. Assessment occurred pre-, post-waitlist/treatment, and after 1 year. Mean avoidance of dental care before treatment was 11.4 years. A total of 77% sought dental care in the follow-up year. Both treatments were equally effective at reducing avoidance behavior and changing cognitions during the feared situation. Post-treatment, the five-session group scored lower on the dental anxiety scales, but at follow-up, both groups reported the same level of dental anxiety. Conclusion: Both treatment conditions enable a return to ordinary dental treatment.
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| 12. |
- Ollendick, Thomas, H., et al.
(författare)
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One-Session Treatment of Specific Phobias in Youth : A Randomized Clinical Trial in the United States and Sweden
- 2009
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Ingår i: Journal of Consulting and Clinical Psychology. - : American Psychological Association (APA). - 0022-006X .- 1939-2117. ; 77:3, s. 504-509
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Tidskriftsartikel (refereegranskat)abstract
- One hundred and ninety-six youth, ages 7–16, who fulfilled Diagnostic and Statistical Manual of Mental Disorders (4th ed.) criteria for various specific phobias were randomized to a one-session exposure treatment, education support treatment, or a wait list control group. After the waiting period, the wait list participants were offered treatment and, if interested, rerandomized to 1 of the 2 active treatments. The phobias were assessed with semistructured diagnostic interviews, clinician severity ratings, and behavioral avoidance tests, whereas fears, general anxiety, depression, and behavior problems were assessed with self- and parent report measures. Assessments were completed pretreatment, posttreatment, and at 6 months following treatment. Results showed that both treatment conditions were superior to the wait list control condition and that 1-session exposure treatment was superior to education support treatment on clinician ratings of phobic severity, percentage of participants who were diagnosis free, child ratings of anxiety during the behavioral avoidance test, and treatment satisfaction as reported by the youth and their parents. There were no differences on self-report measures. Treatment effects were maintained at follow-up. Implications of these findings are discussed.
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| 13. |
- Ramnerö, Jonas, 1959-
(författare)
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Behavioral Treatments of Panic Disorder with Agoraphobia : Treatment Process and Determinants of Change
- 2005
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The present dissertation comprises four empirical studies within the area of behavioral treatment of panic disorder with agoraphobia. The focus is on studying issues pertaining to outcome, treatment process and determinants of change. The first study is a randomized controlled treatment study of 73 patients undergoing 16 sessions of either exposure in vivo (E), or cognitive behavior therapy (CBT). Both treatments showed clear improvements at post-treatment that were well maintained at 1-year follow up, and there were no significant differences between the treatments.The second study concerned prediction of outcome in the same sample. From a variety of pre-treatment characteristics severity of avoidance was the one most related to outcome. Most predictors were found unrelated. Two approaches of prediction were also compared: treating outcome as a categorical vs. continuous variable. The different approaches yielded a somewhat dissimilar picture of the impact of pre-treatment severity of avoidance. The third study examined different aspects of the therapeutic relationship, and their relation to outcome. Clients’ perceptions of therapists and their ratings of the working alliance were generally not related to outcome at any point. On the other hand, therapists’ perceptions of patients as showing goal-direction and active participation were related to outcome from early on in therapy. The fourth study examined different aspects of change. It was found that change in indices of the frequency of panic attacks was not closely related to change in agoraphobic avoidance at post-treatment. Change in avoidance was also more related to other aspects of outcome. At one-year follow-up, a more unitary picture, regarding the different aspects of change was observed.
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| 14. |
- Ramnerö, Jonas, et al.
(författare)
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Panic and avoidance in panic disorder with agoraphobia : Clinical relevance of change in different aspects of the disorder
- 2007
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Ingår i: Journal of Behavior Therapy and Experimental Psychiatry. - : Elsevier BV. - 0005-7916 .- 1873-7943. ; 38:1, s. 29-39
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Tidskriftsartikel (refereegranskat)abstract
- Different aspects of change were examined in 62 patients who fulfilled the DSM-IV criteria for a primary diagnosis of panic disorder with agoraphobia of moderate to severe magnitude, and who were treated with 16 sessions of behavioral therapy. The treatment resulted in substantial effects on panic attacks and agoraphobic avoidance. Panic-free status only differentiated the patients regarding mood at pre- and post-treatment. Changes in panic and avoidance were related to each other, but change in avoidance was more related to change in negative affect. Change in quality of life (QOL) was also more associated with change in avoidance at post-treatment. At follow-up change in QOL was more related to change in panic than change in avoidance.
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| 15. |
- Ramnerö, Jonas, et al.
