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Behandlingsstudie avseende tre sessioners exponeringsfokuserad KBT vid panikångest. En pilotstudie vid en vårdcentral i södra Sverige.

Bergmark Hall, Christina LU (2016) PPTN76 20161
Department of Psychology
Abstract
This study investigated the short-term outcome of a three session exposure in vivo treatment – E-CBT – for eight primary health care patients with panic disorder, who used distraction techniques as their most common safety behavior. The primary question was if this abbreviated treatment that, besides initial psychoeducation, solely used exposure in vivo as therapeutic intervention, could show short- term effects that were comparable to the effects commonly seen in standard CBT approaches to panic disorder. Subjects were eight primary health care patients recruited from routine primary health care. Treatment consisted of three weekly sessions with initial psychoeducation followed by exposure in vivo alone. Subjects were randomised to a... (More)
This study investigated the short-term outcome of a three session exposure in vivo treatment – E-CBT – for eight primary health care patients with panic disorder, who used distraction techniques as their most common safety behavior. The primary question was if this abbreviated treatment that, besides initial psychoeducation, solely used exposure in vivo as therapeutic intervention, could show short- term effects that were comparable to the effects commonly seen in standard CBT approaches to panic disorder. Subjects were eight primary health care patients recruited from routine primary health care. Treatment consisted of three weekly sessions with initial psychoeducation followed by exposure in vivo alone. Subjects were randomised to a baseline period of one, two or three weeks. Outcome measurements were six commonly used self-rating scales assessing panic symptoms and agoraphobia. Measurements were taken at baseline, post treatment and at two follow-up occasions; one and two weeks after termination of treatment. Primary outcome measure was Panic Disorder Severity Scale Self-Report (PDSS-SR). Two of the instruments and another one assessing the quality of the therapeutic alliance, were also administrated during treatment sessions to enable a closer study of the possible changes during treatment. The study employed an experimental single case-design. On a group level, significant improvements were observed on all outcome measures. Within-group effect sizes were high (Cohen´s d ranging from 1.17–3.00). 75 % of the subjects showed a reliable change on the primary outcome measure PDSS-SR, and 50 % clinical significance. Analyses at the individual level were carried out to study changes over time for each participant. No significant correlation was found between participants ratings of the quality of the therapeutic alliance during the treatment period and their outcome on PDSS-SR. The results as a whole, give support to the primary hypothesis of the study that E-CBT can show short-term effects that are comparable to the effects of standard CBT for patients with panic anxiety. The results of this study provide a basis for pursuing and further developing the exposure technique in treatment of panic disorder and for testing it in group designs with larger samples and different therapists. (Less)
Popular Abstract (Swedish)
Studiens syfte var att undersöka det kortsiktiga utfallet av en ny, exponeringsfokuserad behandling – E-KBT – för personer med panikångest. Den primära frågeställningen var om en kortare KBT-behandling bestående av tre sessioner med exponering in vivo som huvudkomponent, kan ge kortsiktiga effekter jämförbara med det positiva utfall som ses vid standard KBT-behandling för individer som har panikångest och använder sig av distraktionstekniker som säkerhetsbeteende. Åtta primärvårdspatienter deltog i studien. Deltagarna rekryterades ur det naturliga patientunderlaget vid en vårdcentral. Behandlingen bestod av tre sessioner innehållande kort psykoedukation, därutöver endast exponering in vivo. Deltagarna slumpades till en, två eller tre... (More)
