EFFECTIVENESS OF COGNITIVE BEHAVIORAL THERAPY FOR INSOMNIA: INFLUENCE OF SLIGHT-TO-MODERATE DEPRESSIVE SYMPTOM SEVERITY AND WORRYING

2014 ◽  
Vol 31 (8) ◽  
pp. 662-668 ◽  
Author(s):  
Astrid B. H. Hamoen ◽  
Else M. Redlich ◽  
Al W. de Weerd
2020 ◽  
Vol 22 (1) ◽  
pp. 8-14 ◽  
Author(s):  
Elizabeth S. Gromisch ◽  
Robert D. Kerns ◽  
Rebecca Czlapinski ◽  
Beth Beenken ◽  
John Otis ◽  
...  

Abstract Background: Pain is a common and often debilitating symptom in persons with multiple sclerosis (MS). Besides interfering with daily functioning, pain in MS is associated with higher levels of depression and anxiety. Although cognitive behavioral therapy (CBT) for pain has been found to be an effective treatment in other populations, there has been a dearth of research in persons with MS. Methods: Persons with MS with at least moderate pain severity (N = 20) were randomly assigned to one of two groups: CBT plus standard care or MS-related education plus standard care, each of which met for 12 sessions. Changes in pain severity, pain interference, and depressive symptom severity from baseline to 15-week follow-up were assessed using a 2×2 factorial design. Participants also rated their satisfaction with their treatment and accomplishment of personally meaningful behavioral goals. Results: Both treatment groups rated their treatment satisfaction as very high and their behavioral goals as largely met, although only the CBT plus standard care group's mean goal accomplishment ratings represented significant improvement. Although there were no significant differences between groups after treatment on the three primary outcomes, there was an overall improvement over time for pain severity, pain interference, and depressive symptom severity. Conclusions: Cognitive behavioral therapy or education-based programs may be helpful adjunctive treatments for persons with MS experiencing pain.


2018 ◽  
Vol 23 (12) ◽  
pp. 2314-2323 ◽  
Author(s):  
Zhen Yang ◽  
Shi Gu ◽  
Nicolas Honnorat ◽  
Kristin A. Linn ◽  
Russell T. Shinohara ◽  
...  

2021 ◽  
Vol 11 ◽  
Author(s):  
Frank J. Don ◽  
Ellen Driessen ◽  
Jaap Peen ◽  
Jan Spijker ◽  
Robert J. DeRubeis ◽  
...  

Background: The therapeutic alliance is considered an important causal agent of psychotherapy efficacy. However, studies in cognitive behavioral therapy (CBT) for depression have suggested that alliance might be more of a consequence rather than a cause of depressive symptom change, while adherence to CBT specific techniques was found to be associated with subsequent depression change. We aimed to add to this body of literature by assessing the temporal associations of both therapeutic alliance and manual adherence with depressive symptom change in a relatively large sample of depressed adult outpatients over the full course of CBT.Methods: Adults with a major depressive episode (n = 98) participating in a randomized clinical trial were offered 22 weeks of CBT and rated the Penn Helping Alliance Questionnaire (HAq-I) at weeks 5 and 22. Therapists rated their adherence to the CBT manual after each session and observers assessed the Hamilton Depression Rating Scale scores at weeks 0, 5, 10, and 22. Linear mixed model analyses were used to assess the associations of alliance and adherence with prior and subsequent depression change.Results: HAq-I Relationship and manual adherence ratings were not significantly associated with prior nor with subsequent depression change (p > 0.14). Prior depression change was associated with the HAq-I subscale Perceived helpfulness at the end of treatment (r = 0.30, CI = 0.03–0.56, p = 0.03).Conclusion: We were not able to replicate prior depression change in CBT for depression to be associated with improved quality of the therapeutic alliance when using a more “pure” measure of the therapeutic relationship. Limitations of this study include the subjective alliance and adherence assessments. Our findings indicate the need to appropriately distinguish between the perceived helpfulness and the relationship factors when examining therapeutic alliance.


10.2196/16350 ◽  
2020 ◽  
Vol 8 (6) ◽  
pp. e16350
Author(s):  
Hilary Weingarden ◽  
Aleksandar Matic ◽  
Roger Garriga Calleja ◽  
Jennifer L Greenberg ◽  
Oliver Harrison ◽  
...  

Background Smartphone-delivered cognitive behavioral therapy (CBT) is becoming more common, but research on the topic remains in its infancy. Little is known about how people typically engage with smartphone CBT or which engagement and mobility patterns may optimize treatment. Passive smartphone data offer a unique opportunity to gain insight into these knowledge gaps. Objective This study aimed to examine passive smartphone data across a pilot course of smartphone CBT for body dysmorphic disorder (BDD), a psychiatric illness characterized by a preoccupation with a perceived defect in physical appearance, to inform hypothesis generation and the design of subsequent, larger trials. Methods A total of 10 adults with primary diagnoses of BDD were recruited nationally and completed telehealth clinician assessments with a reliable evaluator. In a 12-week open pilot trial of smartphone CBT, we initially characterized natural patterns of engagement with the treatment and tested how engagement and mobility patterns across treatment corresponded with treatment response. Results Most participants interacted briefly and frequently with smartphone-delivered treatment. More frequent app usage (r=–0.57), as opposed to greater usage duration (r=–0.084), correlated strongly with response. GPS-detected time at home, a potential digital marker of avoidance, decreased across treatment and correlated moderately with BDD severity (r=0.49). Conclusions The sample was small in this pilot study; thus, results should be used to inform the hypotheses and design of subsequent trials. The results provide initial evidence that frequent (even if brief) practice of CBT skills may optimize response to smartphone CBT and that mobility patterns may serve as useful passive markers of symptom severity. This is one of the first studies to examine the value that passively collected sensor data may contribute to understanding and optimizing users’ response to smartphone CBT. With further validation, the results can inform how to enhance smartphone CBT design.