(författare)
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Therapists’ and clients’ perceptions of each other and working alliance in the behavioral treatment of panic disorder with agoraphobia
- 2007
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Ingår i: Psychotherapy Research. - : Informa UK Limited. - 1050-3307 .- 1468-4381. ; 7:3, s. 320-328
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Tidskriftsartikel (refereegranskat)abstract
- Fifty-nine patients who fulfilled criteria for a primary diagnosis of panic disorder with moderate to severe agoraphobia were treated with 16 sessions of behavioral therapy. The study investigated the relationship between therapists' and clients' perception of each other, working alliance, and outcome. There was initially a low correspondence between therapist and client perceptions but a growing consensus during treatment. This was most pronounced regarding high ratings of therapist qualities and the perception of the client as attractive. Clients' perceptions showed virtually zero correlation with outcome regardless of time. Therapist perception of client as showing active participation and goal direction yielded positive correlations with outcome at posttreatment and follow-up from Session 4 and throughout treatment. No significant relation between working alliance and outcome was found apart from the fact that those who improved during follow-up rated the alliance significantly higher than those who did not improve.
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| 16. |
- Reuterskiöld, Lena, et al.
(författare)
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Exploring child and parent factors in the diagnostic agreement on the Anxiety Disorders Interview Schedule
- 2008
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Ingår i: Journal of Psychopathology and Behavioral Assessment. - : Springer Science and Business Media LLC. - 0882-2689 .- 1573-3505. ; 30:4, s. 279-290
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Tidskriftsartikel (refereegranskat)abstract
- Worryingly low levels of parent–child agreement on child psychiatric diagnosis are reported. This study examined parent–child agreement on diagnostic categories and severity ratings with the Anxiety Disorders Interview Schedule, Child and Parents versions (ADIS-C/P). Children’s age, gender, motivation and self-concept and parent’s general psychopathology and diagnoses were examined. Participants were 110 children (aged 8–14 years) with a principal specific phobia diagnosis, and their parents. Findings revealed excellent parent–child agreement on principal specific phobia diagnosis (97.3%), and fair levels of concordance on most co-occurring secondary diagnoses. As expected, children with high motivation had generally stronger parent–child agreement on diagnoses and severity ratings (for ADHD p < .001). Parents reported overall more diagnoses for their children (for GAD p < .03; SOCP p < .02) and parents with diagnoses seemed more tuned in to their children’s problematic behavior. It is suggested that clinicians screen for motivation status early in the assessment phase and use both parts of the ADIS-C/P.
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| 17. |
- Reuterskiöld, Lena, 1962-
(författare)
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Fears, anxieties and cognitive-behavioral treatment of specific phobias in youth
- 2009
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The present dissertation consists of three empirical studies on children and adolescents presenting with various specific phobias in Stockholm, Sweden and in Virginia, USA. The overall aim was to contribute to our understanding of childhood fears, anxiety and phobias and to evaluate the efficacy and portability of a one-session treatment of specific phobias in youth. Study I tested the dimensionality of the Parental Bonding Instrument, across three generations and for two countries, and examined if parenting behaviors of indifference and overprotection were associated with more anxiety problems in children. The results showed that the four-factor representation of parental behavior provided an adequate fit for the instrument across informants. Perceived overprotection was associated with significantly more anxiety symptoms and comorbid diagnosis in children. Study II explored parent-child agreement on a diagnostic screening instrument for youths. The results indicated that children scoring high on motivation at treatment entry had generally stronger parent-child agreement on co-occurring diagnoses and severity ratings. Parents reported overall more diagnoses for their children, and parents who themselves qualified for a diagnosis seemed more tuned in to their children’s problematic behavior. Study III compared a one-session treatment with an education-supportive treatment condition, and a wait-list control condition for children presenting with various types of specific phobias. The results showed that both treatment conditions were superior to the wait-list control condition and that one-session exposure treatment was superior to education-supportive treatment on several measures. Treatment effects were maintained at a 6-month follow-up. Overall, the above findings suggest that the one-session treatment is portable and effective in treating a variety of specific phobias in children and adolescents.
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| 18. |
- Shafran, R., et al.
(författare)
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Mind the gap : Improving the dissemination of CBT
- 2009
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Ingår i: Behaviour Research and Therapy. - : Elsevier. - 0005-7967 .- 1873-622X. ; 47:11, s. 902-909
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Tidskriftsartikel (refereegranskat)abstract
- Empirically supported psychological treatments have been developed for a range of psychiatric disorders but there is evidence that patients are not receiving them in routine clinical care. Furthermore, even when patients do receive these treatments there is evidence that they are often not well delivered. The aim of this paper is to identify the barriers to the dissemination of evidence-based psychological treatments and then propose ways of overcoming them, hence potentially bridging the gap between research findings and clinical practice.
