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Gerhard Andersson - One of the best experts on this subject based on the ideXlab platform.

  • internet based vs face to face Cognitive Behavior Therapy for psychiatric and somatic disorders an updated systematic review and meta analysis
    2018
    Co-Authors: Per Carlbring, Gerhard Andersson, Pim Cuijpers, Heleen Riper, Erik Hedmanlagerlof
    Abstract:

    AbstractDuring the last two decades, Internet-delivered Cognitive Behavior Therapy (ICBT) has been tested in hundreds of randomized controlled trials, often with promising results. However, the con...

  • internet supported versus face to face Cognitive Behavior Therapy for depression
    2016
    Co-Authors: Gerhard Andersson, Naira Topooco, Odd E Havik, Tine Nordgreen
    Abstract:

    Major depression and depressive symptoms are highly prevalent and there is a need for different forms of psychological treatments that can be delivered from a distance at a low cost. In the present review the authors contrast face-to-face and Internet-delivered Cognitive Behavior Therapy (ICBT) for depression. A total of five studies are reviewed in which guided ICBT was directly compared against face-to-face CBT. Meta-analytic summary statistics were calculated for the five studies involving a total of 429 participants. The average effect size difference was Hedge's g = 0.12 (95% CI: -0.06-0.30) in the direction of favoring guided ICBT. The small difference in effect has no implication for clinical practice. The overall empirical status of clinician-guided ICBT for depression is commented on and future challenges are highlighted. Among these are developing treatments for patients with more severe and long-standing depression and for children, adolescents and the elderly. Also, there is a need to investigate mechanisms of change.

  • a content analysis of client e mails in guided internet based Cognitive Behavior Therapy for depression
    2015
    Co-Authors: Natalie Svartvatten, Gerhard Andersson, Mattias Segerlund, Inga Dennhag, Per Carlbring
    Abstract:

    The relationship between what a client writes when communicating with an online therapist and treatment outcome in internet-based Cognitive Behavior Therapy (ICBT) is largely unknown. The aim of th ...

  • personality change following internet based Cognitive Behavior Therapy for severe health anxiety
    2014
    Co-Authors: Erik Hedman, Gerhard Andersson, Christian Ruck, Nils Lindefors, Erik Andersson, Petter Gustavsson, Mats Lekander, Brjánn Ljótsson
    Abstract:

    Personality traits have traditionally been viewed as stable, but recent studies suggest that they could be affected through psychological treatment. Internet-based Cognitive Behavior Therapy (ICBT) for severe health anxiety (DSM-IV hypochondriasis) has been shown to be effective in reducing health anxiety, but its effect on measures of personality traits has not been investigated. The main aim of this study was to investigate the impact of ICBT on personality traits in the three broad dimensions - neuroticism, extraversion and aggression. We hypothesized that participants in ICBT would reduce their level of neuroticism compared to controls that did not receive the active treatment. No specific predictions were made regarding extraversion and aggression. Data from a randomized controlled trial were used in which participants were allocated to 12 weeks of ICBT (n = 40) or to a basic attention control condition (n = 41). Personality traits were assessed with the Swedish Universities Scales of Personality and the primary outcome of health anxiety was the Health Anxiety Inventory. There was a significant interaction effect of group and time on neuroticism-related scales, indicating larger pre- to post-treatment reductions in the Internet-based CBT group compared to the control condition. Analyses at 6-month follow-up showed that changes were stable. Traits relating to extraversion and aggression were largely unchanged. This study is the first to demonstrate that a brief ICBT intervention for severe health anxiety causes long-term changes in measures of personality traits related to neuroticism. The treatment thus has a broader impact than just reducing health anxiety.

