Therapist‐supported Internet‐based cognitive behaviour therapy yields similar effects as face‐to‐face therapy for psychiatric and somatic disorders: an updated systematic review and meta‐analysis

World Psychiatry, Journal Year: 2023, Volume and Issue: 22(2), P. 305 - 314

Published: May 9, 2023

Providing therapist-guided cognitive behaviour therapy via the Internet (ICBT) has advantages, but a central research question is to what extent similar clinical effects can be obtained as with gold-standard face-to-face (CBT). In previous meta-analysis published in this journal, which was updated 2018, we found evidence that pooled for two formats were equivalent treatment of psychiatric and somatic disorders, number randomized trials relatively low (n=20). As field moves rapidly, aim current study conduct an update our systematic review ICBT vs. CBT disorders adults. We searched PubMed database relevant studies from 2016 2022. The main inclusion criteria had compare using controlled design targeting adult populations. Quality assessment made Cochrane risk bias (Version 1), outcome estimate standardized effect size (Hedges' g) random model. screened 5,601 records included 11 new trials, adding them 20 previously identified ones (total n=31). Sixteen different conditions targeted studies. Half fields depression/depressive symptoms or some form anxiety disorder. across all g=0.02 (95% CI: -0.09 0.14) quality acceptable. This further supports notion therapist-supported yields CBT.

Language: Английский

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The Neuropsychology of Anxiety

Oxford University Press eBooks, Journal Year: 2024, Volume and Issue: unknown

Published: May 7, 2024

Abstract The Neuropsychology of Anxiety first appeared in 1982 as the volume Oxford Psychology Series, and it quickly established itself classic work on subject. It second edition (appearing 2000) have been cited at a steadily increasing rate passing 500/year 2017. field has continued to expand last quarter century necessitating this third edition. This completely updated revised (with many figures converted colour) retains original core concepts while expanding often simplifying details. includes new chapter prefrontal cortex, which integrates frontal hippocampal views anxiety an extensively modified personality providing basis for further developments Reinforcement Sensitivity Theory. book is essential postgraduate students researchers experimental psychology neuroscience, well all clinical psychologists psychiatrists.

Language: Английский

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Post‐traumatic stress disorder: evolving conceptualization and evidence, and future research directions

World Psychiatry, Journal Year: 2025, Volume and Issue: 24(1), P. 52 - 80

Published: Jan. 15, 2025

The understanding of responses to traumatic events has been greatly influenced by the introduction diagnosis post‐traumatic stress disorder (PTSD). In this paper we review initial versions diagnostic criteria for condition and associated epidemiological findings, including sociocultural differences. We consider evidence reactions occurring in multiple contexts not previously defined as traumatic, implications that these observations have diagnosis. More recent developments such DSM‐5 dissociative subtype ICD‐11 complex PTSD are reviewed, adding there several distinct phenotypes. describe psychological foundations PTSD, involving disturbances memory well identity. A broader focus on identity may be able accommodate group communal influences experience trauma impact resource loss. then summarize current concerning biological with a particular genetic neuroimaging studies. Whereas progress prevention disappointing, is now an extensive supporting efficacy variety treatments established trauma‐focused interventions – cognitive behavior therapy (TF‐CBT) eye movement desensitization reprocessing (EMDR) non‐trauma‐focused therapies, which also include some emerging identity‐based approaches present‐centered compassion‐focused therapies. Additionally, promising neither nor pharmacological, or combine pharmacological approach, 3,4‐methylenedioxymethamphetamine (MDMA)‐assisted psychotherapy. advances priority areas adapting resource‐limited settings across cultural contexts, community‐based approaches. conclude identifying future directions work mental health.

Language: Английский

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Therapist-assisted online psychological therapies differing in trauma focus for post-traumatic stress disorder (STOP-PTSD): a UK-based, single-blind, randomised controlled trial

The Lancet Psychiatry, Journal Year: 2023, Volume and Issue: 10(8), P. 608 - 622

Published: July 19, 2023

Many patients are currently unable to access psychological treatments for post-traumatic stress disorder (PTSD), and it is unclear which types of therapist-assisted internet-based work best. We aimed investigate whether a novel internet-delivered cognitive therapy PTSD (iCT-PTSD), implements all procedures first-line, trauma-focused intervention recommended by the UK National Institute Health Care Excellence (NICE) PTSD, superior management (iStress-PTSD), comprehensive behavioural treatment programme focusing on wide range coping skills.

