Slide
Centre Interdisciplinaire
de Recherche et d’Innovation
en Cybersécurité et Société
de Recherche et d’Innovation
en Cybersécurité et Société
1.
Ouellet-Courtois, C.; Bouchard, S.; Giguère, C. -E.; Koszycki, D.; Lavoie, M. E.; Aardema, F.
Cognitive mechanisms of change in OCD: Inferential confusion, obsessive beliefs, and mindfulness across three randomized treatments Journal Article
In: Behaviour Research and Therapy, vol. 201, 2026, ISSN: 00057967 (ISSN).
Abstract | Links | BibTeX | Tags: adult, antidepressant agent, Anxiety disorder, article, behavior therapy, benzodiazepine, clinical outcome, clinical trial, cognition, cognitive behavioral therapy, Cognitive mechanisms of change, confusion, confusion (uncertainty), controlled study, Depression, exposure and response prevention, female, human, Humans, Implosive Therapy, inference based cognitive behavioral therapy, Inferential confusion, major clinical study, male, Middle Aged, mindfulness, mindfulness-based stress reduction, multicenter study, obsession, obsessive compulsive disorder, Obsessive-Compulsive Disorder, procedures, psychology, randomized controlled trial, risk factor, Sensitivity analysis, Therapy, treatment outcome, Young Adult
@article{ouellet-courtoisCognitiveMechanismsChange2026,
title = {Cognitive mechanisms of change in OCD: Inferential confusion, obsessive beliefs, and mindfulness across three randomized treatments},
author = {C. Ouellet-Courtois and S. Bouchard and C. -E. Giguère and D. Koszycki and M. E. Lavoie and F. Aardema},
url = {https://www.scopus.com/pages/publications/105034701697?origin=resultslist},
doi = {10.1016/j.brat.2026.105022},
issn = {00057967 (ISSN)},
year = {2026},
date = {2026-01-01},
journal = {Behaviour Research and Therapy},
volume = {201},
publisher = {Elsevier Ltd},
abstract = {Cognitive-behavioral therapy (CBT) with exposure and response prevention (ERP) is widely regarded as the gold-standard psychological treatment for obsessive–compulsive disorder (OCD). Inference-based cognitive behavioral therapy (I-CBT) represents a distinct cognitive approach that targets inferential confusion, defined as a reasoning process whereby imagined possibilities are treated as reflecting reality, without relying on deliberate exposure. The present study reports further mechanism-focused analyses from a previously published multicenter randomized controlled trial (Aardema et al., 2022; ClinicalTrials.gov Identifier: NCT01794156) comparing CBT with ERP, I-CBT, and mindfulness-based stress reduction (MBSR) for OCD. A total of 111 participants with a primary diagnosis of OCD were randomized to one of three treatment conditions. Across treatments, therapy was associated with significant reductions in inferential confusion and obsessive belief domains, whereas dispositional mindfulness did not show significant change. At the bivariate level, residualized changes in inferential confusion, obsessive belief domains, and mindfulness were associated with reductions in OCD symptoms. However, when examined concurrently using mixed-effects models, only reductions in inferential confusion accounted for unique symptom improvement over time. This association was consistent across modalities and remained robust after controlling for concurrent anxiety and depression. Sensitivity analyses indicated that psychotropic medication use did not account for this association; controlling for medication strengthened the independent contribution of inferential confusion (partial η2 ≈ .29). These findings indicate that inferential confusion was independently associated with symptom improvement in OCD across therapeutic approaches. © 2026 Elsevier Ltd},
keywords = {adult, antidepressant agent, Anxiety disorder, article, behavior therapy, benzodiazepine, clinical outcome, clinical trial, cognition, cognitive behavioral therapy, Cognitive mechanisms of change, confusion, confusion (uncertainty), controlled study, Depression, exposure and response prevention, female, human, Humans, Implosive Therapy, inference based cognitive behavioral therapy, Inferential confusion, major clinical study, male, Middle Aged, mindfulness, mindfulness-based stress reduction, multicenter study, obsession, obsessive compulsive disorder, Obsessive-Compulsive Disorder, procedures, psychology, randomized controlled trial, risk factor, Sensitivity analysis, Therapy, treatment outcome, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Cognitive-behavioral therapy (CBT) with exposure and response prevention (ERP) is widely regarded as the gold-standard psychological treatment for obsessive–compulsive disorder (OCD). Inference-based cognitive behavioral therapy (I-CBT) represents a distinct cognitive approach that targets inferential confusion, defined as a reasoning process whereby imagined possibilities are treated as reflecting reality, without relying on deliberate exposure. The present study reports further mechanism-focused analyses from a previously published multicenter randomized controlled trial (Aardema et al., 2022; ClinicalTrials.gov Identifier: NCT01794156) comparing CBT with ERP, I-CBT, and mindfulness-based stress reduction (MBSR) for OCD. A total of 111 participants with a primary diagnosis of OCD were randomized to one of three treatment conditions. Across treatments, therapy was associated with significant reductions in inferential confusion and obsessive belief domains, whereas dispositional mindfulness did not show significant change. At the bivariate level, residualized changes in inferential confusion, obsessive belief domains, and mindfulness were associated with reductions in OCD symptoms. However, when examined concurrently using mixed-effects models, only reductions in inferential confusion accounted for unique symptom improvement over time. This association was consistent across modalities and remained robust after controlling for concurrent anxiety and depression. Sensitivity analyses indicated that psychotropic medication use did not account for this association; controlling for medication strengthened the independent contribution of inferential confusion (partial η2 ≈ .29). These findings indicate that inferential confusion was independently associated with symptom improvement in OCD across therapeutic approaches. © 2026 Elsevier Ltd
2.
Corno, G.; Zamora, Á.; Bouchard, S.; Baños, R.; Baillot, A.; Monthuy-Blanc, J.
Exploring Virtual Reality for Body Image Assessment and Psychological Interventions in Individuals With Obesity: a Comprehensive Review Journal Article
In: Obesity Reviews, vol. 27, no. 4, 2026, ISSN: 14677881 (ISSN).