  • guided internet based vs face to face Cognitive Behavior Therapy for psychiatric and somatic disorders a systematic review and meta analysis
    2014
    Co-Authors: Gerhard Andersson, Per Carlbring, Pim Cuijpers, Heleen Riper, Erik Hedman
    Abstract:

    Internet-delivered Cognitive Behavior Therapy (ICBT) has been tested in many research trials, but to a lesser extent directly compared to face-to-face delivered Cognitive Behavior Therapy (CBT). We conducted a systematic review and meta-analysis of trials in which guided ICBT was directly compared to face-to-face CBT. Studies on psychiatric and somatic conditions were included. Systematic searches resulted in 13 studies (total N=1053) that met all criteria and were included in the review. There were three studies on social anxiety disorder, three on panic disorder, two on depressive symptoms, two on body dissatisfaction, one on tinnitus, one on male sexual dysfunction, and one on spider phobia. Face-to-face CBT was either in the individual format (n=6) or in the group format (n=7). We also assessed quality and risk of bias. Results showed a pooled effect size (Hedges' g) at post-treatment of −0.01 (95% CI: −0.13 to 0.12), indicating that guided ICBT and face-to-face treatment produce equivalent overall effects. Study quality did not affect outcomes. While the overall results indicate equivalence, there are still few studies for each psychiatric and somatic condition and many conditions for which guided ICBT has not been compared to face-to-face treatment. Thus, more research is needed to establish equivalence of the two treatment formats.

Erik Hedman - One of the best experts on this subject based on the ideXlab platform.

  • internet delivered Cognitive Behavior Therapy for children and adolescents a systematic review and meta analysis
    2016
    Co-Authors: Erik Hedman, Sarah Vigerland, Fabian Lenhard, Marianne Bonnert, Maria Lalouni, Johan Ahlen, Ola Olen, Eva Serlachius, Brjánn Ljótsson
    Abstract:

    Internet-delivered Cognitive Behavior Therapy (ICBT) is a relatively novel treatment format with the potential to increase accessibility of evidence-based care. However, little is known about the feasibility and efficacy of ICBT in children and adolescents. We conducted a comprehensive systematic review and meta-analysis of ICBT for children and adolescents to provide an overview of the field and assess the efficacy of these interventions. A systematic literature search of six electronic databases was performed to identify ICBT intervention studies for children with a psychiatric condition, such as social anxiety disorder, or a somatic condition, such as chronic pain. Two reviewers independently rated study quality. Twenty-five studies, targeting 11 different disorders, were included in the review. Study quality and presentation of treatment variables, such as therapist time and treatment adherence, varied largely. Twenty-four studies (N=1882) were included in the meta-analysis and ICBT yielded moderate between-group effect sizes when compared with waitlist, g=0.62, 95% CI [0.41, 0.84]. The results suggest that CBT for psychiatric and somatic conditions in children and adolescents can be successfully adapted to an internet-delivered format.

  • personality change following internet based Cognitive Behavior Therapy for severe health anxiety
    2014
    Co-Authors: Erik Hedman, Gerhard Andersson, Christian Ruck, Nils Lindefors, Erik Andersson, Petter Gustavsson, Mats Lekander, Brjánn Ljótsson
    Abstract:

    Personality traits have traditionally been viewed as stable, but recent studies suggest that they could be affected through psychological treatment. Internet-based Cognitive Behavior Therapy (ICBT) for severe health anxiety (DSM-IV hypochondriasis) has been shown to be effective in reducing health anxiety, but its effect on measures of personality traits has not been investigated. The main aim of this study was to investigate the impact of ICBT on personality traits in the three broad dimensions - neuroticism, extraversion and aggression. We hypothesized that participants in ICBT would reduce their level of neuroticism compared to controls that did not receive the active treatment. No specific predictions were made regarding extraversion and aggression. Data from a randomized controlled trial were used in which participants were allocated to 12 weeks of ICBT (n = 40) or to a basic attention control condition (n = 41). Personality traits were assessed with the Swedish Universities Scales of Personality and the primary outcome of health anxiety was the Health Anxiety Inventory. There was a significant interaction effect of group and time on neuroticism-related scales, indicating larger pre- to post-treatment reductions in the Internet-based CBT group compared to the control condition. Analyses at 6-month follow-up showed that changes were stable. Traits relating to extraversion and aggression were largely unchanged. This study is the first to demonstrate that a brief ICBT intervention for severe health anxiety causes long-term changes in measures of personality traits related to neuroticism. The treatment thus has a broader impact than just reducing health anxiety.

