Slide
Centre Interdisciplinaire
de Recherche et d’Innovation
en Cybersécurité et Société
de Recherche et d’Innovation
en Cybersécurité et Société
1.
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},
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.
2.
Sert, O. P.; Potvin, S.; Lipp, O.; Dellazizzo, L.; Laurelli, M.; Breton, R.; Lalonde, P.; Phraxayavong, K.; O'Connor, K.; Pelletier, J. -F.; Boukhalfi, T.; Renaud, P.; Dumais, A.
Virtual reality therapy for refractory auditory verbal hallucinations in schizophrenia: A pilot clinical trial Journal Article
In: Schizophrenia Research, vol. 197, pp. 176–181, 2018, ISSN: 09209964, (Publisher: Elsevier B.V.).
Abstract | Links | BibTeX | Tags: adult, article, auditory hallucination, auditory verbal hallucination, clinical article, clinical effectiveness, computer assisted therapy, Computer-Assisted, controlled study, Cross-Over Studies, crossover procedure, disease severity, distress syndrome, female, follow up, Follow-Up Studies, hallucination, Hallucinations, human, Humans, male, Middle Aged, neuroleptic agent, outcome assessment, Outcome Assessment (Health Care), phase 2 clinical trial, physiology, Pilot Projects, pilot study, priority journal, procedures, psychotherapy, quality of life, randomized controlled trial, schizophrenia, Speech Perception, symptom, Therapy, therapy delay, therapy effect, treatment duration, treatment response, virtual reality, virtual reality exposure therapy
@article{du_sert_virtual_2018,
title = {Virtual reality therapy for refractory auditory verbal hallucinations in schizophrenia: A pilot clinical trial},
author = {O. P. Sert and S. Potvin and O. Lipp and L. Dellazizzo and M. Laurelli and R. Breton and P. Lalonde and K. Phraxayavong and K. O'Connor and J. -F. Pelletier and T. Boukhalfi and P. Renaud and A. Dumais},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85042420594&doi=10.1016%2fj.schres.2018.02.031&partnerID=40&md5=fe98669ecfdfb69d05cc9ebb58fecdcc},
doi = {10.1016/j.schres.2018.02.031},
issn = {09209964},
year = {2018},
date = {2018-01-01},
journal = {Schizophrenia Research},
volume = {197},
pages = {176–181},
abstract = {Schizophrenia is a chronic and severe mental illness that poses significant challenges. While many pharmacological and psychosocial interventions are available, many treatment-resistant schizophrenia patients continue to suffer from persistent psychotic symptoms, notably auditory verbal hallucinations (AVH), which are highly disabling. This unmet clinical need requires new innovative treatment options. Recently, a psychological therapy using computerized technology has shown large therapeutic effects on AVH severity by enabling patients to engage in a dialogue with a computerized representation of their voices. These very promising results have been extended by our team using immersive virtual reality (VR). Our study was a 7-week phase-II, randomized, partial cross-over trial. Nineteen schizophrenia patients with refractory AVH were recruited and randomly allocated to either VR-assisted therapy (VRT) or treatment-as-usual (TAU). The group allocated to TAU consisted of antipsychotic treatment and usual meetings with clinicians. The TAU group then received a delayed 7 weeks of VRT. A follow-up was ensured 3 months after the last VRT therapy session. Changes in psychiatric symptoms, before and after TAU or VRT, were assessed using a linear mixed-effects model. Our findings showed that VRT produced significant improvements in AVH severity, depressive symptoms and quality of life that lasted at the 3-month follow-up period. Consistent with previous research, our results suggest that VRT might be efficacious in reducing AVH related distress. The therapeutic effects of VRT on the distress associated with the voices were particularly prominent (d = 1.2). VRT is a highly novel and promising intervention for refractory AVH in schizophrenia. © 2018},
note = {Publisher: Elsevier B.V.},
keywords = {adult, article, auditory hallucination, auditory verbal hallucination, clinical article, clinical effectiveness, computer assisted therapy, Computer-Assisted, controlled study, Cross-Over Studies, crossover procedure, disease severity, distress syndrome, female, follow up, Follow-Up Studies, hallucination, Hallucinations, human, Humans, male, Middle Aged, neuroleptic agent, outcome assessment, Outcome Assessment (Health Care), phase 2 clinical trial, physiology, Pilot Projects, pilot study, priority journal, procedures, psychotherapy, quality of life, randomized controlled trial, schizophrenia, Speech Perception, symptom, Therapy, therapy delay, therapy effect, treatment duration, treatment response, virtual reality, virtual reality exposure therapy},
pubstate = {published},
tppubtype = {article}
}
Schizophrenia is a chronic and severe mental illness that poses significant challenges. While many pharmacological and psychosocial interventions are available, many treatment-resistant schizophrenia patients continue to suffer from persistent psychotic symptoms, notably auditory verbal hallucinations (AVH), which are highly disabling. This unmet clinical need requires new innovative treatment options. Recently, a psychological therapy using computerized technology has shown large therapeutic effects on AVH severity by enabling patients to engage in a dialogue with a computerized representation of their voices. These very promising results have been extended by our team using immersive virtual reality (VR). Our study was a 7-week phase-II, randomized, partial cross-over trial. Nineteen schizophrenia patients with refractory AVH were recruited and randomly allocated to either VR-assisted therapy (VRT) or treatment-as-usual (TAU). The group allocated to TAU consisted of antipsychotic treatment and usual meetings with clinicians. The TAU group then received a delayed 7 weeks of VRT. A follow-up was ensured 3 months after the last VRT therapy session. Changes in psychiatric symptoms, before and after TAU or VRT, were assessed using a linear mixed-effects model. Our findings showed that VRT produced significant improvements in AVH severity, depressive symptoms and quality of life that lasted at the 3-month follow-up period. Consistent with previous research, our results suggest that VRT might be efficacious in reducing AVH related distress. The therapeutic effects of VRT on the distress associated with the voices were particularly prominent (d = 1.2). VRT is a highly novel and promising intervention for refractory AVH in schizophrenia. © 2018
3.