Language: Английский

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Blended Psychological Therapy for the Treatment of Psychological Disorders in Adult Patients: Systematic Review and Meta-Analysis

Interactive Journal of Medical Research, Journal Year: 2024, Volume and Issue: 13, P. e49660 - e49660

Published: Oct. 29, 2024

Background Blended therapy (BT) combines digital with face-to-face psychological interventions. BT may improve access to treatment, uptake, and adherence. However, research is scarce on the structure of models. Objective We synthesized literature describe models used for treatment disorders in adults. investigated whether structure, content, ratio affected efficacy, also conducted meta-analyses examine efficacy intervention-control dyads associations between outcomes versus model structure. Methods PsycINFO, CINAHL, Embase, ProQuest, MEDLINE databases were searched. Eligibility criteria included articles published English till March 2023 that described elements as part an intervention plan treating adult patients. developed a coding framework characterize A meta-analysis was calculate effect size (ES; Cohen d 95% CIs) regarding pre- posttreatment depression anxiety The review registered PROSPERO followed PRISMA (Preferred Reporting Items Systematic Reviews Meta-Analyses) guidelines. Results Searches identified 8436 articles, data extracted from 29 studies. interventions analyzed classified according mode interaction components (integrated vs sequential), role (core supplementary), component delivery (alternate case-by-case), materials assignment (standardized personalized). Most (n=24) cognitive behavioral approach or treatment. Mean rates uptake (91%) adherence (81%) reported across individual more effective noninferior usual, large spread moderate ES (n=9; d=–1.1, CI –0.6 –1.6, P<.001, z score=–4.3). small, nonsignificant found (n=5; d=–0.1, –0.3 0.05, P=.17, score=–1.4). Higher ESs blended supplementary design (depression: n=11, d=–0.75, –0.56 –0.95; anxiety: n=8, d=–0.9, –1.2); fewer (≤6) sessions n=9, d=–0.7, –0.5 –0.9; n=7, d=–0.8, –1.3); lower (≤50%) n=5, –1.1; n=4, 0.006 –1.6). Conclusions This study confirmed integrated feasible deliver. be but results nonsignificant. Future studies assessing different therapeutic approaches are required. Trial Registration CRD42021258977; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=258977

Language: Английский

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Internet- and mobile-based psychological interventions for post-traumatic stress symptoms in youth: a systematic review and meta-analysis

npj Digital Medicine, Journal Year: 2024, Volume and Issue: 7(1)

Published: Feb. 29, 2024

Abstract Psychological interventions can help reduce posttraumatic stress symptoms (PTSS) in youth, but many do not seek help. Internet- and mobile-based (IMIs) show promise expanding treatment options. However, the overall evidence on IMIs reducing PTSS among youth remains unclear. This systematic review meta-analysis investigated efficacy of reduction for exposed to traumatic events. A comprehensive literature search was conducted January 2023 including non-randomized randomized-controlled trials (RCT) investigating effects aged ≤25 years. Six studies were identified with five providing data meta-analysis. The majority included different types trauma irrespective severity at baseline ( k = 5). We found a small within-group effect from post-treatment g −0.39, 95% CrI: −0.67 −0.11, 5; n 558; 9 comparisons). No emerged when comparing control conditions 0.04; 95%-CrI: -0.52 0.6, 3; 768; 4 Heterogeneity low between within studies. All showed least some concerns terms risk bias. Current does conclusively support addressing PTSS. revealed scarcity events, most being feasibility rather than adequately powered RCTs lacking focus. underscores demand more high-quality research.

Language: Английский

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The impact of trauma and how to intervene: a narrative review of psychotraumatology over the past 15 years

European journal of psychotraumatology, Journal Year: 2025, Volume and Issue: 16(1)

Published: Feb. 6, 2025

To mark 15 years of the European Journal Psychotraumatology, editors reviewed past 15-year research on trauma exposure and its consequences, as well developments in (early) psychological, pharmacological complementary interventions. In all sections this paper, we provide perspectives sex/gender aspects, life course trends, cross-cultural/global systemic societal contexts. Globally, majority people experience stressful events that may be characterized traumatic. However, definitions what is traumatic are not necessarily straightforward or universal. Traumatic have a wide range transdiagnostic mental physical health limited to posttraumatic stress disorder (PTSD). Research genetic, molecular, neurobiological influences show promise for further understanding underlying risk resilience trauma-related consequences. Symptom presentation, prevalence, course, response experiences, differ depending individuals' age developmental phase, sex/gender, sociocultural environmental contexts, socio-political forces. Early interventions potential prevent acute reactions from escalating PTSD diagnosis whether delivered golden hours weeks after trauma. prevention still scarce compared treatment where several evidence-based complementary/ integrative exist, novel forms delivery become available. Here, focus how best address negative outcomes following trauma, serve individuals across spectrum, including very young old, include considerations ethnicity, culture diverse beyond Western, Educated, Industrialized, Rich, Democratic (WEIRD) countries. We conclude with providing directions future aimed at improving well-being impacted by around world. The EJPT webinar provides 90-minute summary paper can downloaded here [http://bit.ly/4jdtx6k].

