Maarit Pelzer, Jessica Werthmann, Christian Fleischhaker, Jennifer Svaldi, B. Tuschen-Caffier
Background Anorexia Nervosa (AN) is a severe mental illness, which typically develops in adolescence and, if left untreated, often becomes chronic. Body dissatisfaction is a core characteristic of AN. Mirror exposure (ME) is an effective therapeutic technique to tackle body dissatisfaction in adult patients with eating disorders, but there is limited evidence for the effects of ME in adolescence. One potential mechanism underlying effects of ME on body dissatisfaction is change in body-related attention bias. However, this mechanism remains to be empirically tested. Accordingly, the aim of the current study is twofold: primarily, we aim to test if ME can reduce body dissatisfaction and associated symptoms in adolescent patients with AN. Additionally, we aim to investigate whether change in biased body-related attention due to ME is a possible mechanism of action. Method Adolescent patients with AN are randomized to either 12 sessions of ME (3 ME-sessions/week) or wait-list within four weeks. Main outcomes include body dissatisfaction and associated symptoms of AN. Moreover, body-related attention bias is assessed at baseline and post-treatment by means of eye-tracking with two paradigms. Further, process variables are collected weekly. In addition, 12 weeks after end of the study, the acceptability of the ME is assessed. Discussion The main aim of the study is to evaluate high-frequency and high-intense ME for treating body dissatisfaction in adolescents with AN. In addition, we would like to clarify whether change in attentional bias for body stimuli is a mechanism underlying change in body dissatisfaction due to ME.
背景 神经性厌食症（AN）是一种严重的精神疾病，通常在青春期发病，如果不及时治疗，往往会转为慢性病。身体不满意是厌食症的核心特征。镜像暴露（ME）是一种有效的治疗方法，可以解决成年进食障碍患者对身体不满意的问题，但对青少年进行镜像暴露的效果却证据有限。镜像暴露对身体不满意产生影响的一个潜在机制是改变与身体相关的注意偏差。然而，这一机制仍有待实证检验。因此，本研究的目的有两个：首先，我们旨在测试ME是否能减少青少年自闭症患者对身体的不满和相关症状。此外，我们还旨在研究ME是否会改变身体相关注意力的偏差，这可能是ME的作用机制之一。 方法 对患有AN的青少年患者进行随机分组，在四周内接受12次ME治疗（每周3次ME治疗）或等待治疗。主要结果包括身体不满意度和相关的AN症状。此外，在基线和治疗后，通过眼动追踪和两种范式评估与身体相关的注意力偏差。此外，每周还收集过程变量。此外，在研究结束 12 周后，还将对 ME 的可接受性进行评估。 讨论 本研究的主要目的是评估高频和高强度ME治疗AN青少年身体不满意的效果。此外，我们还希望阐明身体刺激的注意偏差变化是否是ME改变身体不满意度的内在机制。
{"title":"Mirror exposure training for adolescents with anorexia nervosa (MIRADAN): Cognitive mechanisms of body disturbance – A study protocol","authors":"Maarit Pelzer, Jessica Werthmann, Christian Fleischhaker, Jennifer Svaldi, B. Tuschen-Caffier","doi":"10.32872/cpe.11277","DOIUrl":"https://doi.org/10.32872/cpe.11277","url":null,"abstract":"\u0000 Background\u0000 Anorexia Nervosa (AN) is a severe mental illness, which typically develops in adolescence and, if left untreated, often becomes chronic. Body dissatisfaction is a core characteristic of AN. Mirror exposure (ME) is an effective therapeutic technique to tackle body dissatisfaction in adult patients with eating disorders, but there is limited evidence for the effects of ME in adolescence. One potential mechanism underlying effects of ME on body dissatisfaction is change in body-related attention bias. However, this mechanism remains to be empirically tested. Accordingly, the aim of the current study is twofold: primarily, we aim to test if ME can reduce body dissatisfaction and associated symptoms in adolescent patients with AN. Additionally, we aim to investigate whether change in biased body-related attention due to ME is a possible mechanism of action.\u0000 \u0000 \u0000 Method\u0000 Adolescent patients with AN are randomized to either 12 sessions of ME (3 ME-sessions/week) or wait-list within four weeks. Main outcomes include body dissatisfaction and associated symptoms of AN. Moreover, body-related attention bias is assessed at baseline and post-treatment by means of eye-tracking with two paradigms. Further, process variables are collected weekly. In addition, 12 weeks after end of the study, the acceptability of the ME is assessed.\u0000 \u0000 \u0000 Discussion\u0000 The main aim of the study is to evaluate high-frequency and high-intense ME for treating body dissatisfaction in adolescents with AN. In addition, we would like to clarify whether change in attentional bias for body stimuli is a mechanism underlying change in body dissatisfaction due to ME.\u0000","PeriodicalId":34029,"journal":{"name":"Clinical Psychology in Europe","volume":"34 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138946938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Well-defined measures of therapeutic benefit are essential for evaluating therapies and services. However, there is no single gold standard for defining ‘successful’ outcomes. We therefore examined the potential impact of adopting different success criteria. Method We analysed data for 7,064 patients undergoing psychological therapy in a single UK IAPT (Increasing Access to Psychological Therapy) Service, each patient being assessed for depression (PHQ-9) and anxiety (GAD-7) both at the start and end of treatment. Predictors of successful outcomes based on these measures were analysed separately for three different success