Abstract | Links | BibTeX | Tags: adult, Anxiety disorder, Assertiveness, Bariatric Surgery, body dysmorphic disorder, body image, body image assessment, body image avoidance questionnaire, body image disturbances, body satisfaction scale, bulimia, Clinical research, cognitive behavioral therapy, cognitive therapy, Depression, electroconvulsive therapy, exercise, feeding behavior, female, follow up, gastric banding, geography, group therapy, human, Humans, Italy, low calorie diet, male, obesity, overnutrition, physical activity, procedures, psychology, psychotherapy, quality of life, review, social background, systematic review, Therapy, Three-Factor-Eating-Questionnaire, training, virtual reality
@article{cornoExploringVirtualReality2026,
title = {Exploring Virtual Reality for Body Image Assessment and Psychological Interventions in Individuals With Obesity: a Comprehensive Review},
author = {G. Corno and Á. Zamora and S. Bouchard and R. Baños and A. Baillot and J. Monthuy-Blanc},
url = {https://www.scopus.com/pages/publications/105024457568?origin=resultslist},
doi = {10.1111/obr.70051},
issn = {14677881 (ISSN)},
year = {2026},
date = {2026-01-01},
journal = {Obesity Reviews},
volume = {27},
number = {4},
publisher = {John Wiley and Sons Inc},
abstract = {Introduction: Individuals living with obesity often experience body image (BI) disturbances, which can negatively affect their quality of life and treatment outcomes. Virtual reality (VR) has emerged as a promising tool for enhancing psychological interventions, but no comprehensive review has specifically focused on VR-based studies addressing BI disturbances in this population. Methods: This comprehensive review examined studies utilizing VR for the assessment and treatment of BI disturbances in individuals with obesity. Twelve studies met the inclusion criteria. Results: Studies were categorized into three groups: (i) VR in psychological interventions for individuals with obesity, (ii) VR interventions following metabolic and bariatric surgery, and (iii) VR-based full-body illusion experiments. The primary clinical application was experiential cognitive therapy, which demonstrated greater efficacy in reducing negative BI compared with standard cognitive behavioral therapy and other treatments. Studies involving post-metabolic and bariatric surgery adults also supported VR's efficacy in reducing BI dissatisfaction, though long-term benefits were inconsistent. Full-body illusion experiments suggested that VR can help modify distorted body perceptions. However, most studies were conducted by the same research group, focused exclusively on women, and were limited to specific geographical regions, primarily Italy. Conclusion: While preliminary results suggest that VR is a promising tool for treating BI disturbances in individuals with obesity, the field remains under-researched. Notably, no studies have explored VR's potential as an assessment tool in this population. Future studies should include more diverse populations, investigate long-term outcomes, and explore potential barriers to clinical implementation. © 2025 The Author(s). Obesity Reviews published by John Wiley & Sons Ltd on behalf of World Obesity Federation.},
keywords = {adult, Anxiety disorder, Assertiveness, Bariatric Surgery, body dysmorphic disorder, body image, body image assessment, body image avoidance questionnaire, body image disturbances, body satisfaction scale, bulimia, Clinical research, cognitive behavioral therapy, cognitive therapy, Depression, electroconvulsive therapy, exercise, feeding behavior, female, follow up, gastric banding, geography, group therapy, human, Humans, Italy, low calorie diet, male, obesity, overnutrition, physical activity, procedures, psychology, psychotherapy, quality of life, review, social background, systematic review, Therapy, Three-Factor-Eating-Questionnaire, training, virtual reality},
pubstate = {published},
tppubtype = {article}
}
Introduction: Individuals living with obesity often experience body image (BI) disturbances, which can negatively affect their quality of life and treatment outcomes. Virtual reality (VR) has emerged as a promising tool for enhancing psychological interventions, but no comprehensive review has specifically focused on VR-based studies addressing BI disturbances in this population. Methods: This comprehensive review examined studies utilizing VR for the assessment and treatment of BI disturbances in individuals with obesity. Twelve studies met the inclusion criteria. Results: Studies were categorized into three groups: (i) VR in psychological interventions for individuals with obesity, (ii) VR interventions following metabolic and bariatric surgery, and (iii) VR-based full-body illusion experiments. The primary clinical application was experiential cognitive therapy, which demonstrated greater efficacy in reducing negative BI compared with standard cognitive behavioral therapy and other treatments. Studies involving post-metabolic and bariatric surgery adults also supported VR's efficacy in reducing BI dissatisfaction, though long-term benefits were inconsistent. Full-body illusion experiments suggested that VR can help modify distorted body perceptions. However, most studies were conducted by the same research group, focused exclusively on women, and were limited to specific geographical regions, primarily Italy. Conclusion: While preliminary results suggest that VR is a promising tool for treating BI disturbances in individuals with obesity, the field remains under-researched. Notably, no studies have explored VR's potential as an assessment tool in this population. Future studies should include more diverse populations, investigate long-term outcomes, and explore potential barriers to clinical implementation. © 2025 The Author(s). Obesity Reviews published by John Wiley & Sons Ltd on behalf of World Obesity Federation.
3.
Scholten, W.; Seldenrijk, A.; Hoogendoorn, A.; Bosman, R.; Muntingh, A.; Karyotaki, E.; Andersson, G.; Berger, T.; Carlbring, P.; Furmark, T.; Bouchard, S.; Goldin, P.; Kampmann, I.; Morina, N.; Kocovski, N.; Leibing, E.; Leichsenring, F.; Stolz, T.; Balkom, A. Van; Batelaan, N.
In: JAMA Psychiatry, vol. 80, no. 8, pp. 822–831, 2023, ISSN: 2168622X (ISSN), (Publisher: American Medical Association).
Abstract | Links | BibTeX | Tags: adult, antidepressant agent, Anxiety disorder, article, avoidant personality disorder, clinical outcome, cognitive behavioral therapy, comorbidity, cycloserine, Depression, disease severity, female, hospital admission, human, Humans, Liebowitz Social Anxiety Scale, male, meta analysis, paroxetine, phobia, Preferred Reporting Items for Systematic Reviews and Meta-Analyses, procedures, psychotropic agent, randomized controlled trial (topic), Randomized Controlled Trials as Topic, semi structured interview, Social, social anxiety, social phobia, Structured Clinical Interview for DSM Disorders, symptom, systematic review, treatment response, Waiting Lists
@article{scholten_baseline_2023,
title = {Baseline Severity as a Moderator of the Waiting List-Controlled Association of Cognitive Behavioral Therapy with Symptom Change in Social Anxiety Disorder: A Systematic Review and Individual Patient Data Meta-analysis},
author = {W. Scholten and A. Seldenrijk and A. Hoogendoorn and R. Bosman and A. Muntingh and E. Karyotaki and G. Andersson and T. Berger and P. Carlbring and T. Furmark and S. Bouchard and P. Goldin and I. Kampmann and N. Morina and N. Kocovski and E. Leibing and F. Leichsenring and T. Stolz and A. Van Balkom and N. Batelaan},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85166386036&doi=10.1001%2fjamapsychiatry.2023.1291&partnerID=40&md5=c279c8b0ff2d3b4558c6f8803cdda0af},
doi = {10.1001/jamapsychiatry.2023.1291},
issn = {2168622X (ISSN)},
year = {2023},
date = {2023-01-01},
journal = {JAMA Psychiatry},
volume = {80},
number = {8},
pages = {822–831},
publisher = {American Medical Association},