  • guided internet based vs face to face Cognitive Behavior Therapy for psychiatric and somatic disorders a systematic review and meta analysis
    2014
    Co-Authors: Gerhard Andersson, Per Carlbring, Pim Cuijpers, Heleen Riper, Erik Hedman
    Abstract:

    Internet-delivered Cognitive Behavior Therapy (ICBT) has been tested in many research trials, but to a lesser extent directly compared to face-to-face delivered Cognitive Behavior Therapy (CBT). We conducted a systematic review and meta-analysis of trials in which guided ICBT was directly compared to face-to-face CBT. Studies on psychiatric and somatic conditions were included. Systematic searches resulted in 13 studies (total N=1053) that met all criteria and were included in the review. There were three studies on social anxiety disorder, three on panic disorder, two on depressive symptoms, two on body dissatisfaction, one on tinnitus, one on male sexual dysfunction, and one on spider phobia. Face-to-face CBT was either in the individual format (n=6) or in the group format (n=7). We also assessed quality and risk of bias. Results showed a pooled effect size (Hedges' g) at post-treatment of −0.01 (95% CI: −0.13 to 0.12), indicating that guided ICBT and face-to-face treatment produce equivalent overall effects. Study quality did not affect outcomes. While the overall results indicate equivalence, there are still few studies for each psychiatric and somatic condition and many conditions for which guided ICBT has not been compared to face-to-face treatment. Thus, more research is needed to establish equivalence of the two treatment formats.

  • effectiveness and cost effectiveness of individually tailored internet delivered Cognitive Behavior Therapy for anxiety disorders in a primary care population a randomized controlled trial
    2014
    Co-Authors: Lise Bergman Nordgren, Gerhard Andersson, Erik Hedman, Julie Etienne, Jessica Bodin, Asa Kadowaki, Stina Eriksson, Emelie Lindkvist, Per Carlbring
    Abstract:

    A significant proportion of the general population suffers from anxiety disorders, often with comorbid psychiatric conditions. Internet-delivered Cognitive Behavior Therapy (ICBT) has been found to ...

  • effectiveness of guided internet based Cognitive Behavior Therapy in regular clinical settings
    2013
    Co-Authors: Gerhard Andersson, Erik Hedman
    Abstract:

    Summary Therapist-guided internet-based Cognitive Behavior Therapy (ICBT) has been tested in numerous controlled trials conducted in research settings. It is now established that this novel treatment format works for a range of clinical conditions. It is less well known if the promising results from efficacy studies can be transferred to routine clinical practice. In this paper we review the evidence from effectiveness studies and highlight challenges when implementing ICBT. Following literature searches we identified 4 controlled trials and 8 open studies, involving a total of 3,888 patients. There is now an increasing number of effectiveness studies on ICBT with studies on panic disorder, social anxiety disorder, generalized anxiety disorder, post-traumatic stress disorder, depression, tinnitus, and irritable bowel syndrome. All indicate that it is possible to transfer ICBT to clinical practice with sustained effects and moderate to large effect sizes. However, it is not clear which model to use for service delivery, and more work remains to be done on dissemination of ICBT. Moreover, the knowledge about outcome predictors from controlled efficacy trials is probably less relevant, and studies with large clinically representative samples are needed to investigate for which patients ICBT is suitable. In this work existing data could be combined and reanalyzed to study predictors of outcome.

Brjánn Ljótsson - One of the best experts on this subject based on the ideXlab platform.

