@article{guingo_efficacy_2026,

title = {Efficacy of Virtual Reality vs. Tablet Games for Pain and Anxiety in Children Undergoing Bone Pins Removal: Randomised Clinical Trial},

author = {E. Guingo and M. H. Debeurme and R. P. Santos and S. Addab and P. Rainville and S. Bouchard and K. Chougui and A. Tsimicalis and M. -L. Nault and T. Ducruet and O. Ledjiar and M. Noel and K. St-Arneault and C. Cotes-Turpin and N. Hung and P. Ouimet and S. Parent and J. Gardner and M. Bernstein and S. Le May},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-105004216228&doi=10.1111%2Fjan.16991&partnerID=40&md5=9200a82b5c9572abcc5170e9c9d6142b},

doi = {10.1111/jan.16991},

issn = {03092402 (ISSN)},

year  = {2026},

date = {2026-01-01},

journal = {Journal of Advanced Nursing},

volume = {82},

number = {2},

pages = {1791–1802},

abstract = {Aims: To verify the efficacy of virtual reality compared to tablet games for pain and anxiety management in children undergoing percutaneous bone pin and/or suture removal procedures. Design: Randomised clinical trial using two parallel groups: (1) virtual reality or (2) tablet game. Methods: Three-center, randomised pragmatic clinical trial, using a parallel design with two groups (experimental group: immersive virtual reality; active comparator: tablet games). Children aged 6–17 requiring percutaneous pins and/or sutures were recruited between 2020 and 2022 from three outpatient orthopaedic clinics in paediatric hospitals. Pain was measured with the Numerical Rating Scale and anxiety with the Child Fear Scale before and immediately after the procedure. Results: A total of 188 participants were assigned to either the virtual reality group (96 participants) or the tablet group (92 participants). At the first assessment, there was no noticeable difference between the two groups in terms of pain or anxiety levels. However, further analysis revealed that participants aged 13 and older in the virtual reality group experienced significantly lower anxiety. Conclusion: Virtual reality was not more efficacious than games on a tablet for pain and anxiety of children undergoing removal of bone pins or sutures. However, virtual reality demonstrated a benefit in reducing anxiety for teenagers, particularly those aged 13-older. Implication for the Professional and/or Patient Care: Virtual reality games provide an immersive, non-pharmacological alternative of for anxiety management of teenagers during pins and/or sutures removal. Impact: This study showed that a virtual reality game may help reduce anxiety during pins and/or sutures removal procedures in patients aged 13 years and older. Reporting Method: We adhered to the CONSORT checklist for reporting results. Patient or Public Contribution: A patient partner reviewed the study design, methods and final manuscript. Trial Registration: NCT03680625. © 2025 The Author(s). Journal of Advanced Nursing published by John Wiley & Sons Ltd.},

keywords = {Adolescent, analgesia, Anxiety, Bone Nails, Child, Children, clinical trial, comparative study, controlled study, female, human, Humans, intramedullary nailing, male, multicenter study, Pain Management, procedural pain, procedures, randomized controlled trial, Therapy, video game, Video Games, virtual reality},

pubstate = {published},

tppubtype = {article}

}

@article{guingoEfficacyVirtualReality2026,

title = {Efficacy of Virtual Reality vs. Tablet Games for Pain and Anxiety in Children Undergoing Bone Pins Removal: Randomised Clinical Trial},

author = {E. Guingo and M. H. Debeurme and R. P. Santos and S. Addab and P. Rainville and S. Bouchard and K. Chougui and A. Tsimicalis and M. -L. Nault and T. Ducruet and O. Ledjiar and M. Noel and K. St-Arneault and C. Cotes-Turpin and N. Hung and P. Ouimet and S. Parent and J. Gardner and M. Bernstein and S. Le May},

url = {https://www.scopus.com/pages/publications/105004216228?origin=resultslist},

