Change search
Refine search result
1234 1 - 50 of 163
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Rows per page
  • 5
  • 10
  • 20
  • 50
  • 100
  • 250
Sort
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
Select
The maximal number of hits you can export is 250. When you want to export more records please use the 'Create feeds' function.
  • 1. Aafjes-van Doorn, Katie
    et al.
    Lilliengren, Peter
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Cooper, Angela
    McDonald, James
    Falkenström, Fredrik
    Patients’ Affective Processes Within Initial Experiential Dynamic Therapy Sessions2017In: Psychotherapy, ISSN 0033-3204, E-ISSN 1939-1536, Vol. 54, no 2, 175-183 p.Article in journal (Refereed)
    Abstract [en]

    Research has indicated that patients’ in-session experience of previously avoided affects may be important for effective psychotherapy. The aim of this study was to investigate patients’ in-session levels of affect experiencing in relation to their corresponding levels of insight, motivation, and inhibitory affects in initial Experiential Dynamic Therapy (EDT) sessions. Four hundred sixty-six 10-min video segments from 31 initial sessions were rated using the Achievement of Therapeutic Objectives Scale. A series of multilevel growth models, controlling for between-therapist variability, were estimated to predict patients’ adaptive affect experiencing (Activating Affects) across session segments. In line with our expectations, higher within-person levels of Insight and Motivation related to higher levels of Activating Affects per segment. Contrary to expectations, however, lower levels of Inhibition were not associated with higher levels of Activating Affects. Further, using a time-lagged model, we did not find that the levels of Insight, Motivation, or Inhibition during one session segment predicted Activating Affects in the next, possibly indicating that 10-min segments may be suboptimal for testing temporal relationships in affective processes. Our results suggest that, to intensify patients’ immediate affect experiencing in initial EDT sessions, therapists should focus on increasing insight into defensive patterns and, in particular, motivation to give them up. Future research should examine the impact of specific inhibitory affects more closely, as well as between-therapist variability in patients’ in-session adaptive affect experiencing.

  • 2. Abbass, Allan
    et al.
    Town, Joel
    Ogrodniczuk, John
    Joffres, Michel
    Lilliengren, Peter
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Intensive Short-Term Dynamic Psychotherapy Trial Therapy Effectiveness and Role of Unlocking the Unconscious2017In: Journal of Nervous and Mental Disease, ISSN 0022-3018, E-ISSN 1539-736X, Vol. 205, no 6, 453-457 p.Article in journal (Refereed)
    Abstract [en]

    This study examined the effects of trial therapy interviews using intensive short-term dynamic psychotherapy with 500 mixed sample, tertiary center patients. Furthermore, we investigated whether the effect of trial therapy was larger for patients who had a major unlocking of the unconscious during the interview compared with those who did not. Outcome measures were the Brief Symptom Inventory (BSI) and the Inventory of Interpersonal Problems (IIP), measured at baseline and at 1-month follow-up. Significant outcome effects were observed for both the BSI and the IIP with small to moderate preeffect/posteffect sizes, Cohen's d = 0.52 and 0.23, respectively. Treatment effects were greater in patientswho had a major unlocking of the unconscious comparedwith thosewho did not. The trial therapy interview appears to be beneficial, and its effects may relate to certain therapeutic processes. Further controlled research is warranted.

  • 3. Abdollahi, Abbas
    et al.
    Carlbring, Per
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Coping Style as a Moderator of Perfectionism and Suicidal Ideation Among Undergraduate Students2017In: Journal of Rational-Emotive & Cognitive-Behavior Therapy, ISSN 0894-9085, E-ISSN 1573-6563, Vol. 35, no 3, 223-239 p.Article in journal (Refereed)
    Abstract [en]

    Suicide is a serious and growing public health problem and remains an unnecessary cause of death globally. In Iran, the highest prevalence of acute and chronic suicidal ideation is among young people aged 16-24. This study investigates the relationship between coping style, two types of perfectionism, and suicidal ideation among undergraduates, and examines coping style as a moderator of the relationship between perfectionism and suicidal ideation. Multi-stage cluster random sampling was employed to recruit 547 undergraduate students aged 19-24 years from the Islamic Azad University of Karaj. Structural Equation Modelling indicated that suicidal ideation was negatively associated with adaptive perfectionism and task-focused coping but positively associated with emotion-focused coping, avoidance coping, and maladaptive perfectionism. Coping style (including the three styles of task-focused, emotion-focused, and avoidance coping) was found to moderate the relationship between perfectionism and suicidal ideation. The study advances understanding of the importance of coping style in this context and explains how perfectionism affects suicidal ideation.

  • 4. Abdollahi, Abbas
    et al.
    Carlbring, Per
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Khanbani, Mehdi
    Abdollahi Ghahfarokhi, Shahyar
    Emotional intelligence moderates perceived stress and suicidal ideation among depressed adolescent inpatients2016In: Personality and Individual Differences, ISSN 0191-8869, E-ISSN 1873-3549, Vol. 102, 223-228 p.Article in journal (Refereed)
    Abstract [en]

    Because it remains one of the third leading causes of death among adolescents around the world, suicide is a major public health concern. This study was designed in response to this concern by examining the relationships among perceived stress, emotional intelligence, and suicidal ideation and to test the moderating role of emotional intelligence in the relationship between perceived stress and suicidal ideation. A sample of depressed adolescents (n = 202) was recruited from five hospitals in Tehran, Iran, and then asked to complete measures of patient health, suicidal ideation, perceived stress, and emotional intelligence. Structural Equation Modeling showed that depressed adolescent in-patients with high levels of perceived stress and low levels of emotional intelligence were more likely to report suicidal ideation. Multi-group analysis indicated that depressed in-patients high in both perceived stress and emotional intelligence had less suicidal ideation than others. The findings support the notion that perceived stress acts as a vulnerability factor that increase suicidal ideation among depressed inpatients. Suicidal history moderated the relationship between emotional intelligence and suicidal ideation. These findings also highlight the importance of emotional intelligence as a buffer in the relationship between perceived stress and suicidal ideation.

  • 5. Abdollahi, Abbas
    et al.
    Hosseinian, Simin
    Beh-Pajooh, Ahmad
    Carlbring, Per
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Self-Concealment Mediates the Relationship Between Perfectionism and Attitudes Toward Seeking Psychological Help Among Adolescents2017In: Psychological Reports, ISSN 0033-2941, E-ISSN 1558-691X, Vol. 120, no 6, 1019-1036 p.Article in journal (Refereed)
    Abstract [en]

    One of the biggest barriers in treating adolescents with mental health problems is their refusing to seek psychological help. This study was designed to examine the relationships between two forms of perfectionism, self-concealment and attitudes toward seeking psychological help and to test the mediating role of self-concealment in the relationship between perfectionism and attitudes toward seeking psychological help among Malaysian high school students. The participants were 475 Malaysian high school students from four high schools in Kuala Lumpur, Malaysia. Structural equation modelling results indicated that high school students with high levels of socially prescribed perfectionism, high levels of self-concealment, and low levels of self-oriented perfectionism reported negative attitudes toward seeking psychological help. Bootstrapping analysis showed that self-concealment emerged as a significant, full mediator in the link between socially prescribed perfectionism and attitudes toward seeking psychological help. Moderated mediation analysis also examined whether the results generalized across men and women. The results revealed that male students with socially prescribed perfectionism are more likely to engage in self-concealment, which in turn, leads to negative attitudes toward seeking psychological help more than their female counterparts. The results suggested that students high in socially prescribed perfectionism were more likely to engage in self-concealment and be less inclined to seek psychological help.

  • 6. Abdollahi, Abbas
    et al.
    LeBouthillier, Daniel M.
    Najafi, Mahmoud
    Asmundson, Gordon J. G.
    Hosseinian, Simin
    Shahidi, Shahriar
    Carlbring, Per
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Kalhori, Atefeh
    Sadeghi, Hassan
    Jalili, Marzieh
    Effect of exercise augmentation of cognitive behavioural therapy for the treatment of suicidal ideation and depression2017In: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 219, 58-63 p.Article in journal (Refereed)
    Abstract [en]

    Background: Suicidal ideation and depression are prevalent and costly conditions that reduce quality of life. This study was designed to determine the efficacy of exercise as an adjunct to cognitive behavioural therapy (CBT) for suicidal ideation and depression among depressed individuals.

    Methods: In a randomized clinical trial, 54 mildly to moderately depressed patients (54% female, mean age=48.25) were assigned to a combined CBT and exercise group or to a CBT only group. Both groups received one weekly session of therapy for 12 weeks, while the combined group also completed exercise three times weekly over the same period. Self-reported suicidal ideation, depression, and activities of daily living were measured at the beginning and the end of treatment.

    Results: Multilevel modelling revealed greater improvements in suicidal ideation, depression, and activities of daily living in the combined CBT and exercise group, compared to the CBT only group.

    Limitations: No follow-up data were collected, so the long-term effects (i.e., maintenance of gains) is unclear.

    Conclusions: The findings revealed that exercise adjunct to CBT effectively decreases both depressive symptoms and suicidal ideation in mildly to moderately depressed individuals.

  • 7.
    Andersson, Gerhard
    et al.
    Linköpings universitet och Karolinska Instutet.
    Carlbring, Per
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Behandling via internet2016In: Socialt arbete och internet: att förstå och hantera sociala problem på nya arenor / [ed] Kristian Daneback, Emma Sorbring, Stockholm: Liber, 2016, 215-225 p.Chapter in book (Other (popular science, discussion, etc.))
    Abstract [sv]

    Inom det sociala arbetets praktik ser vi en ökad närvaro av internetrelaterade problem. Samtidigt föredrar allt fler människor webbaserad hjälp, samt råd och stöd i relation till mer traditionella behandlings- och preventionsprogram, vilket öppnar för nya möjligheter för det sociala arbetet.