criteria: based either on assessing clinically significant change, or reliable change, in depression and anxiety. Results The choice of criteria had little bearing on which variables predicted successful outcomes. However, the direction of the relationship between initial PHQ-9 or GAD-7 score and outcome success reverses when the criteria used to judge success are changed: successful outcomes are less probable under clinically significant change criteria for patients entering the service with more severe depression and/or anxiety but are more probable for such patients under reliable change criteria. Conclusion Relevant for clinicians, researchers, and policymakers, the choice of success criteria adopted can substantially change the incentives for patient selection into a therapy service. Our analysis highlights how the methods used to evaluate treatment outcomes could impact the priorities and organisation of therapeutic services, which could then impact on who is offered treatment. We recommend further investigations of success criteria in other conditions or treatments to determine the reproducibility of the effects we found.
{"title":"How and why the choice of success criteria can impact therapy service delivery: A worked example from a psychological therapy service for anxiety and depression","authors":"Mark H. Wheeler, S. Orbell, Tim Rakow","doi":"10.32872/cpe.10237","DOIUrl":"https://doi.org/10.32872/cpe.10237","url":null,"abstract":"\u0000 Background\u0000 Well-defined measures of therapeutic benefit are essential for evaluating therapies and services. However, there is no single gold standard for defining ‘successful’ outcomes. We therefore examined the potential impact of adopting different success criteria.\u0000 \u0000 \u0000 Method\u0000 We analysed data for 7,064 patients undergoing psychological therapy in a single UK IAPT (Increasing Access to Psychological Therapy) Service, each patient being assessed for depression (PHQ-9) and anxiety (GAD-7) both at the start and end of treatment. Predictors of successful outcomes based on these measures were analysed separately for three different success criteria: based either on assessing clinically significant change, or reliable change, in depression and anxiety.\u0000 \u0000 \u0000 Results\u0000 The choice of criteria had little bearing on which variables predicted successful outcomes. However, the direction of the relationship between initial PHQ-9 or GAD-7 score and outcome success reverses when the criteria used to judge success are changed: successful outcomes are less probable under clinically significant change criteria for patients entering the service with more severe depression and/or anxiety but are more probable for such patients under reliable change criteria.\u0000 \u0000 \u0000 Conclusion\u0000 Relevant for clinicians, researchers, and policymakers, the choice of success criteria adopted can substantially change the incentives for patient selection into a therapy service. Our analysis highlights how the methods used to evaluate treatment outcomes could impact the priorities and organisation of therapeutic services, which could then impact on who is offered treatment. We recommend further investigations of success criteria in other conditions or treatments to determine the reproducibility of the effects we found.\u0000","PeriodicalId":34029,"journal":{"name":"Clinical Psychology in Europe","volume":"23 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138947069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Helen Niemeyer, Christine Knaevelsrud, Robbie C. M. van Aert, Thomas Ehring
Background It is a precondition for evidence-based practice that research is replicable in a wide variety of clinical settings. Current standards for identifying evidence-based psychological interventions and making recommendations for clinical practice in clinical guidelines include criteria that are relevant for replicability, but a better understanding as well refined definitions of replicability are needed enabling empirical research on this topic. Recent advances on this issue were made in the wider field of psychology and in other disciplines, which offers the opportunity to define and potentially increase replicability also in research on psychological interventions. Method This article proposes a research strategy for assessing, understanding, and improving replicability in research on psychological interventions. Results/Conclusion First, we establish a replication taxonomy ranging from direct to conceptual replication adapted to the field of research on clinical interventions, propose study characteristics that increase the trustworthiness of results, and define statistical criteria for successful replication with respect to the quantitative outcomes of the original and replication studies. Second, we propose how to establish such standards for future research, i.e., in order to design future replication studies for psychological interventions as well as to apply them when investigating which factors are causing the (non-)replicability of findings in the current literature.