  • internet delivered Cognitive Behavior Therapy for children and adolescents a systematic review and meta analysis
    2016
    Co-Authors: Erik Hedman, Sarah Vigerland, Fabian Lenhard, Marianne Bonnert, Maria Lalouni, Johan Ahlen, Ola Olen, Eva Serlachius, Brjánn Ljótsson
    Abstract:

    Internet-delivered Cognitive Behavior Therapy (ICBT) is a relatively novel treatment format with the potential to increase accessibility of evidence-based care. However, little is known about the feasibility and efficacy of ICBT in children and adolescents. We conducted a comprehensive systematic review and meta-analysis of ICBT for children and adolescents to provide an overview of the field and assess the efficacy of these interventions. A systematic literature search of six electronic databases was performed to identify ICBT intervention studies for children with a psychiatric condition, such as social anxiety disorder, or a somatic condition, such as chronic pain. Two reviewers independently rated study quality. Twenty-five studies, targeting 11 different disorders, were included in the review. Study quality and presentation of treatment variables, such as therapist time and treatment adherence, varied largely. Twenty-four studies (N=1882) were included in the meta-analysis and ICBT yielded moderate between-group effect sizes when compared with waitlist, g=0.62, 95% CI [0.41, 0.84]. The results suggest that CBT for psychiatric and somatic conditions in children and adolescents can be successfully adapted to an internet-delivered format.

  • personality change following internet based Cognitive Behavior Therapy for severe health anxiety
    2014
    Co-Authors: Erik Hedman, Gerhard Andersson, Christian Ruck, Nils Lindefors, Erik Andersson, Petter Gustavsson, Mats Lekander, Brjánn Ljótsson
    Abstract:

    Personality traits have traditionally been viewed as stable, but recent studies suggest that they could be affected through psychological treatment. Internet-based Cognitive Behavior Therapy (ICBT) for severe health anxiety (DSM-IV hypochondriasis) has been shown to be effective in reducing health anxiety, but its effect on measures of personality traits has not been investigated. The main aim of this study was to investigate the impact of ICBT on personality traits in the three broad dimensions - neuroticism, extraversion and aggression. We hypothesized that participants in ICBT would reduce their level of neuroticism compared to controls that did not receive the active treatment. No specific predictions were made regarding extraversion and aggression. Data from a randomized controlled trial were used in which participants were allocated to 12 weeks of ICBT (n = 40) or to a basic attention control condition (n = 41). Personality traits were assessed with the Swedish Universities Scales of Personality and the primary outcome of health anxiety was the Health Anxiety Inventory. There was a significant interaction effect of group and time on neuroticism-related scales, indicating larger pre- to post-treatment reductions in the Internet-based CBT group compared to the control condition. Analyses at 6-month follow-up showed that changes were stable. Traits relating to extraversion and aggression were largely unchanged. This study is the first to demonstrate that a brief ICBT intervention for severe health anxiety causes long-term changes in measures of personality traits related to neuroticism. The treatment thus has a broader impact than just reducing health anxiety.

  • Cognitive Behavior Therapy versus interpersonal psychoTherapy for social anxiety disorder delivered via smartphone and computer: A randomized controlled trial
    2014
    Co-Authors: Jesper Dagöö, Per Carlbring, Robert Persson Asplund, Helene Andersson Bsenko, Sofia Hjerling, Anna Holmberg, Susanne Westh, Louise Öberg, Brjánn Ljótsson, Tomas Furmark
    Abstract:

    In this study, a previously evaluated guided Internet-based Cognitive Behavior Therapy for social anxiety disorder (SAD) was adapted for mobile phone administration (mCBT). The treatment was compar ...

  • Cognitive Behavior Therapy via the internet a systematic review of applications clinical efficacy and cost effectiveness
    2012
    Co-Authors: Erik Hedman, Brjánn Ljótsson, Nils Lindefors
    Abstract:

    Internet-based Cognitive Behavior Therapy (ICBT) is a promising treatment that may increase availability of Cognitive Behavior Therapy (CBT) for psychiatric disorders and other clinical problems. T...