abstract = {Importance: Social anxiety disorder (SAD) can be adequately treated with cognitive behavioral therapy (CBT). However, there is a large gap in knowledge on factors associated with prognosis, and it is unclear whether symptom severity predicts response to CBT for SAD. Objective: To examine baseline SAD symptom severity as a moderator of the association between CBT and symptom change in patients with SAD. Data Sources: For this systematic review and individual patient data meta-analysis (IPDMA), PubMed, PsycInfo, Embase, and the Cochrane Library were searched from January 1, 1990, to January 13, 2023. Primary search topics were social anxiety disorder, cognitive behavior therapy, and randomized controlled trial. Study Selection: Inclusion criteria were randomized clinical trials comparing CBT with being on a waiting list and using the Liebowitz Social Anxiety Scale (LSAS) in adults with a primary clinical diagnosis of SAD. Data Extraction and Synthesis: Authors of included studies were approached to provide individual-level data. Data were extracted by pairs of authors following the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guideline, and risk of bias was assessed using the Cochrane tool. An IPDMA was conducted using a 2-stage approach for the association of CBT with change in LSAS scores from baseline to posttreatment and for the interaction effect of baseline LSAS score by condition using random-effects models. Main Outcomes and Measures: The main outcome was the baseline to posttreatment change in symptom severity measured by the LSAS. Results: A total of 12 studies including 1246 patients with SAD (mean [SD] age, 35.3 [10.9] years; 738 [59.2%] female) were included in the meta-analysis. A waiting list-controlled association between CBT and pretreatment to posttreatment LSAS change was found (b = -20.3; 95% CI, -24.9 to -15.6; P <.001; Cohen d = -0.95; 95% CI, -1.16 to -0.73). Baseline LSAS scores moderated the differences between CBT and waiting list with respect to pretreatment to posttreatment symptom reductions (b = -0.22; 95% CI, -0.39 to -0.06; P =.009), indicating that individuals with severe symptoms had larger waiting list-controlled symptom reductions after CBT (Cohen d = -1.13 [95% CI, -1.39 to -0.88] for patients with very severe SAD; Cohen d = -0.54 [95% CI, -0.80 to -0.29] for patients with mild SAD). Conclusions and Relevance: In this systematic review and IPDMA, higher baseline SAD symptom severity was associated with greater (absolute but not relative) symptom reductions after CBT in patients with SAD. The findings contribute to personalized care by suggesting that clinicians can confidently offer CBT to individuals with severe SAD symptoms.. © 2023 American Medical Association. All rights reserved.},
note = {Publisher: American Medical Association},
keywords = {adult, antidepressant agent, Anxiety disorder, article, avoidant personality disorder, clinical outcome, cognitive behavioral therapy, comorbidity, cycloserine, Depression, disease severity, female, hospital admission, human, Humans, Liebowitz Social Anxiety Scale, male, meta analysis, paroxetine, phobia, Preferred Reporting Items for Systematic Reviews and Meta-Analyses, procedures, psychotropic agent, randomized controlled trial (topic), Randomized Controlled Trials as Topic, semi structured interview, Social, social anxiety, social phobia, Structured Clinical Interview for DSM Disorders, symptom, systematic review, treatment response, Waiting Lists},
pubstate = {published},
tppubtype = {article}
}
Importance: Social anxiety disorder (SAD) can be adequately treated with cognitive behavioral therapy (CBT). However, there is a large gap in knowledge on factors associated with prognosis, and it is unclear whether symptom severity predicts response to CBT for SAD. Objective: To examine baseline SAD symptom severity as a moderator of the association between CBT and symptom change in patients with SAD. Data Sources: For this systematic review and individual patient data meta-analysis (IPDMA), PubMed, PsycInfo, Embase, and the Cochrane Library were searched from January 1, 1990, to January 13, 2023. Primary search topics were social anxiety disorder, cognitive behavior therapy, and randomized controlled trial. Study Selection: Inclusion criteria were randomized clinical trials comparing CBT with being on a waiting list and using the Liebowitz Social Anxiety Scale (LSAS) in adults with a primary clinical diagnosis of SAD. Data Extraction and Synthesis: Authors of included studies were approached to provide individual-level data. Data were extracted by pairs of authors following the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guideline, and risk of bias was assessed using the Cochrane tool. An IPDMA was conducted using a 2-stage approach for the association of CBT with change in LSAS scores from baseline to posttreatment and for the interaction effect of baseline LSAS score by condition using random-effects models. Main Outcomes and Measures: The main outcome was the baseline to posttreatment change in symptom severity measured by the LSAS. Results: A total of 12 studies including 1246 patients with SAD (mean [SD] age, 35.3 [10.9] years; 738 [59.2%] female) were included in the meta-analysis. A waiting list-controlled association between CBT and pretreatment to posttreatment LSAS change was found (b = -20.3; 95% CI, -24.9 to -15.6; P <.001; Cohen d = -0.95; 95% CI, -1.16 to -0.73). Baseline LSAS scores moderated the differences between CBT and waiting list with respect to pretreatment to posttreatment symptom reductions (b = -0.22; 95% CI, -0.39 to -0.06; P =.009), indicating that individuals with severe symptoms had larger waiting list-controlled symptom reductions after CBT (Cohen d = -1.13 [95% CI, -1.39 to -0.88] for patients with very severe SAD; Cohen d = -0.54 [95% CI, -0.80 to -0.29] for patients with mild SAD). Conclusions and Relevance: In this systematic review and IPDMA, higher baseline SAD symptom severity was associated with greater (absolute but not relative) symptom reductions after CBT in patients with SAD. The findings contribute to personalized care by suggesting that clinicians can confidently offer CBT to individuals with severe SAD symptoms.. © 2023 American Medical Association. All rights reserved.
4.
Bouchard, S.; Berthiaume, M.; Robillard, G.; Allard, M.; Green-Demers, I.; Watts, S.; Marchand, A.; Gosselin, P.; Langlois, F.; Belleville, G.; Dugas, M. J.
The moderating and mediating role of telepresence and cognitive change in cognitive behaviour therapy delivered via videoconference Journal Article
In: Clinical Psychology and Psychotherapy, vol. 30, no. 3, pp. 575–586, 2023, ISSN: 10633995, (Publisher: John Wiley and Sons Ltd).
Abstract | Links | BibTeX | Tags: agoraphobia, Anxiety disorder, Anxiety Disorders, cognition, cognitive behavioral therapy, human, Humans, procedures, treatment outcome, videoconferencing
@article{bouchard_moderating_2023,
title = {The moderating and mediating role of telepresence and cognitive change in cognitive behaviour therapy delivered via videoconference},
author = {S. Bouchard and M. Berthiaume and G. Robillard and M. Allard and I. Green-Demers and S. Watts and A. Marchand and P. Gosselin and F. Langlois and G. Belleville and M. J. Dugas},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85139800809&doi=10.1002%2fcpp.2816&partnerID=40&md5=5eac58684326b5475037e1474aa932f7},
doi = {10.1002/cpp.2816},
issn = {10633995},
year = {2023},
date = {2023-01-01},
journal = {Clinical Psychology and Psychotherapy},
volume = {30},
number = {3},
pages = {575–586},
publisher = {John Wiley and Sons Ltd},
abstract = {In this study, we combined the results of two controlled trials and examined the relationships between working alliance, telepresence, cognitive change and treatment outcome. Sixty-five participants with a primary diagnosis of generalized anxiety disorder (GAD) or panic disorder with agoraphobia (PDA) received cognitive behaviour therapy delivered via videoconference. Participants completed measures of working alliance and telepresence after three psychotherapy sessions. They also completed measures of treatment outcome and dysfunctional beliefs (cognitive change) specific to PDA and GAD at pretreatment and posttreatment. Results revealed that telepresence at the fifth session moderated the relationship between the working alliance at the first and fifth sessions. As telepresence increased, its impact on the working alliance diminished. Cognitive change mediated the relationship between the working alliance at the fifth session and treatment outcome. © 2022 John Wiley & Sons Ltd.},
note = {Publisher: John Wiley and Sons Ltd},
keywords = {agoraphobia, Anxiety disorder, Anxiety Disorders, cognition, cognitive behavioral therapy, human, Humans, procedures, treatment outcome, videoconferencing},
pubstate = {published},
tppubtype = {article}
}
In this study, we combined the results of two controlled trials and examined the relationships between working alliance, telepresence, cognitive change and treatment outcome. Sixty-five participants with a primary diagnosis of generalized anxiety disorder (GAD) or panic disorder with agoraphobia (PDA) received cognitive behaviour therapy delivered via videoconference. Participants completed measures of working alliance and telepresence after three psychotherapy sessions. They also completed measures of treatment outcome and dysfunctional beliefs (cognitive change) specific to PDA and GAD at pretreatment and posttreatment. Results revealed that telepresence at the fifth session moderated the relationship between the working alliance at the first and fifth sessions. As telepresence increased, its impact on the working alliance diminished. Cognitive change mediated the relationship between the working alliance at the fifth session and treatment outcome. © 2022 John Wiley & Sons Ltd.