doi = {10.1111/jan.16991},

issn = {03092402 (ISSN)},

year  = {2026},

date = {2026-01-01},

journal = {Journal of Advanced Nursing},

volume = {82},

number = {2},

pages = {1791–1802},

publisher = {John Wiley and Sons Inc},

abstract = {Aims: To verify the efficacy of virtual reality compared to tablet games for pain and anxiety management in children undergoing percutaneous bone pin and/or suture removal procedures. Design: Randomised clinical trial using two parallel groups: (1) virtual reality or (2) tablet game. Methods: Three-center, randomised pragmatic clinical trial, using a parallel design with two groups (experimental group: immersive virtual reality; active comparator: tablet games). Children aged 6–17 requiring percutaneous pins and/or sutures were recruited between 2020 and 2022 from three outpatient orthopaedic clinics in paediatric hospitals. Pain was measured with the Numerical Rating Scale and anxiety with the Child Fear Scale before and immediately after the procedure. Results: A total of 188 participants were assigned to either the virtual reality group (96 participants) or the tablet group (92 participants). At the first assessment, there was no noticeable difference between the two groups in terms of pain or anxiety levels. However, further analysis revealed that participants aged 13 and older in the virtual reality group experienced significantly lower anxiety. Conclusion: Virtual reality was not more efficacious than games on a tablet for pain and anxiety of children undergoing removal of bone pins or sutures. However, virtual reality demonstrated a benefit in reducing anxiety for teenagers, particularly those aged 13-older. Implication for the Professional and/or Patient Care: Virtual reality games provide an immersive, non-pharmacological alternative of for anxiety management of teenagers during pins and/or sutures removal. Impact: This study showed that a virtual reality game may help reduce anxiety during pins and/or sutures removal procedures in patients aged 13 years and older. Reporting Method: We adhered to the CONSORT checklist for reporting results. Patient or Public Contribution: A patient partner reviewed the study design, methods and final manuscript. Trial Registration: NCT03680625. © 2025 The Author(s). Journal of Advanced Nursing published by John Wiley & Sons Ltd.},

keywords = {Adolescent, analgesia, Anxiety, Bone Nails, Child, Children, clinical trial, comparative study, controlled study, female, human, Humans, intramedullary nailing, male, multicenter study, Pain Management, procedural pain, procedures, randomized controlled trial, Therapy, video game, Video Games, virtual reality},

pubstate = {published},

tppubtype = {article}

}

@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}

}

@article{guingoEfficacyVirtualReality2026a,

title = {Efficacy of Virtual Reality vs. Tablet Games for Pain and Anxiety in Children Undergoing Bone Pins Removal: Randomised Clinical Trial},

author = {E. Guingo and M. H. Debeurme and R. P. Santos and S. Addab and P. Rainville and S. Bouchard and K. Chougui and A. Tsimicalis and M. -L. Nault and T. Ducruet and O. Ledjiar and M. Noel and K. St-Arneault and C. Cotes-Turpin and N. Hung and P. Ouimet and S. Parent and J. Gardner and M. Bernstein and S. Le May},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-105004216228&doi=10.1111%2Fjan.16991&partnerID=40&md5=9200a82b5c9572abcc5170e9c9d6142b},

doi = {10.1111/jan.16991},

issn = {03092402 (ISSN)},

year  = {2026},

date = {2026-01-01},

journal = {Journal of Advanced Nursing},

volume = {82},

number = {2},

pages = {1791–1802},

abstract = {Aims: To verify the efficacy of virtual reality compared to tablet games for pain and anxiety management in children undergoing percutaneous bone pin and/or suture removal procedures. Design: Randomised clinical trial using two parallel groups: (1) virtual reality or (2) tablet game. Methods: Three-center, randomised pragmatic clinical trial, using a parallel design with two groups (experimental group: immersive virtual reality; active comparator: tablet games). Children aged 6–17 requiring percutaneous pins and/or sutures were recruited between 2020 and 2022 from three outpatient orthopaedic clinics in paediatric hospitals. Pain was measured with the Numerical Rating Scale and anxiety with the Child Fear Scale before and immediately after the procedure. Results: A total of 188 participants were assigned to either the virtual reality group (96 participants) or the tablet group (92 participants). At the first assessment, there was no noticeable difference between the two groups in terms of pain or anxiety levels. However, further analysis revealed that participants aged 13 and older in the virtual reality group experienced significantly lower anxiety. Conclusion: Virtual reality was not more efficacious than games on a tablet for pain and anxiety of children undergoing removal of bone pins or sutures. However, virtual reality demonstrated a benefit in reducing anxiety for teenagers, particularly those aged 13-older. Implication for the Professional and/or Patient Care: Virtual reality games provide an immersive, non-pharmacological alternative of for anxiety management of teenagers during pins and/or sutures removal. Impact: This study showed that a virtual reality game may help reduce anxiety during pins and/or sutures removal procedures in patients aged 13 years and older. Reporting Method: We adhered to the CONSORT checklist for reporting results. Patient or Public Contribution: A patient partner reviewed the study design, methods and final manuscript. Trial Registration: NCT03680625. © 2025 The Author(s). Journal of Advanced Nursing published by John Wiley & Sons Ltd.},