  • 8. Andersson, Gerhard
    et al.
    Carlbring, Per
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Enduring effects of ICBT2017Conference paper (Refereed)
    Abstract [en]

    Introduction: Numerous randomized controlled trials have been conducted on internet interventions. In addition to the effects observed in these trials immediately after treatment there are several long-term follow-ups. The aim of this talk is to review the long-term effects of internet-delivered CBT (ICBT) with a focus on results at 1-year or later following treatment termination.

    Methods: We were able to locate examples of enduring effects for a range of conditions including mood and anxiety disorders and somatic disorders. The longest follow-up period has been five years.

    Results: Large within-group effects have been documented in most trials, with effects sizes being moderate to large for anxiety and depression studies.

    Discussion: Studies have failed to document how much the treatment is used during the follow-up period and in the case of depression it is unclear if episodes of depression have occured during the period covered. We conclude that the effects of ICBT appear to be enduring but that more research is needed.

  • 9. Andersson, Gerhard
    et al.
    Carlbring, Per
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Internet-Assisted Cognitive Behavioral Therapy2017In: Psychiatric Clinics of North America, ISSN 0193-953X, E-ISSN 1558-3147, Vol. 40, no 4, 689-700 p.Article in journal (Refereed)
    Abstract [en]

    The Internet, including modern information technology, has had a dramatic impact on many areas of life, including health care and psychological treatment. In particular, cognitive–behavioral therapy (CBT) has been found to be a form of psychological treatment that has been possible to transfer to other modes of delivery than regular face-to-face and group formats. The Internet is not only useful for providing CBT, but has a significant role in providing information about CBT and conditions that are treated using CBT. In addition, modern information technology also has a major role in assessment procedures, such as online administration of self-report mea- sures. In this article, we focus mainly on Internet-supported treatments, although another emerging format is to use video conferencing systems and conduct real- time face-to-face CBT, CBT training, or supervision.

  • 10. Andersson, Gerhard
    et al.
    Carlbring, Per
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Internet-based brief therapies2018In: The art and science of brief psychotherapies: A Practioner's Guide / [ed] M. J. Dewan, B. N. Steenbarger, & R. P. Greenberg, Arlington: American Psychiatric Association , 2018, 3, 315-325 p.Chapter in book (Refereed)
    Abstract [en]

    With all of the expert-authored content that made previous editions indispensable references for students and practitioners alike, this third edition of The Art and Science of Brief Psychotherapies: A Practitioner’s Guide has been updated to reflect this rapidly changing field.

    Most chapters include new material that documents recent developments within existing models, and new chapters tackle topics that include the following:

    • Multicultural practice
    • Mentalizing
    • Motivational interviewing
    • Dialectical behavior therapy
    • Telepsychiatry
    • Internet-based interventions

    All chapters summarize the ideas underlying each modality, the evidence for effectiveness, and the techniques and interventions central to each.

    In this edition, the DVD of videos has been replaced with 40 updated streaming videos—available on desktop and mobile devices—that show experienced practitioners engaged in a range of brief therapies, allowing for a deeper and richer learning experience for readers.

    In a national and global environment of limited economic resources and multiple demands on patients’ time, short-term treatment modalities are increasingly important. Integrating theory, research, and step-by-step procedures, The Art and Science of Brief Psychotherapies is an ideal introduction to the range of short-term therapies for psychiatry residents, psychology interns, social work students, and experienced practitioners looking to broaden their practice.

  • 11. Andersson, Gerhard
    et al.
    Carlbring, Per
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Hadjistavropoulos, Heather D.
    Internet-Based Cognitive Behavior Therapy2017In: The Science of Cognitive Behavioral Therapy / [ed] Stefan G. Hofmann , Gordon J. G. Asmundson, London: Elsevier, 2017, 531-549 p.Chapter in book (Refereed)
    Abstract [en]

    Internet-based cognitive behavior therapy (ICBT) is an evidence-based form of CBT. Most programs include text, video, and audio files and are similar to face-to-face CBT in terms of content and duration of treatment. Most often ICBT includes some guidance from a therapist, although automated self-guided ICBT programs also exist. Studies suggest that guided ICBT can be as effective as face-to-face CBT for anxiety and mood disorders as well as for distress associated with certain somatic disorders. Transdiagnostic programs, either relying on presentation of common strategies for, or tailoring of treatment to, disorders have generated strong outcomes in controlled trials. Interventions for problems like procrastination also show promise. Studies on predictors and mediators of outcome are emerging, but there is a need to develop intervention-specific theories in order to better understand change mechanisms. In the future, blending of face-to-face CBT and modern information technology are expected to be more common and attractive to therapists.

  • 12. Andersson, Gerhard
    et al.
    Carlbring, Per
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Lindefors, Nils
    History and current status of ICBT2016In: Guided internet-based treatments in psychiatry / [ed] Nils Lindefors, Gerhard Andersson, Springer, 2016, 1-16 p.Chapter in book (Refereed)
    Abstract [en]

    We begin this chapter with a discussion of the history of ICBT and its roots in bibliotherapy and computerised CBT. We then provide a brief description of one way of administering guided ICBT, including the role of the therapist and data security issues. This description is followed by examples of conditions that are not covered later in the book, such as specific phobias and addictions. We end this chapter with a discussion of technical developments, cost-effectiveness and implementation.

  • 13. Andersson, Gerhard
    et al.
    Rozental, Alexander
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology. UCL Institute of Child Health, University College London, London, England.
    Shafran, Roz
    Carlbring, Per
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology. UCL Institute of Child Health, University College London, London, England.
    Long-term effects of internet-supported cognitive behaviour therapy2018In: Expert Review of Neurotherapeutics, ISSN 1473-7175, E-ISSN 1744-8360, Vol. 18, no 1, 21-28 p.Article in journal (Refereed)
    Abstract [en]

    Introduction: Internet-supported and therapist-guided cognitive behaviour therapy (ICBT) is effective for a range of problems in the short run, but less is known about the long-term effects with follow-ups of two years or longer.

    Areas covered: This paper reviews studies in which the long-term effects of guided ICBT were investigated. Following literature searches in PubMed and other sources meta-analytic statistics were calculated for 14 studies involving a total of 902 participants, and an average follow-up period of three years. Studies were from Sweden (n = 11) or the Netherlands (n = 3). Long-term outcome studies were found for panic disorder, social anxiety disorder, generalized anxiety disorder, depression, mixed anxiety and depression, obsessive-compulsive disorder, pathological gambling, stress and chronic fatigue. The duration of the treatments was usually short (8–15 weeks). The pre-to follow-up effect size was Hedge’s g = 1.52, but with a significant heterogeneity. The average symptom improvement across studies was 50%. Treatment seeking in the follow-up period was not documented and few studies mentioned negative effects.

    Expert commentary: While effects may be overestimated, it is likely that therapist-supported ICBT can have enduring effects. Long-term follow-up data should be collected for more conditions and new technologies like smartphone-delivered treatments.

  • 14. Ankarberg, Peter
    et al.
    Bergsten, Katja
    Bohman, Gunnar
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Bäck, Malin
    Falkenström, Fredrik
    Klingström, Anders
    Lilliengren, Peter
    Philips, Björn
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Werbart, Andrzej
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Socialstyrelsens riktlinjer är partiska och ovetenskapliga!2017In: Psykoterapi, ISSN 2001-5836, Vol. 26, no 2, 30-34 p.Article in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

    Denna artikel är ett remissvar med synpunkter på de nationella riktlinjerna för ångest och depression, som vi publicerar i sin helhet i tidskriften. Vi gör det på grund av den ingående kunskap om processerna i riktlinjearbetet som några av författarna har kunnat få genom egen medverkan och närvaro i det arbetet.

  • 15. Bas-Hoogendam, Janna Marie
    et al.
    van Steenbergen, Henk
    Pannekoek, J. Nienke
    Fouche, Jean-Paul
    Lochner, Christine
    Hattingh, Coenraad J.
    Cremers, Henk R.
    Furmark, Tomas
    Månsson, Kristoffer N.T.
    Frick, Andreas
    Engman, Jonas
    Boraxbekk, Carl-Johan
    Carlbring, Per
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Sample Size Matters: A Voxel-Based Morphometry Multi-Center Mega-Analysis of Gray Matter Volume in Social Anxiety Disorder2017In: Biological Psychiatry, ISSN 0006-3223, E-ISSN 1873-2402, Vol. 81, no 10, S7-S8 p.Article in journal (Other academic)
    Abstract [en]

    Background: Social Anxiety Disorder (SAD) is a disabling psychiatric disorder, associated with high co-morbidity. Previous research on structural brain alterations associated with SAD has yielded inconsistent results concerning changes in gray matter (GM) in various brain regions, as well as on the relationship between GM and SAD-symptomatology. These heterogeneous findings are possibly due to limited sample sizes. Multi-site imaging offers new possibilities to investigate SAD-related GM changes in larger samples.

    Methods: An international multi-center mega-analysis on the largest database of SAD brain scans to date was performed to compare GM volumes of SAD-patients (n=174) and healthy participants (n=213) using voxel-based morphometry. A hypothesis-driven region of interest (ROI) approach was used, focusing on the basal ganglia, amygdala-hippocampal complex, prefrontal cortex and parietal cortex.

    Results: SAD-patients had larger GM volume in the dorsal striatum when compared to healthy participants. This increase correlated positively with the level of social anxiety symptoms. No SAD-related differences in GM volume were present in the other ROIs.

    Conclusions: The results suggest a role for the dorsal striatum in SAD, but previously reported SAD-related changes in GM in the amygdala, hippocampus, precuneus, prefrontal cortex and parietal regions were not replicated. Thereby, our findings indicate that sample size matters and stress the need for meta-analyses like those performed by the Enhancing NeuroImaging Genetics through Meta-Analysis (ENIGMA) Consortium and its working groups. Actually, the collaborative effort for this work has resulted in the start of the ENIGMA-Anxiety workgroup.