5.
Dugas, M. J.; Marchal, K. Giguère; Cormier, S.; Bouchard, S.; Gouin, J. -P.; Shafran, R.
Pain catastrophizing and worry about health in generalized anxiety disorder Journal Article
In: Clinical Psychology and Psychotherapy, vol. 30, no. 4, pp. 852–861, 2023, ISSN: 10633995, (Publisher: John Wiley and Sons Ltd).
Abstract | Links | BibTeX | Tags: adult, Anxiety, Anxiety disorder, Anxiety Disorders, Catastrophization, catastrophizing, human, Humans, Pain, psychology, uncertainty
@article{dugas_pain_2023,
title = {Pain catastrophizing and worry about health in generalized anxiety disorder},
author = {M. J. Dugas and K. Giguère Marchal and S. Cormier and S. Bouchard and J. -P. Gouin and R. Shafran},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85150514206&doi=10.1002%2fcpp.2843&partnerID=40&md5=2676de0f5a42bcdaea5f10aa5e8e3f55},
doi = {10.1002/cpp.2843},
issn = {10633995},
year = {2023},
date = {2023-01-01},
journal = {Clinical Psychology and Psychotherapy},
volume = {30},
number = {4},
pages = {852–861},
publisher = {John Wiley and Sons Ltd},
abstract = {Because the diagnostic criteria of generalized anxiety disorder (GAD) are not tied to specific worry domains (worry is ‘generalized’), research on the content of worry in GAD is lacking. To our knowledge, no study has addressed vulnerability for specific worry topics in GAD. The goal of the current study, a secondary analysis of data from a clinical trial, is to explore the relationship between pain catastrophizing and worry about health in a sample of 60 adults with primary GAD. All data for this study were collected at pretest, prior to randomization to experimental condition in the larger trial. The hypotheses were that (1) pain catastrophizing would be positively related to the severity of GAD, (2) the relationship between pain catastrophizing and the severity of GAD would not be explained by intolerance of uncertainty and psychological rigidity, and (3) pain catastrophizing would be greater in participants reporting worry about health compared to those not reporting worry about health. All hypotheses were confirmed, suggesting that pain catastrophizing may be a threat-specific vulnerability for health-related worry in GAD. The implications of the current findings include a better understanding of the ideographic content of worry, which could help focus treatment interventions for individuals with GAD. © 2023 The Authors. Clinical Psychology & Psychotherapy published by John Wiley & Sons Ltd.},
note = {Publisher: John Wiley and Sons Ltd},
keywords = {adult, Anxiety, Anxiety disorder, Anxiety Disorders, Catastrophization, catastrophizing, human, Humans, Pain, psychology, uncertainty},
pubstate = {published},
tppubtype = {article}
}
Because the diagnostic criteria of generalized anxiety disorder (GAD) are not tied to specific worry domains (worry is ‘generalized’), research on the content of worry in GAD is lacking. To our knowledge, no study has addressed vulnerability for specific worry topics in GAD. The goal of the current study, a secondary analysis of data from a clinical trial, is to explore the relationship between pain catastrophizing and worry about health in a sample of 60 adults with primary GAD. All data for this study were collected at pretest, prior to randomization to experimental condition in the larger trial. The hypotheses were that (1) pain catastrophizing would be positively related to the severity of GAD, (2) the relationship between pain catastrophizing and the severity of GAD would not be explained by intolerance of uncertainty and psychological rigidity, and (3) pain catastrophizing would be greater in participants reporting worry about health compared to those not reporting worry about health. All hypotheses were confirmed, suggesting that pain catastrophizing may be a threat-specific vulnerability for health-related worry in GAD. The implications of the current findings include a better understanding of the ideographic content of worry, which could help focus treatment interventions for individuals with GAD. © 2023 The Authors. Clinical Psychology & Psychotherapy published by John Wiley & Sons Ltd.
6.
Clemmensen, L.; Jørgensen, G.; Gundersen, K. B.; Smith, L. C.; Midtgaard, J.; Bouchard, S.; Thomsen, C. P.; Turgut, L.; Glenthoj, L. B.
In: BMJ Open, vol. 13, no. 9, 2023, ISSN: 20446055, (Publisher: BMJ Publishing Group).