{"title":"Research into evidence-based psychological interventions needs a stronger focus on replicability","authors":"Helen Niemeyer, Christine Knaevelsrud, Robbie C. M. van Aert, Thomas Ehring","doi":"10.32872/cpe.9997","DOIUrl":"https://doi.org/10.32872/cpe.9997","url":null,"abstract":"<sec xmlns=\"http://www.ncbi.nlm.nih.gov/JATS1\"> <title>Background</title> It is a precondition for evidence-based practice that research is replicable in a wide variety of clinical settings. Current standards for identifying evidence-based psychological interventions and making recommendations for clinical practice in clinical guidelines include criteria that are relevant for replicability, but a better understanding as well refined definitions of replicability are needed enabling empirical research on this topic. Recent advances on this issue were made in the wider field of psychology and in other disciplines, which offers the opportunity to define and potentially increase replicability also in research on psychological interventions. </sec> <sec xmlns=\"http://www.ncbi.nlm.nih.gov/JATS1\"> <title>Method</title> This article proposes a research strategy for assessing, understanding, and improving replicability in research on psychological interventions. </sec> <sec xmlns=\"http://www.ncbi.nlm.nih.gov/JATS1\"> <title>Results/Conclusion</title> First, we establish a replication taxonomy ranging from direct to conceptual replication adapted to the field of research on clinical interventions, propose study characteristics that increase the trustworthiness of results, and define statistical criteria for successful replication with respect to the quantitative outcomes of the original and replication studies. Second, we propose how to establish such standards for future research, i.e., in order to design future replication studies for psychological interventions as well as to apply them when investigating which factors are causing the (non-)replicability of findings in the current literature. </sec>","PeriodicalId":34029,"journal":{"name":"Clinical Psychology in Europe","volume":"84 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135133240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mari Hysing, Keith J. Petrie, Allison G. Harvey, Kari-Jussie Lønning, Børge Sivertsen
Background There is evidence of increasing levels of loneliness in Norwegian young people before the COVID-19 pandemic. It is not clear how the COVID-19 pandemic, and the associated necessary restrictions, impacted on these trends. Aims To examine how loneliness in young people changed across the pandemic, how loneliness relates to demographic characteristics and how different pandemic restrictions impacted loneliness. Method We analyzed data from three waves of a Norwegian national higher education student survey (the SHoT-study). Data was examined from 2018 from a total of 49,836 students, 2021 from 62,212 students, and from 2022 from 53,362 (response rates 31-35%). Loneliness was measured by “The Three-Item Loneliness Scale” (T-ILS). Results There was a sharp increase in loneliness from 2018 to 2021, and a reduction in levels of loneliness in 2022, although at increased levels compared to prior to the pandemic. Females consistently report higher levels of loneliness than males, with a larger difference during the peak of the pandemic. There were higher rates of loneliness in geographical regions with higher COVID rates and greater pandemic-related restrictions during 2021. Loneliness was lower among students reporting more days on campus in 2021 and for those with lectures on campus in 2022, both with dose-response associations. Conclusions Loneliness is a major public health problem among young adults in higher education. Loneliness increased during the pandemic and has decreased but is still not back to pre-pandemic levels. The results suggest the importance of open campuses and in-person lectures, for increased social connectedness among young people.