Language: Английский

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Application and Mechanisms of Internet-Based Cognitive Behavioral Therapy (iCBT) in Improving Psychological State in Cancer Patients

Journal of Cancer, Journal Year: 2023, Volume and Issue: 14(11), P. 1981 - 2000

Published: Jan. 1, 2023

This review article is an overview of the effectiveness internet-based cognitive behavioral therapy (iCBT) in Improving Psychological State Cancer Patients.iCBT's has been investigated treating and managing conditions like depression, psychiatric disorders, generalized anxiety disorder (GAD), panic disorder, obsessive compulsive (OCD), post-traumatic stress (PTSD), adjustment bipolar chronic pain, phobias.iCBT's role treatment medical such as diabetes mellitus with comorbid illnesses was also explored.We conducted a thorough literature search using PubMed, Embase, Google Scholar, Wanfang no restrictions on date.iCBT's controlling cancer patients established literature.Development popularization iCBT, treament forms platforms for application strategies efficacy iCBT insomnia patients, current status application, genetic researches disorders were all reviewed discussed this review.From data compiled, we conclude that useful or improving psychological state patients.

Language: Английский

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Cost-effectiveness of therapist-assisted internet-delivered psychological therapies for PTSD differing in trauma focus in England: an economic evaluation based on the STOP-PTSD trial

The Lancet Psychiatry, Journal Year: 2024, Volume and Issue: 11(5), P. 339 - 347

Published: March 27, 2024

BackgroundAlthough there are effective psychological treatments for post-traumatic stress disorder (PTSD), they remain inaccessible many people. Digitally enabled therapy is a way to overcome this problem; however, little evidence on which forms of these therapies most cost in PTSD. We aimed assess the cost-effectiveness STOP-PTSD trial, evaluated two therapist-assisted, internet-delivered cognitive behavioural therapies: PTSD (iCT-PTSD) and programme focusing management (iStress-PTSD).MethodsIn health economic evaluation, we used data from trial (n=217), single-blind, randomised controlled compare iCT-PTSD iStress-PTSD terms resource use outcomes. In participants (aged ≥18 years) who met DSM-5 criteria were recruited primary care services South East England. The interventions delivered online with therapist support first 12 weeks, three telephone calls over next 3 months. Participants completed questionnaires symptoms, wellbeing, quality life, at baseline, 13 26 39 weeks after randomisation. analysis per quality-adjusted life year (QALY) post-randomisation, perspective English National Health Service (NHS) personal social basis intention-to-treat complete cases. Treatment modules platform design developed extensive input service users: users also advised protocol methods, including measures. This pre-planned trial; was registered prospectively ISRCTN Registry (ISRCTN16806208).FindingsNHS costs similar across treatment groups, but clinical outcomes superior compared iStress-PTSD. incremental ratio NHS estimated as £1921 QALY. had an 91·6% chance being £20 000 QALY threshold. From societal perspective, saving iStress-PTSD.InterpretationiCT-PTSD cost-effective form relative iStress-PTSD, it could be considered implementation.FundingWellcome Trust Institute Research Oxford Biomedical Centre.

Language: Английский

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Helpful but not enough: exploring participants’ experiences of a digital therapist-guided prolonged exposure treatment for PTSD

European journal of psychotraumatology, Journal Year: 2025, Volume and Issue: 16(1)

Published: Feb. 10, 2025

Background: Post-traumatic stress disorder (PTSD) can be a severe psychiatric condition, and access to timely evidence-based treatment is often limited. Prolonged exposure recommended as first line in clinical guidelines. There limited research on how digital formats of prolonged used increase availability impact user experience. Therefore, we wanted investigate patients' experiences therapist-guided internet-delivered format (HOPE; Huddinge Online Exposure), part an uncontrolled feasibility study.

Language: Английский

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