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Guided and unguided...
Guided and unguided internet-delivered psychodynamic therapy for social anxiety disorder : A randomized controlled trial
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- Mechler, Jakob (author)
- Stockholms universitet,Klinisk psykologi
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- Lindqvist, Karin (author)
- Stockholms universitet,Klinisk psykologi
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- Magnusson, Kristoffer (author)
- Karolinska Institutet
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Ringström, Adrián (author)
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Krafman, Johan Daun (author)
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Alvinzi, Pär (author)
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Kassius, Love (author)
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Sowa, Josefine (author)
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Andersson, Gerhard (author)
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- Carlbring, Per, 1972- (author)
- Stockholms universitet,Klinisk psykologi
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(creator_code:org_t)
- 2024
- 2024
- English.
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In: npj Mental Health Research. - 2731-4251. ; 3:1
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https://doi.org/10.1...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Subject headings
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- Social Anxiety Disorder (SAD) is highly prevalent and debilitating disorder. Treatments exist but are not accessible and/or helpful for all patients, indicating a need for accessible treatment alternatives. The aim of the present trial was to evaluate internet-delivered psychodynamic therapy (IPDT) with and without therapist guidance, compared to a waitlist control condition, in the treatment of adults with SAD.In this randomized, clinical trial, we tested whether IPDT was superior to a waitlist control, and whether IPDT with therapeutic guidance was superior to unguided IPDT. Participants were recruited nationwide in Sweden. Eligible participants were ≥ 18 years old and scoring ≥ 60 on the Liebowitz Social Anxiety Scale self-report (LSAS-SR) whilst not fulfilling any of the exclusion criteria. Included participants were randomly assigned to IPDT with guidance (n = 60), IPDT without guidance (n = 61), or waitlist (n = 60).The IPDT intervention comprised eight self-help modules based on affect-focused dynamic therapy, delivered over 8 weeks on a secure online platform. The primary outcome was SAD symptoms severity measured weekly by the LSAS-SR. Primary analyses were calculated on an intention-to-treat sample including all participants randomly assigned. Secondary outcomes were depressive symptoms, generalized anxiety, quality of life, emotion regulation and defensive functioning. At post-treatment, both active treatments were superior to the waitlist condition with guided treatment exhibiting larger between group effects than unguided treatment (d = 1.07 95% CI [0.72, 1.43], p < .001 and d = 0.61, 95% CI [0.25, 0.98], p = .0018) on the LSAS-SR respectively.Guided IPDT lead to larger improvements than unguided IPDT (d = 0.46, 95% CI [0.11, 0.80], p < .01). At post-treatment, guided IPDT was superior to waitlist on all secondary outcome measures. Unguided IPDT was superior to waitlist on depressive symptoms and general anxiety, but not on emotion regulation, self-compassion or quality of life. Guided IPDT was superior to unguided PDT on depressive symptoms, with a trend towards superiority on a measure of generalized anxiety. At six and twelve month follow-up there were no significant differences between guided and unguided IPDT.In conclusion, IPDT shows promising effects in the treatment of SAD, with larger benefits from guided IPDT compared to non-guided, at least at post-treatment. This finding increases the range of accessible and effective treatment alternatives for adults suffering from SAD.The study was prospectively registered at ClinicalTrials (NCT05015166).
Subject headings
- SAMHÄLLSVETENSKAP -- Psykologi (hsv//swe)
- SOCIAL SCIENCES -- Psychology (hsv//eng)
Keyword
- Social Anxiety Disorder
- SAD
- treatment alternatives
- IPDT
- therapist guidance
- Sweden
- psykologi
- Psychology
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Mechler, Jakob
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Lindqvist, Karin
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Magnusson, Krist ...
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Ringström, Adriá ...
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Krafman, Johan D ...
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Alvinzi, Pär
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show more...
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Kassius, Love
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Sowa, Josefine
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Andersson, Gerha ...
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Carlbring, Per, ...
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show less...
- About the subject
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- SOCIAL SCIENCES
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SOCIAL SCIENCES
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and Psychology
- Articles in the publication
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npj Mental Healt ...
- By the university
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Stockholm University
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Karolinska Institutet