Extension and replication of an internet-based treatment program for panic disorder
- Authors: Richards, Jeffrey , Alvarenga, Marlies
- Date: 2002
- Type: Text , Journal article
- Relation: Cognitive Behaviour Therapy Vol. 31, no. 1 (2002), p. 41-47
- Full Text: false
- Reviewed:
- Description: This study describes an internet-based intervention for people with panic disorder that consisted of a 5-module program. Participants accessed the program for 5-8 weeks and were then re-assessed 3 months later. Use of the program was associated with reductions in severity of panic disorder and in catastrophic misinterpretation of ambiguous panic body sensations in 9 people with this anxiety disorder. There were also non-significant trends for body vigilance to decrease over the course of the study. Further investigations of the efficacy of this medium for the treatment of panic disorder and the associated mechanisms of change are warranted.
- Description: 2003000077
Efficacy of internet therapy for panic disorder
- Authors: Klein, Britt , Richards, Jeffrey , Austin, David
- Date: 2006
- Type: Text , Journal article
- Relation: Journal of Behavior Therapy and Experimental Psychiatry Vol. 37, no. 3 (2006), p. 213-238
- Full Text: false
- Reviewed:
- Description: Fifty-five people with panic disorder (PD) were randomised to internet-based cognitive behavioural panic treatment (CBT) (with email contact), therapist-assisted CBT manual or information-only control (both with telephone contact). Both CBT treatments were more effective in reducing PD symptomatology, panic-related cognition, negative affect, and number of GP visits and improving physical health ratings. Internet treatment was more effective than CBT manual in reducing clinician-rated agoraphobia and number of GP visits at post-assessment. At follow-up, these effects were maintained for both CBT groups, with internet CBT better at improving physical health ratings and reducing GP visits. This study provides support for the efficacy of internet-based CBT. © 2005 Elsevier Ltd. All rights reserved.
- Description: C1
Interpretation of ambiguous interoceptive stimuli in panic disorder and nonclinical panic
- Authors: Richards, Jeffrey , Austin, David , Alvarenga, Marlies
- Date: 2001
- Type: Text , Journal article
- Relation: Cognitive Therapy and Research Vol. 25, no. 3 (2001), p. 235-246
- Full Text: false
- Reviewed:
- Description: Cognitive bias in the misinterpretation of ambiguous interoceptive stimuli has been demonstrated in panic disorder. This study investigated whether this cognitive bias also occurs in people with nonclinical panic who are at risk of developing panic disorder. The responses of 25 people with nonclinical panic were compared to those of 20 people with panic disorder and 69 nonpanic controls on a measure of interpretive bias, the Brief Body Sensations Interpretation Questionnaire. There was evidence for interpretive cognitive bias for ambiguous interoceptive stimuli among the nonclinical panickers which did not differ from that of the people with panic disorder, but which differed from the nonpanic controls. High anxiety sensitivity predicted interpretive bias toward both interoceptive and external stimuli. Results therefore suggest that interpretive cognitive bias for ambiguous interoceptive stimuli may be a risk factor for the development of panic disorder.
The relative contributions of negative cognitions and self-efficacy to severity of panic attacks in panic disorder
- Authors: Richards, Jeffrey , Pier, Ciaran
- Date: 2002
- Type: Text , Journal article
- Relation: Behaviour Change Vol. 19, no. 2 (2002), p. 102-111
- Full Text: false
- Reviewed:
- Description: The aim of this study was to determine the degree to which fearful and catastrophic cognitions, and self-efficacy for managing panic predicted various panic attack characteristics in panic disorder. The cognitive variables consisted of anxiety sensitivity, the frequency of fearful agoraphobic cognitions and measures of catastrophic misinterpretation of symptoms. The panic parameters were number and severity of panic symptoms, distress associated with panic attacks, worry about future panics, duration of panic disorder, and life interference due to panic disorder. These variables were measured in 40 people with panic disorder, 31 of whom also had significant agoraphobia. The frequency of fearful agoraphobic cognitions was the strongest predictor of panic attack symptomatology, predicting number of symptoms, symptom severity and degree of anticipatory fear of panic. Catastrophic misinterpretation of symptoms and anxiety sensitivity did not independently predict any panic parameters. Only self-efficacy for managing the rapid build-up of panic symptoms was specifically related to panic severity. The results therefore suggest that cognitive behaviour therapy for panic symptoms in panic disorder should reduce fearful cognitions rather than focus on panic coping strategies. The results offer little support for the contribution of the expectancy or catastrophic misinterpretation theories to the maintenance of panic disorder.