{"title":"Loneliness across the COVID-19 pandemic: Risk factors in Norwegian young people","authors":"Mari Hysing, Keith J. Petrie, Allison G. Harvey, Kari-Jussie Lønning, Børge Sivertsen","doi":"10.32872/cpe.10483","DOIUrl":"https://doi.org/10.32872/cpe.10483","url":null,"abstract":"<sec xmlns=\"http://www.ncbi.nlm.nih.gov/JATS1\"> <title>Background</title> There is evidence of increasing levels of loneliness in Norwegian young people before the COVID-19 pandemic. It is not clear how the COVID-19 pandemic, and the associated necessary restrictions, impacted on these trends. </sec> <sec xmlns=\"http://www.ncbi.nlm.nih.gov/JATS1\"> <title>Aims</title> To examine how loneliness in young people changed across the pandemic, how loneliness relates to demographic characteristics and how different pandemic restrictions impacted loneliness. </sec> <sec xmlns=\"http://www.ncbi.nlm.nih.gov/JATS1\"> <title>Method</title> We analyzed data from three waves of a Norwegian national higher education student survey (the SHoT-study). Data was examined from 2018 from a total of 49,836 students, 2021 from 62,212 students, and from 2022 from 53,362 (response rates 31-35%). Loneliness was measured by “The Three-Item Loneliness Scale” (T-ILS). </sec> <sec xmlns=\"http://www.ncbi.nlm.nih.gov/JATS1\"> <title>Results</title> There was a sharp increase in loneliness from 2018 to 2021, and a reduction in levels of loneliness in 2022, although at increased levels compared to prior to the pandemic. Females consistently report higher levels of loneliness than males, with a larger difference during the peak of the pandemic. There were higher rates of loneliness in geographical regions with higher COVID rates and greater pandemic-related restrictions during 2021. Loneliness was lower among students reporting more days on campus in 2021 and for those with lectures on campus in 2022, both with dose-response associations. </sec> <sec xmlns=\"http://www.ncbi.nlm.nih.gov/JATS1\"> <title>Conclusions</title> Loneliness is a major public health problem among young adults in higher education. Loneliness increased during the pandemic and has decreased but is still not back to pre-pandemic levels. The results suggest the importance of open campuses and in-person lectures, for increased social connectedness among young people. </sec>","PeriodicalId":34029,"journal":{"name":"Clinical Psychology in Europe","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135133389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Julia Asbrand, Tanja Michael, Hanna Christiansen, Gerhard Reese
The rock band Fury in the slaughterhouse sang that “every generation got its own disease”, however, remaining in that wording, the current generation of children and adolescents in Europe has to cope with several severe “diseases” at the same time: the war of Russia against Ukraine, the social and mental health consequences of the Covid-19-pandemic, the economic downturn, societal polarization, and last but not least, the twin crises of biodiversity loss and climate change. Each of these crises have visible and measurable consequences, and some crises mutually reinforce each other. The climate crisis, for instance, has already brought irreversible damage to some societies and natural habitats around the world. According to the Intergovernmental Panel on Climate Change (IPCC, 2023), weather phenomena such as droughts, storms and floods will become more likely and more intense. It is estimated that people who are born today will experience heat waves up to seven times more often than people who are in their forties to sixties today (Thiery et al., 2021). Furthermore, climate change is linked to macroeconomic consequences negatively affect ing the economic situations of states and individuals and is thus a driving force behind increasing poverty (e.g., Kotz et al., 2021). The climate crisis also accelerates biodiversity loss. Further, both environmental degradation as well as climate change undermine peace and increase the likelihood for conflict between groups, representing additional stressors for development both on an individual and a societal level (e.g., Palmer, 2022). Unsurpris ingly, a recent meta-analysis shows that climate events are negatively correlated with mental health (Cuijpers et al., 2023), and a recent review demonstrates that the risk for
{"title":"Growing (up) in times of multiple crises – A call for mental health (research) action","authors":"Julia Asbrand, Tanja Michael, Hanna Christiansen, Gerhard Reese","doi":"10.32872/cpe.12713","DOIUrl":"https://doi.org/10.32872/cpe.12713","url":null,"abstract":"The rock band Fury in the slaughterhouse sang that “every generation got its own disease”, however, remaining in that wording, the current generation of children and adolescents in Europe has to cope with several severe “diseases” at the same time: the war of Russia against Ukraine, the social and mental health consequences of the Covid-19-pandemic, the economic downturn, societal polarization, and last but not least, the twin crises of biodiversity loss and climate change. Each of these crises have visible and measurable consequences, and some crises mutually reinforce each other. The climate crisis, for instance, has already brought irreversible damage to some societies and natural habitats around the world. According to the Intergovernmental Panel on Climate Change (IPCC, 2023), weather phenomena such as droughts, storms and floods will become more likely and more intense. It is estimated that people who are born today will experience heat waves up to seven times more often than people who are in their forties to sixties today (Thiery et al., 2021). Furthermore, climate change is linked to macroeconomic consequences negatively affect ing the economic situations of states and individuals and is thus a driving force behind increasing poverty (e.g., Kotz et al., 2021). The climate crisis also accelerates biodiversity loss. Further, both environmental degradation as well as climate change undermine peace and increase the likelihood for conflict between groups, representing additional stressors for development both on an individual and a societal level (e.g., Palmer, 2022). Unsurpris ingly, a recent meta-analysis shows that climate events are negatively correlated with mental health (Cuijpers et al., 2023), and a recent review demonstrates that the risk for","PeriodicalId":34029,"journal":{"name":"Clinical Psychology in Europe","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135132829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maria Kleinstäuber, Andreas Schröder, Sarah Daehler, Karen Johanne Pallesen, Charlotte U. Rask, Mathias Sanyer, Omer Van den Bergh, Marie Weinreich Petersen, Judith G. M. Rosmalen
