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For better or worse: An individual patient data meta-analysis of deterioration among participants receiving Internet-based cognitive behavior therapy
Karolinska Institutet.
Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
Freie Universität Berlin.
Linköping University.
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2016 (English)In: EABCT 2016 Abstract Book: Total Awareness, The European Association for Behavioural and Cognitive Therapies , 2016, 285-285 p.Conference paper, Abstract (Other (popular science, discussion, etc.))
Abstract [en]

Objective: Psychological treatments can relieve mental distress and improve well-being, and the dissemination of evidencebased methods is believed to aid patients in gaining access to the right type of help. Meanwhile, Internet-based cognitive behavior therapy (ICBT) has shown promising results for many psychiatric disorders. However, research on the potential for negative effects of psychological treatments has been lacking. Method: An individual patient data meta-analysis of 29 clinical trials of ICBT (N = 2866) was performed using the Reliable Change Index for each of the primary outcome measures to distinguish deterioration rates among patients in treatment and control conditions. Statistical analyses of predictors were subsequently conducted using generalized linear mixed models. Missing data was handled by multiple imputation. Results: Deterioration rates were 122 (5.8%) in treatment and 130 (17.4%) in control conditions, yielding a total of 252 (8.8%). Patients in a control condition had higher odds of deteriorating, Odds Ratios (OR) 3.10, 95% Confidence Interval (CI) [2.21-4.34]. Clinical severity at pre treatment was related to lower odds, OR 0.62, 95% CI [0.50-0.77], and 0.51, 95% CI [0.51-0.80], for treatment and control conditions. In terms of sociodemographic variables, being in a relationship, 0.58, 95% CI [0.35-0.95], having at least a university degree, 0.54, 95% CI [0.33-0.88], and being older, 0.78, 95% CI, [0.62-0.98], were also associated with lower odds of deterioration, but only for patients assigned to treatment. Conclusion: Deterioration among patients receiving ICBT is not uncommon and should be monitored by researchers in order to reverse a negative treatment trend.

Place, publisher, year, edition, pages
The European Association for Behavioural and Cognitive Therapies , 2016. 285-285 p.
Keyword [en]
negative effects, internet-based cognitive behavior therapy, deterioration
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Research subject
URN: urn:nbn:se:su:diva-134699OAI: diva2:1037428
46th European Association of Behavioural and Cognitive Therapies congress, August 31 - September 3, Stockholm, Sweden.
Available from: 2016-10-14 Created: 2016-10-14 Last updated: 2016-10-14

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