Abstract | Links | BibTeX | Tags: Anxiety disorder, article, Behavior Observation Techniques, behavioral observation, borderline state, clinical effectiveness, clinical outcome, clinical protocol, Coercion, cognitive behavioral therapy, comparative study, Denmark, Depression, feasibility study, health care need, hospital patient, human, Humans, intensive care unit, Intensive Care Units, interpersonal communication, leisure, Leisure Activities, major clinical study, neuroleptic agent, non participant observation, Patient Satisfaction, peer review, pilot study, psychiatric intensive care unit, qualitative analysis, quantitative analysis, schizophrenia spectrum disorder, semi structured interview, virtual reality, virtual reality delivered stress reduction
@article{clemmensen_study_2023,
title = {Study protocol for virtual leisure investigating the effect of virtual reality-delivered stress reduction, entertainment and distraction on the use of coercion and need-based medication and patient satisfaction at a closed psychiatric intensive care unit - A mixed-methods pilot clinical trial},
author = {L. Clemmensen and G. Jørgensen and K. B. Gundersen and L. C. Smith and J. Midtgaard and S. Bouchard and C. P. Thomsen and L. Turgut and L. B. Glenthoj},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85172425765&doi=10.1136%2fbmjopen-2022-070566&partnerID=40&md5=87f1ee7c5b1f4d9245722d461eb9e6d2},
doi = {10.1136/bmjopen-2022-070566},
issn = {20446055},
year = {2023},
date = {2023-01-01},
journal = {BMJ Open},
volume = {13},
number = {9},
publisher = {BMJ Publishing Group},
abstract = {Introduction The environment at a psychiatric inpatient ward can lead to emotional distress and behavioural deviations in vulnerable individuals potentially resulting in conflicts, increased use of need-based medication and coercive actions, along with low satisfaction with treatment. To accommodate these challenges, recreational and entertaining interventions are recommended. The tested interventions have, however, shown varying effects and demand a high degree of planning and staff involvement while being difficult to adapt to individual needs. Virtual reality (VR) may help overcome these challenges. Methods and analysis The study is a mixed-methods clinical trial with a target sample of 124 patients hospitalised at a closed psychiatric ward in the capital region of Denmark. Outcomes (eg, coercion, need-based medication and perceived stress) for a 12-month period where all patients are offered VR-based recreational experiences during their hospitalisation will be compared with outcomes for a 12-month period where VR is not offered. Feasibility and acceptability will be explored with qualitative interviews supplemented with non-participant observations and focus groups. The study began on 1 January 2023, and we expect to complete data collection by 31 December 2024. Ethics and dissemination The study is registered at Danish Data Protection Agency (j.no P-2022-466) and is approved by the Committee on Health Research Ethics of the capital region of Denmark (j.no 22013313). All patients will be required to provide informed consent. Results from this study will be disseminated via peer-reviewed journals and congress/consortium presentations. Trial registration number NCT05654740. © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.},
note = {Publisher: BMJ Publishing Group},
keywords = {Anxiety disorder, article, Behavior Observation Techniques, behavioral observation, borderline state, clinical effectiveness, clinical outcome, clinical protocol, Coercion, cognitive behavioral therapy, comparative study, Denmark, Depression, feasibility study, health care need, hospital patient, human, Humans, intensive care unit, Intensive Care Units, interpersonal communication, leisure, Leisure Activities, major clinical study, neuroleptic agent, non participant observation, Patient Satisfaction, peer review, pilot study, psychiatric intensive care unit, qualitative analysis, quantitative analysis, schizophrenia spectrum disorder, semi structured interview, virtual reality, virtual reality delivered stress reduction},
pubstate = {published},
tppubtype = {article}
}
Introduction The environment at a psychiatric inpatient ward can lead to emotional distress and behavioural deviations in vulnerable individuals potentially resulting in conflicts, increased use of need-based medication and coercive actions, along with low satisfaction with treatment. To accommodate these challenges, recreational and entertaining interventions are recommended. The tested interventions have, however, shown varying effects and demand a high degree of planning and staff involvement while being difficult to adapt to individual needs. Virtual reality (VR) may help overcome these challenges. Methods and analysis The study is a mixed-methods clinical trial with a target sample of 124 patients hospitalised at a closed psychiatric ward in the capital region of Denmark. Outcomes (eg, coercion, need-based medication and perceived stress) for a 12-month period where all patients are offered VR-based recreational experiences during their hospitalisation will be compared with outcomes for a 12-month period where VR is not offered. Feasibility and acceptability will be explored with qualitative interviews supplemented with non-participant observations and focus groups. The study began on 1 January 2023, and we expect to complete data collection by 31 December 2024. Ethics and dissemination The study is registered at Danish Data Protection Agency (j.no P-2022-466) and is approved by the Committee on Health Research Ethics of the capital region of Denmark (j.no 22013313). All patients will be required to provide informed consent. Results from this study will be disseminated via peer-reviewed journals and congress/consortium presentations. Trial registration number NCT05654740. © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
7.
Scholten, W.; Seldenrijk, A.; Hoogendoorn, A.; Bosman, R.; Muntingh, A.; Karyotaki, E.; Andersson, G.; Berger, T.; Carlbring, P.; Furmark, T.; Bouchard, S.; Goldin, P.; Kampmann, I.; Morina, N.; Kocovski, N.; Leibing, E.; Leichsenring, F.; Stolz, T.; Balkom, A. Van; Batelaan, N.
In: JAMA Psychiatry, vol. 80, no. 8, pp. 822–831, 2023, ISSN: 2168622X (ISSN).
Abstract | Links | BibTeX | Tags: adult, antidepressant agent, Anxiety disorder, article, avoidant personality disorder, clinical outcome, cognitive behavioral therapy, comorbidity, cycloserine, Depression, disease severity, female, hospital admission, human, Humans, Liebowitz Social Anxiety Scale, male, meta analysis, paroxetine, phobia, Preferred Reporting Items for Systematic Reviews and Meta-Analyses, procedures, psychotropic agent, randomized controlled trial (topic), Randomized Controlled Trials as Topic, semi structured interview, Social, social anxiety, social phobia, Structured Clinical Interview for DSM Disorders, symptom, systematic review, treatment response, Waiting Lists
@article{scholtenBaselineSeverityModerator2023,
title = {Baseline Severity as a Moderator of the Waiting List-Controlled Association of Cognitive Behavioral Therapy with Symptom Change in Social Anxiety Disorder: A Systematic Review and Individual Patient Data Meta-analysis},
author = {W. Scholten and A. Seldenrijk and A. Hoogendoorn and R. Bosman and A. Muntingh and E. Karyotaki and G. Andersson and T. Berger and P. Carlbring and T. Furmark and S. Bouchard and P. Goldin and I. Kampmann and N. Morina and N. Kocovski and E. Leibing and F. Leichsenring and T. Stolz and A. Van Balkom and N. Batelaan},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85166386036&doi=10.1001%2fjamapsychiatry.2023.1291&partnerID=40&md5=c279c8b0ff2d3b4558c6f8803cdda0af},
doi = {10.1001/jamapsychiatry.2023.1291},
issn = {2168622X (ISSN)},
year = {2023},
date = {2023-01-01},
journal = {JAMA Psychiatry},
volume = {80},
number = {8},
pages = {822–831},
publisher = {American Medical Association},