Studiens syfte var att undersöka det kortsiktiga utfallet av en ny, exponeringsfokuserad behandling – E-KBT – för personer med panikångest. Den primära frågeställningen var om en kortare KBT-behandling bestående av tre sessioner med exponering in vivo som huvudkomponent, kan ge kortsiktiga effekter jämförbara med det positiva utfall som ses vid standard KBT-behandling för individer som har panikångest och använder sig av distraktionstekniker som säkerhetsbeteende. Åtta primärvårdspatienter deltog i studien. Deltagarna rekryterades ur det naturliga patientunderlaget vid en vårdcentral. Behandlingen bestod av tre sessioner innehållande kort psykoedukation, därutöver endast exponering in vivo. Deltagarna slumpades till en, två eller tre veckors baslinjeperiod. Deltagarna besvarade sex självskattningsformulär relaterade till panikångest vid förmätningen, eftermätningen och vid två uppföljningstillfällen. Primärt utfallsmått var Panic Disorder Severity Scale Self-Report (PDSS-SR). Deltagarna besvarade även två av utfallsmåtten samt ytterligare ett formulär kring kvaliteten på den terapeutiska alliansen i samband med behandlingssessionerna för att närmare studera den eventuella förändringen under behandlingens gång. En multipel fallstudie-design användes. Samtliga utfallsmått i studien förbättrades signifikant på gruppnivå; effektstorlekarna var överlag starka (d = 1,17 och d = 3,00). På det primära utfallsmåttet PDSS-SR, uppnådde 75 % en reliabel förändring, 50 % klinisk signifikans. Analyser på individnivå gjordes för att studera tidsförloppet. Inget signifikant samband kunde hittas mellan deltagarnas skattningar av kvaliteten på den terapeutiska alliansen under behandlingsperioden och deras utfall på PDSS-SR. Resultaten som helhet bekräftar studiens antagande att E-KBT kan ge kortsiktiga effekter som är jämförbara med standard KBT. Resultaten ger stöd för att det finns anledning att gå vidare med att pröva avkortade, exponeringsfokuserade behandlingsupplägg på större sampel, med olika behandlare och under mer kontrollerade betingelser. (Less)
Please use this url to cite or link to this publication:
@misc{8873695,
  abstract     = {This study investigated the short-term outcome of a three session exposure in vivo treatment – E-CBT – for eight primary health care patients with panic disorder, who used distraction techniques as their most common safety behavior. The primary question was if this abbreviated treatment that, besides initial psychoeducation, solely used exposure in vivo as therapeutic intervention, could show short- term effects that were comparable to the effects commonly seen in standard CBT approaches to panic disorder. Subjects were eight primary health care patients recruited from routine primary health care. Treatment consisted of three weekly sessions with initial psychoeducation followed by exposure in vivo alone. Subjects were randomised to a baseline period of one, two or three weeks. Outcome measurements were six commonly used self-rating scales assessing panic symptoms and agoraphobia. Measurements were taken at baseline, post treatment and at two follow-up occasions; one and two weeks after termination of treatment. Primary outcome measure was Panic Disorder Severity Scale Self-Report (PDSS-SR). Two of the instruments and another one assessing the quality of the therapeutic alliance, were also administrated during treatment sessions to enable a closer study of the possible changes during treatment. The study employed an experimental single case-design. On a group level, significant improvements were observed on all outcome measures. Within-group effect sizes were high (Cohen´s d ranging from 1.17–3.00). 75 % of the subjects showed a reliable change on the primary outcome measure PDSS-SR, and 50 % clinical significance. Analyses at the individual level were carried out to study changes over time for each participant. No significant correlation was found between participants ratings of the quality of the therapeutic alliance during the treatment period and their outcome on PDSS-SR. The results as a whole, give support to the primary hypothesis of the study that E-CBT can show short-term effects that are comparable to the effects of standard CBT for patients with panic anxiety. The results of this study provide a basis for pursuing and further developing the exposure technique in treatment of panic disorder and for testing it in group designs with larger samples and different therapists.},
  author       = {Bergmark Hall, Christina},
  keyword      = {distraction techniques,exposure therapy,exposure in vivo,panic disorder (PD),Cognitive behavior therapy (KBT),safety behavior,agoraphobic avoidance,multiple single-case design,Kognitiv beteendeterapi (KBT),panikångest,paniksyndrom (PD),exponering in vivo,agorafobiskt undvikande,exponeringsterapi,säkerhetsbeteende,distraktionstekniker,multipel fallstudie-design},
  language     = {swe},
  note         = {Student Paper},
  title        = {Behandlingsstudie avseende tre sessioners exponeringsfokuserad KBT vid panikångest. En pilotstudie vid en vårdcentral i södra Sverige.},
  year         = {2016},
}