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| 19. |
- Thorndike, Frances P., et al.
(författare)
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Web-based measurement : Effect of completing single or multiple items per webpage
- 2009
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Ingår i: Computers in human behavior. - : Elsevier. - 0747-5632 .- 1873-7692. ; 25:2, s. 393-401
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Tidskriftsartikel (refereegranskat)abstract
- The current study was conducted to determine whether participants respond differently to online questionnaires presenting all items on a single webpage versus questionnaires presenting only one item per page, and whether participants prefer one format over the other. Of participants seeking self-help treatment on the Internet (for depression, social phobia, or panic disorder), 710 completed four questionnaires (Beck Depression Inventory, Beck Anxiety Inventory, Quality of Life Index, Montgomery-Åsberg Depression Rating Scale) on the Internet on two occasions. The questionnaires were either presented with one questionnaire on one webpage (e.g., BDI on one webpage) or on multiple webpages (e.g., BDI on 21 webpages with one item each). Results suggest that the four web questionnaires measure the same construct across diagnostic group (depression, social phobia, panic), presentation type (single versus multiple items per page), and order of presentation (which format first). Within each diagnostic group, factor means for all questionnaires were equivalent across presentation method and time. Furthermore, factor means varied as expected across samples (e.g., depressed group scored higher on BDI), providing evidence of construct validity. The majority of participants in each diagnostic group preferred the single item per page format, even though this format required more time.
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| 20. |
- Vika, Margrethe, et al.
(författare)
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Fear of blood, injury, and injections, and its relationship to dental anxiety and probability of avoiding dental treatment among 18-year-olds in Norway
- 2008
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Ingår i: International Journal of Paediatric Dentistry. - 0960-7439 .- 1365-263X. ; 18:3, s. 163-169
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Tidskriftsartikel (refereegranskat)abstract
- Background: More knowledge about the relationship between blood–injury–injection phobia (BIIP) and dental anxiety (DA) may give new clinically relevant information in the assessment and management of children with DA.Objective: The aims of this study were to explore the relationships between BIIP and DA, and to explore to what extent the two subtypes of BIIP in combination with DA are related to self-reported probability of avoiding dental treatment if a dental injection is needed.Methods: The subjects were a random sample of 1385 18-year-olds attending high schools in a county of Norway, and the data were collected by use of questionnaires completed in classrooms. The survey instruments applied were Dental Fear Survey, Injection Phobia Scale-Anxiety, and Mutilation Questionnaire.Results: About 11% of the subjects with DA and subtypes of BIIP, respectively, reported high probability of avoiding dental treatment in a situation where a dental injection was possibly needed. In multiple regression analysis, only DA contributed to self-reports of high probability of avoiding dental treatment.Conclusion: The results indicate that among adolescents, BIIP is relatively often connected with DA. Clinical implications are discussed.
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| 21. |
- Vika, Margrethe, et al.
(författare)
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One- vs. five-session treatment of intra-oral injection phobia : a randomized clinical study
- 2009
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Ingår i: European Journal of Oral Sciences. - : John Wiley & Sons, Inc. - 0909-8836 .- 1600-0722. ; 117:3, s. 279-285
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Tidskriftsartikel (refereegranskat)abstract
- The present study aimed to evaluate the effect of one and five sessions of treatment for intra-oral injection phobia in 55 subjects fulfilling the DSM-IV criteria for specific phobia. The subjects were randomly assigned to one or five sessions of cognitive behavioural therapy (CBT) performed by dentists. Assessments included behavioural tests and self-report instruments used pretreatment, post-treatment, and at 1 yr of follow-up. The dental anxiety scale (DAS), the injection phobia scale-anxiety, and the mutilation questionnaires were applied. Mean avoidance duration of intra-oral injections before treatment was 7.0 yr. The results showed that 89% of the subjects had received intra-oral injections from a regular dentist during the 1-yr follow-up. The only significant difference between the one- and the five-session groups was that the five-session group reported less anxiety (as measured using the DAS) at 1 yr of follow-up. It was concluded that both treatments performed by dentists specially trained in CBT have a significant treatment effect on the intra-oral injection phobia.