keywords = {Adolescent, analgesia, Anxiety, Bone Nails, Child, Children, clinical trial, comparative study, controlled study, female, human, Humans, intramedullary nailing, male, multicenter study, Pain Management, procedural pain, procedures, randomized controlled trial, Therapy, video game, Video Games, virtual reality},

pubstate = {published},

tppubtype = {article}

}

@article{le_du_new_2023,

title = {A New Option for Pain Prevention Using a Therapeutic Virtual Reality Solution for Bone Marrow Biopsy (REVEH Trial): Open-Label, Randomized, Multicenter, Phase 3 Study},

author = {K. Le Du and A. -L. Septans and F. Maloisel and H. Vanquaethem and A. Schmitt and M. Le Goff and A. Clavert and M. Zinger and H. Bourgeois and O. Dupuis and F. Denis and S. Bouchard},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85148250546&doi=10.2196%2f38619&partnerID=40&md5=e27bfbd3d4c42f8850daf70bdf60b384},

doi = {10.2196/38619},

issn = {14388871 (ISSN)},

year  = {2023},

date = {2023-01-01},

journal = {Journal of Medical Internet Research},

volume = {25},

publisher = {JMIR Publications Inc.},

abstract = {Background: Evidence regarding the analgesic effect of distraction through immersion in virtual reality (VR) for care-induced pain has been documented in several phase 2 trials, but comparison with standard treatments in large, randomized studies is needed. Objective: In this open-label, multicenter, randomized, phase 3 trial, we evaluated the safety and efficacy of a novel VR therapy solution for distraction in the context of bone marrow biopsy. Methods: Bliss is a VR software with 4 imaginary interactive environments in 3 dimensions with binaural sound (head-mounted display). Efficacy regarding pain intensity was evaluated using a visual analog scale (VAS; score from 0 to 10) immediately after the biopsy. Secondary end points were anxiety and tolerance. Modified intention-to-treat analysis was performed. Results: Overall, 126 patients with previously documented untreated or suspected malignant hemopathy between September 6, 2018, and May 18, 2020, were randomly assigned in a 1:1 ratio to receive pain prevention with a mixture of nitrous oxide/oxygen (MEOPA; n=63) or VR (n=63) before and during the bone marrow biopsy. We excluded 8 patients from the final analysis (3 in the MEOPA group and 5 in the VR group). All patients received local anesthesia (lidocaine) before biopsy. Follow-up was limited to 1 month after the biopsy. Participants' median age was 65.5 (range 18-87) years, and 54.2% (64/118) of patients were male. The average pain intensity was 3.5 (SD 2.6, 95% CI -1.6 to 8.6) for the MEOPA group and 3.0 (SD 2.4, 95% CI -1.7 to 7.7) for the VR group, without any significant differences in age, sex, center, and hemopathy (P=.26). Concerning anxiety, 67.5% (79/117; fear of pain questionnaire) of the patients were afraid before the biopsy, and anxiety scores were moderate to very high in 26.3% (30/114; revised Spielberger State-Trait Anxiety Inventory questionnaire) of the patients before the biopsy and 9.0% (10/114) after the biopsy for all patients, without a significant difference between the 2 groups (P=.83). Immersion in VR was well tolerated by the majority (54/57, 95%) of patients in the VR group. Conclusions: The intensity of pain did not significantly differ between both arms. VR was well tolerated, and the satisfaction of patients, nurses, and physicians was very high. VR could be an alternative treatment in case of contraindication or intolerance to MEOPA. © 2023 Journal of Medical Internet Research. All rights reserved.},

