| 1. |
- Andersson, Gerhard, 1966-, et al.
(författare)
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An overview and analysis of the behaviorist criticism of the diagnostic and statistical manual of mental disorders (DSM)
- 2006
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Ingår i: Clinical Psychologist. - 1328-4207 .- 1742-9552. ; 10, s. 67-77
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Tidskriftsartikel (refereegranskat)abstract
- While a majority of cognitive-behavioural researchers and clinicians adhere to the classification system provided in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994, 2000), strong objections have been voiced among behaviourists who find the dichotomous allocation of patients into psychiatric diagnoses incompatible with the philosophy of behaviorism and practice of functional analysis. The aim of this paper is to give an overview of the current debate and to analyze the tension between the DSM-IV and functional analysis along the following contrasts: Inductive vs. Deductive, Idiographic vs. Nomothetic, Contextualism vs. Mechanism, Social constructions vs. Real Entities, and Dimensions vs. Categories. Finally, some suggested alternatives are discussed. It is concluded that there is a need for alternative systems to the DSM with treatment utility.
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| 2. |
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| 3. |
- Bergvall, Hillevi, et al.
(författare)
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Development of competence in cognitive behavioural therapy and the role of metacognition among clinical psychology and psychotherapy students
- 2023
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Ingår i: Behavioural and Cognitive Psychotherapy. - : CAMBRIDGE UNIV PRESS. - 1352-4658 .- 1469-1833. ; 51:3
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Tidskriftsartikel (refereegranskat)abstract
- Background:There is a paucity of research on therapist competence development following extensive training in cognitive behavioural therapy (CBT). In addition, metacognitive ability (the knowledge and regulation of ones cognitive processes) has been associated with learning in various domains but its role in learning CBT is unknown. Aims:To investigate to what extent psychology and psychotherapy students acquired competence in CBT following extensive training, and the role of metacognition. Method:CBT competence and metacognitive activity were assessed in 73 psychology and psychotherapy students before and after 1.5 years of CBT training, using role-plays with a standardised patient. Results:Using linear mixed modelling, we found large improvements of CBT competence from pre- to post-assessment. At post-assessment, 72% performed above the competence threshold (36 points on the Cognitive Therapy Scale-Revised). Higher competence was correlated with lower accuracy in self-assessment, a measure of metacognitive ability. The more competent therapists tended to under-estimate their performance, while less competent therapists made more accurate self-assessments. Metacognitive activity did not predict CBT competence development. Participant characteristics (e.g. age, clinical experience) did not moderate competence development. Conclusions:Competence improved over time and most students performed over the threshold post-assessment. The more competent therapists tended to under-rate their competence. In contrast to what has been found in other learning domains, metacognitive ability was not associated with competence development in our study. Hence, metacognition and competence may be unrelated in CBT or perhaps other methods are required to measure metacognition.
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| 4. |
- Ghaderi, Ata, et al.
(författare)
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A Randomized Controlled Trial of the Effectiveness of Virtually Delivered Body Project (vBP) Groups to Prevent Eating Disorders
- 2020
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Ingår i: Journal of Consulting and Clinical Psychology. - : American Psychological Association (APA). - 0022-006X .- 1939-2117. ; 88:7, s. 643-656
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To investigate the effectiveness of Body Project groups delivered virtually (vBP) by peer educators for prevention of eating disorders. Method: In a randomized controlled trial vBP groups (N = 149) were compared with a placebo (expressive writing, EW: N = 148) over 24-month follow-up and to a waitlist control condition (N = 146) over 6-month follow-up among females (15-20 years old) with body image concerns. The primary outcome was incidence of eating disorder onset over 2-year follow-up measured by blinded diagnostic interviews. Waitlist participants were offered the vBP after 6 months. Results: The incidence of eating disorders onset over 24 months follow up were 3 in vBP (2.0%) and 13 in EW (8.8%), a significant difference; Hazard Ratio (Experiment B) = 0.26, 95% confidence interval (CI) [0.075, 0.92], p = .037. Incidence of eating disorder onset in vBP participants was 77% less than in EW participants. The vBP participants generally showed significantly greater reduction in eating disorder symptoms, clinical impairment, body dissatisfaction, and internalization of thin ideal compared with the waitlist participants at postintervention and 6-month follow-up, and in eating disorder symptoms, restraint, body dissatisfaction, and internalization of thin ideal compared with the EW participants at postintervention, and 6-, 12-, 18-, or 24-months follow-up. EW participants reported significantly greater reduction in clinical impairment and body dissatisfaction at postintervention compared with the waitlist participants. Conclusions: The present reduction in the incidence of eating disorders is notable given that the intervention was implemented virtually, rather than in-person. The vBP might be a viable option for future evaluation of scalable prevention of eating disorders.