  • 16. Bas-Hoogendam, Janna Marie
    et al.
    van Steenbergen, Henk
    Pannekoek, J. Nienke
    Fouche, Jean-Paul
    Lochner, Christine
    Hattingh, Coenraad J.
    Cremers, Henk R.
    Furmark, Tomas
    Månsson, Kristoffer N.T.
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology. Uppsala University, Sweden; Karolinska Institutet, Sweden.
    Frick, Andreas
    Engman, Jonas
    Boraxbekk, Carl-Johan
    Carlbring, Per
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Andersson, Gerhard
    Fredrikson, Mats
    Straube, Thomas
    Peterburs, Jutta
    Klumpp, Heide
    Phan, K. Luan
    Roelofs, Karin
    Veltman, Dick J.
    van Tol, Marie-José
    Stein, Dan J.
    van der Wee, Nic J. A.
    Voxel-based morphometry multi-center mega-analysis of brain structure in social anxiety disorder2017In: NeuroImage: Clinical, ISSN 0353-8842, E-ISSN 2213-1582, Vol. 16, 678-688 p.Article in journal (Refereed)
    Abstract [en]

    Social anxiety disorder (SAD) is a prevalent and disabling mental disorder, associated with significant psychiatric co-morbidity. Previous research on structural brain alterations associated with SAD has yielded inconsistent results concerning the direction of the changes in gray matter (GM) in various brain regions, as well as on the relationship between brain structure and SAD-symptomatology. These heterogeneous findings are possibly due to limited sample sizes. Multi-site imaging offers new opportunities to investigate SAD-related alterations in brain structure in larger samples.

    An international multi-center mega-analysis on the largest database of SAD structural T1-weighted 3T MRI scans to date was performed to compare GM volume of SAD-patients (n = 174) and healthy control (HC)-participants (n = 213) using voxel-based morphometry. A hypothesis-driven region of interest (ROI) approach was used, focusing on the basal ganglia, the amygdala-hippocampal complex, the prefrontal cortex, and the parietal cortex. SAD-patients had larger GM volume in the dorsal striatum when compared to HC-participants. This increase correlated positively with the severity of self-reported social anxiety symptoms. No SAD-related differences in GM volume were present in the other ROIs. Thereby, the results of this mega-analysis suggest a role for the dorsal striatum in SAD, but previously reported SAD-related changes in GM in the amygdala, hippocampus, precuneus, prefrontal cortex and parietal regions were not replicated. Our findings emphasize the importance of large sample imaging studies and the need for meta-analyses like those performed by the Enhancing NeuroImaging Genetics through Meta-Analysis (ENIGMA) Consortium.

  • 17. Bergman Nordgren, Lise
    et al.
    Carlbring, Per
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Andersson, Gerhard
    Tailoring CBT-treatments delivered via the internet: Some examples from a Swedish context2017Conference paper (Refereed)
    Abstract [en]

    Introduction: In mental health comorbidity is common, both physical and psychiatric. Normally studies on cognitive behavior therapy (CBT) protocols do not exclude comorbid patients but leave the comorbidity to improve without being addressed, or remain unchanged without being identified. since most cognitive behavior treatment protocols are diagnosis-specific. Based on the idea that several problems can be targeted at once, individually tailored CBT protocols have developed. Including patients’ specific symptom profile and preferences, and the knowledge from established disorder-specific programs these protocols opens for individualization both before and during treatment based on individual progress. Tailoring can also be done to target different age groups and include for example the interface of the treatment program and the clinical examples used.

    Methods: Most programs have been tested in randomized controlled trials against active waitlist conditions. Specific symptom measures served as primary outcome measures and measures of life quality as secondary. Some studies also included economic evaluations of cost- effectiveness and ratings of therapeutic alliance. Our samples have been both self-recruited and referred by health care professionals. Most of the studies have measure-points not only directly at post treatment, but also at one- and two-year follow-up.

    Results: Taken together the tailored programs show, on average, a medium to large effect size (Cohen’s d) on primary outcome measures regarding both anxiety and depressive symptoms, and small effect sizes on life quality measures. Effects were sustained at follow-up. The tailored treatment proved to be cost-effective administered in regular care. We also found patient ratings of therapeutic alliance to correlate with outcome.

    Discussion: Individually tailored internet-administered CBT show promising results. Based on the available data, it might be a feasible approach in treating anxiety and depression. Acceptability, for whom it is most beneficial, and if some components are more powerful than others, are questions left to be answered.

  • 18. Bjaastad, Jon Fauskanger
    et al.
    Haugland, Bente Storm Mowatt
    Fjermestad, Krister W.
    Torsheim, Torbjorn
    Havik, Odd E.
    Heiervang, Einar R.
    Öst, Lars-Goran
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology. Karolinska Institutet, Sweden.
    Competence and Adherence Scale for Cognitive Behavioral Therapy (CAS-CBT) for Anxiety Disorders in Youth: Psychometric Properties2016In: Psychological Assessment, ISSN 1040-3590, E-ISSN 1939-134X, Vol. 28, no 8, 908-916 p.Article in journal (Refereed)
    Abstract [en]

    The aim of the present study was to evaluate the psychometric properties of the Competence and Adherence Scale for Cognitive Behavioral Therapy (CAS-CBT). The CAS-CBT is an 11-item scale developed to measure adherence and competence in cognitive-behavioral therapy (CBT) for anxiety disorders in youth. A total of 181 videotapes from the treatment sessions in a randomized controlled effectiveness trial (Wergeland et al., 2014) comprising youth (N = 182, M age = 11.5 years, SD = 2.1, range 8-15 years, 53% girls, 90.7% Caucasian) with mixed anxiety disorders were assessed with the CAS-CBT to investigate interitem correlations, internal consistency, and factor structure. Internal consistency was good (Cronbach's alpha = .87). Factor analysis suggested a 2-factor solution with Factor 1 representing CBT structure and session goals (explaining 46.9% of the variance) and Factor 2 representing process and relational skills (explaining 19.7% of the variance). The sum-score for adherence and competence was strongly intercorrelated, r = .79, p < .001. Novice raters (graduate psychology students) obtained satisfactory accuracy (ICC > .40, n = 10 videotapes) and also good to excellent interrater reliability when compared to expert raters (ICC = .83 for adherence and .64 for competence, n = 26 videotapes). High rater stability was also found (n = 15 videotapes). The findings suggest that the CAS-CBT is a reliable measure of adherence and competence in manualized CBT for anxiety disorders in youth. Further research is needed to investigate the validity of the scale and psychometric properties when used with other treatment programs, disorders and treatment formats.

  • 19. Boettcher, Johanna
    et al.
    Carlbring, Per
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Warnock-Parkes, Emma
    Willutzki, Ulrike
    Innovations in the Treatment of Social Anxiety Disorder2017Conference paper (Other academic)
    Abstract [en]

    Social anxiety disorder (SAD) is a very common and disabling mental disorder. Cognitive-behaviour therapy (CBT) is first-line treatment and has a strong empirical basis. However, not all patients benefit from CBT. About one third of the treated patients do not respond to a sufficient degree (Rodebaugh, Holaway, & Heimberg, 2004). Additionally, access to CBT is often limited. Only a small minority of patients with SAD receives adequate, evidence-based treatment (e.g. Issakidis & Andrews, 2002). Hence, there is a pressing need to optimize existing treatment approaches and to lower treatment barriers. The planned symposium will present different approaches on how to make CBT more efficient and more available for patients with SAD. Treatments that are facilitated via the Internet have the potential to reach patients who are otherwise unlikely to receive adequate treatment (e.g. patients in remote areas, patients fearing stigmatization, patients too shy to initiate face-to-face contact). At the same time, technology-based interventions also help to bring important therapeutic techniques into practice. The first two talks will therefore focus on innovations in the field of Internet-based CBT for SAD and will present strategies to facilitate exposure exercises. Johanna Boettcher will present two studies on a newly developed app for SAD. In a gamified approach, the app guides and motivates patients to conduct exposure exercises in their natural environment. The second presentation will introduce virtual reality (VR) exposure therapy for social fears. Per Carlbring will present data on a RCT, evaluating the impact of a three-hour VR exposure session on public speaking anxiety.  The third talk will present a different angle on how to improve treatment outcomes. Emma Warnock- Parks will outline how video-feedback can be optimized in the treatment of socially anxious patients  in order to increase its impact on patients’ symptomatology. She will present data on the beneficial effect of video feedback on patients’ distorted self-images and will show ways how to make this technique even more powerful. Optimizing intervention techniques and contexts is one way to improve treatment of SAD. It is also important to consider external factors that may influence treatment adherence or outcome. In the last talk, Ulrike Willutzki will present data on a long-time neglected topic in SAD. She will demonstrate how the well-meant support of patients’ spouses can contribute to the maintenance of the disorder. She will discuss how partners can be educated and become involved in treatment helping the patient to overcome anxiety in difficult social situations.  The planned symposium will offer four different strategies that can be implemented to improve cognitive-behavioural treatment techniques and to further the access to CBT. The symposium therefore contributes to a better understanding on how CBT for SAD can become more efficient in alleviating patients’ suffering.

  • 20. Boraxbekk, C. J.
    et al.
    Hagkvist, Filip
    Lindner, Philip
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology. Umeå University, Sweden; Karolinska Institutet, Sweden.
    Motor and mental training in older people: Transfer, interference, and associated functional neural responses2016In: Neuropsychologia, ISSN 0028-3932, E-ISSN 1873-3514, Vol. 89, 371-377 p.Article in journal (Refereed)
    Abstract [en]

    Learning new motor skills may become more difficult with advanced age. In the present study, we randomized 56 older individuals, including 30 women (mean age 70.6 years), to 6 weeks of motor training, mental (motor imagery) training, or a combination of motor and mental training of a finger tapping sequence. Performance improvements and post-training functional magnetic resonance imaging (fMRI) were used to investigate performance gains and associated underlying neural processes. Motor only training and a combination of motor and mental training improved performance in the trained task more than mental-only training. The fMRI data showed that motor training was associated with a representation in the premotor cortex and mental training with a representation in the secondary visual cortex. Combining motor and mental training resulted in both premotor and visual cortex representations. During fMRI scanning, reduced performance was observed in the combined motor and mental training group, possibly indicating interference between the two training methods. We concluded that motor and motor imagery training in older individuals is associated with different functional brain responses. Furthermore, adding mental training to motor training did not result in additional performance gains compared to motor-only training and combining training methods may result in interference between representations, reducing performance.