note = {Publisher: JMIR Publications Inc.},

keywords = {80 and over, Adolescent, adult, aged, alprazolam, Anxiety, article, Biopsy, blood pressure measurement, Bone Marrow, bone marrow biopsy, clinical trial, controlled study, demographics, digital health, digital therapeutics, Distraction, Effectiveness, efficacy, eHealth, female, follow up, head-mounted display, hematologic disease, human, human tissue, Humans, hypertension, imagery, imaginary, imagination, Immersive environment, Intention to Treat Analysis, interactive environment, leukemia, lidocaine, local anesthesia, lymphoma, major clinical study, male, medical procedure, Meopa, Middle Aged, monoclonal immunoglobulinemia, multicenter study, myelodysplastic syndrome, myeloma, myeloproliferative disorder, myeloproliferative neoplasm, nitrous oxide plus oxygen, open study, Pain, pain intensity, pain measurement, paracetamol, phase 3 clinical trial, prospective study, questionnaire, randomized controlled trial, RCT, relaxation training, safety, satisfaction, solid malignant neoplasm, State Trait Anxiety Inventory, very elderly, virtual reality, visual analog scale, VR, Young Adult},

pubstate = {published},

tppubtype = {article}

}

@article{leduNewOptionPain2023,

title = {A New Option for Pain Prevention Using a Therapeutic Virtual Reality Solution for Bone Marrow Biopsy (REVEH Trial): Open-Label, Randomized, Multicenter, Phase 3 Study},

author = {K. Le Du and A. -L. Septans and F. Maloisel and H. Vanquaethem and A. Schmitt and M. Le Goff and A. Clavert and M. Zinger and H. Bourgeois and O. Dupuis and F. Denis and S. Bouchard},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85148250546&doi=10.2196%2f38619&partnerID=40&md5=e27bfbd3d4c42f8850daf70bdf60b384},

doi = {10.2196/38619},

issn = {14388871 (ISSN)},

year  = {2023},

date = {2023-01-01},

journal = {Journal of Medical Internet Research},

volume = {25},

publisher = {JMIR Publications Inc.},

abstract = {Background: Evidence regarding the analgesic effect of distraction through immersion in virtual reality (VR) for care-induced pain has been documented in several phase 2 trials, but comparison with standard treatments in large, randomized studies is needed. Objective: In this open-label, multicenter, randomized, phase 3 trial, we evaluated the safety and efficacy of a novel VR therapy solution for distraction in the context of bone marrow biopsy. Methods: Bliss is a VR software with 4 imaginary interactive environments in 3 dimensions with binaural sound (head-mounted display). Efficacy regarding pain intensity was evaluated using a visual analog scale (VAS; score from 0 to 10) immediately after the biopsy. Secondary end points were anxiety and tolerance. Modified intention-to-treat analysis was performed. Results: Overall, 126 patients with previously documented untreated or suspected malignant hemopathy between September 6, 2018, and May 18, 2020, were randomly assigned in a 1:1 ratio to receive pain prevention with a mixture of nitrous oxide/oxygen (MEOPA; n=63) or VR (n=63) before and during the bone marrow biopsy. We excluded 8 patients from the final analysis (3 in the MEOPA group and 5 in the VR group). All patients received local anesthesia (lidocaine) before biopsy. Follow-up was limited to 1 month after the biopsy. Participants' median age was 65.5 (range 18-87) years, and 54.2% (64/118) of patients were male. The average pain intensity was 3.5 (SD 2.6, 95% CI -1.6 to 8.6) for the MEOPA group and 3.0 (SD 2.4, 95% CI -1.7 to 7.7) for the VR group, without any significant differences in age, sex, center, and hemopathy (P=.26). Concerning anxiety, 67.5% (79/117; fear of pain questionnaire) of the patients were afraid before the biopsy, and anxiety scores were moderate to very high in 26.3% (30/114; revised Spielberger State-Trait Anxiety Inventory questionnaire) of the patients before the biopsy and 9.0% (10/114) after the biopsy for all patients, without a significant difference between the 2 groups (P=.83). Immersion in VR was well tolerated by the majority (54/57, 95%) of patients in the VR group. Conclusions: The intensity of pain did not significantly differ between both arms. VR was well tolerated, and the satisfaction of patients, nurses, and physicians was very high. VR could be an alternative treatment in case of contraindication or intolerance to MEOPA. © 2023 Journal of Medical Internet Research. All rights reserved.},