Background This umbrella review systematically assesses the variety and relative dominance of current aetiological views within the scientific literature for the three most investigated symptom-defined functional somatic syndromes (FSS) and their classificatory analogues within psychiatry and psychology. Method An umbrella review of narrative and systematic reviews with and without meta-analyses based on a search of electronic databases (PubMed, Web of Science, Embase, PsychINFO) was conducted. Eligible reviews were published in English, focused on research of any kind of aetiological factors in adults diagnosed with fibromyalgia syndrome (FMS), irritable bowel syndrome (IBS), chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME), and somatic symptom disorder (SSD)/somatoform disorder (SFD). Results We included 452 reviews (132 systematic reviews including meta-analyses, 133 systematic reviews, 197 narrative reviews), of which 132 (29%) focused on two or more of the investigated health conditions simultaneously. Across diagnoses, biological factors were addressed in 90% (k = 405), psychological in 33% (k = 150), social in 12% (k = 54), and healthcare factors in 5% (k = 23) of the reviews. The methodological quality of the included systematic reviews (k = 255) was low (low/critically low: 41% [k = 104]; moderate: 49% [k = 126]; high quality: 10% [k = 25]). The high-quality systematic reviews suggest that deficient conditioned pain modulation, genetic factors, changes in the immune, endocrinological, gastrointestinal, cardiovascular, and nervous system, and psychosocial factors such as sexual abuse and pain catastrophizing increase the risk for FSS. Conclusion Only very few systematic reviews have used comprehensive, biopsychosocial disease models to guide the selection of aetiological factors in FSS research. Future research should strive for higher scientific standards and broaden its perspective on these health conditions.
{"title":"Aetiological understanding of fibromyalgia, irritable bowel syndrome, chronic fatigue syndrome and classificatory analogues: A systematic umbrella review","authors":"Maria Kleinstäuber, Andreas Schröder, Sarah Daehler, Karen Johanne Pallesen, Charlotte U. Rask, Mathias Sanyer, Omer Van den Bergh, Marie Weinreich Petersen, Judith G. M. Rosmalen","doi":"10.32872/cpe.11179","DOIUrl":"https://doi.org/10.32872/cpe.11179","url":null,"abstract":"<sec xmlns=\"http://www.ncbi.nlm.nih.gov/JATS1\"> <title>Background</title> This umbrella review systematically assesses the variety and relative dominance of current aetiological views within the scientific literature for the three most investigated symptom-defined functional somatic syndromes (FSS) and their classificatory analogues within psychiatry and psychology. </sec> <sec xmlns=\"http://www.ncbi.nlm.nih.gov/JATS1\"> <title>Method</title> An umbrella review of narrative and systematic reviews with and without meta-analyses based on a search of electronic databases (PubMed, Web of Science, Embase, PsychINFO) was conducted. Eligible reviews were published in English, focused on research of any kind of aetiological factors in adults diagnosed with fibromyalgia syndrome (FMS), irritable bowel syndrome (IBS), chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME), and somatic symptom disorder (SSD)/somatoform disorder (SFD). </sec> <sec xmlns=\"http://www.ncbi.nlm.nih.gov/JATS1\"> <title>Results</title> We included 452 reviews (132 systematic reviews including meta-analyses, 133 systematic reviews, 197 narrative reviews), of which 132 (29%) focused on two or more of the investigated health conditions simultaneously. Across diagnoses, biological factors were addressed in 90% (k = 405), psychological in 33% (k = 150), social in 12% (k = 54), and healthcare factors in 5% (k = 23) of the reviews. The methodological quality of the included systematic reviews (k = 255) was low (low/critically low: 41% [k = 104]; moderate: 49% [k = 126]; high quality: 10% [k = 25]). The high-quality systematic reviews suggest that deficient conditioned pain modulation, genetic factors, changes in the immune, endocrinological, gastrointestinal, cardiovascular, and nervous system, and psychosocial factors such as sexual abuse and pain catastrophizing increase the risk for FSS. </sec> <sec xmlns=\"http://www.ncbi.nlm.nih.gov/JATS1\"> <title>Conclusion</title> Only very few systematic reviews have used comprehensive, biopsychosocial disease models to guide the selection of aetiological factors in FSS research. Future research should strive for higher scientific standards and broaden its perspective on these health conditions. </sec>","PeriodicalId":34029,"journal":{"name":"Clinical Psychology in Europe","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135132697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anton Käll, Cecilia Olsson Lynch, Kajsa Sundling, Tomas Furmark, Per Carlbring, Gerhard Andersson