  • 21. Bouchard, Stéphane
    et al.
    Carlbring, Per
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Loranger, Claudie
    Botella, Cristina
    Mechanisms underlying the efficacy of exposure in virtual reality for anxiety disorders2016In: EABCT 2016 Abstract Book: Total Awareness, 2016, 139-139 p.Conference paper (Refereed)
    Abstract [en]

    Many studies have documented the efficacy and effectiveness of using virtual reality to conduct exposure in the treatment of anxiety disorders (Wiederhold &amp; Bouchard, 2014). However, the factors related to treatment outcome remain unclear. In this symposium, four studies will be presented in order to document: (a) the role of presence in the potential of virtual reality (VR) to induce anxiety reactions in people suffering from an anxiety disorder (PTSD); (b) mechanisms of change, including treatment expectations, in the cognitive behavior treatment (CBT) of panic disorder where VR and in vivo techniques were used to conduct exposure; (c) the role of cognitive changes and self-efficacy compared to other predictors of change, such as presence and treatment alliance, in the CBT of social anxiety using VR and in vivo exposure; and (d) expanding these findings on predictors of change to augmented reality exposure for specific phobia. The first study is based on an experimental anxiety induction protocol while the other three use randomized control trials. The findings highlight to contribution of a few factors specific to technology-based exposure and those common to CBT of anxiety disorders. Attendees to the symposium will benefit from a clear understanding of what are the few key factors they need to take into account when conducting exposure with VR and augmented reality.

  • 22. Böttcher, Johanna
    et al.
    Magnusson, Kristoffer
    Marklund, Arvid
    Carlbring, Per
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Challenger: eine, 'smarte' Erweiterung der internet-basierten Behandlung sozialer Ängste2017Conference paper (Refereed)
    Abstract [de]

    Hintergrund: Online-Behandlungen für soziale Angststörungen (SAS) sind bereits gut untersucht. Ein nächster Schritt ist die Erprobung von Smartphone Anwendungen. Diese bieten zahlreiche Möglichkeiten, die Umsetzung einzelner Behandlungselemente im Alltag zu vereinfachen. „Challenger“ ist eine jüngst entwickelte App, die die Durchführung von Expositionsübungen unterstützt. Spielerisch bietet sie den Nutzer*innen Übungen an, die auf die individuellen Bedürfnisse der Betroffenen, sowie auf aktuelle räumliche und situationale Merkmale abgestimmt sind. Die vorliegende Studie untersucht, welchen zusätzlichen Nutzen Challenger zur internet-basierten Behandlung sozialer Ängste beiträgt.Methode: 209 Patient*innen mit SAS wurden zufällig drei Gruppen zugeteilt. Die erste Gruppe erhielt ein unbegleitetes Selbsthilfeprogramm mit zusätzlichem Zugang zur App, die zweite Gruppe erhielt ausschließlich das Selbsthilfeprogramm und die dritte Gruppe war eine Warteliste-Kontrollgruppe. Die Teilnehmer*innen füllten vor, nach und 12 Monate nach Ende der Behandlung Fragebögen zu sozialen Ängsten und sekundären Maßen aus.Ergebnisse: Beide aktive Gruppen zeigten bedeutsame Verbesserungen der sozialen Ängste. Patient*innen, die zusätzlich mit der App trainierten, waren der aktiven Vergleichsgruppe leicht überlegen (kontrolliertes d=0,25). Die Therapieerfolge waren über 12 Monate stabil. Diskussion: Die untersuchte Kombination der Challenger App mit internet-basierter Selbsthilfe war für Patient*innen mit SAS wirksam. Da die ungeleitete App keine personellen Ressourcen fordert und gleichzeitig einen neuartigen, spielerischen Zugang zu Expositionsübungen bietet, empfiehlt sich ihre weitere Erforschung in anderen Behandlungskontexten.

  • 23.
    Carlbring, Per
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Internet-based CBT Interventions2017Conference paper (Other academic)
    Abstract [en]

    Internet-delivered cognitive behavior therapy (ICBT) has a relatively short history, with the first trials being conducted in the late 1990s. Since then well above 150 randomized controlled trials suggest that ICBT can be effective. Effect sizes for ICBT have been well within the range of face-to-face CBT with the exception of unguided programs (e.g., not even minimal therapist contact), which usually, but not always, result in smaller effects.

    So, the evidence is there but how is it done? In this workshop two pioneers in the field will present some recent research findings, but primarily share their experiences of how to become a true expert internet therapist. It is clear that therapist guidance generally is important for good outcome – but how much, how often and when should you do it? And most importantly, what should you write in your feedback? Based on their own research from analyzing the written content of email messages, sent from both the client and the therapist, clear suggestions will be shared and also practiced during the workshop.

    In the workshop clinical case examples will be provided together with screenshots and demonstration of treatment systems including the Swedish web platform as well as a gamified virtual reality exposure therapy intervention. Furthermore, a recently tested smartphone application will also be briefly presented.

    Finally, you will learn about the risk of negative effects of Internet-based cognitive behavior therapy and how to measure the occurrence of symptom deterioration, adverse and unwanted events, and their relationship with long term treatment outcome.

  • 24.
    Carlbring, Per
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Internet-Delivered CBT: State of the Art and Future Directions2016In: EABCT 2016 Abstract Book: Total Awareness, 2016, 18-18 p.Conference paper (Refereed)
    Abstract [en]

    Internet-delivered cognitive behavior therapy (ICBT) has a relatively short history, with the first trials being conducted in the late 1990s. Since then well above 120 randomized controlled trials suggest that ICBT can be effective. Effect sizes for ICBT have been well within the range of face-to-face CBT with the exception of unguided programs (e.g., not even minimal therapist contact), which usually, but not always, result in smaller effects. So, the evidence is there but how is it done? In this keynote Carlbring will present recent research findings from efficacy and effectiveness studies, but also share experiences of how to become a true expert internet therapist. It is clear that therapist guidance generally is important for good outcome – but how much, how often and when should you do it? And most importantly, what should you write in your feedback? Based on the Swedish research from analyzing the written content of email messages, sent from both the client and the therapist, suggestions will be shared.

    In the keynote short clinical case examples will be provided together with screenshots and demonstration of treatment systems including the Swedish web platform as well as a gamified virtual reality exposure therapy intervention. Furthermore, a recently tested smartphone application will also be briefly presented.

    Finally, you will learn about the risk of negative effects of Internet-based cognitive behavior therapy and how to measure the occurrence of symptom deterioration, adverse and unwanted events, and their relationship with long term treatment outcome.

  • 25.
    Carlbring, Per
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Single-session Gamified Virtual Reality Exposure Therapy for Spider Phobia vs. Traditional Exposure Therapy: A Randomized-controlled Non-inferiority Trial with 12-month Follow-up2017Conference paper (Other academic)
    Abstract [en]

    Introduction: This is the first large randomized-controlled trial to evaluate whether commercially available VR hardware and software can be used for exposure therapy. The aim of this study was to compare gold-standard One Session Therapy (OST) for reduction of spider phobia symptoms and avoidance behavior using in vivo spiders and a human therapist, to a newly developed single-session gamified Virtual Reality Exposure Therapy (VRET) application with modern, consumer-available VR hardware, virtual spiders, and a virtual therapist. Method: Subjects (N=100) with spider phobia, diagnosed, and meeting inclusion criteria were recruited from the general population and randomized to 2 treatment arms. In 1-week intervals, pre-measurement, 3-hr treatment and post-measurement were completed with an in-vivo behavioral approach test (BAT) serving as the primary outcome measure for both groups. This study was powered to detect a non-inferiority margin of a 2-point between-group difference on the BAT, with a standard deviation of 4 (at 80% power). Results: 98 patients commenced treatment and 97 patients completed post-measurement. Per protocol analysis indicated VR was not non-inferior to OST. Repeated-measures ANOVA identified a significant main effect of time (p<.001) and time x group effect (p<.05). Both OST and VR participants experienced large BAT within-group effect sizes (d=2.28 and d=1.45, respectively). By the time of the conference there will be 12-month follow-up data including prediction analysis and the effect of treatment credibility, preference and working alliance. Conclusion: OST is the superior treatment option for spider phobia. VRET is an effective alternative if OST cannot be provided, as pure self-help, as the initial intervention in a stepped-care model, or as a possible post-OST booster.

  • 26.
    Carlbring, Per
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Using the internet and virtual reality to treat psychological problems2017Conference paper (Other academic)
  • 27.
    Carlbring, Per
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Andersson, Gerhard
    Internet treatment for anxiety disorders2016In: EABCT 2016 Abstract Book: Total Awareness, 2016, 51-51 p.Conference paper (Refereed)
    Abstract [en]

    Scientific background: Internet-delivered cognitive behavior therapy (ICBT) has a relatively short history, with the first trials being conducted in the late 1990s. Since then well above 120 randomized controlled trials suggest that ICBT can be effective. Effect sizes for ICBT have been well within the range of face-to-face CBT with the exception of unguided programs (e.g., not even minimal therapist contact), which usually, but not always, result in smaller effects.

    So, the evidence is there but how is it done? In this workshop two pioneers in the field will present some recent research findings, but primarily share their experiences of how to become a true expert internet therapist. It is clear that therapist guidance generally is important for good outcome – but how much, how often and when should you do it? And most importantly, what should you write in your feedback? Based on their own research from analyzing the written content of email messages, sent from both the client and the therapist, clear suggestions will be shared and also practiced during the workshop.