keywords = {80 and over, Adolescent, adult, aged, alprazolam, Anxiety, article, Biopsy, blood pressure measurement, Bone Marrow, bone marrow biopsy, clinical trial, controlled study, demographics, digital health, digital therapeutics, Distraction, Effectiveness, efficacy, eHealth, female, follow up, head-mounted display, hematologic disease, human, human tissue, Humans, hypertension, imagery, imaginary, imagination, Immersive environment, Intention to Treat Analysis, interactive environment, leukemia, lidocaine, local anesthesia, lymphoma, major clinical study, male, medical procedure, Meopa, Middle Aged, monoclonal immunoglobulinemia, multicenter study, myelodysplastic syndrome, myeloma, myeloproliferative disorder, myeloproliferative neoplasm, nitrous oxide plus oxygen, open study, Pain, pain intensity, pain measurement, paracetamol, phase 3 clinical trial, prospective study, questionnaire, randomized controlled trial, RCT, relaxation training, safety, satisfaction, solid malignant neoplasm, State Trait Anxiety Inventory, very elderly, virtual reality, visual analog scale, VR, Young Adult},

pubstate = {published},

tppubtype = {article}

}

@article{aardema_evaluation_2022,

title = {Evaluation of Inference-Based Cognitive-Behavioral Therapy for Obsessive-Compulsive Disorder: A Multicenter Randomized Controlled Trial with Three Treatment Modalities},

author = {F. Aardema and S. Bouchard and D. Koszycki and M. E. Lavoie and J. -S. Audet and K. O'Connor},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85131012874&doi=10.1159%2f000524425&partnerID=40&md5=ff9a6095068e094c394e952eca4ca318},

doi = {10.1159/000524425},

issn = {00333190 (ISSN)},

year  = {2022},

date = {2022-01-01},

journal = {Psychotherapy and Psychosomatics},

volume = {91},

number = {5},

pages = {348–359},

publisher = {S. Karger AG},

abstract = {Introduction: Inference-based cognitive-behavioral therapy (I-CBT) is a specialized psychological treatment for obsessive-compulsive disorder (OCD) without deliberate and prolonged exposure and response prevention (ERP) that focuses on strengthening reality-based reasoning and correcting the dysfunctional reasoning giving rise to erroneous obsessional doubts and ideas. Objective: The present study aimed to evaluate the effectiveness of I-CBT through a comparison with appraisal-based cognitive behavioral therapy (A-CBT) and an adapted mindfulness-based stress reduction (MBSR) intervention. Methods: This was a two-site, parallel-arm randomized controlled trial (RCT) comparing I-CBT with A-CBT. The MBSR intervention acted as a non-specific active control condition. Following formal evaluation, 111 participants diagnosed with OCD were randomly assigned. The principal outcome measure was the Yale-Brown Obsessive-Compulsive Scale. Results: All treatments significantly reduced general OCD severity and specific symptom dimensions without a significant difference between treatments. I-CBT was associated with significant reductions in all symptom dimensions at post-test. Also, I-CBT led to significantly greater improvement in overvalued ideation, as well as significantly higher rates of remission as compared to MBSR at mid-test. Conclusions: I-CBT and MBSR appear to be effective, alternative treatment options for those with OCD that yield similar outcomes as A-CBT. I-CBT may have an edge in terms of the rapidity by which patients reach remission, its generalizability across symptom dimension, its potentially higher level of acceptability, and effectiveness for overvalued ideation. Future research is needed to assess whether additional alternative treatments options can help to increase the number of people successfully treated. © 2022 The Author(s). Published by S. Karger AG, Basel.},

note = {Publisher: S. Karger AG},

keywords = {adult, aged, appraisal based cognitive behavioral therapy, article, clinical effectiveness, clinical evaluation, clinical outcome, clinical trial, cognitive behavioral therapy, Cognitive-behavioral therapy, controlled study, disease severity, female, human, Humans, inference based cognitive behavioral therapy, Inference-based approach, intermethod comparison, major clinical study, male, mindfulness, mindfulness-based stress reduction, multicenter study, obsessive compulsive disorder, Obsessive-Compulsive Disorder, patient dropout, procedures, randomized controlled trial, remission, treatment outcome, treatment refusal, Yale Brown Obsessive Compulsive Scale},