Laforest, M.; Bouchard, S.; Bossé, J.; Mesly, O.
In: Frontiers in Psychiatry, vol. 7, no. JUN, 2016, ISSN: 16640640 (ISSN), (Publisher: Frontiers Research Foundation).
Abstract | Links | BibTeX | Tags: adult, aged, article, CBT, clinical effectiveness, cognitive behavioral therapy, disease severity, exposure, female, generalized anxiety disorder, human, hypnosis, male, obsessive compulsive disorder, Obsessive-Compulsive Disorder, pilot study, psychologic assessment, Response prevention, self report, treatment duration, treatment outcome, treatment response, virtual reality, Yale Brown Obsessive Compulsive Scale
@article{laforest_effectiveness_2016,
title = {Effectiveness of in virtuo exposure and response prevention treatment using cognitive-behavioral therapy for obsessive-compulsive disorder: A study based on a single-case study protocol},
author = {M. Laforest and S. Bouchard and J. Bossé and O. Mesly},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-84977551825&doi=10.3389%2ffpsyt.2016.00099&partnerID=40&md5=8aaf926230112d06a0c1e629e49b51c6},
doi = {10.3389/fpsyt.2016.00099},
issn = {16640640 (ISSN)},
year = {2016},
date = {2016-01-01},
journal = {Frontiers in Psychiatry},
volume = {7},
number = {JUN},
abstract = {Obsessive-compulsive disorder (OCD) is characterized by the presence of distressing, recurrent and intrusive thoughts, impulses, or doubts as well as behavioral or mental rituals. OCD has various subtypes, including the fear of contamination in which individuals fear bacteria, germs, disease, or bodily secretions, and engage in clinically significant cleaning and avoidance rituals. Cognitive-behavioral therapy (CBT) is an effective treatment for OCD and involves, among other therapeutic strategies, exposing patients to feared stimuli while preventing them to engage in compulsive behaviors. In recent years, virtual reality (VR) has shown the potential of in virtuo exposure with people suffering from anxiety disorders and OCD. The objective of this pilotstudy is to examine the effectiveness of a CBT program where exposure in conducted in virtuo. Three adults suffering from OCD with a dominant subtype of contamination were enrolled in a single-case design with multiple baselines across participants. The presence and intensity of obsessions and compulsions were assessed daily during baselines of 3-, 4-, or 5-week, and a 12-session treatment. Follow-up information was gathered after 4 and 8 months. Treatment outcome is assessed with visual inspection of the graphs and ARMA time-series analyses. Clinical information, self-reports, and details of the treatment are provided for each patient. Statistical analyses for the time-series data revealed a statistically significant improvement in all three participants, but global improvement is considered positive for only two. This study innovates in proving preliminary support for the usefulness of VR in the CBT of OCD with contamination features. © 2016 Laforest, Bouchard, Bossé and Mesly.},
note = {Publisher: Frontiers Research Foundation},
keywords = {adult, aged, article, CBT, clinical effectiveness, cognitive behavioral therapy, disease severity, exposure, female, generalized anxiety disorder, human, hypnosis, male, obsessive compulsive disorder, Obsessive-Compulsive Disorder, pilot study, psychologic assessment, Response prevention, self report, treatment duration, treatment outcome, treatment response, virtual reality, Yale Brown Obsessive Compulsive Scale},
pubstate = {published},
tppubtype = {article}
}
Obsessive-compulsive disorder (OCD) is characterized by the presence of distressing, recurrent and intrusive thoughts, impulses, or doubts as well as behavioral or mental rituals. OCD has various subtypes, including the fear of contamination in which individuals fear bacteria, germs, disease, or bodily secretions, and engage in clinically significant cleaning and avoidance rituals. Cognitive-behavioral therapy (CBT) is an effective treatment for OCD and involves, among other therapeutic strategies, exposing patients to feared stimuli while preventing them to engage in compulsive behaviors. In recent years, virtual reality (VR) has shown the potential of in virtuo exposure with people suffering from anxiety disorders and OCD. The objective of this pilotstudy is to examine the effectiveness of a CBT program where exposure in conducted in virtuo. Three adults suffering from OCD with a dominant subtype of contamination were enrolled in a single-case design with multiple baselines across participants. The presence and intensity of obsessions and compulsions were assessed daily during baselines of 3-, 4-, or 5-week, and a 12-session treatment. Follow-up information was gathered after 4 and 8 months. Treatment outcome is assessed with visual inspection of the graphs and ARMA time-series analyses. Clinical information, self-reports, and details of the treatment are provided for each patient. Statistical analyses for the time-series data revealed a statistically significant improvement in all three participants, but global improvement is considered positive for only two. This study innovates in proving preliminary support for the usefulness of VR in the CBT of OCD with contamination features. © 2016 Laforest, Bouchard, Bossé and Mesly.
