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Individually Tailored Internet-Based Treatment for Young Adults and Adults With Panic Attacks: Randomized Controlled Trial
Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
Umeå University, Sweden .
Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
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2012 (English)In: Journal of Medical Internet Research, ISSN 1438-8871, E-ISSN 1438-8871, Vol. 14, no 3, 32-44 p.Article in journal (Refereed) Published
Abstract [en]

Background: Previous studies on Internet-based treatment with minimal therapist guidance have shown promising results for several specific diagnoses. Objective: To 91) investigate the effects of a tailored, therapist-guided, Internet-based treatment for individuals with reoccurring panic attacks, and 92) to examine whether people in different age groups 918-30 years and 31-45 years) would respond differently to the treatment. Methods: We recruited 149 participants from an online list of individuals having expressed an interest in Internet treatment. Screening consisted of online questionnaires followed by a telephone interview. A total of 57 participants were included after a semistructured diagnostic interview, and they were randomly assigned to an 8-week treatment program 9n = 29) or to a control condition 9n = 28). Treatment consisted of individually prescribed cognitive behavior therapy text modules in conjunction with online therapist guidance. The control group consisted of people on a waitlist who later received treatment. Results: All dependent measures improved significantly immediately following treatment and at the 12-month follow-up. The between-group effect size on the primary outcome measure, the Panic Disorder Severity Scale, was d = 1.41 995% confidence interval 0.81-1.95) at posttreatment. The within-group effect size from pretreatment to 12-month follow-up was d = 1.66 995% confidence interval 1.14-2.35). Age group had no effect, suggesting that age did not influence the outcome. Conclusions: Tailoring an Internet-based treatment can be a feasible approach in the treatment of panic symptoms and comorbid anxiety and depressive symptoms. Younger adults benefit as much as adults over 30 years and up to 45 years of age.

Place, publisher, year, edition, pages
Journal of Medical Internet Research , 2012. Vol. 14, no 3, 32-44 p.
Keyword [en]
Anxiety; depression; effectiveness; Internet-based treatment; cognitive behavior therapy
National Category
Social Sciences
Identifiers
URN: urn:nbn:se:liu:diva-79782DOI: 10.2196/jmir.1853ISI: 000305797300003OAI: oai:DiVA.org:liu-79782DiVA: diva2:545013
Available from: 2012-08-17 Created: 2012-08-14 Last updated: 2017-12-07
In thesis
1. Individually tailored internet-based cognitive behavioural therapy for adolescents, young adults and older adults with anxiety
Open this publication in new window or tab >>Individually tailored internet-based cognitive behavioural therapy for adolescents, young adults and older adults with anxiety
2017 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Anxiety disorders share the feature of excessive fear, anxiety and related behavioural disturbances. Fear is defined as the emotional response to a real or a perceived imminent threat and anxiety is the anticipation of a future threat. The anxiety disorders covered in this thesis are panic disorder with or without agoraphobia, social phobia, post-traumatic stress disorder, generalized anxiety disorder and anxiety disorder not otherwise specified.

Cognitive behavioural treatment protocols are typically designed to target one specific disorder and falls under the definition of disorder-specific cognitive behavioural therapy. It is however unclear if this is the most optimal approach in regards to the high comorbidity between anxiety disorders and depressive disorders. Internet-based cognitive behavioural therapy has in the past generally been disorder-specific and from above mentioned predicament two alternative treatment approaches emerged, the tailored and the transdiagnostic approach that aims to simultaneously treat both principal and comorbid disorders. Previous trials on internet-based cognitive behavioural therapy have targeted adults in general and relatively few target adolescents, young adults and older adults.

The aims of this thesis were to further develop and test the effects of tailored internet-based cognitive behavioural therapy on the basis of age, for adolescents, young adults and older adults. Specifically by developing and testing the effects of individually tailored internet-based cognitive behavioural therapy for adolescents with anxiety and comorbid depressive symptoms and by adapting and testing the effects of individually tailored internet-based cognitive behavioural therapy for young adults and older adults with anxiety and comorbid depressive symptoms. These aims were tested in two pilot effectiveness studies (Paper I and III) and two efficacy randomised controlled trials (Paper II and IV). The results from these four trials showed significant results across all outcome measures with overall moderate to large effect sizes. The tentative conclusion based on these results is that tailoring internet-based cognitive behavioural therapy can be a feasible approach in the treatment of anxiety symptoms and comorbid depressive symptoms for adolescents, young adults and older adults. Despite the positive findings of the studies in this thesis, there is a need for more research examining the acceptability and effectiveness of internet-based cognitive behavioural therapy for adolescents, young adults and older adults with anxiety and depression before implementation on a larger scale.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2017. 68 p.
Series
Linköping Studies in Arts and Science, ISSN 0282-9800 ; 710
Series
Linköping Studies in Behavioural Science, ISSN 1654-2029 ; 198
Keyword
internet-based treatment, cognitive behavioural therapy
National Category
Applied Psychology Psychiatry Behavioral Sciences Biology Gerontology, specializing in Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-135823 (URN)10.3384/diss.diva-135823 (DOI)9789176855669 (ISBN)
Public defence
2017-04-21, Sal I:101, Hus I, Campus Valla, Linköping, 10:00 (English)
Opponent
Supervisors
Available from: 2017-03-23 Created: 2017-03-23 Last updated: 2017-04-19Bibliographically approved

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Silfvernagel, KristinAndersson, Gerhard

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