  • Cognitive Behavior Therapy via the internet a systematic review of applications clinical efficacy and cost effectiveness
    2012
    Co-Authors: Erik Hedman, Brjánn Ljótsson, Nils Lindefors
    Abstract:

    Internet-based Cognitive Behavior Therapy (ICBT) is a promising treatment that may increase availability of Cognitive Behavior Therapy (CBT) for psychiatric disorders and other clinical problems. The main objective of this study was to determine the applications, clinical efficacy and cost-effectiveness of ICBT. The authors conducted a systematic review to identify randomized controlled trials investigating CBT delivered via the internet for adult patient populations. Searches to identify studies investigating cost-effectiveness of ICBT were also conducted. Evidence status for each clinical application was determined using the American Psychologist Association criteria for empirically supported treatments. Of 1104 studies reviewed, 108 met criteria for inclusion, of which 103 reported on clinical efficacy and eight on cost-effectiveness. Results showed that ICBT has been tested for 25 different clinical disorders, whereas most randomized controlled trials have been aimed at depression, anxiety disorders and chronic pain. Internet-based treatments for depression, social phobia and panic disorder were classified as well-established, that is, meeting the highest level of criteria for evidence. Effect sizes were large in the treatment of depression, anxiety disorders, severe health anxiety, irritable bowel syndrome, female sexual dysfunction, eating disorders, cannabis use and pathological gambling. For other clinical problems, effect sizes were small to moderate. Comparison to conventional CBT showed that ICBT produces equivalent effects. Cost-effectiveness data were relatively scarce but suggested that ICBT has more than 50% probability of being cost effective compared with no treatment or to conventional CBT when willingness to pay for an additional improvement is zero. Although ICBT is a promising treatment option for several disorders, it can only be regarded as a well-established treatment for depression, panic disorder and social phobia. It seems that ICBT is as effective as conventional CBT for respective clinical disorder, that is, if conventional CBT works then ICBT works. The large effects and the limited therapist time required suggest that the treatment is highly cost effective for well-established indications.

Per Carlbring - One of the best experts on this subject based on the ideXlab platform.

Christian Ruck - One of the best experts on this subject based on the ideXlab platform.

  • personality change following internet based Cognitive Behavior Therapy for severe health anxiety
    2014
    Co-Authors: Erik Hedman, Gerhard Andersson, Christian Ruck, Nils Lindefors, Erik Andersson, Petter Gustavsson, Mats Lekander, Brjánn Ljótsson
    Abstract:

    Personality traits have traditionally been viewed as stable, but recent studies suggest that they could be affected through psychological treatment. Internet-based Cognitive Behavior Therapy (ICBT) for severe health anxiety (DSM-IV hypochondriasis) has been shown to be effective in reducing health anxiety, but its effect on measures of personality traits has not been investigated. The main aim of this study was to investigate the impact of ICBT on personality traits in the three broad dimensions - neuroticism, extraversion and aggression. We hypothesized that participants in ICBT would reduce their level of neuroticism compared to controls that did not receive the active treatment. No specific predictions were made regarding extraversion and aggression. Data from a randomized controlled trial were used in which participants were allocated to 12 weeks of ICBT (n = 40) or to a basic attention control condition (n = 41). Personality traits were assessed with the Swedish Universities Scales of Personality and the primary outcome of health anxiety was the Health Anxiety Inventory. There was a significant interaction effect of group and time on neuroticism-related scales, indicating larger pre- to post-treatment reductions in the Internet-based CBT group compared to the control condition. Analyses at 6-month follow-up showed that changes were stable. Traits relating to extraversion and aggression were largely unchanged. This study is the first to demonstrate that a brief ICBT intervention for severe health anxiety causes long-term changes in measures of personality traits related to neuroticism. The treatment thus has a broader impact than just reducing health anxiety.