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| 5. |
- Hedman, Erik, et al.
(författare)
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Clinical effectiveness and cost-effectiveness of Internet- vs. group-based cognitive behavior therapy for social anxiety disorder : 4-Year follow-up of a randomized trial
- 2014
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Ingår i: Behaviour Research and Therapy. - : Elsevier. - 0005-7967 .- 1873-622X. ; 59, s. 20-29
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Tidskriftsartikel (refereegranskat)abstract
- Social anxiety disorder (SAD) is common, debilitating and associated with high societal costs. The disorder can be effectively treated with Internet-based cognitive behavior therapy (ICBT), but no previous study has investigated the long-term clinical or health economic effects of ICBT for SAD in comparison to an evidence-based control treatment. The aim of the study was to investigate the clinical effectiveness and cost-effectiveness of ICBT compared to cognitive behavioral group therapy (CBGT) four years post-treatment. We conducted a 4-year follow-up study of participants who had received ICBT or CBGT for SAD within the context of a randomized controlled non-inferiority trial. The cost-effectiveness analyses were conducted taking a societal perspective. Participants in both treatment groups made large improvements from baseline to 4-year follow-up on the primary outcome measure (d = 1.34-1.48) and the 95% CI of the mean difference on the primary outcome was well within the non-inferiority margin. ICBT and CBGT were similarly cost-effective and both groups reduced their indirect costs. We conclude that ICBT for SAD yields large sustainable effects and is at least as long-term effective as CBGT. Intervention costs of both treatments are offset by net societal cost reductions in a short time. (C) 2014 Elsevier Ltd. All rights reserved.
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| 6. |
- Johansson, Linda, et al.
(författare)
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Implicit memory bias for eating- and body appearance-related sentences in eating disorders : An application of Jacoby's white noise task
- 2008
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Ingår i: Cognitive Behaviour Therapy. - : Routledge. - 1650-6073 .- 1651-2316. ; 37:3, s. 135-145
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Tidskriftsartikel (refereegranskat)abstract
- Jacoby's white noise task and an explicit recognition task were used to investigate whether individuals with eating disorders demonstrate implicit memory bias and explicit memory bias, respectively, for information related to eating and body appearance. Included were 33 women with eating disorders (seven with anorexia nervosa and 26 with bulimia nervosa), 29 with nonclinical eating disorder‐related concerns, and 36 healthy controls. Results showed partial support for implicit memory bias but no support for explicit memory bias. These findings suggest that eating disorders may be characterized by relative initial automatic bias for eating disorder‐relevant information but not by bias at later stages of information processing. However, previous studies have demonstrated explicit memory bias in eating disorders, which is inconsistent with this interpretation. Future research is required to clarify the precise cognitive biases associated with eating disorders.
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| 7. |
- Johansson, Linda, et al.