- Description: 2003000074
The catastrophic misinterpretation model of panic disorder
- Authors: Austin, David , Richards, Jeffrey
- Date: 2001
- Type: Text , Journal article
- Relation: Behaviour Research and Therapy Vol. 39, no. 11 (2001), p. 1277-1291
- Full Text: false
- Reviewed:
- Description: In the catastrophic misinterpretation model of panic ark [Behav. Res. Ther. 24(1986)1461] proposes that panic attacks result from the misinterpretation of autonomic arousal stimuli as precursors to a physical or psychological emergency. The model has been widely examined, with many researchers suggesting that this specific cognitive bias is implicated in both the phenomenon of panic, and the aetiology and maintenance of panic disorder. Various research methodologies have provided only partial or inconclusive support for the model as being uniquely associated with panic, and as a cognitive process underpinning the experience of panic. This paper reviews the body of existing evidence and its implications for the model and proposes future research directions. The influence of implicit operational definitions of key terms in the catastrophic misinterpretation literature (e.g. 'catastrophe', 'threat', 'anxiety-related') are examined, and clarifications proposed. Inconsistencies and limitations in the measurement of catastrophic misinterpretation are highlighted, and subsequently developments to measurement instruments are proposed. © 2001 Elsevier Science Ltd. All rights reserved.
Internet-based treatment for panic disorder
- Authors: Richards, Jeffrey , Klein, Britt , Carlbring, Per
- Date: 2003
- Type: Text , Journal article
- Relation: Cognitive Behaviour Therapy Vol. 32, no. 3 (2003), p. 125-135
- Full Text: false
- Reviewed:
- Description: Increasingly, the internet is being used as a source of mental health information as well as structured treatment programs for people with mental health concerns or problems. The present review focuses mainly on research conducted at the University of Ballarat in Australia, and Uppsala University in Sweden, on internet-based treatment for panic disorder, one of the more common and disabling anxiety disorders. Our studies suggest that internet-based cognitive behavioural therapy is an effective intervention for panic disorder, and that it is more effective than some other self-help therapies. We have found that this mode of intervention is associated with clinically significant change, improved psychological well-being and functioning, and low participant attrition, provided that timely, limited therapist assistance is also provided. This review also discusses treatment credibility and participant satisfaction, as well as assessment and crisis management issues. Although promising as a form of intervention, there is a need for more research on the efficacy of internet-based treatment for PD and on comparisons with evidence-based face-to-face therapies.
- Description: C1
- Description: 2003000467
Modification of the body sensations interpretation questionnaire (BSIQ-M) : Validity and reliability
- Authors: Austin, David , Richards, Jeffrey , Klein, Britt
- Date: 2006
- Type: Text , Journal article
- Relation: Journal of Anxiety Disorders Vol. 20, no. 2 (2006), p. 237-251
- Full Text: false
- Reviewed:
- Description: The catastrophic misinterpretation model [Behav. Res. Ther. 24 (1986) 461-470] proposes that panic attacks result from misinterpretation of interoceptive stimuli as precursors to physical or psychological emergency. Inconclusive evidence for the model may be partly explained by limitations of the questionnaires developed to measure catastrophic misinterpretation. For example, the Body Sensations Interpretation Questionnaire (BSIQ) is unable to clarify whether anxiety-related interpretations of ambiguous interoceptive stimuli represent catastrophic misinterpretations or responses masking feared outcomes (e.g., heart failure). Additionally, it lacks items relating to several DSM-IV criteria for panic, thereby limiting content validity. Reliability is also potentially compromised due to experimenter-coding of participant-generated responses. A modified form of the BSIQ was developed to address these limitations and evaluated with non-anxious controls (n=34) and people with panic disorder (n=38). The revised questionnaire demonstrated good to excellent internal consistency, inter-rater reliability, and construct validity and is a useful development of the BSIQ.
Internet-based treatment for panic disorder: Does frequency of therapist contact make a difference?
- Authors: Klein, Britt , Austin, David , Pier, Ciaran , Kiropoulos, Litza , Shandley, Kerrie , Mitchell, Joanna , Gilson, Kathryn , Ciechomski, Lisa
- Date: 2009
- Type: Text , Journal article
- Relation: Cognitive Behaviour Therapy Vol. 38, no. 2 (2009), p. 100-113
- Full Text: false
- Reviewed:
- Description: Internet-based interventions with therapist support have proven effective for treating a range of mental health conditions. This study examined whether frequency of therapist contact affected treatment outcomes. Fifty-seven people with panic disorder (including 32 with agoraphobia) were randomly allocated to an 8-week Internet-based cognitive behavioural treatment intervention (Panic Online) with either frequent (three e-mails per week) or infrequent (one e-mail per week) support from a psychologist. Posttreatment, intention-to-treat analyses revealed that both treatments were effective at improving panic disorder and agoraphobia severity ratings, panic-related cognitions, negative affect, and psychological and physical quality of life domains, with no differences between conditions. High end-state functioning was achieved by 28.6% of the frequent and infrequent participants, respectively. Therapist alliance, treatment credibility, and satisfaction also did not differ between groups, despite significantly greater therapist time invested in the frequent contact condition. The results provide evidence that the effectiveness of Internet-based mental health interventions may be independent of the frequency of therapist support and may, therefore, be more cost-effective than previously reported. © 2009 Taylor & Francis.