    In the workshop clinical case examples will be provided together with screenshots and demonstration of treatment systems including the Swedish web platform as well as a gamified virtual reality exposure therapy intervention. Furthermore, a recently tested smartphone application will also be briefly presented.

    Finally, you will learn about the risk of negative effects of Internet-based cognitive behavior therapy and how to measure the occurrence of symptom deterioration, adverse and unwanted events, and their relationship with long term treatment outcome.

    Key learning objectives

    • Understanding the varieties of Internet treatments and their differential effects
    • Getting to know what is needed to set up a service using the Internet (the basics)
    • Learning what is required to obtain good outcomes with guided Internet treatment
    • Knowing what is required in terms of therapist training and skills.
    • Learning about the pros and cons of Internet treatment including tailoring treatment according to patient symptom profile.

  • 28.
    Carlbring, Per
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Andersson, Gerhard
    Cuijpers, Pim
    Riper, Heleen
    Hedman, Erik
    Internet-based vs. face-to-face cognitive behavior therapy for psychiatric and somatic disorders: An updated systematic review and meta-analysis2017Conference paper (Refereed)
    Abstract [en]

    During the last two decades, Internet-delivered cognitive behavior therapy (ICBT) has been tested in hundreds of randomized controlled trials, often with promising results. However, the control groups were often waitlist, care-as-usual or attention control. Hence, little is known about the relative efficacy of ICBT as compared to face-to-face cognitive behavior therapy (CBT). In the present systematic review and meta-analysis, which included 1418 participants, guided ICBT for psychiatric and somatic conditions were directly compared to face-to-face CBT within the same trial. Out of the 2078 articles screened, a total of 20 studies met all inclusion criteria. These included three studies on social anxiety disorder, three on panic disorder, four on depression, two on body dissatisfaction, two on insomnia, two on tinnitus, one on male sexual dysfunction, one on spider phobia, one on snake phobia, and one on fibromyalgia. Half of the face-to-face CBT treatments were administered in an individual format, and the other half were administered in a group format. Results showed a pooled effect size at post-treatment of Hedges g = 0.05 (95% CI, -0.09 to 0.20), indicating that ICBT and face-to-face treatment produced equivalent overall effects. Study quality did not affect outcomes. While the overall results indicate equivalence, there have been few studies of the individual psychiatric and somatic conditions so far, and for the majority, guided ICBT has not been compared against face-to-face treatment. Thus, more research, preferably with larger sample sizes, is needed to establish the general equivalence of the two treatment formats.

  • 29.
    Carlbring, Per
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Boettcher, Johanna
    Magnusson, Kristoffer
    Marklund, Arvid
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Andersson, Gerhard
    Adding a Smartphone App to Bibliotherapy for Social Anxiety: A Randomized Controlled Comparison2017In: Program Book, Association for Behavioral and Cognitive Therapies , 2017, 394-394 p., PS9-#A29Conference paper (Refereed)
    Abstract [en]

    The efficacy of Internet-based treatments and bibliotherapy for Social Anxiety Disorder is well established. The next step is to evaluate smartphone supported interventions. ‘Challenger’ is a recently developed facilitating the implementation of exposure exercises in daily life. The present study evaluates the efficacy of the combination of Challenger and bibliotherapy for Social Anxiety Disorder. A total of 209 patients with Social Anxiety Disorder were randomly allocated to three groups. The first group received app and bibliotherapy for six weeks (parallel design) and the second group received first bibliotherapy for six weeks and then the app for another six weeks (sequential design). The third group was a wait-list control group. Participants filled in questionnaires on primary and secondary outcomes post treatment as well as at 4 and 12 months follow-up. Participants using both app and bibliotherapy showed somewhat larger reductions in social fears after six weeks of treatment compared to participants using only bibliotherapy (d=0.25). Decreases in social anxiety were large for both groups after 12 weeks of treatment (d= 1.11-1.20) and were maintained throughout the follow-up period. Results of the current study support the notion of adding a smartphone app to bibliotherapy for Social Anxiety Disorder. Future study should investigate the potential of the app in different treatment settings.

  • 30.
    Carlbring, Per
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Hassmén, Peter
    Nyström, Markus
    Lindner, Philip
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Andersson, Gerhard
    The relative effects of behavioral activation vs. physical exercise in the treatment of mild to moderate depression2016Conference paper (Refereed)
    Abstract [en]

    Aim: Despite their potential as low-threshold, low-cost and high-flexibility treatments of depression, behavioral activation and physical exercise have not yet been directly compared. This study has examined the effects of these interventions, administered via the Internet.

    Method: In this randomized controlled trial a total of 312 participants meeting the diagnostic criteria for mild to moderate major depression, recruited in multiple cycles and randomized to either a waiting list control group with delayed treatment, or one of the four active treatment groups: (1) physical exercise without a clear psychological treatment rationale; (2) physical exercise with a psychological treatment rationale; (3) behavioral activation a la Lewinsohn; or (4) behavioral activation a la Martel.

    Results: A total of 72% were women and the average age of the participants were M=42.3 years (SD=13,5). More than half (53,9%) had a history of previous psychological treatment. Primary outcome measure was the 9-item Patient Health Questionnaire. Assessments were made on a weekly basis for the full duration of the acute treatment which was 12 weeks.

    Conclusion: The preliminary results are in line with previous online studies showing that all active treatment groups were superior to the waitlist (large effect sizes) and that only minor differences could be identified between the four active groups (large within effect sizes). At the time of the conference 6-month follow-up data will be available in addition to the already collected post- assessment data (analyzed according to the intention-to-treat principle).

  • 31.
    Carlbring, Per
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Huppert, Jonathan
    Koster, Ernst
    Watkins, Ed
    Boettcher, Johanna
    Blackwell, Simon
    What can bias modification training add to CBT?2016In: EABCT 2016 Abstract Book: Total Awareness, 2016, 100-100 p.Conference paper (Other (popular science, discussion, etc.))
    Abstract [en]

    Bias modification training is a broad but very different form of CBT that is heavily inspired by experimental psychopathology research. Basically this treatment targets mechanisms maintaining psychopathology such as selective attention and memory biases. Some studies have found large effects of bias modification training but there are also negative findings. The panel will discuss the pros and cons of this treatment format including the prospect of combining traditional CBT delivery with bias modification training.

  • 32.
    Carlbring, Per
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Lindner, P.
    Miloff, Alexander
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Fagernäs, S.
    Andersen, J.
    Sigeman, M.
    Furmark, T.
    Andersson, Gerhard
    In session virtual reality use for public speaking anxiety: A randomized controlled trial2017Conference paper (Refereed)
    Abstract [en]

    Fear of public speaking is common and for some individuals this interferes significantly with the person's life and causes marked distress. We wanted to test a newly developed virtual reality assisted 1-session in-person treatment (3 hours). The therapist guided session consisted of a series of behavioral experiments based on the expectancy violation principle. This was followed by a 4-week booster intervention delivered via the internet. Following a diagnostic interview a total of 50 individuals with a score of ≥ 60 on the Personal Report of Public Speaking Anxiety questionnaire were randomized to a treatment or a control condition. A total of 78% also met criteria for social anxiety disorder. Considering only having had one treatment session in-person the preliminary results were promising with a between group effect size on the primary outcome (Public Speaking Anxiety Scale) of Cohen’s d=1.32 before commencing the internet-based booster program. Four weeks later the between-group effect size was d=1.90. However, on the secondary outcome measures the effect sizes were more often moderate than large. At the time of the conference 6-month follow-up data will be available in addition to the already collected post-assessment data (analyzed according to the intention-to-treat principle).

  • 33.
    Carlbring, Per
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Lindner, Philip
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Miloff, Alexander
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Fagernäs, S.
    Andersen, J.
    Sigeman, M.
    Furmark, T.
    Andersson, Gerhard
    The efficacy of internet-based virtual reality exposure therapy for public speaking anxiety: A randomized controlled trial2017Conference paper (Other academic)
    Abstract [en]

    Fear of public speaking is common and for some individuals this interferes significantly with the person's life and causes marked distress. We wanted to test a newly developed virtual reality assisted 1-session in-person treatment (3 hours). The therapist guided session consisted of a series of behavioral experiments based on the expectancy violation principle. This was followed by a 4-week booster intervention delivered via the internet. Following a diagnostic interview a total of 50 individuals with a score of ≥ 60 on the Personal Report of Public Speaking Anxiety questionnaire were randomized to a treatment or a control condition. A total of 78% also met criteria for social anxiety disorder. Considering only having had one treatment session in-person the preliminary results were promising with a between group effect size on the primary outcome (Public Speaking Anxiety Scale) of Cohen’s d=1.32 before commencing the internet-based booster program. Four weeks later the between-group effect size was d=1.90. However, on the secondary outcome measures the effect sizes were more often moderate than large. At the time of the conference 6-month follow-up data will be available in addition to the already collected post-assessment data (analyzed according to the intention-to-treat principle).

  • 34.
    Carlbring, Per
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Marklund, A.
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Miloff, Alexander
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Sjöblom, K.
    Delin, L.
    Lundén, C.
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Blomdahl, R.
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Braun, U.
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Cotter, K.
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Magnusson, K.
    Andersson, G.
    Treat your social anxiety disorder with this gamified smartphone app2016Conference paper (Refereed)
    Abstract [en]

    Aim: Social anxiety disorder (SAD) is a common debilitating mental illness with large negative effects on quality of life and economic productivity. Modern psychotherapy treatments utilizing cognitive–behavioral theory are increasingly delivered over the Internet and more recently using smartphone applications. The Challenger App written natively for the Apple iPhone was developed at the Stockholm University Department of Psychology for the treatment of SAD and uses a number of advanced features not previously seen in past mental health applications; these include real-time location awareness, notifications, anonymous social interaction between users, a high-degree of personalization and use of gamification techniques.