pubstate = {published},

tppubtype = {article}

}

@article{aardemaEvaluationInferenceBasedCognitiveBehavioral2022,

title = {Evaluation of Inference-Based Cognitive-Behavioral Therapy for Obsessive-Compulsive Disorder: A Multicenter Randomized Controlled Trial with Three Treatment Modalities},

author = {F. Aardema and S. Bouchard and D. Koszycki and M. E. Lavoie and J. -S. Audet and K. O'Connor},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85131012874&doi=10.1159%2f000524425&partnerID=40&md5=ff9a6095068e094c394e952eca4ca318},

doi = {10.1159/000524425},

issn = {00333190 (ISSN)},

year  = {2022},

date = {2022-01-01},

journal = {Psychotherapy and Psychosomatics},

volume = {91},

number = {5},

pages = {348–359},

publisher = {S. Karger AG},

abstract = {Introduction: Inference-based cognitive-behavioral therapy (I-CBT) is a specialized psychological treatment for obsessive-compulsive disorder (OCD) without deliberate and prolonged exposure and response prevention (ERP) that focuses on strengthening reality-based reasoning and correcting the dysfunctional reasoning giving rise to erroneous obsessional doubts and ideas. Objective: The present study aimed to evaluate the effectiveness of I-CBT through a comparison with appraisal-based cognitive behavioral therapy (A-CBT) and an adapted mindfulness-based stress reduction (MBSR) intervention. Methods: This was a two-site, parallel-arm randomized controlled trial (RCT) comparing I-CBT with A-CBT. The MBSR intervention acted as a non-specific active control condition. Following formal evaluation, 111 participants diagnosed with OCD were randomly assigned. The principal outcome measure was the Yale-Brown Obsessive-Compulsive Scale. Results: All treatments significantly reduced general OCD severity and specific symptom dimensions without a significant difference between treatments. I-CBT was associated with significant reductions in all symptom dimensions at post-test. Also, I-CBT led to significantly greater improvement in overvalued ideation, as well as significantly higher rates of remission as compared to MBSR at mid-test. Conclusions: I-CBT and MBSR appear to be effective, alternative treatment options for those with OCD that yield similar outcomes as A-CBT. I-CBT may have an edge in terms of the rapidity by which patients reach remission, its generalizability across symptom dimension, its potentially higher level of acceptability, and effectiveness for overvalued ideation. Future research is needed to assess whether additional alternative treatments options can help to increase the number of people successfully treated. © 2022 The Author(s). Published by S. Karger AG, Basel.},

keywords = {adult, aged, appraisal based cognitive behavioral therapy, article, clinical effectiveness, clinical evaluation, clinical outcome, clinical trial, cognitive behavioral therapy, Cognitive-behavioral therapy, controlled study, disease severity, female, human, Humans, inference based cognitive behavioral therapy, Inference-based approach, intermethod comparison, major clinical study, male, mindfulness, mindfulness-based stress reduction, multicenter study, obsessive compulsive disorder, Obsessive-Compulsive Disorder, patient dropout, procedures, randomized controlled trial, remission, treatment outcome, treatment refusal, Yale Brown Obsessive Compulsive Scale},

pubstate = {published},

tppubtype = {article}

}

@article{cousineau_insomnia_2016,

title = {Insomnia symptoms following treatment for comorbid panic disorder with agoraphobia and generalized anxiety disorder},

author = {H. Cousineau and A. Marchand and S. Bouchard and C. Bélanger and P. Gosselin and F. Langlois and J. Labrecque and M. J. Dugas and G. Belleville},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-84962128029&doi=10.1097%2fNMD.0000000000000466&partnerID=40&md5=2ca2dd82c29553bd7377ba64dd5522cc},