abstract = {Importance: Social anxiety disorder (SAD) can be adequately treated with cognitive behavioral therapy (CBT). However, there is a large gap in knowledge on factors associated with prognosis, and it is unclear whether symptom severity predicts response to CBT for SAD. Objective: To examine baseline SAD symptom severity as a moderator of the association between CBT and symptom change in patients with SAD. Data Sources: For this systematic review and individual patient data meta-analysis (IPDMA), PubMed, PsycInfo, Embase, and the Cochrane Library were searched from January 1, 1990, to January 13, 2023. Primary search topics were social anxiety disorder, cognitive behavior therapy, and randomized controlled trial. Study Selection: Inclusion criteria were randomized clinical trials comparing CBT with being on a waiting list and using the Liebowitz Social Anxiety Scale (LSAS) in adults with a primary clinical diagnosis of SAD. Data Extraction and Synthesis: Authors of included studies were approached to provide individual-level data. Data were extracted by pairs of authors following the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guideline, and risk of bias was assessed using the Cochrane tool. An IPDMA was conducted using a 2-stage approach for the association of CBT with change in LSAS scores from baseline to posttreatment and for the interaction effect of baseline LSAS score by condition using random-effects models. Main Outcomes and Measures: The main outcome was the baseline to posttreatment change in symptom severity measured by the LSAS. Results: A total of 12 studies including 1246 patients with SAD (mean [SD] age, 35.3 [10.9] years; 738 [59.2%] female) were included in the meta-analysis. A waiting list-controlled association between CBT and pretreatment to posttreatment LSAS change was found (b = -20.3; 95% CI, -24.9 to -15.6; P <.001; Cohen d = -0.95; 95% CI, -1.16 to -0.73). Baseline LSAS scores moderated the differences between CBT and waiting list with respect to pretreatment to posttreatment symptom reductions (b = -0.22; 95% CI, -0.39 to -0.06; P =.009), indicating that individuals with severe symptoms had larger waiting list-controlled symptom reductions after CBT (Cohen d = -1.13 [95% CI, -1.39 to -0.88] for patients with very severe SAD; Cohen d = -0.54 [95% CI, -0.80 to -0.29] for patients with mild SAD). Conclusions and Relevance: In this systematic review and IPDMA, higher baseline SAD symptom severity was associated with greater (absolute but not relative) symptom reductions after CBT in patients with SAD. The findings contribute to personalized care by suggesting that clinicians can confidently offer CBT to individuals with severe SAD symptoms.. © 2023 American Medical Association. All rights reserved.},
keywords = {adult, antidepressant agent, Anxiety disorder, article, avoidant personality disorder, clinical outcome, cognitive behavioral therapy, comorbidity, cycloserine, Depression, disease severity, female, hospital admission, human, Humans, Liebowitz Social Anxiety Scale, male, meta analysis, paroxetine, phobia, Preferred Reporting Items for Systematic Reviews and Meta-Analyses, procedures, psychotropic agent, randomized controlled trial (topic), Randomized Controlled Trials as Topic, semi structured interview, Social, social anxiety, social phobia, Structured Clinical Interview for DSM Disorders, symptom, systematic review, treatment response, Waiting Lists},
pubstate = {published},
tppubtype = {article}
}
Importance: Social anxiety disorder (SAD) can be adequately treated with cognitive behavioral therapy (CBT). However, there is a large gap in knowledge on factors associated with prognosis, and it is unclear whether symptom severity predicts response to CBT for SAD. Objective: To examine baseline SAD symptom severity as a moderator of the association between CBT and symptom change in patients with SAD. Data Sources: For this systematic review and individual patient data meta-analysis (IPDMA), PubMed, PsycInfo, Embase, and the Cochrane Library were searched from January 1, 1990, to January 13, 2023. Primary search topics were social anxiety disorder, cognitive behavior therapy, and randomized controlled trial. Study Selection: Inclusion criteria were randomized clinical trials comparing CBT with being on a waiting list and using the Liebowitz Social Anxiety Scale (LSAS) in adults with a primary clinical diagnosis of SAD. Data Extraction and Synthesis: Authors of included studies were approached to provide individual-level data. Data were extracted by pairs of authors following the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guideline, and risk of bias was assessed using the Cochrane tool. An IPDMA was conducted using a 2-stage approach for the association of CBT with change in LSAS scores from baseline to posttreatment and for the interaction effect of baseline LSAS score by condition using random-effects models. Main Outcomes and Measures: The main outcome was the baseline to posttreatment change in symptom severity measured by the LSAS. Results: A total of 12 studies including 1246 patients with SAD (mean [SD] age, 35.3 [10.9] years; 738 [59.2%] female) were included in the meta-analysis. A waiting list-controlled association between CBT and pretreatment to posttreatment LSAS change was found (b = -20.3; 95% CI, -24.9 to -15.6; P <.001; Cohen d = -0.95; 95% CI, -1.16 to -0.73). Baseline LSAS scores moderated the differences between CBT and waiting list with respect to pretreatment to posttreatment symptom reductions (b = -0.22; 95% CI, -0.39 to -0.06; P =.009), indicating that individuals with severe symptoms had larger waiting list-controlled symptom reductions after CBT (Cohen d = -1.13 [95% CI, -1.39 to -0.88] for patients with very severe SAD; Cohen d = -0.54 [95% CI, -0.80 to -0.29] for patients with mild SAD). Conclusions and Relevance: In this systematic review and IPDMA, higher baseline SAD symptom severity was associated with greater (absolute but not relative) symptom reductions after CBT in patients with SAD. The findings contribute to personalized care by suggesting that clinicians can confidently offer CBT to individuals with severe SAD symptoms.. © 2023 American Medical Association. All rights reserved.
8.
Ørskov, P. T.; Lichtenstein, M. B.; Ernst, M. T.; Fasterholdt, I.; Matthiesen, A. F.; Scirea, M.; Bouchard, S.; Andersen, T. E.
In: Frontiers in Psychiatry, vol. 13, 2022, ISSN: 16640640 (ISSN), (Publisher: Frontiers Media S.A.).
Abstract | Links | BibTeX | Tags: adult, aged, Alcohol Use Disorders Identification Test, anxiety assessment, Anxiety disorder, article, behavior disorder assessment, cognitive behavioral therapy, comparative effectiveness, controlled study, Depression, Drug Use Disorders Identification Test, electrodermal activity, exposure, Fear of Negative Evaluation, follow up, health economics, Heart Rate, human, Leibowitz Anxiety Scale, Machine learning, major clinical study, psychological distress assessment, psychophysiological measurements, randomized controlled trial, Simulator Sickness Questionnaire, social anxiety, Social Interaction Anxiety Scale, social phobia, Subjective Units of Distress Scale, therapy effect, treatment duration, treatment outcome, virtual reality, virtual reality exposure therapy, Working Alliance Inventory
@article{orskov_cognitive_2022,
title = {Cognitive behavioral therapy with adaptive virtual reality exposure vs. cognitive behavioral therapy with in vivo exposure in the treatment of social anxiety disorder: A study protocol for a randomized controlled trial},
author = {P. T. Ørskov and M. B. Lichtenstein and M. T. Ernst and I. Fasterholdt and A. F. Matthiesen and M. Scirea and S. Bouchard and T. E. Andersen},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85140322564&doi=10.3389%2ffpsyt.2022.991755&partnerID=40&md5=1dacd4e05081f4790ccd5e0d7224e0ca},
doi = {10.3389/fpsyt.2022.991755},
issn = {16640640 (ISSN)},
year = {2022},
date = {2022-01-01},
journal = {Frontiers in Psychiatry},
volume = {13},
publisher = {Frontiers Media S.A.},
abstract = {Background: Social anxiety disorder (SAD) has a high prevalence and an early onset with recovery taking decades to occur. Current evidence supports the efficacy of cognitive behavioral therapy (CBT) with virtual reality (VR) exposure. However, the evidence is based on a sparse number of studies with predominantly small sample sizes. There is a need for more trials investigating the optimal way of applying VR based exposure for SAD. In this trial, we will test the efficacy of CBT with adaptive VR exposure allowing adjustment of the exposure based on real-time monitoring of the participants's anxiety level. Methods: The trial is a randomized controlled, assessor-blinded, parallel-group superiority trail. The study has two arms: (1) CBT including exposure in vivo (CBT-Exp), (2) CBT including exposure therapy using individually tailored VR-content and a system to track anxiety levels (CBT-ExpVR). Treatment is individual, manual-based and consists of 10 weekly sessions with a duration of 60 min. The study includes 90 participants diagnosed with SAD. Assessments are carried out pre-treatment, mid-treatment and at follow-up (6 and 12 months). The primary outcome is the mean score on the Social Interaction Anxiety Scale (SIAS) with the primary endpoint being post-treatment. Discussion: The study adds to the existing knowledge by assessing the efficacy of CBT with adaptive VR exposure. The study has high methodological rigor using a randomized controlled trial with a large sample size that includes follow-up data and validated measures for social anxiety outcomes. Clinical trial registration: ClinicalTrials.gov, identifier: NCT05302518. Copyright © 2022 Ørskov, Lichtenstein, Ernst, Fasterholdt, Matthiesen, Scirea, Bouchard and Andersen.},