4.
Dugas, M. J.; Francis, K.; Bouchard, S.
In: Cognitive Behaviour Therapy, vol. 38, no. 1, pp. 29–41, 2009, ISSN: 16512316 (ISSN).
Abstract | Links | BibTeX | Tags: adult, Anxiety Disorders, article, clinical article, clinical trial, cognitive therapy, controlled clinical trial, controlled study, disease association, female, generalized anxiety disorder, human, Humans, male, mental stress, Middle Aged, Personality Assessment, Personality Inventory, psychoanalysis, Psychometrics, randomized controlled trial, Relaxation Therapy, relaxation training, Single-case designs, somatoform disorder, Somatoform Disorders, Symptom change profiles, symptomatology, time series analysis, Treatment mechanisms, treatment outcome, treatment response
@article{dugas_cognitive_2009,
title = {Cognitive behavioural therapy and applied relaxation for generalized anxiety disorder: A time series analysis of change in worry and somatic anxiety},
author = {M. J. Dugas and K. Francis and S. Bouchard},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-61549090786&doi=10.1080%2f16506070802473221&partnerID=40&md5=78e775f09aa9806132cd1335ffef92b6},
doi = {10.1080/16506070802473221},
issn = {16512316 (ISSN)},
year = {2009},
date = {2009-01-01},
journal = {Cognitive Behaviour Therapy},
volume = {38},
number = {1},
pages = {29–41},
abstract = {The present study examined symptom change profiles in patients with generalized anxiety disorder (GAD) receiving either cognitive behavioural therapy (CBT) or applied relaxation (AR). It was hypothesized that (a) changes in worry would uniquely predict changes in somatic anxiety for most participants receiving CBT and (b) changes in somatic anxiety would uniquely predict changes in worry for most participants in the AR condition. Twenty participants (CBT n = 10; AR n = 10) completed daily ratings of worry and somatic anxiety during therapy, and multivariate time series analysis was used to assess the causal impact of each variable on the other. The hypotheses were not supported because we found no evidence of a match between individual symptom change profiles and treatment condition. Rather, a bidirectional relationship between worry and somatic anxiety was observed in 80% of participants receiving CBT and 70% of participants receiving AR. When only treatment responders were considered, 83% of participants receiving CBT and 86% of those receiving AR had such a bidirectional effect. The findings are discussed in terms of models of psychopathology that posit dynamic interactions between symptom clusters and in terms of the value of examining treatment mechanisms at the individual level.},
keywords = {adult, Anxiety Disorders, article, clinical article, clinical trial, cognitive therapy, controlled clinical trial, controlled study, disease association, female, generalized anxiety disorder, human, Humans, male, mental stress, Middle Aged, Personality Assessment, Personality Inventory, psychoanalysis, Psychometrics, randomized controlled trial, Relaxation Therapy, relaxation training, Single-case designs, somatoform disorder, Somatoform Disorders, Symptom change profiles, symptomatology, time series analysis, Treatment mechanisms, treatment outcome, treatment response},
pubstate = {published},
tppubtype = {article}
}
The present study examined symptom change profiles in patients with generalized anxiety disorder (GAD) receiving either cognitive behavioural therapy (CBT) or applied relaxation (AR). It was hypothesized that (a) changes in worry would uniquely predict changes in somatic anxiety for most participants receiving CBT and (b) changes in somatic anxiety would uniquely predict changes in worry for most participants in the AR condition. Twenty participants (CBT n = 10; AR n = 10) completed daily ratings of worry and somatic anxiety during therapy, and multivariate time series analysis was used to assess the causal impact of each variable on the other. The hypotheses were not supported because we found no evidence of a match between individual symptom change profiles and treatment condition. Rather, a bidirectional relationship between worry and somatic anxiety was observed in 80% of participants receiving CBT and 70% of participants receiving AR. When only treatment responders were considered, 83% of participants receiving CBT and 86% of those receiving AR had such a bidirectional effect. The findings are discussed in terms of models of psychopathology that posit dynamic interactions between symptom clusters and in terms of the value of examining treatment mechanisms at the individual level.