doi = {10.1097/NMD.0000000000000466},

issn = {00223018},

year  = {2016},

date = {2016-01-01},

journal = {Journal of Nervous and Mental Disease},

volume = {204},

number = {4},

pages = {267–273},

publisher = {Lippincott Williams and Wilkins},

abstract = {Patients with panic disorder with agoraphobia (PDA) or generalized anxiety disorder (GAD) frequently also suffer from insomnia. However, the impact of cognitive-behavioral therapy (CBT) for anxiety disorders on insomnia has been understudied. Furthermore, comorbidity between anxiety disorders is common. Our main objective was to assess the impact of CBT for PDA or GAD on insomnia. In a quasi-experimental design, 86 participants with PDA and GAD received conventional CBT for their primary disorder or combined CBT for both disorders. Overall, CBTs had a significant impact on reducing insomnia symptoms (η2 = 0.58). However, among people with insomnia at pretest (67%), 33% still had an insomnia diagnosis, and the majority (63%) had clinically significant residual insomnia following treatment. In conclusion, the CBTs had a positive effect on the reduction of insomnia, but a significant proportion of participants still had insomnia problems following treatment. Clinicians should address insomnia during CBT for PDA and GAD. Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.},

note = {Publisher: Lippincott Williams and Wilkins},

keywords = {adult, agoraphobia, antidepressant agent, Anxiety Disorders, anxiolytic agent, article, clinical trial, cognitive therapy, cohort analysis, Cohort Studies, Combined Modality Therapy, comorbidity, comparative study, controlled study, Depression, disease severity, female, generalized anxiety disorder, human, Humans, hypnotic agent, insomnia, major clinical study, male, Middle Aged, multicenter study, multimodality cancer therapy, nocturnal panic attack, panic, Panic Disorder, panic disorder with agoraphobia, patient worry, procedures, psychoeducation, psychology, psychotropic agent, Psychotropic Drugs, quasi experimental study, Quebec, randomized controlled trial, Sleep Initiation and Maintenance Disorders, statistical significance, treatment outcome, wakefulness, Young Adult},

pubstate = {published},

tppubtype = {article}

}

@article{cousineauInsomniaSymptomsFollowing2016,

title = {Insomnia symptoms following treatment for comorbid panic disorder with agoraphobia and generalized anxiety disorder},

author = {H. Cousineau and A. Marchand and S. Bouchard and C. Bélanger and P. Gosselin and F. Langlois and J. Labrecque and M. J. Dugas and G. Belleville},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-84962128029&doi=10.1097%2fNMD.0000000000000466&partnerID=40&md5=2ca2dd82c29553bd7377ba64dd5522cc},

doi = {10.1097/NMD.0000000000000466},

issn = {00223018},

year  = {2016},

date = {2016-01-01},

journal = {Journal of Nervous and Mental Disease},

volume = {204},

number = {4},

pages = {267–273},

publisher = {Lippincott Williams and Wilkins},

abstract = {Patients with panic disorder with agoraphobia (PDA) or generalized anxiety disorder (GAD) frequently also suffer from insomnia. However, the impact of cognitive-behavioral therapy (CBT) for anxiety disorders on insomnia has been understudied. Furthermore, comorbidity between anxiety disorders is common. Our main objective was to assess the impact of CBT for PDA or GAD on insomnia. In a quasi-experimental design, 86 participants with PDA and GAD received conventional CBT for their primary disorder or combined CBT for both disorders. Overall, CBTs had a significant impact on reducing insomnia symptoms (η2 = 0.58). However, among people with insomnia at pretest (67%), 33% still had an insomnia diagnosis, and the majority (63%) had clinically significant residual insomnia following treatment. In conclusion, the CBTs had a positive effect on the reduction of insomnia, but a significant proportion of participants still had insomnia problems following treatment. Clinicians should address insomnia during CBT for PDA and GAD. Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.},

keywords = {adult, agoraphobia, antidepressant agent, Anxiety Disorders, anxiolytic agent, article, clinical trial, cognitive therapy, cohort analysis, Cohort Studies, Combined Modality Therapy, comorbidity, comparative study, controlled study, Depression, disease severity, female, generalized anxiety disorder, human, Humans, hypnotic agent, insomnia, major clinical study, male, Middle Aged, multicenter study, multimodality cancer therapy, nocturnal panic attack, panic, Panic Disorder, panic disorder with agoraphobia, patient worry, procedures, psychoeducation, psychology, psychotropic agent, Psychotropic Drugs, quasi experimental study, Quebec, randomized controlled trial, Sleep Initiation and Maintenance Disorders, statistical significance, treatment outcome, wakefulness, Young Adult},

pubstate = {published},

tppubtype = {article}

}