  • clinical and genetic outcome determinants of internet and group based Cognitive Behavior Therapy for social anxiety disorder
    2012
    Co-Authors: Erik Hedman, Gerhard Andersson, Brjánn Ljótsson, Nils Lindefors, Evelyn Andersson, Martin Schalling, Christian Ruck
    Abstract:

    Hedman E, Andersson E, Ljotsson B, Andersson G, Andersson E, Schalling M, Lindefors N, Ruck C. Clinical and genetic outcome determinants of Internet- and group-based Cognitive Behavior Therapy for social anxiety disorder (SAD). Objective: No study has investigated clinical or genetic predictors and moderators of Internet-based Cognitive Behavior Therapy (ICBT) compared with Cognitive Behavioral group Therapy for (CBGT) for SAD. Identification of predictors and moderators is essential to the clinician in deciding which treatment to recommend for whom. We aimed to identify clinical and genetic (5-HTTLPR, COMTval158met, and BDNFval66met) predictors and moderators of ICBT and CBGT. Method: We performed three types of analyses on data from a sample comprising participants (N = 126) who had undergone ICBT or CBGT in a randomized controlled trial. Outcomes were i) end state symptom severity, ii) SAD diagnosis, and iii) clinically significant improvement. Results: The most stable predictors of better treatment response were working full time, having children, less depressive symptoms, higher expectancy of treatment effectiveness, and adhering to treatment. None of the tested gene polymorphisms were associated with treatment outcome. Comorbid general anxiety and depression were moderators meaning that lower levels were associated with a better treatment response in ICBT but not in CBGT. Conclusion: We conclude that demographic factors, symptom burden, adherence, and expectations may play an important role as predictors of treatment outcome. The investigated gene polymorphisms do not appear to make a difference.

  • internet based Cognitive Behavior Therapy for obsessive compulsive disorder a pilot study
    2011
    Co-Authors: Erik Andersson, Gerhard Andersson, Erik Hedman, Brjánn Ljótsson, Nils Lindefors, Viktor Kaldo, Bjorn Paxling, Christian Ruck
    Abstract:

    Background: Cognitive Behavior Therapy (CBT) is widely regarded as an effective treatment for obsessive compulsive disorder (OCD), but access to CBT therapists is limited. Internet-based CBT (ICBT) with therapist support is a way to increase access to CBT but has not been developed or tested for OCD. The aim of this study was to evaluate ICBT for OCD. Method: An open trial where patients (N = 23) received a 15-week ICBT program with therapist support consisting of psychoeducation, Cognitive restructuring and exposure with response prevention. The primary outcome was the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), which was assessed by a psychiatrist before and immediately after treatment. Secondary outcomes were self-rated measures of OCD symptoms, depressive symptoms, general functioning, anxiety and quality of life. All assessments were made at baseline and post-treatment. Results: All participants completed the primary outcome measure at all assessment points. There were reductions in OCD symptoms with a large within-group effect size (Cohen’s d = 1.56). At post-treatment, 61% of participants had a clinically significant improvement and 43% no longer fulfilled the diagnostic criteria of OCD. The treatment also resulted in statistically significant improvements in self-rated OCD symptoms, general functioning and depression. Conclusions: ICBT with therapist support reduces OCD symptoms, depressive symptoms and improves general functioning. Randomized trials are needed to confirm the effectiveness of this new treatment format. Trial Registration: ClinicalTrials.gov: NCT01348529

  • a 5 year follow up of internet based Cognitive Behavior Therapy for social anxiety disorder
    2011
    Co-Authors: Erik Hedman, Per Carlbring, Brjánn Ljótsson, Tomas Furmark, Christian Ruck, Nils Lindefors, Gerhard Andersson
    Abstract:

    Background: Internet-based Cognitive Behavior Therapy (CBT) has been shown to be a promising method to disseminate Cognitive Behavior Therapy for social anxiety disorder (SAD). Several trials have ...