Objectives Clinician-supported internet-delivered cognitive behavioral therapy (ICBT) can be an effective treatment option when treating social anxiety disorder (SAD). Unguided ICBT is often found to be less effective. One possible solution to reduce the costs of clinician support is to provide support on demand. In this format of guidance, participants have the option to contact their clinician if needed. In a few studies, this mode of support has been compared favorably to scheduled support. Method Participants in a previously reported controlled trial on SAD who had been in a waitlist control group were randomly allocated to ICBT with either on-demand guidance or scheduled weekly therapist guidance. A total of 99 participants were included. Data were collected weekly on the primary outcome measure, the Liebowitz Social Anxiety Scale self-report (LSAS-SR), and at pre- and post-treatment for secondary measures. Data were analyzed in accordance with the intention-to-treat principle using mixed-effects models. Results Both groups improved significantly during the treatment according to the LSAS-SR ratings. The groups did not differ in their estimated change during the treatment period, with a between-group effect of d = 0.02, 95% CI [-0.37, 0.43]. Both groups experienced similar improvement also on the secondary outcome measures, with small between-group effect sizes on all outcomes. Conclusions The findings indicate that support on demand can be an effective way of providing guidance in ICBT for SAD, although more research on this topic is needed. A limitation of the study is that it was conducted in 2009, and the findings were in the file drawer. Subsequent published studies support our initial findings, but more research is needed.
{"title":"Scheduled support versus support on demand in internet-delivered cognitive behavioral therapy for social anxiety disorder: Randomized controlled trial","authors":"Anton Käll, Cecilia Olsson Lynch, Kajsa Sundling, Tomas Furmark, Per Carlbring, Gerhard Andersson","doi":"10.32872/cpe.11379","DOIUrl":"https://doi.org/10.32872/cpe.11379","url":null,"abstract":"<sec xmlns=\"http://www.ncbi.nlm.nih.gov/JATS1\"> <title>Objectives</title> Clinician-supported internet-delivered cognitive behavioral therapy (ICBT) can be an effective treatment option when treating social anxiety disorder (SAD). Unguided ICBT is often found to be less effective. One possible solution to reduce the costs of clinician support is to provide support on demand. In this format of guidance, participants have the option to contact their clinician if needed. In a few studies, this mode of support has been compared favorably to scheduled support. </sec> <sec xmlns=\"http://www.ncbi.nlm.nih.gov/JATS1\"> <title>Method</title> Participants in a previously reported controlled trial on SAD who had been in a waitlist control group were randomly allocated to ICBT with either on-demand guidance or scheduled weekly therapist guidance. A total of 99 participants were included. Data were collected weekly on the primary outcome measure, the Liebowitz Social Anxiety Scale self-report (LSAS-SR), and at pre- and post-treatment for secondary measures. Data were analyzed in accordance with the intention-to-treat principle using mixed-effects models. </sec> <sec xmlns=\"http://www.ncbi.nlm.nih.gov/JATS1\"> <title>Results</title> Both groups improved significantly during the treatment according to the LSAS-SR ratings. The groups did not differ in their estimated change during the treatment period, with a between-group effect of d = 0.02, 95% CI [-0.37, 0.43]. Both groups experienced similar improvement also on the secondary outcome measures, with small between-group effect sizes on all outcomes. </sec> <sec xmlns=\"http://www.ncbi.nlm.nih.gov/JATS1\"> <title>Conclusions</title> The findings indicate that support on demand can be an effective way of providing guidance in ICBT for SAD, although more research on this topic is needed. A limitation of the study is that it was conducted in 2009, and the findings were in the file drawer. Subsequent published studies support our initial findings, but more research is needed. </sec>","PeriodicalId":34029,"journal":{"name":"Clinical Psychology in Europe","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135132830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jakob Fink-Lamotte, Jürgen Hoyer, Pauline Platter, Christian Stierle, Cornelia Exner
Background Shame is considered an important factor in the development and maintenance of many psychological disorders, e.g., social anxiety disorder, and an interesting target point for therapeutic intervention. Method In the present experimental study, we used an online-adopted Autobiographical Emotional Memory Task (AEMT) to induce shame and tested different micro-interventions (self-compassion, cognitive reappraisal, and a control intervention) with respect to their potential to reduce shame intensity. One-hundred-and-fifteen healthy subjects participated in the study and completed a series of self-report questionnaires on self-compassion, shame, and social anxiety. Results The experimental shame induction was well accepted and successful (with significantly heightened feelings of shame); there were no study drop-outs. There was a significant time*condition interaction, which was due the self-compassion-based intervention resulting in a significantly larger reduction of shame than the control condition (counting fishes). In addition, the main effect of the factor experimental condition was further moderated (enhanced) by trait social anxiety and trait self-compassion. Conclusion The findings demonstrate the usefulness of online-adopted AEMT for the experimental induction of shame. They suggest that especially self-compassion interventions can be beneficial in alleviating intense shame experiences, which is in accordance with self-compassion theory. Overall, the results are promising in the context of experimental shame research and its potential clinical impacts call for further replication.