    Method: A total of 209 participants with a primary diagnosis of SAD were randomized to one of three groups: 1) Self-help book, 2) Self-help book + the Challenger app, or 3) waitlist. The treatment period lasted 6 weeks. Primary outcome measure was Liebowitz Social Anxiety Scale self- report (LSAS-SR). Also included where the Quality of Life Inventory, Patient Health Questionnaire, and the Generalized Anxiety Disorder-7 (GAD-7). Outcome was analyzed according to the intention to treat principle.

    Results: Both treatment groups were superior to the waitlist. On the main outcome measure (LSAS-SR) the effect size for the waitlist was Cohens d=0.14. The group that received the self-help book with the addition of the Challenger app was significantly superior (d=1.0) to just reading the self- help book (d=0.61). Participants requited by way of Newspaper advertisement were more likely to reach high end-state functioning (OR=4.1) and the same was true for participants without prior psychological treatment history as compared with having a previous experience (OR=4.4).

    Conclusion: Adding the smartphone app is a cost effective way of improving the outcome when treating SAD with a self-help book.

  • 35.
    Carlbring, Per
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Miloff, Alexander
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Lindner, Philip
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Reuterskiöld, Lena
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Hamilton, William
    Andersson, Gerhard
    ITSY: A gamified one-session virtual reality app with 12-month follow-up data2017Conference paper (Other academic)
    Abstract [en]

    Introduction: This is the first large randomized-controlled trial to evaluate whether commercially available VR hardware and software can be used for exposure therapy. The aim of this study was to compare gold-standard One Session Therapy (OST) for reduction of spider phobia symptoms and avoidance behavior using in vivo spiders and a human therapist, to a newly developed single-session gamified Virtual Reality Exposure Therapy (VRET) application with modern, consumer-available VR hardware, virtual spiders, and a virtual therapist. Method: Subjects (N=100) with spider phobia, diagnosed, and meeting inclusion criteria were recruited from the general population and randomized to 2 treatment arms. In 1-week intervals, pre-measurement, 3-hr treatment and post-measurement were completed with an in-vivo behavioral approach test (BAT) serving as the primary outcome measure for both groups. This study was powered to detect a non-inferiority margin of a 2-point between-group difference on the BAT, with a standard deviation of 4 (at 80% power). Results: 98 patients commenced treatment and 97 patients completed post-measurement. Per protocol analysis indicated VR was not non-inferior to OST. Repeated-measures ANOVA identified a significant main effect of time.

  • 36.
    Carlbring, Per
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Miloff, Alexander
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Lindner, Philip
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Reuterskiöld, Lotta
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Hamilton, William
    Andersson, Gerhard
    ITSY: A Gamified One-Session Virtual Reality App With 12-Month Follow-Up Data2017In: Program Book, 2017, 396-396 p.Conference paper (Refereed)
    Abstract [en]

    Introduction: This is the first large randomized-controlled trial to evaluate whether commercially available VR hardware and software can be used for exposure therapy. The aim of this study was to compare gold-standard One Session Therapy (OST) for reduction of spider phobia symptoms and avoidance behavior using in vivo spiders and a human therapist, to a newly developed single-session gamified Virtual Reality Exposure Therapy (VRET) application with modern, consumer-available VR hardware, virtual spiders, and a virtual therapist.

    Method: Subjects (N=100) with spider phobia, diagnosed, and meeting inclusion criteria were recruited from the general population and randomized to 2 treatment arms. In 1-week intervals, pre-measurement, 3-hr treatment and post-measurement were completed with an in-vivo behavioral approach test (BAT) serving as the primary outcome measure for both groups. This study was powered to detect a non-inferiority margin of a 2-point between-group difference on the BAT, with a standard deviation of 4 (at 80% power).

    Results: 98 patients commenced treatment and 97 patients completed post-measurement. Per protocol analysis indicated VR was not non-inferior to OST. Repeated-measures ANOVA identified a significant main effect of time (p < .001) and time x group effect (p < .05). Both OST and VR participants experienced large BAT within-group effect sizes (d=2.28 and d=1.45, respectively). By the time of the conference there will be 12-month follow-up data including prediction analysis and the effect of treatment credibility and working alliance (with the virtual therapist).

    Conclusion: OST is the superior treatment option for spider phobia. VRET is an effective alternative if OST cannot be provided, as pure self-help, as the initial intervention in a stepped-care model, or as a possible post-OST booster.

  • 37.
    Carlbring, Per
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Nyström, Markus
    Stenling, Andreas
    Neely, Gregory
    Lindner, Philip
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Andersson, Gerhard
    Martell, Christopher R.
    Hassmén, Peter
    Behavioral Activation Versus Physical Activity Via the Internet: A Randomized Controlled Trial2017In: Program Book, 2017, 396-396 p.Conference paper (Refereed)
    Abstract [en]

    A major problem today is that only about fifty percent of those affected by depression seeks help. One way to reach more sufferers would be by offering easily accessible internet based treatments. The purpose of this study was to compare/evaluate four therapist supported internet administered treatments. Two hundred eighty six participants were included. The treatment period lasted twelve weeks, consisting of the following treatments: 1) physical activity without treatment rational, 2) physical activity with treatment rational, 3) behavioral activation without treatment rational and 4) behavioral activation with treatment rational. All groups (including a control-group) showed a significant decrease in depressive symptoms. When the treatment groups were pooled and compared to the control group, there were significant differences from pretest to posttest (Hedges g av treatment =1.01, control group =0.47).This held true also when each of the four treatment groups was compared to the control group, with one exception: Physical activity without treatment rationale. The differences between how many modules the participants completed could indicate that there are other factors than the treatments that caused the symptom reduction, however, the dose-response analysis did not detect any significant differences on account of modules completed. The results support the positive effects of internet administered treatments for depression, and highlights the importance of psychoeducation, which tends to affect both the treatment outcome and the probability of remaining in treatment. These aspects need to be considered when developing and conducting new treatments for depression, since they would increase the likelihood of positive treatment outcomes.

  • 38.
    Carlbring, Per
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Shafran, Roz
    Wade, Tracey
    Egan, Sarah
    Bergman Nordgren, Lise
    Landström, Andreas
    Roos, Stina
    Skoglund, Malin
    Thelander, Elisabet
    Trossell, Linnéa
    Örtenholm, Alexander
    Andersson, Gerhard
    A Randomized Controlled Trial of Internet-Based CBT for Perfectionism Including an Investigation of Outcome Predictors2017In: Program Book, 2017, 128-128 p.Conference paper (Refereed)
    Abstract [en]

    Being highly attentive to details can be a positive feature. However, for some individuals, perfectionismcan lead to distress and is associated with many psychiatric disorders. Cognitive behavior therapy has been shown to yield many benefits for those experiencing problems with perfectionism, but the access to evidence-based care is limited. The current study investigated the efficacy of guided Internet-based Cognitive Behavior Therapy (ICBT) and predictors of treatment outcome. In total, 156 individuals were included and randomized to an eight-week treatment or wait-list control. Self-report measures of perfectionism, depression, anxiety, self-criticism, self-compassion, and quality of life were distributed during screening and at post-treatment. Intention-to-treat were used for all statistical analyses. Moderate to large between-group effect sizes were obtained for the primary outcome measures, Frost Multidimensional Perfectionism Scale, subscales Concerns over Mistakes and Personal Standards, Cohen's d ¼ 0.68e1.00, 95% Confidence Interval (CI) [0.36e1.33], with 35 (44.9%) of the patients in treatment being improved. Predictors were also explored, but none were related to treatment outcome. In sum, guided ICBT can be helpful for addressing problems with clinical perfectionism, but research of its long-term benefits is warranted.

  • 39. Cernvall, Martin
    et al.
    Carlbring, Per
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Ljungman, Lisa
    Ljungman, Gustaf
    von Essen, Louise
    Internet-based guided self-help for parents of children diagnosed with cancer: Long-term follow-up of a randomized controlled trial2016In: EABCT 2016 Abstract Book: Total Awareness, 2016, 470-470 p.Conference paper (Other academic)
    Abstract [en]

    Background: A considerable proportion of parents of children on cancer treatment experience distress such as symptoms of posttraumatic stress (PTSS), depression and anxiety. The purpose was to investigate the long-term efficacy of Internetbased guided self-help for these parents.

    Methods: 58 parents of children on cancer treatment (median months since diagnosis = 3) were randomized to receive 10 weeks of guided self-help via the Internet or to wait-list (intervention n = 31, wait-list n = 27). The intervention utilized principles from cognitive behavior therapy and included psychoeducation, relaxation training, coping with thoughts and feelings, problem solving, and emotional writing. Weekly support via e-mail was provided. Outcomes included PTSS (PCL-C), depression (BDI-II) and anxiety (BAI) and were assessed at pre and post intervention and at one-year follow-up.

    Results: 18 participants completed the intervention. 16 participants in the intervention condition and 16 participants in the wait-list condition participated in the one-year follow-up. Intention-to-treat analyses indicated significant time*group interactions for all three outcomes with reductions favoring the intervention group: PCL-C; F = 10.9, < .001, BDI-II; F = 12.0, < .001, BAI; F = 14.6, < .001. At the one-year follow-up there were large between-group effect sizes for all three outcomes (Cohens d 0.8 to 1.1).

    Conclusions: The high drop-out rate warrants caution in interpretation of the findings. However, Internet-based guided self-help may be an accessible alternative for some parents of children on cancer treatment and findings indicate that short-term efficacy can be maintained in the long term.

  • 40. Cernvall, Martin
    et al.
    Carlbring, Per
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Wikman, Anna
    Ljungman, Lisa
    Ljungman, Gustaf
    von Essen, Louise
    Twelve-Month Follow-Up of a Randomized Controlled Trial of Internet-Based Guided Self-Help for Parents of Children on Cancer Treatment2017In: Journal of Medical Internet Research, ISSN 1438-8871, E-ISSN 1438-8871, Vol. 19, no 7, e273Article in journal (Refereed)
    Abstract [en]

    Background: A substantial proportion of parents of children on cancer treatment report psychological distress such as symptoms of post-traumatic stress (PTSS), depression, and anxiety. During their child’s treatment many parents also experience an economic burden.