(författare)
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Stroop interference for food- and body-related words : A meta-analysis
- 2005
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Ingår i: Eating Behaviors. - : Elsevier BV. - 1471-0153 .- 1873-7358. ; 6:3, s. 271-281
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Tidskriftsartikel (refereegranskat)abstract
- According to cognitive theories of eating disorders, biased information processing in favour of dysfunctional attitudes about food and body appearance plays a vital role in the development and maintenance of such disorders. Data from 27 studies evaluating Stroop interference for food- and body-related words with negative overtones were included in a meta-analysis in order to investigate whether such processing biases are specific to eating disordered samples. Participants were females characterised as eating disordered, non-eating disordered but nevertheless over-concerned with body appearance and eating, and normal controls. Mean Stroop interference for eating disordered females was of medium effect size (Cohen's d=0.48) and significantly larger than for both non-eating disordered females concerned with body appearance and eating, and normal control females (both d=0.21). Stroop interference for eating disordered females was thus of fairly modest magnitude where it was unclear whether such interference is specific to this sample. © 2004 Elsevier Ltd. All rights reserved.
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| 8. |
- Johansson, Linda, et al.
(författare)
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The role of sensitivity to external food cues in attentional allocation to food words on dot probe and Stroop tasks
- 2004
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Ingår i: Eating Behaviors. - 1471-0153 .- 1873-7358. ; 5:3, s. 261-271
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Tidskriftsartikel (refereegranskat)abstract
- The role of sensitivity of external food cues in producing attentional bias toward food-, body-weight-, and shape-related words on the Stroop and the dot probe tasks was examined. Contrary to expectations, individuals high in responsiveness to external food cues directed attention away from food words, whereas individuals low in responsiveness to external food cues directed their attention toward food words on the dot probe task. No significant differences were found between the groups high and low in sensitivity to external food cues for body words on the dot probe task or for food or body words on the Stroop task. Results are discussed with reference to theoretical views of differences between the Stroop and the dot probe tasks.
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| 9. |
- Ljotsson, B., et al.
(författare)
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Remote treatment of bulimia nervosa and binge eating disorder : A randomized trial of Internet-assisted cognitive behavioural therapy
- 2007
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Ingår i: Behaviour Research and Therapy. - : Elsevier BV. - 0005-7967 .- 1873-622X. ; 45:4, s. 649-661
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Tidskriftsartikel (refereegranskat)abstract
- The present study investigated the efficacy of self-help based on cognitive behaviour therapy in combination with Internet support in the treatment of bulimia nervosa and binge eating disorder. After confirming the diagnosis with an in-person interview, 73 patients were randomly allocated to treatment or a waiting list control group. Treated individuals showed marked improvement after 12 weeks of self-help compared to the control group on both primary and secondary outcome measures. Intent-to-treat analyses revealed that 37% (46% among completers) had no binge eating or purging at the end of the treatment and a considerable number of patients achieved clinically significant improvement on most of the other measures as well. The results were maintained at the 6-month follow-up, and provide evidence to support the continued use and development of self-help programmes.
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| 10. |
- Nordgren, Line, et al.
(författare)
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Identifying Subgroups of Patients With Eating Disorders Based on Emotion Dysregulation Profiles : A Factor Mixture Modeling Approach to Classification
- 2022
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Ingår i: Psychological Assessment. - Washington, United States : American Psychological Association (APA). - 1040-3590 .- 1939-134X. ; 34:4, s. 367-378
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Tidskriftsartikel (refereegranskat)abstract
- This study aimed to investigate whether individuals with eating disorders (ED; N = 857) could be empirically classified into qualitatively distinct subgroups based on their emotion dysregulation profiles. A series of increasingly complex models (factor analysis; FA, latent class analysis; LCA, and factor mixture models; FMM) were evaluated to determine whether the structure of psychopathology was best characterized by emotional dysregulation subtypes, dimensions, or a combination of the two. The subscales of the difficulties in emotion regulation scale were used as indicators. Data were split into an exploratory and confirmatory dataset, and the best-fitting models in the exploratory set were compared and validated against clinically relevant variables in the confirmatory set. Results confirmed that individuals could be grouped into three latent classes that were clearly distinguishable on ED pathology and psychiatric comorbidity. Specifically, individuals belonging to the class with more severe emotion dysregulation had higher levels of ED pathology and were more likely to engage in vomiting and binge eating as well as substance abuse and self-harm. These results provide initial support for emotional dysregulation profiling as a viable transdiagnostic approach to classification in the field of EDs.
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