| 1. |
- Andersson, Gerhard, 1966-, et al.
(författare)
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Internet-Based Exposure Treatment Versus One-Session Exposure Treatment of Snake Phobia : A Randomized Controlled Trial
- 2013
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Ingår i: Cognitive Behaviour Therapy. - : Informa UK Limited. - 1650-6073 .- 1651-2316. ; 42:4, s. 284-291
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Tidskriftsartikel (refereegranskat)abstract
- In this study, the authors compared guided Internet-delivered self-help with one-session exposure treatment (OST) in a sample of snake phobic patients. A total of 30 patients were included following a screening on the Internet and a structured clinical interview. The Internet treatment consisted of four weekly text modules which were presented on a web page, a video in which exposure was modelled, and support provided via Internet. The OST was delivered in a three-hour session following a brief orientation session. The main outcome was the behavioural approach test (BAT), and as secondary measures questionnaires measuring anxiety symptoms and depression were used. Results showed that the groups did not differ at post-treatment or follow-up, with the exception of a significant interaction for the BAT in favour of the OST. At post-treatment, 61.5% of the Internet group and 84.6% of the OST group achieved a clinically significant improvement on the BAT. At follow-up, the corresponding figures were 90% for the Internet group and 100% for the OST group (completer sample). Within-group effect sizes for the Snake Phobia Questionnaire were large (d = 1.63 and d = 2.31 for the Internet and OST groups, respectively, at post-treatment). It is concluded that guided Internet-delivered exposure treatment is a potential treatment option in the treatment of snake phobia, but that OST probably is better.
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| 2. |
- 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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| 3. |
- 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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| 4. |
- Andersson, Gerhard, et al.
(författare)
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Paniksyndrom : ond cirkel av feltolkade kroppsliga signaler
- 2011
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Ingår i: Läkartidningen. - : Läkartidningen förlag AB. - 0023-7205 .- 1652-7518. ; 108:14, s. 795-797
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Tidskriftsartikel (refereegranskat)abstract
- Attacker av intensiv rädsla utan tydlig yttre orsak som leder till rädsla för nya attacker – det kännetecknar paniksyndrom. Evidensbaserade behandlingsalternativ finns, och det finns inget skäl att avvakta med behandling.
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| 5. |
- Andersson, Gerhard, et al.
(författare)
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Paniksyndrom - ond cirkel av feltolkade kroppsliga signaler
- 2011
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Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 108:14, s. 795-797
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Tidskriftsartikel (refereegranskat)abstract
- Paniksyndrom kännetecknas av plötsliga, oväntade panikattacker med rädsla för nya attacker eller konsekvenser av dem. En andel patienter har även agorafobi. Olika förklaringsmodeller har förts fram för att beskriva hur paniksyndrom uppstår och vidmakthålls. Flera behandlingar för paniksyndrom finns, och bland dem är det psykologisk behandling i form av kognitiv beteendeterapi (KBT) eller läkemedelsbehandling (i första hand selektiva serotoninåterupptagshämmare) som rekommenderas och som har stöd i forskningen. I Sverige har Internetbaserad KBT för paniksyndrom utvecklats och prövats med framgång. I valet av behandling bör patientens preferenser vägas in.
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| 6. |
- 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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| 7. |
- Haug, Thomas, et al.
(författare)
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Stepped care versus face-to–face cognitive behavior therapy for panic disorder and social anxiety disorder : Predictors and moderators of outcome
- 2015
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Ingår i: Behaviour Research and Therapy. - : Elsevier. - 0005-7967 .- 1873-622X. ; 71, s. 76-89
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate predictors and moderators of treatment outcome by comparing immediate face-to-face cognitive behavioral therapy (FtF-CBT) to a Stepped Care treatment model comprising three steps: Psychoeducation, Internet-delivered CBT, and FtF-CBT for panic disorder (PD) and social anxiety disorder (SAD).Method: Patients (N = 173) were recruited from nine public mental health out-patient clinics and randomized to immediate FtF-CBT or Stepped Care treatment. Characteristics related to social functioning, impairment from the anxiety disorder, and comorbidity was investigated as predictors and moderators by treatment format and diagnosis in multiple regression analyses.Results: Lower social functioning, higher impairment from the anxiety disorder, and a comorbidcluster C personality disorder were associated with significantly less improvement, particularly among patients with PD. Furthermore, having a comorbid anxiety disorder was associated with a better treatment outcome among patients with PD but not patients with SAD. Patients with a comorbid depression had similar outcomes from the different treatments, but patients without comorbid depression had better outcomes from immediate FtF-CBT compared to guided self-help.Conclusions: In general, the same patient characteristics appear to be associated with the treatment outcome for CBT provided in low- and high-intensity formats when treated in public mental health care clinics. The findings suggest that patients with lower social functioning and higher impairment from their anxiety disorder benefit less from these treatments and may require more adapted and extensive treatment.ClinicalTrials.govIdentifier: NCT00619138.