A controlled trial of internet-based cognitive-behavioural therapy for panic disorder with face-to-face support from a general practitioner or email support from a psychologist
- Authors: Pier, Ciaran , Austin, David , Klein, Britt , Mitchell, Joanna , Schattner, Peter , Ciechomski, Lisa , Gilson, Kathryn , Pierce, David , Shandley, Kerrie , Wade, Victoria
- Date: 2008
- Type: Text , Journal article
- Relation: Mental Health in Family Medicine Vol. 5, no. 1 (2008), p. 28-29
- Full Text: false
- Reviewed:
- Description: Background: Panic disorder (PD) is one of the most common anxiety disorders seen in general practice, but provision of evidence-based cognitive-behavioural treatment (CBT) is rare. Many Australian GPs are now trained to deliver focused psychological strategies, but in practice this is time consuming and costly. Objective: To evaluate the efficacy of an internet-based CBT intervention (Panic Online) for the treatment of PD supported by general practitioner (GP)-delivered therapeutic assistance. Design: Panic Online supported by GP-delivered face-to-face therapy was compared to Panic Online supported by psychologist-delivered email therapy. Methods: Sixty-five people with a primary diagnosis of PD (78% of whom also had agoraphobia) completed 12 weeks of therapy using Panic Online and therapeutic assistance with his/her GP (n = 34) or a clinical psychologist (n = 31). The mean duration of PD for participants allocated to these groups was 59 months and 58 months, respectively. Participants completed a clinical diagnostic interview delivered by a psychologist via telephone and questionnaires to assess panic-related symptoms, before and after treatment. Results: The total attrition rate was 20%, with no group differences in attrition frequency. Both treatments led to significant improvements in panic attack frequency, depression, anxiety, stress, anxiety sensitivity and quality of life. There were no statistically significant differences in the two treatments on any of these measures, or in the frequency of participants with clinically significant PD at post assessment. Conclusions: When provided with accessible online treatment protocols, GPs trained to deliver focused psychological strategies can achieve patient outcomes comparable to efficacious treatments delivered by clinical psychologists. The findings of this research provide a model for how GPs may be assisted to provide evidence-based mental healthcare successfully. © 2008 Radcliffe Publishing.
Considerations in the development of a therapist-assisted internet cognitive behavior therapy service.
- Authors: Hadjistavropoulos, Heather , Thompson, Maureen , Ivanov, Max , Drost, Christina , Butz, Cory , Klein, Britt , Austin, David
- Date: 2011
- Type: Text , Journal article
- Relation: Professional Psychology: Research and Practice Vol. 42, no. 6 (2011), p. 463-471
- Full Text: false
- Description: There is mounting evidence in clinical trials that therapist-assisted Internet cognitive behavior therapy (TAICBT) is efficacious in the treatment of depression and anxiety. Nevertheless, many clinical service providers (both individuals and organizations) question whether offering this form of treatment in clinical practice is feasible. As such, having information on the factors involved in the development of this service is essential. In this article, we describe the steps taken to develop a TAICBT service that registered professionals and students (under supervision) can use with clients suffering from symptoms of depression, generalized anxiety, and panic disorder. We share salient decisions made in developing this web application and the necessary unit policies and procedures. We also offer lessons learned and practical recommendations to providers who may want to translate this promising TAICBT research into practice. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Internet-based treatment for panic disorder: does frequency of therapist contact make a difference?
- Authors: Kiropoulos, Litza , Klein, Britt , Austin, David , Gilson, Kathryn , Pier, Ciaran , Mitchell, Joanna , Ciechomski, Lisa
- Date: 2008
- Type: Text , Journal article
- Relation: Cognitive behaviour therapy Vol. 22, no. 8 (2008), p. 1273-1284
- Full Text: false
- Reviewed:
- Description: rInternet-based interventions with therapist support have proven effective for treating a range of mental health conditions. This study examined whether frequency of therapist contact affected treatment outcomes. Fifty-seven people with panic disorder (including 32 with agoraphobia) were randomly allocated to an 8-week Internet-based cognitive behavioural treatment intervention (Panic Online) with either frequent (three e-mails per week) or infrequent (one e-mail per week) support from a psychologist. Posttreatment, intention-to-treat analyses revealed that both treatments were effective at improving panic disorder and agoraphobia severity ratings, panic-related cognitions, negative affect, and psychological and physical quality of life domains, with no differences between conditions. High end-state functioning was achieved by 28.6% of the frequent and infrequent participants, respectively. Therapist alliance, treatment credibility, and satisfaction also did not differ between groups, despite significantly greater therapist time invested in the frequent contact condition. The results provide evidence that the effectiveness of Internet-based mental health interventions may be independent of the frequency of therapist support and may, therefore, be more cost-effective than previously reported.