Web-based therapist-assisted cognitive behavioral treatment of panic symptoms: A randomized controlled trial with a three-year follow-up

Ruwaard, Jeroen; Broeksteeg, J.L.W.; Schrieken, Bart; Emmelkamp, P.M.G.; Lange, Alfred

doi:10.1016/j.janxdis.2010.01.010

Cited by 65 publications

(36 citation statements)

References 43 publications

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“…Fear of body sensations was also more prevalent in those with more healthcare consultations. The participants in our study were somewhat frightened by their body sensations, and had higher scores than normal controls, but lower than patients with panic and agoraphobia [28,35]. In a study by Jonsbu et al [30], patients with NCCP also scored similar to ours on the BSQ, and Goodacre et al [36] found that a majority of the patients worried about their pain.…”

Section: Discussionsupporting

confidence: 76%

Depressive Symptoms, Cardiac Anxiety, and Fear of Body Sensations in Patients with Non-Cardiac Chest Pain, and Their Relation to Healthcare-Seeking Behavior: A Cross-Sectional Study

Mourad

Strömberg

Johansson

et al. 2015

Patient

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Results: About 26 % (n=141) of the study participants reported at least moderate depressive symptoms, 42 % (n=229) reported at least moderate cardiac anxiety, and 62 % (n=337) reported some degree of fear of body sensations. We found a strong positive relationship between depressive symptoms and cardiac anxiety (rs=0.49, p<.01), depressive symptoms and fear of body sensations (rs=0.50, p<.01), and cardiac anxiety and fear of body sensations (rs=0.56, p<.01). About 60 % of the participants sought care due to chest pain once, 26 % 2-3 times, and the rest more than 3 times. In a multivariable regression analysis, and after adjusting for multi-morbidity, cardiac anxiety was the only variable independently associated with healthcare seeking behaviour. Conclusions:Patients with NCCP and many healthcare consultations had high levels of depressive symptoms and cardiac anxiety, and moderate levels of fear of body sensations.Cardiac anxiety had the strongest relationship with healthcare seeking behaviour, and may 2 therefore be an important target for intervention to alleviate suffering and reduce healthcare use and costs. Key points for decision makers• Patients with non-cardiac chest pain and many healthcare consultations experience high levels of depressive symptoms and cardiac anxiety, and moderate levels of fear of body sensations.• Depressive symptoms, cardiac anxiety and fear of body sensations are strongly related to each other and to healthcare seeking behaviour.• Cardiac anxiety influence healthcare seeking behaviour the most and should therefore be targeted with interventions to improve patient outcomes and reduce healthcare costs.3

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Section: Discussionsupporting

confidence: 76%

Depressive Symptoms, Cardiac Anxiety, and Fear of Body Sensations in Patients with Non-Cardiac Chest Pain, and Their Relation to Healthcare-Seeking Behavior: A Cross-Sectional Study

Mourad

Strömberg

Johansson

et al. 2015

Patient

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“…= 413, p = 0.0005) [28] and mean MI score = 2.54 (t = 5.24, d.f. = 102, p = 0.0001), respectively [29]. Results of this study have to be interpreted with caution, however, given the relatively small sample size.…”

Section: Discussionmentioning

confidence: 89%

Virtual Reality Exposure Therapy Does Not Provide Any Additional Value in Agoraphobic Patients: A Randomized Controlled Trial

Meyerbroeker

Morina

Kerkhof

et al. 2013

Psychother Psychosom

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Background: A number of studies have demonstrated the efficacy of virtual reality exposure therapy (VRET) in specific phobias, but research in seriously impaired patients with agoraphobia is lacking. In this randomized controlled trial with patients with agoraphobia and panic disorder, VRET and exposure in vivo were compared in terms of outcome and processes involved. Methods: Patients with panic disorder with agoraphobia (n = 55) were randomly assigned to receive 4 sessions of cognitive behavioral therapy (CBT) followed by either 6 sessions of VRET or 6 sessions of exposure in vivo or to a waiting list control condition. Results: Analyses showed that both active treatment packages were significantly more effective than no treatment and that no differences between VRET and exposure in vivo were found in three out of four outcome measures. On the panic disorder severity scale, however, CBT plus exposure in vivo was more effective than CBT plus VRET. The results show clear synchrony of temporal processes involved in VRET and exposure in vivo on weekly avoidance measures and cognitive measures. Further, it was shown that initial changes in agoraphobic cognitions during the CBT phase predicted later changes in agoraphobic avoidance behavior. Conclusion: These data support the notion that therapeutic processes involved might be the same in VRET and exposure in vivo. However, given the slight superiority of exposure in vivo above VRET, the costs involved in the implementation of VRET and the lack of long-term follow-up, VRET cannot yet be recommended for patients with agoraphobia.

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“…However, more recently, there has been an increase in the number and nature of methodologically sound studies examining such interventions. Most of these studies have demonstrated positive outcomes for a variety of psychological and behavioural health issues, such as depressive symptoms/depression (Andersson et al, 2005;Christensen, Griffiths, & Jorm, 2004;Clarke et al, 2005;Robertson, Smith, Castle, & Tannenbaum, 2006;Ruwaard et al, 2009;Spek et al, 2007;Titov et al, 2010;Vernmark et al, 2010), panic disorder (Carlbring, Westling, Ljungstrand, Ekselius & Andersson, 2001; Klein & Richards, 2001;Klein, Richards, & Austin, 2006;Pier et al, 2008;Ruwaard, Broeksteeg, Schrieken, Emmelkamp, & Lange, 2010;Schneider, Mataix-Cols, Marks, & Bachofen, 2003), social anxiety disorder (Andersson et al, 2006;Carlbring, Gunnarsdo´ttir, et al, 2007;Titov, Andrews, Choi, Schwenke, & Mahoney, 2008;Titov, Andrews, & Schwencke, 2008), posttraumatic stress symptoms/disorder Klein et al, 2010;Lange et al, 2003), anxiety prevention (Bennett, Reynolds, Christensen, & Griffiths, 2010;Christensen, Griffiths, et al, 2010;Kenardy, McCafferty, & Rosa, 2003), work-related stress (Ruwaard, Lange, Bouwman, Broeksteeg, & Schrieken, 2007), eating disorders/weight problems (Ljo´tsson, Mitsell, Lundin, Carlbring, & Ghaderi, 2007;Tate, Jackvony, & Wing, 2006;Winzelberg et al, 2000), encopresis (Ritterband et al, 2003), smoking (Swartz, Noell, Schroeder, ...…”

mentioning

confidence: 99%

Establishing Guidelines for Executing and Reporting Internet Intervention Research

Proudfoot

Klein

Barak

et al. 2011

Cognitive Behaviour Therapy

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176

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Web-based therapist-assisted cognitive behavioral treatment of panic symptoms: A randomized controlled trial with a three-year follow-up

Cited by 65 publications

References 43 publications

Depressive Symptoms, Cardiac Anxiety, and Fear of Body Sensations in Patients with Non-Cardiac Chest Pain, and Their Relation to Healthcare-Seeking Behavior: A Cross-Sectional Study

Depressive Symptoms, Cardiac Anxiety, and Fear of Body Sensations in Patients with Non-Cardiac Chest Pain, and Their Relation to Healthcare-Seeking Behavior: A Cross-Sectional Study

Virtual Reality Exposure Therapy Does Not Provide Any Additional Value in Agoraphobic Patients: A Randomized Controlled Trial

Establishing Guidelines for Executing and Reporting Internet Intervention Research

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