{"title":"Shame on me? Love me tender! Inducing and reducing shame and fear in social anxiety in an analogous sample","authors":"Jakob Fink-Lamotte, Jürgen Hoyer, Pauline Platter, Christian Stierle, Cornelia Exner","doi":"10.32872/cpe.7895","DOIUrl":"https://doi.org/10.32872/cpe.7895","url":null,"abstract":"<sec xmlns=\"http://www.ncbi.nlm.nih.gov/JATS1\"> <title>Background</title> Shame is considered an important factor in the development and maintenance of many psychological disorders, e.g., social anxiety disorder, and an interesting target point for therapeutic intervention. </sec> <sec xmlns=\"http://www.ncbi.nlm.nih.gov/JATS1\"> <title>Method</title> In the present experimental study, we used an online-adopted Autobiographical Emotional Memory Task (AEMT) to induce shame and tested different micro-interventions (self-compassion, cognitive reappraisal, and a control intervention) with respect to their potential to reduce shame intensity. One-hundred-and-fifteen healthy subjects participated in the study and completed a series of self-report questionnaires on self-compassion, shame, and social anxiety. </sec> <sec xmlns=\"http://www.ncbi.nlm.nih.gov/JATS1\"> <title>Results</title> The experimental shame induction was well accepted and successful (with significantly heightened feelings of shame); there were no study drop-outs. There was a significant time*condition interaction, which was due the self-compassion-based intervention resulting in a significantly larger reduction of shame than the control condition (counting fishes). In addition, the main effect of the factor experimental condition was further moderated (enhanced) by trait social anxiety and trait self-compassion. </sec> <sec xmlns=\"http://www.ncbi.nlm.nih.gov/JATS1\"> <title>Conclusion</title> The findings demonstrate the usefulness of online-adopted AEMT for the experimental induction of shame. They suggest that especially self-compassion interventions can be beneficial in alleviating intense shame experiences, which is in accordance with self-compassion theory. Overall, the results are promising in the context of experimental shame research and its potential clinical impacts call for further replication. </sec>","PeriodicalId":34029,"journal":{"name":"Clinical Psychology in Europe","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135132832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Eiko I. Fried, Ricarda K. K. Proppert, Carlotta L. Rieble
Background Depression is common, debilitating, often chronic, and affects young people disproportionately. Given that only 50% of patients improve under initial treatment, experts agree that prevention is the most effective way to change depression’s global disease burden. The biggest barrier to successful prevention is to identify individuals at risk for depression in the near future. To close this gap, this protocol paper introduces the WARN-D study, our effort to build a personalized early warning system for depression. Method To develop the system, we follow around 2,000 students over 2 years. Stage 1 comprises an extensive baseline assessment in which we collect a broad set of predictors for depression. Stage 2 lasts 3 months and zooms into participants’ daily experiences that may predict depression; we use smartwatches to collect digital phenotype data such as sleep and activity, and we use a smartphone app to query participants about their experiences 4 times a day and once every Sunday. In Stage 3, we follow participants for 21 months, assessing transdiagnostic outcomes (including stress, functional impairment, anxiety, and depression) as well as additional predictors for future depression every 3 months. Collected data will be utilized to build a personalized prediction model for depression onset. Discussion Overall, WARN-D will function similarly to a weather forecast, with the core difference that one can only seek shelter from a thunderstorm and clean up afterwards, while depression may be successfully prevented before it occurs.