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| 22. |
- Öst, Lars-Göran
(författare)
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Cognitive behavior therapy for anxiety disorders : 40 years of progress
- 2008
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Ingår i: Nordic Journal of Psychiatry. - : Informa UK Limited. - 0803-9488 .- 1502-4725. ; 62:Suppl 47, s. 5-10
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Tidskriftsartikel (refereegranskat)abstract
- Cognitive-behavior therapies (CBT) have been evaluated in randomized controlled studies (RCT) and anxiety disorders since 1966 and for each disorder there are at least two CBT methods that are considered evidence based (empirically supported) today. Numerous meta-analyses have evaluated the efficacy of these methods against various control conditions. However, none has looked at whether modern CBT studies lead to better treatment effects than were obtained 10-40 years ago. The aim of this paper is to present a meta-analysis focusing on the mean extent of change achieved by the CBT treatments across decades (from the 1970s onwards). Database searches yielded a total of 432 RCTs for the anxiety disorders combined and 364 of these allowed calculation of within-group effect size (ES) or percentage clinical improvement. Separate ESs were calculated for three central measures: independent assessor rating, self-report and behavioral approach test. The results showed that in most instances there was no significant change in ES across time. In a few instances, the treatment effects were greater in modern studies. However, it was more common with a negative development, or a mixed development (first positive then negative or vice versa). There was no significant change in proportion of clinical improvement. Treatment time and attrition either increased or remained stable. If the single studies that gave the highest ES each decade were compared, all anxiety disorders besides panic disorder and obsessive-compulsive disorder showed a positive development. Possible explanations to the results are discussed.
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| 23. |
- Öst, Lars-Göran
(författare)
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Efficacy of the third wave of behavioral therapies : A systematic review and meta-analysis
- 2008
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Ingår i: Behaviour Research and Therapy. - : Elsevier BV. - 0005-7967 .- 1873-622X. ; 46:3, s. 296-321
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Tidskriftsartikel (refereegranskat)abstract
- During the last two decades a number of therapies, under the name of the third wave of cognitive behavior therapy (CBT), have been developed: acceptance and commitment therapy (ACT), dialectical behavior therapy (DBT), cognitive behavioral analysis system of psychotherapy (CBASP), functional analytic psychotherapy (FAP), and integrative behavioral couple therapy (IBCT). The purposes of this review article of third wave treatment RCTs were: (1) to describe and review them methodologically, (2) to meta-analytically assess their efficacy, and (3) to evaluate if they currently fulfil the criteria for empirically supported treatments. There are 13 RCTs both in ACT and DBT, 1 in CBASP, 2 in IBCT, and none in FAP. The conclusions that can be drawn are that the third wave treatment RCTs used a research methodology that was significantly less stringent than CBT studies; that the mean effect size was moderate for both ACT and DBT, and that none of the third wave therapies fulfilled the criteria for empirically supported treatments. The article ends with suggestions on how to improve future RCTs to increase the possibility of them becoming empirically supported treatments.
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| 24. |
- Öst, Lars-Göran
(författare)
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Inventing the wheel once more or learning from the history of psychotherapy research methodology : Reply to Gaudiano's comments on Öst's (2008) review
- 2009
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Ingår i: Behaviour Research and Therapy. - : Elsevier. - 0005-7967 .- 1873-622X. ; 47:12, s. 1071-1073
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Gaudiano's criticism of one part of my review of ACT outcome research (Öst, 2008) is refuted on all issues but one. It is clear that the average amount of grant support for the ACT-studies was smaller than that of CBT-studies, even if the proportion of studies having grant support was not lower. However, that fact should only influence 25% (2 out of 8) of the methodology variables on which ACT-studies had lower mean scores than CBT-studies. It is not acceptable that a relatively new treatment, such as ACT, should be evaluated by more lenient criteria than already established therapies like CBT. If proponents of a new treatment wish to claim that their therapy is empirically supported then they have to accept to be evaluated by the APA Task Force criteria. It is time that ACT researchers start using the current psychotherapy research methodology.
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| 25. |
- Öst, Lars-Göran
(författare)
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The Claustrophobia Scale: A psychometric evaluation
- 2007
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Ingår i: Behaviour Research and Therapy. - : Elsevier BV. - 0005-7967. ; 45:5, s. 1053-1064
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Tidskriftsartikel (refereegranskat)abstract
- This article presents a psychometric evaluation of the Claustrophobia Scale (CS), consisting of one subscale for measuring anxiety (20 items, 0-4) and one for avoidance (18 items, 0-2). Participants were 87 claustrophobic patients and 200 normal controls randomly selected from the community. The results show that CS has excellent internal consistency, high test--retest reliability, concurrent and discriminant validity. The patients and controls differ significantly on the total scores of anxiety and avoidance, as well as on each individual item scores. The CS was also found to be sensitive to change after cognitive behavioral treatment. Preliminary factor analyses yielded two factors for each subscale; "Being in small enclosed spaces" and "Other people present", accounting for large proportions of the variance. The CS is useful both as a state, and as an outcome self-report measure of claustrophobia.
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