    Objective: The aim of this study was to evaluate the long-term efficacy of Internet-based guided self-help for parents of children on cancer treatment.

    Methods: This study was a parallel randomized controlled trial comparing a 10-week Internet-based guided self-help program, including weekly support from a therapist via encrypted email, with a wait-list control condition. The intervention was based on cognitive behavior therapy (CBT) and focused on psychoeducation and skills to cope with difficult thoughts and feelings. Primary outcome was self-reported PTSS. Secondary outcomes were self-reported symptoms of depression, anxiety, health care consumption, and sick leave during the past month. Outcomes were assessed pre- and postintervention and at 12-month follow-up. Parents of children on cancer treatment were invited by health care personnel at pediatric oncology centers, and parents meeting the modified symptom criteria on the PCL-C were included in the study. Self-report assessments were provided on the Web.

    Results: A total of 58 parents of children on cancer treatment (median months since diagnosis=3) were included in the study (intervention n=31 and control n=27). A total of 18 participants completed the intervention, and 16 participants in each group participated in the 12-month follow-up. Intention-to-treat analyses revealed significant effects in favor of the intervention on the primary outcome PTSS, with large between-group effect sizes at postassessment (d=0.89; 95% CI 0.35-1.43) and at 12-month follow-up (d=0.78; 95% CI 0.25-1.32). Significant effects in favor of the intervention on the secondary outcomes depression and anxiety were also observed. However, there was no evidence for intervention efficacy on health care consumption or sick leave.

    Conclusions: Using the Internet to provide psychological interventions shows promise as an effective mode of delivery for parents reporting an increased level of PTSS and who consider Internet-based interventions as a viable option. Future research should corroborate these findings and also develop and evaluate interventions and policies that may help ameliorate the economic burden that parents may face during their child’s treatment for cancer.

  • 41. Cernvall, Martin
    et al.
    Hovén, Emma
    Ljungman, Lisa
    Ljungman, Gustaf
    Carlbring, Per
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    von Essen, Louise
    Posttraumatic Stress and Attentional Bias towards Cancer-Related Stimuli in Parents of Children Recently Diagnosed with Cancer2016In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 11, no 4, e0152778Article in journal (Refereed)
    Abstract [en]

    Objectives To investigate whether posttraumatic stress symptoms (PTSS) are related to attentional bias towards cancer-related stimuli among parents of children recently diagnosed with cancer. Methods Sixty-two parents completed questionnaires measuring PTSS, depression, and anxiety and the emotional Stroop task via the Internet. The emotional Stroop task included cancer-related words, cardiovascular disease-related words, and neutral words. Results Participants were split in two groups based on the median of PTSS: High-PTSS and Low-PTSS. There was a significant interaction between word-type and group and a planned contrast test of this interaction indicated that the High-PTSS group had longer response latencies on cancer-related words compared to the other word-type and group combinations. Conclusions Findings suggest that PTSS are related to attentional bias towards cancer-related stimuli among parents of children recently diagnosed with cancer. Implications of this finding for the understanding of PTSS in this population, future research, and clinical practice are discussed.

  • 42. Cernvall, Martin
    et al.
    Skogseid, Ellen
    Carlbring, Per
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Ljungman, Lisa
    Ljungman, Gustaf
    von Essen, Louise
    Experiential avoidance and rumination in parents of children on cancer treatment: relationships with posttraumatic stress symptoms and symptoms of depression2016In: Journal of clinical psychology in medical settings, ISSN 1068-9583, E-ISSN 1573-3572, Vol. 23, no 1, 67-76 p.Article in journal (Refereed)
    Abstract [en]

    We conducted a cross-sectional survey study to investigate whether there is a relationship between experiential avoidance (EA), rumination, post-traumatic stress symptoms (PTSS), and symptoms of depression, in parents of children on cancer treatment. Data from 79 parents (55 mothers) of 79 children with a median of three months since their cancer diagnosis were included in cross-sectional analyses. EA and rumination were positively correlated with PTSS and symptoms of depression. EA and rumination did not provide incremental explained variance in PTSS over and above that explained by symptoms of depression, while controlling for symptoms of anxiety and demographic characteristics. However, EA and rumination provided incremental explained variance in symptoms of depression over and above that explained by PTSS, while controlling for symptoms of anxiety and demographic characteristics. Rumination and EA are important constructs in the understanding of PTSS and symptoms of depression in parents of children on cancer treatment. Future research should delineate the temporal relationships between these constructs.

  • 43. Clefberg Liberman, Lisa
    et al.
    Larsson, Karolina
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Paz Altuzarra, Maria
    Öst, Lars-Göran
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Ollendick, Thomas
    Self-reported Life Satisfaction and Response Style Differences Among Children in Chile and Sweden2015In: Journal of Child and Family Studies, ISSN 1062-1024, E-ISSN 1573-2843, Vol. 24, no 1, 66-75 p.Article in journal (Refereed)
    Abstract [en]

    The purpose of the current study was to assess self-perceived life satisfaction in Chilean and Swedish children. The total sample consisted of a non-clinical sample of 1,352 school children between 8 and 14 years of age. Analyses were carried out to compare the children's subjective quality of life and life satisfaction. In addition, possible response style differences across the two countries were explored. Based on our findings, no difference was found between the two countries for the total life satisfaction score, and the only area on which the Swedish children had a significantly higher rating than the Chilean children was on their satisfaction with their friends. However, the Chilean children reported a higher satisfaction with their siblings, school and health than the Swedish children. Moreover, an interaction effect was found between country and age group on the school variable, with the three age groups in the Swedish sample being significantly different, whereas no significant difference was found between the age groups on this variable among the Chilean children. Overall, the satisfaction with the children's different life areas decreased, as they grew older, whereas gender differences were only found on three variables. Small significant response style differences were found between the Chilean and Swedish children. As the effect sizes of these differences were quite small, they should be viewed with caution, and are not likely to explain the few differences found between the children. How I Feel about Things seems fully adequate for use across normal non-clinical boys and girls belonging to different age groups and living in different countries in order to assess their self-reported life satisfaction.

  • 44.
    Cortes, Diana
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Biological psychology.
    Laukka, Petri
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Cognitive psychology.
    Asperholm, Martin
    Fredborg, William
    Döllinger, Lillian
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Xiao, Shanshan
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Biological psychology.
    Högman, Lennart
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Biological psychology.
    Dang, Junhua
    Fischer, Håkan
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Biological psychology.
    Intranasal Oxytocin and Response Inhibition in Young and Older Adults2017Conference paper (Refereed)
    Abstract [en]

    In normal aging, people are confronted with impairment in both socioemotional and cognitive abilities. Specifically, there are age-related declines in inhibitory processes that regulate attention towards irrelevant material. In last years, the intranasal administration of the neuropeptide oxytocin has mainly been related to improvements in several domains such as emotion recognition and memory, but to date the effects of oxytocin in aging remain largely unknown. In a randomized, double blind, placebo controlled, within-subjects study design, we investigated whether oxytocin facilitates inhibitory processing in older adults compared to younger adults. In total, 41 older adults (51% women; age range 65-75 years) and 37 younger adults (49% women; age range 20-30 years) participated in this study two times, receiving a single intranasal dose of 40 IU of placebo and oxytocin in randomized order 45 minutes before engaging in the task. Participants were tested approximately a month apart and mostly at the same hour during both occasions. Inhibition was measured with a Go/NoGo task which included happy and neutral faces as targets (Go stimuli) and distractors (NoGo stimuli) shown on a computer screen. Participants were instructed to press a button any time they saw a target and remain passive when encountering a distractor. Preliminary results indicate effects for happy and neutral faces, but only in the distractor condition. For happy distractors, women rejected correctly happy faces more accurately than men did, both in the placebo and oxytocin conditions. A main effect of age was observed for the neutral distractors, where older adults were more successful in inhibiting responses than younger adults during oxytocin and placebo treatments. We did not observe effects of oxytocin in the different tasks. The role of oxytocin was not clear distinguished in the tasks. In sum, our findings showed that age and gender can influence inhibition but their effects depend on the displayed emotions. This suggests that the ability to inhibit interfering distractors may remain intact despite of age and that deficits in inhibition may be selective. The role of oxytocin in inhibition needs to be further investigated since it is possible that it is context dependent.

  • 45. Dahlin, Mats
    et al.
    Andersson, Gerhard
    Magnusson, Kristoffer
    Johansson, Tomas
    Sjögren, Johan
    Håkansson, Andreas
    Pettersson, Magnus
    Kadowaki, Åsa
    Cuijpers, Pim
    Carlbring, Per
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Internet-delivered acceptance-based behaviour therapy for generalized anxiety disorder: A randomized controlled trial2016In: Behaviour Research and Therapy, ISSN 0005-7967, E-ISSN 1873-622X, Vol. 77, 86-95 p.Article in journal (Refereed)
    Abstract [en]

    Generalized anxiety disorder (GAD) is a disabling condition which can be treated with cognitive behaviour therapy (CBT). The present study tested the effects of therapist-guided internet-delivered acceptance-based behaviour therapy on symptoms of GAD and quality of life. An audio CD with acceptance and mindfulness exercises and a separate workbook were also included in the treatment. Participants diagnosed with GAD (N = 103) were randomly allocated to immediate therapist-guided internet-delivered acceptance-based behaviour therapy or to a waiting-list control condition. A six month follow-up was also included. Results using hierarchical linear modelling showed moderate to large effects on symptoms of GAD (Cohen's d = 0.70 to 0.98), moderate effects on depressive symptoms (Cohen's d = 0.51 to 0.56), and no effect on quality of life. Follow-up data showed maintained effects. While there was a 20% dropout rate, sensitivity analyses showed that dropouts did not differ in their degree of change during treatment. To conclude, our study suggests that internet-delivered acceptance-based behaviour therapy can be effective in reducing the symptoms of GAD.