{"title":"Building an early warning system for depression: Rationale, objectives, and methods of the WARN-D study","authors":"Eiko I. Fried, Ricarda K. K. Proppert, Carlotta L. Rieble","doi":"10.32872/cpe.10075","DOIUrl":"https://doi.org/10.32872/cpe.10075","url":null,"abstract":"Background\u0000 Depression is common, debilitating, often chronic, and affects young people disproportionately. Given that only 50% of patients improve under initial treatment, experts agree that prevention is the most effective way to change depression’s global disease burden. The biggest barrier to successful prevention is to identify individuals at risk for depression in the near future. To close this gap, this protocol paper introduces the WARN-D study, our effort to build a personalized early warning system for depression.\u0000 \u0000 \u0000 Method\u0000 To develop the system, we follow around 2,000 students over 2 years. Stage 1 comprises an extensive baseline assessment in which we collect a broad set of predictors for depression. Stage 2 lasts 3 months and zooms into participants’ daily experiences that may predict depression; we use smartwatches to collect digital phenotype data such as sleep and activity, and we use a smartphone app to query participants about their experiences 4 times a day and once every Sunday. In Stage 3, we follow participants for 21 months, assessing transdiagnostic outcomes (including stress, functional impairment, anxiety, and depression) as well as additional predictors for future depression every 3 months. Collected data will be utilized to build a personalized prediction model for depression onset.\u0000 \u0000 \u0000 Discussion\u0000 Overall, WARN-D will function similarly to a weather forecast, with the core difference that one can only seek shelter from a thunderstorm and clean up afterwards, while depression may be successfully prevented before it occurs.","PeriodicalId":34029,"journal":{"name":"Clinical Psychology in Europe","volume":"2015 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135133384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background This report presents the single case of Jack, a 67-year-old referred to our Older Adult Community Mental Health Team (OA CMHT) for his distressing persecutory delusion and high levels of worry. Jack also reported learning difficulties and autistic traits, although neither were formally diagnosed. Method Ten sessions of worry intervention taken from The Feeling Safe Programme worry module were used to reduce Jack’s time spent worrying and increase his engagement in meaningful activity. Weekly face-to-face sessions were held, with Jack’s brother acting as a co-therapist. Adaptations to the intervention were made based on Jack’s learning preferences. An AB single case experimental design was adopted to compare Jack’s scores on measures of worry, paranoia and delusional conviction, and wellbeing and daily functioning before and after intervention. Results Results demonstrate the worry intervention improved Jack’s scores on all measures to a clinically significant degree. Conclusions This is the first known report of applying the worry intervention to an older adult. The results show the intervention can be of considerable benefit in terms of reducing worry and paranoia, in the context of both older age and suspected neurodiversity.
{"title":"Worry intervention in an older adult with a persecutory delusion: A single case experimental design","authors":"Poppy Brown, Anna Crabtree","doi":"10.32872/cpe.11173","DOIUrl":"https://doi.org/10.32872/cpe.11173","url":null,"abstract":"<sec xmlns=\"http://www.ncbi.nlm.nih.gov/JATS1\"> <title>Background</title> This report presents the single case of Jack, a 67-year-old referred to our Older Adult Community Mental Health Team (OA CMHT) for his distressing persecutory delusion and high levels of worry. Jack also reported learning difficulties and autistic traits, although neither were formally diagnosed. </sec> <sec xmlns=\"http://www.ncbi.nlm.nih.gov/JATS1\"> <title>Method</title> Ten sessions of worry intervention taken from The Feeling Safe Programme worry module were used to reduce Jack’s time spent worrying and increase his engagement in meaningful activity. Weekly face-to-face sessions were held, with Jack’s brother acting as a co-therapist. Adaptations to the intervention were made based on Jack’s learning preferences. An AB single case experimental design was adopted to compare Jack’s scores on measures of worry, paranoia and delusional conviction, and wellbeing and daily functioning before and after intervention. </sec> <sec xmlns=\"http://www.ncbi.nlm.nih.gov/JATS1\"> <title>Results</title> Results demonstrate the worry intervention improved Jack’s scores on all measures to a clinically significant degree. </sec> <sec xmlns=\"http://www.ncbi.nlm.nih.gov/JATS1\"> <title>Conclusions</title> This is the first known report of applying the worry intervention to an older adult. The results show the intervention can be of considerable benefit in terms of reducing worry and paranoia, in the context of both older age and suspected neurodiversity. </sec>","PeriodicalId":34029,"journal":{"name":"Clinical Psychology in Europe","volume":"2015 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135133388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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