note = {Publisher: Frontiers Media S.A.},
keywords = {adult, aged, Alcohol Use Disorders Identification Test, anxiety assessment, Anxiety disorder, article, behavior disorder assessment, cognitive behavioral therapy, comparative effectiveness, controlled study, Depression, Drug Use Disorders Identification Test, electrodermal activity, exposure, Fear of Negative Evaluation, follow up, health economics, Heart Rate, human, Leibowitz Anxiety Scale, Machine learning, major clinical study, psychological distress assessment, psychophysiological measurements, randomized controlled trial, Simulator Sickness Questionnaire, social anxiety, Social Interaction Anxiety Scale, social phobia, Subjective Units of Distress Scale, therapy effect, treatment duration, treatment outcome, virtual reality, virtual reality exposure therapy, Working Alliance Inventory},
pubstate = {published},
tppubtype = {article}
}
Background: Social anxiety disorder (SAD) has a high prevalence and an early onset with recovery taking decades to occur. Current evidence supports the efficacy of cognitive behavioral therapy (CBT) with virtual reality (VR) exposure. However, the evidence is based on a sparse number of studies with predominantly small sample sizes. There is a need for more trials investigating the optimal way of applying VR based exposure for SAD. In this trial, we will test the efficacy of CBT with adaptive VR exposure allowing adjustment of the exposure based on real-time monitoring of the participants's anxiety level. Methods: The trial is a randomized controlled, assessor-blinded, parallel-group superiority trail. The study has two arms: (1) CBT including exposure in vivo (CBT-Exp), (2) CBT including exposure therapy using individually tailored VR-content and a system to track anxiety levels (CBT-ExpVR). Treatment is individual, manual-based and consists of 10 weekly sessions with a duration of 60 min. The study includes 90 participants diagnosed with SAD. Assessments are carried out pre-treatment, mid-treatment and at follow-up (6 and 12 months). The primary outcome is the mean score on the Social Interaction Anxiety Scale (SIAS) with the primary endpoint being post-treatment. Discussion: The study adds to the existing knowledge by assessing the efficacy of CBT with adaptive VR exposure. The study has high methodological rigor using a randomized controlled trial with a large sample size that includes follow-up data and validated measures for social anxiety outcomes. Clinical trial registration: ClinicalTrials.gov, identifier: NCT05302518. Copyright © 2022 Ørskov, Lichtenstein, Ernst, Fasterholdt, Matthiesen, Scirea, Bouchard and Andersen.
9.
Dugas, M. J.; Sexton, K. A.; Hebert, E. A.; Bouchard, S.; Gouin, J. -P.; Shafran, R.
Behavioral Experiments for Intolerance of Uncertainty: A Randomized Clinical Trial for Adults With Generalized Anxiety Disorder Journal Article
In: Behavior Therapy, vol. 53, no. 6, pp. 1147–1160, 2022, ISSN: 00057894 (ISSN), (Publisher: Elsevier Inc.).
Abstract | Links | BibTeX | Tags: adult, aged, antidepressant agent, Anxiety, Anxiety disorder, Anxiety Disorders, anxiolytic agent, article, behavior assessment, behavioral experiments, benzodiazepine, cognitive behavioral therapy, cognitive vulnerability, Cognitive-behavioral treatment, confusion (uncertainty), controlled study, dependent variable, Depression, disease severity, female, follow up, generalized anxiety disorder, growth curve, human, Humans, intolerance of uncertainty, major clinical study, male, mental disease, outcome assessment, patient worry, procedures, psychology, randomized controlled trial, uncertainty
@article{dugas_behavioral_2022,
title = {Behavioral Experiments for Intolerance of Uncertainty: A Randomized Clinical Trial for Adults With Generalized Anxiety Disorder},
author = {M. J. Dugas and K. A. Sexton and E. A. Hebert and S. Bouchard and J. -P. Gouin and R. Shafran},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85133178888&doi=10.1016%2fj.beth.2022.05.003&partnerID=40&md5=4dd15547cbef29c5f1adc84169176c53},
doi = {10.1016/j.beth.2022.05.003},
issn = {00057894 (ISSN)},
year = {2022},
date = {2022-01-01},
journal = {Behavior Therapy},
volume = {53},
number = {6},
pages = {1147–1160},
publisher = {Elsevier Inc.},
abstract = {Sophisticated multicomponent treatments for adults with generalized anxiety disorder (GAD) have been developed over the past three decades. Although these comprehensive treatments have produced encouraging results, they appear to be less efficacious than treatments for other anxiety disorders. The goal of this randomized controlled trial is to test a newly developed, highly focused treatment for adults with GAD: Behavioral Experiments for Intolerance of Uncertainty. Sixty (60) participants (51 women, 9 men), with a mean age of 34.60 years (range: 19 to 67 years), were randomized to either treatment (n = 30) or wait-list control (n = 30). Treatment consisted of 12 weekly 1-hour sessions in which participants learned to use behavioral experiments to test their catastrophic beliefs about uncertainty. Assessments were conducted at pre-, mid- and postcondition, and at 6- and 12-month follow-up. The primary outcome was the severity of GAD, and secondary outcomes were worry, depression, somatic anxiety, and intolerance of uncertainty. Using growth curve modeling, we found that (1) the treatment group was superior to the wait-list group in terms of change from pre- to posttest on all outcomes; (2) the combined sample (once wait-listed participants received treatment) evidenced large and significant decreases on all outcomes; and (3) treatment gains were either maintained or increased over the 12-month follow-up period of the study. The new treatment is a promising treatment option for adults with GAD considering that it may be as efficacious as more comprehensive evidence-based psychological treatments for GAD. © 2022},
note = {Publisher: Elsevier Inc.},
keywords = {adult, aged, antidepressant agent, Anxiety, Anxiety disorder, Anxiety Disorders, anxiolytic agent, article, behavior assessment, behavioral experiments, benzodiazepine, cognitive behavioral therapy, cognitive vulnerability, Cognitive-behavioral treatment, confusion (uncertainty), controlled study, dependent variable, Depression, disease severity, female, follow up, generalized anxiety disorder, growth curve, human, Humans, intolerance of uncertainty, major clinical study, male, mental disease, outcome assessment, patient worry, procedures, psychology, randomized controlled trial, uncertainty},
pubstate = {published},
tppubtype = {article}
}
Sophisticated multicomponent treatments for adults with generalized anxiety disorder (GAD) have been developed over the past three decades. Although these comprehensive treatments have produced encouraging results, they appear to be less efficacious than treatments for other anxiety disorders. The goal of this randomized controlled trial is to test a newly developed, highly focused treatment for adults with GAD: Behavioral Experiments for Intolerance of Uncertainty. Sixty (60) participants (51 women, 9 men), with a mean age of 34.60 years (range: 19 to 67 years), were randomized to either treatment (n = 30) or wait-list control (n = 30). Treatment consisted of 12 weekly 1-hour sessions in which participants learned to use behavioral experiments to test their catastrophic beliefs about uncertainty. Assessments were conducted at pre-, mid- and postcondition, and at 6- and 12-month follow-up. The primary outcome was the severity of GAD, and secondary outcomes were worry, depression, somatic anxiety, and intolerance of uncertainty. Using growth curve modeling, we found that (1) the treatment group was superior to the wait-list group in terms of change from pre- to posttest on all outcomes; (2) the combined sample (once wait-listed participants received treatment) evidenced large and significant decreases on all outcomes; and (3) treatment gains were either maintained or increased over the 12-month follow-up period of the study. The new treatment is a promising treatment option for adults with GAD considering that it may be as efficacious as more comprehensive evidence-based psychological treatments for GAD. © 2022
10.