2021 ◽  
Author(s):  
Sanam Borji-Navan ◽  
Sakineh Mohammad-Alizadeh-Charandabi ◽  
Khalil Esmaeilpour ◽  
Mojgan Mirghafourvand ◽  
Ali Ahmadian-Khooinarood

Abstract Background: Premenstrual Syndrome (PMS) is a common problem among women of reproductive age, affecting various aspects of their lives. There are very limited studies investigating the effect of Internet-Based Cognitive-Behavioral Therapy (ICBT) on PMS. We aimed to investigate the effect of ICBT on symptom severity of women suffering from PMS and their quality of life in the perimenstrual and late follicular periods. Methods: Ninety-two university students aged 18-35 years with moderate to severe PMS were allocated into two groups of 46 using block randomization. The intervention group underwent ICBT for two menstrual cycles, while the control group received no intervention. All participants filled the Daily Record of Severity of Problems (DRSP) for two menstrual cycles and the Quality of Life Enjoyment and Satisfaction Questionnaire - Short Form (Q-LES-Q-SF) on days 1-2 and 11-13 of the menstrual cycle pre- and post-intervention. Data were analyzed using univariate general linear models. Results: Four students in the intervention group were lost to follow-up. Post-interventionally, the mean score of total PMS symptoms was significantly lower in the intervention group than the control group (10.4 vs. 20.2, adjusted difference: -9.9 [95% CI: -13.3 to -6.6]) and perimenstrual quality of life was significantly higher (64.2 vs. 50.3, 14.1 [8.5 to 19.8]). However, there was no significant intergroup difference in the late follicular quality of life (68.3 vs. 67.3, 1.9 [-4.4 to 8.1]). Conclusions: Internet-Based Cognitive-Behavioral Therapy could effectively reduce PMS symptom severity and improve perimenstrual quality of life, with no significant effect on the late follicular quality of life. Trial registration: The Iranian Registry of Clinical Trials, Identifier: IRCT20100414003706N34, Registered 19 June 2019, https://www.irct.ir/trial/38394


2019 ◽  
Vol 33 (4) ◽  
pp. 301-319
Author(s):  
Ariella P. Lenton-Brym ◽  
Kathleen E. Stewart ◽  
Alice E. Coyne ◽  
Henny A. Westra ◽  
Michael J. Constantino ◽  
...  

Clients with generalized anxiety disorder (GAD) that demonstrate observer-coded treatment ambivalence benefit from the addition of motivational interviewing (MI) to cognitive behavioral therapy (CBT; Button, Westra, Constantino, & Antony, 2016). While observer-coded assessment of ambivalence and readiness for change is resource-intensive, the present study investigates the use of more efficient self-report measures to predict treatment outcomes. Participants (N = 85) with GAD received CBT or MI-CBT and completed self-report measures of readiness for change (Change Questionnaire, Miller & Johnson, 2008) and ambivalence (Treatment Ambivalence Questionnaire, Purdon, Rowa, Gifford, McCabe, & Antony, 2012). Greater self-reported baseline readiness for change was associated with lower posttreatment worry and symptom severity and faster reduction in worry. Self-reported ambivalence was not associated with outcomes. Patients with less concern about adverse consequences of treatment who received CBT experienced greater increases in readiness for change than those receiving MI-CBT. We discuss implications for using these measures in clinical settings.


2019 ◽  
Author(s):  
Hilary Weingarden ◽  
Aleksandar Matic ◽  
Roger Garriga Calleja ◽  
Jennifer L Greenberg ◽  
Oliver Harrison ◽  
...  

BACKGROUND Smartphone-delivered cognitive behavioral therapy (CBT) is becoming more common, but research on the topic remains in its infancy. Little is known about how people typically engage with smartphone CBT or which engagement and mobility patterns may optimize treatment. Passive smartphone data offer a unique opportunity to gain insight into these knowledge gaps. OBJECTIVE This study aimed to examine passive smartphone data across a pilot course of smartphone CBT for body dysmorphic disorder (BDD), a psychiatric illness characterized by a preoccupation with a perceived defect in physical appearance, to inform hypothesis generation and the design of subsequent, larger trials. METHODS A total of 10 adults with primary diagnoses of BDD were recruited nationally and completed telehealth clinician assessments with a reliable evaluator. In a 12-week open pilot trial of smartphone CBT, we initially characterized natural patterns of engagement with the treatment and tested how engagement and mobility patterns across treatment corresponded with treatment response. RESULTS Most participants interacted briefly and frequently with smartphone-delivered treatment. More frequent app usage (<i>r</i>=–0.57), as opposed to greater usage duration (<i>r</i>=–0.084), correlated strongly with response. GPS-detected time at home, a potential digital marker of avoidance, decreased across treatment and correlated moderately with BDD severity (<i>r</i>=0.49). CONCLUSIONS The sample was small in this pilot study; thus, results should be used to inform the hypotheses and design of subsequent trials. The results provide initial evidence that frequent (even if brief) practice of CBT skills may optimize response to smartphone CBT and that mobility patterns may serve as useful passive markers of symptom severity. This is one of the first studies to examine the value that passively collected sensor data may contribute to understanding and optimizing users’ response to smartphone CBT. With further validation, the results can inform how to enhance smartphone CBT design.


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