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| 8. |
- Lindner, Philip, et al.
(författare)
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Validation of the Internet-Administered Quality of Life Inventory (QOLI) in Different Psychiatric Conditions
- 2013
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Ingår i: Cognitive Behaviour Therapy. - : Informa UK Limited. - 1650-6073 .- 1651-2316. ; 42:4, s. 315-327
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Tidskriftsartikel (refereegranskat)abstract
- The Quality of Life Inventory (QOLI) is an established rating scale of self-perceived quality of life across 16 domains. Norms for different psychiatric conditions when rated via the Internet, responsiveness to change following treatment, and the clinical impact of importance-weighting items have yet to be examined. To investigate these unanswered questions, important for the continued and expanded use of the QOLI, we compiled archival screening and post-treatment data from 20 studies featuring Internet-delivered psychological interventions for seven different psychiatric conditions and an undergraduate sample, totalling over 4000 participants. Disorder-specific norms were indicated by between-group analyses and are reported here, item-by-item. The QOLI showed adequate responsiveness to change and construct validity. Discrepancies were found when conducting between-group analyses with and without weighted items (more significant differences when items were not weighted) on both the screening and post-treatment data, suggesting that weighting is a procedure that is likely to have an impact when analysing QOLI results. Limitations and the needs for future research are discussed.
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| 9. |
- Nordegreen, Tine, et al.
(författare)
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Outcome predictors in guided and unguided self-help for social anxiety disorder
- 2012
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Ingår i: Behaviour Research and Therapy. - : Elsevier. - 0005-7967 .- 1873-622X. ; 50:1, s. 12-21
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Tidskriftsartikel (refereegranskat)abstract
- Internet-based self-help with therapist guidance has shown promise as an effective treatment and may increase access to evidence-based psychological treatment for social anxiety disorder (SAD). Although unguided self-help has been suggested primarily as a population-based preventive intervention, some studies indicate that patients with SAD may profit from unguided self-help. Gaining knowledge about predictors of outcome in guided and unguided self-help for SAD is important to ensure that these interventions can be offered to those who are most likely to respond. Utilizing a sample of 245 patients who received either guided or unguided self-help for SAD, the present study examined pre-treatment symptoms and program factors as predictors of treatment adherence and outcome. The results were in line with previous findings from the face-to-face treatment literature: namely, the intensity of baseline SAD symptoms, but not depressive symptoms, predicted treatment outcomes in both unguided and guided self-help groups. Outcomes were unrelated to whether a participant has generalized versus specific SAD. Furthermore, for the unguided self-help group, higher credibility ratings of the treatment program were associated with increased treatment adherence. The findings suggest that guided and unguided self-help may increase access to SAD treatment in a population that is more heterogeneous than previously assumed.
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| 10. |
- Nordgreen, T., et al.
(författare)
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Stepped care for social anxiety disorder or panic disorder : A randomised controlled trial
- 2017
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Konferensbidrag (refereegranskat)abstract
- Background: Stepped Care is considered a cost-effective way to deliver health care but few studies have investigated stepped care models for psychological treatments. Internet-based psychological treatment might be a highly suitable first step in a stepped care model. The aim of this study was to assess the effectiveness of a cognitive behavioral therapy (CBT) stepped care model (psychoeducation, guided Internet-based treatment, and face-to-face CBT) compared with direct face-to-face (FtF) CBT.Methods: Patients with panic disorder or social anxiety disorder were randomized to either stepped care (n = 85) or direct FtF CBT (n = 88). Recovery was defined as meeting two of the following three criteria: loss of diagnosis, below cut-off for self-reported symptoms, and functional improvement.Results: No significant differences in intention-to-treat recovery rates were identified between stepped care (40.0%) and direct FtF CBT (43.2%). The majority of the patients who recovered in the stepped care did so at the less therapist-demanding steps (26/34, 76.5%). Moderate to large within-groups effect sizes were identified at posttreatment and 1-year follow-up. The attrition rates were high: 41.2% in the stepped care condition and 27.3% in the direct FtF CBT condition.Discussion: These findings indicate that the outcome of a stepped care model for anxiety disorders is comparable to that of direct FtF CBT. The rates of improvement at the two less therapist- demanding steps indicate that stepped care models might be useful for increasing patients’ access to evidence-based psychological treatments for anxiety disorders. However, attrition in the stepped care condition was high. This may reflect inflexible stepping-up criteria. Limitations of this study will be discussed together with suggestions for more relevant and flexible stepping up criteria.
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