Ørskov, P. T.; Lichtenstein, M. B.; Ernst, M. T.; Fasterholdt, I.; Matthiesen, A. F.; Scirea, M.; Bouchard, S.; Andersen, T. E.
In: Frontiers in Psychiatry, vol. 13, 2022, ISSN: 16640640 (ISSN).
Abstract | Links | BibTeX | Tags: adult, aged, Alcohol Use Disorders Identification Test, anxiety assessment, Anxiety disorder, article, behavior disorder assessment, cognitive behavioral therapy, comparative effectiveness, controlled study, Depression, Drug Use Disorders Identification Test, electrodermal activity, exposure, Fear of Negative Evaluation, follow up, health economics, Heart Rate, human, Leibowitz Anxiety Scale, Machine learning, major clinical study, psychological distress assessment, psychophysiological measurements, randomized controlled trial, Simulator Sickness Questionnaire, social anxiety, Social Interaction Anxiety Scale, social phobia, Subjective Units of Distress Scale, therapy effect, treatment duration, treatment outcome, virtual reality, virtual reality exposure therapy, Working Alliance Inventory
@article{orskovCognitiveBehavioralTherapy2022,
title = {Cognitive behavioral therapy with adaptive virtual reality exposure vs. cognitive behavioral therapy with in vivo exposure in the treatment of social anxiety disorder: A study protocol for a randomized controlled trial},
author = {P. T. Ørskov and M. B. Lichtenstein and M. T. Ernst and I. Fasterholdt and A. F. Matthiesen and M. Scirea and S. Bouchard and T. E. Andersen},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85140322564&doi=10.3389%2ffpsyt.2022.991755&partnerID=40&md5=1dacd4e05081f4790ccd5e0d7224e0ca},
doi = {10.3389/fpsyt.2022.991755},
issn = {16640640 (ISSN)},
year = {2022},
date = {2022-01-01},
journal = {Frontiers in Psychiatry},
volume = {13},
publisher = {Frontiers Media S.A.},
abstract = {Background: Social anxiety disorder (SAD) has a high prevalence and an early onset with recovery taking decades to occur. Current evidence supports the efficacy of cognitive behavioral therapy (CBT) with virtual reality (VR) exposure. However, the evidence is based on a sparse number of studies with predominantly small sample sizes. There is a need for more trials investigating the optimal way of applying VR based exposure for SAD. In this trial, we will test the efficacy of CBT with adaptive VR exposure allowing adjustment of the exposure based on real-time monitoring of the participants's anxiety level. Methods: The trial is a randomized controlled, assessor-blinded, parallel-group superiority trail. The study has two arms: (1) CBT including exposure in vivo (CBT-Exp), (2) CBT including exposure therapy using individually tailored VR-content and a system to track anxiety levels (CBT-ExpVR). Treatment is individual, manual-based and consists of 10 weekly sessions with a duration of 60 min. The study includes 90 participants diagnosed with SAD. Assessments are carried out pre-treatment, mid-treatment and at follow-up (6 and 12 months). The primary outcome is the mean score on the Social Interaction Anxiety Scale (SIAS) with the primary endpoint being post-treatment. Discussion: The study adds to the existing knowledge by assessing the efficacy of CBT with adaptive VR exposure. The study has high methodological rigor using a randomized controlled trial with a large sample size that includes follow-up data and validated measures for social anxiety outcomes. Clinical trial registration: ClinicalTrials.gov, identifier: NCT05302518. Copyright © 2022 Ørskov, Lichtenstein, Ernst, Fasterholdt, Matthiesen, Scirea, Bouchard and Andersen.},
keywords = {adult, aged, Alcohol Use Disorders Identification Test, anxiety assessment, Anxiety disorder, article, behavior disorder assessment, cognitive behavioral therapy, comparative effectiveness, controlled study, Depression, Drug Use Disorders Identification Test, electrodermal activity, exposure, Fear of Negative Evaluation, follow up, health economics, Heart Rate, human, Leibowitz Anxiety Scale, Machine learning, major clinical study, psychological distress assessment, psychophysiological measurements, randomized controlled trial, Simulator Sickness Questionnaire, social anxiety, Social Interaction Anxiety Scale, social phobia, Subjective Units of Distress Scale, therapy effect, treatment duration, treatment outcome, virtual reality, virtual reality exposure therapy, Working Alliance Inventory},
pubstate = {published},
tppubtype = {article}
}
Background: Social anxiety disorder (SAD) has a high prevalence and an early onset with recovery taking decades to occur. Current evidence supports the efficacy of cognitive behavioral therapy (CBT) with virtual reality (VR) exposure. However, the evidence is based on a sparse number of studies with predominantly small sample sizes. There is a need for more trials investigating the optimal way of applying VR based exposure for SAD. In this trial, we will test the efficacy of CBT with adaptive VR exposure allowing adjustment of the exposure based on real-time monitoring of the participants's anxiety level. Methods: The trial is a randomized controlled, assessor-blinded, parallel-group superiority trail. The study has two arms: (1) CBT including exposure in vivo (CBT-Exp), (2) CBT including exposure therapy using individually tailored VR-content and a system to track anxiety levels (CBT-ExpVR). Treatment is individual, manual-based and consists of 10 weekly sessions with a duration of 60 min. The study includes 90 participants diagnosed with SAD. Assessments are carried out pre-treatment, mid-treatment and at follow-up (6 and 12 months). The primary outcome is the mean score on the Social Interaction Anxiety Scale (SIAS) with the primary endpoint being post-treatment. Discussion: The study adds to the existing knowledge by assessing the efficacy of CBT with adaptive VR exposure. The study has high methodological rigor using a randomized controlled trial with a large sample size that includes follow-up data and validated measures for social anxiety outcomes. Clinical trial registration: ClinicalTrials.gov, identifier: NCT05302518. Copyright © 2022 Ørskov, Lichtenstein, Ernst, Fasterholdt, Matthiesen, Scirea, Bouchard and Andersen.