  • 46. Dahlin, Mats
    et al.
    Ryberg, Marielle
    Vernmark, Kristofer
    Annas, Nina
    Carlbring, Per
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Andersson, Gerhard
    Internet-delivered acceptance-based behavior therapy for generalized anxiety disorder: A pilot study2016In: Internet Interventions, ISSN 2214-7829, Vol. 6, 16-21 p.Article in journal (Refereed)
    Abstract [en]

    Objective: Internet-delivered cognitive behavior therapy (ICBT) has been developed and tested for treating persons with generalized anxiety disorder (GAD). A new form of CBT focuses on acceptance (of internal experiences or difficult psychological content), mindfulness and valued actions. To date this form of CBT has not been delivered via the internet for persons with GAD. The aim of this study was to describe the functionality of a new internet-delivered acceptance-based behavior therapy for GAD, and to test the effect of the intervention in an open pilot trial. Methods: Following exclusion of two patients we included 14 patients diagnosed with GAD from two primary care clinics. At 2–3 months follow-up after treatment 10 patients completed the outcome measures. The treatment lasted for an average of 15 weeks and consisted of acceptance-based techniques, behavior therapy components and homework assignments. Results: A majority of participants completed all modules during the treatment. Findings on the Penn State Worry Questionnaire showed a within-group improvement of Cohen's d = 2.14 at posttreatment. At the follow-up results were maintained. Client satisfaction ratings were high. Conclusions: We conclude that internet-delivered acceptance-based behavior therapy potentially can be a promising new treatment for GAD. A controlled trial of the program has already been completed.

  • 47. Danielsson, Katarina
    et al.
    Jansson Fröjmark, Markus
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Broman, Jan-Erik
    Markström, Agneta
    Cognitive Behavioral Therapy as an Adjunct Treatment to Light Therapy for Delayed Sleep Phase Disorder in Young Adults: A Randomized Controlled Feasibility Study2016In: Behavioral Sleep Medicine, ISSN 1540-2002, Vol. 14, no 2, 212-232 p.Article in journal (Refereed)
    Abstract [en]

    Delayed sleep phase disorder (DSPD) is common among young people, but there is still no evidence-based treatment available. In the present study, the feasibility of cognitive behavioral therapy (CBT) was evaluated as an additive treatment to light therapy (LT) in DSPD. A randomized controlled trial with participants aged 16 to 26 years received LT for two weeks followed by either four weeks of CBT or no treatment (NT). LT advanced sleep-wake rhythm in both groups. Comparing LT+CBT with LT+NT, no significant group differences were observed in the primary endpoints. Although anxiety and depression scores were low at pretreatment, they decreased significantly more in LT+CBT compared to LT+NT. The results are discussed and some suggestions are given for further studies.

  • 48. Danielsson, Katarina
    et al.
    Markström, Agneta
    Broman, Jan-Erik
    von Knorring, Lars
    Jansson-Fröjmark, Markus
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Delayed sleep phase disorder in a Swedish cohort of adolescents and young adults: Prevalence and associated factors2016In: Chronobiology International, ISSN 0742-0528, E-ISSN 1525-6073, Vol. 33, no 10, 1331-1339 p.Article in journal (Refereed)
    Abstract [en]

    A delayed sleep-wake and circadian rhythm often occurs during puberty. While some individuals only develop a delayed sleep phase (DSP), others will fulfill the criteria for the diagnosis of delayed sleep phase disorder (DSPD). All previous studies have however not separated DSP from DSPD, and, as a result, the prevalence and associated factors are largely unknown for the two conditions individually. We estimated the prevalence of DSP and DSPD in a Swedish cohort of adolescents and young adults. We also investigated associated factors in the two conditions relative to each other and individuals with no DSP. A questionnaire regarding sleep patterns, demographics, substance use/abuse and symptoms of depression, anxiety, worry and rumination was sent to 1000 randomly selected participants (16-26 years of age) in Uppsala, Sweden (response rate = 68%). DSP was defined as a late sleep onset and a preferred late wake-up time. The DSPD diagnosis was further operationalized according to the Diagnostic and Statistical Manual of Mental Disorders, Edition 5 (DSM-5) criteria including insomnia or excessive sleepiness, distress or dysfunction caused by the DSP and that the sleep problem had been evident for 3 months. DSP occurred at a frequency of 4.6% and DSPD at a frequency of 4% in the investigated cohort. DSP was more common in males and was associated with not attending educational activity or work, having shift work, nicotine and alcohol use and less rumination. DSPD was equally common in males and females and was associated with not attending educational activity or work and with elevated levels of anxiety. Both DSP and DSPD appear to be common in adolescents and young adults in this Swedish cohort. No educational activity or work was associated with both DSP and DSPD. However, there were also apparent differences between the two groups in shift work, substance use and mental health, relative to persons with no DSP. Thus, it seems reasonable to assess DSP and DSPD as distinct entities in future studies.

  • 49. Ebert, D. D.
    et al.
    Donkin, L.
    Andersson, G.
    Andrews, G.
    Berger, T.
    Carlbring, Per
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Rozental, Alexander
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Choi, I.
    Laferton, J. A. C.
    Johansson, R.
    Kleiboer, A.
    Lange, A.
    Lehr, D.
    Reins, J. A.
    Funk, B.
    Newby, J.
    Perini, S.
    Riper, H.
    Ruwaard, J.
    Sheeber, L.
    Snoek, F. J.
    Titov, N.
    Ünlü Ince, B.
    van Bastelaar, K.
    Vernmark, K.
    van Straten, A.
    Warmerdam, L.
    Salsman, N.
    Cuijpers, P.
    Does Internet-based guided-self-help for depression cause harm?: An individual participant data meta-analysis on deterioration rates and its moderators in randomized controlled trials2016In: Psychological Medicine, ISSN 0033-2917, E-ISSN 1469-8978, Vol. 46, no 13, 2679-2693 p.Article in journal (Refereed)
    Abstract [en]

    Almost nothing is known about the potential negative effects of Internet-based psychological treatments for depression. This study aims at investigating deterioration and its moderators within randomized trials on Internet-based guided self-help for adult depression, using an individual patient data meta-analyses (IPDMA) approach.

    Studies were identified through systematic searches (PubMed, PsycINFO, EMBASE, Cochrane Library). Deterioration in participants was defined as a significant symptom increase according to the reliable change index (i.e. 7.68 points in the CES-D; 7.63 points in the BDI). Two-step IPDMA procedures, with a random-effects model were used to pool data.

    A total of 18 studies (21 comparisons, 2079 participants) contributed data to the analysis. The risk for a reliable deterioration from baseline to post-treatment was significantly lower in the intervention v. control conditions (3.36 v. 7.60; relative risk 0.47, 95% confidence interval 0.29–0.75). Education moderated effects on deterioration, with patients with low education displaying a higher risk for deterioration than patients with higher education. Deterioration rates for patients with low education did not differ statistically significantly between intervention and control groups. The benefit–risk ratio for patients with low education indicated that 9.38 patients achieve a treatment response for each patient experiencing a symptom deterioration.

    Internet-based guided self-help is associated with a mean reduced risk for a symptom deterioration compared to controls. Treatment and symptom progress of patients with low education should be closely monitored, as some patients might face an increased risk for symptom deterioration. Future studies should examine predictors of deterioration in patients with low education.

  • 50. Fagernäs, Simon
    et al.
    Lindner, Philip
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Miloff, Alexander
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Andersen, Joel
    Sigeman, Martin
    Furmark, Tomas
    Andersson, Gerhard
    Carlbring, Per
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Moderating effects of presence and adherence in internetbased CBT with virtual reality exposure therapy for public speaking anxiety2017Conference paper (Refereed)
    Abstract [en]

    Introduction: Previous research has revealed that Virtual Reality Exposure Therapy (VRET) is an effective method for reducing symptoms of public speaking anxiety (PSA). Research about presence in the virtual environment indicates a moderating effect on physiological arousal, but more ambiguous effect on treatment effects where some research indicates a small effect while other indicate no effect. Furthermore, previous research has found adherence to home work assignments to moderate treatment outcome. In this treatment study which aimed for treating public speaking anxiety with VRET and a internetbased CBT-program, we investigated whether presence in the virtual environment and adherence to home work moderated treatment effects.

    Methods: N=25 adult participants from the general public with clinically significant PSA were recruited to a wait-list to another study. After five weeks on waitlist, they started the treatment with a self-guided in virtuo exposure session followed by a four week online maintenance promoting in-vivo exposure. Participants got a simple VR headset by post. The three-hour exposure session included psychoeducation in text, and the participants conducted speech exercises, framed as behavioral experiments targeting idiosyncratic catastrophic beliefs, in front of virtual audiences, and listening to audio recording afterwards. Primary outcome measure was self-reported PSA. To measure moderating effects of presence on the primary outcome measure a self-reported validated scale with subscales for presence (iGroup Presence Questionnaire, IPQ) were used, and for adherence a score were manually calculated based on the number of completed home-work assignments in both a linear model and a binary model dividing participants in two groups: one with at least one completed home work assignment and one with no completed home work assignment. The analysis on presence included both the effects of the VRET-session alone and in combination with the internetbased CBT-program. Data were analyzed using mixed effects modeling.

    Results: No significant results were found in moderating effects of presence with its subscales on the primary outcome measure for either the VRET-session (p = .375-.616) nor in combination with the internetbased CBT-program (p = .454 - .877). Moderating effects of adherence on primary outcome measure neither revealed no significant results in the linear model (p = .368) nor the binary model (p = .113).

    Conclusions: The findings of this study indicate, in line with some previous research, that presence in the virtual environment has no significant moderating effect on treatment outcome. Furthermore, in contrast to previous research, this study found no significant moderating effect on adherence to home work assignments on primary treatment outcome. Internal- and external validity and other potential explanations are discussed in detail in the poster.

1234 1 - 50 of 163
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf