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
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- 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
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
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- 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.
The relationship between attachment style, anxiety sensitivity and interpretive bias among adolescent nonclinical panickers
- Authors: Austin, David , Jamieson, Rachel , Richards, Jeffrey , Winkelman, John
- Date: 2006
- Type: Text , Journal article
- Relation: Behaviour Change Vol. 23, no. 1 (2006), p. 31-41
- Full Text: false
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- Description: Elevated anxiety sensitivity and the tendency to catastrophically misinterpret ambiguous bodily sensations has been demonstrated in people who experience nonclinical levels of panic (Richards, Austin, & Alvarenga, 2001), and anxiety sensitivity has been shown to be associated with insecure attachment in adolescents and young adults (Weems, Berman, Silverman, & Saavedra, 2001). This study investigated the relationship between attachment style, anxiety sensitivity and catastrophic misinterpretation among 11 nonclinical panickers and 58 nonanxious controls aged 18 to 19 years. Participants completed the Brief Bodily Sensations Interpretation Questionnaire (BBSIQ), Anxiety Sensitivity Index (ASI) and an attachment questionnaire. The hypothesis that insecurely attached individuals would demonstrate greater catastrophic misinterpretation and higher anxiety sensitivity than securely attached individuals was not supported; however, nonclinical panickers gave more anxiety-related interpretations of ambiguous internal stimuli than nonanxious controls. Results do not support the notion that attachment style is related to anxiety sensitivity or catastrophic misinterpretation (regardless of panic experience). Results do, however, support the notion that anxiety-related misinterpretation of ambiguous somatic sensations precedes the onset of panic disorder.
- Description: C1
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
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- 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
Interoceptive accuracy in nonclinical panic
- Authors: Richards, Jeffrey , Cooper, Andrew , Winkelman, John
- Date: 2003
- Type: Text , Journal article
- Relation: Cognitive Therapy and Research Vol. 27, no. 4 (2003), p. 447-461
- Full Text: false
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- Description: The psychological models of panic disorder predict that people with this anxiety disorder are able to accurately estimate changes in somatic sensations. This study investigated whether nonclinical panickers, at risk for developing panic disorder, demonstrate enhanced interoceptive ability for changes in sympathetic arousal. Twenty people with nonclinical panic and 36 nonpanic controls estimated changes in overall sympathetic arousal, as measured by pulse transit time. A greater proportion of the nonclinical panickers than nonpanic controls met criterion for accurate interoceptive ability. As a group, nonclinical panickers also demonstrated more accurate perception of sympathetic arousal but only when it changed in predictable ways. Anxiety sensitivity and trait anxiety also appeared related to enhanced interoception, particularly in people who had experienced nonclinical panic. People who are at risk for the development of panic disorder may therefore demonstrate enhanced interoceptive ability for sympathetic arousal.
- Description: C1
- Description: 2003000504
Barriers to the delivery of mental health care in general practice
- Authors: Richards, Jeffrey , McCabe, Marita , Ryan, Paul , Hickie, I. , Grooms, G.
- Date: 2002
- Type: Text , Journal article
- Relation: Australian and New Zealand Journal of Psychiatry Vol. 36, no. 6 (Dec 2002), p. A32-A32
- Full Text: false
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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
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- 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
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
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- 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
Treatment of PTSD : Stress inoculation training with prolonged exposure compared to EMDR
- Authors: Lee, Christopher , Gavriel, Helen , Drummond, Peter , Richards, Jeffrey , Greenwald, Ricky
- Date: 2002
- Type: Text , Journal article
- Relation: Journal of Clinical Psychology Vol. 58, no. 9 (2002), p. 1071-1089
- Full Text: false
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- Description: The effectiveness of Stress Inoculation Training with Prolonged Exposure (SITPE) was compared to Eye Movement Desensitization and Reprocessing (EMDR). Twenty-four participants who had a diagnosis of Post Traumatic Stress Disorder (PTSD) were randomly assigned to one of the treatment conditions. Participants were also their own wait-list control. Outcome measures included self-report and observer-rated measures of PTSD, and self-report measures of depression. On global PTSD measures, there were no significant differences between the treatments at the end of therapy. However on the subscale measures of the degree of intrusion symptoms, EMDR did significantly better than SITPE. At follow-up EMDR was found to lead to greater gains on all measures. © 2002 Wiley Periodicals, Inc.
A brief internet-based treatment for panic disorder
- Authors: Klein, Britt , Richards, Jeffrey
- Date: 2001
- Type: Text , Journal article
- Relation: Behavioural and Cognitive Psychotherapy Vol. 29, no. 1 (2001), p. 113-117
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- Description: This study investigated the effectiveness of an Internet-based intervention for people with panic disorder. Twenty-two participants met criteria for panic disorder and were randomly assigned to either the treatment or a self-monitoring control condition. The study took place over 3 weeks and consisted of one week of self-monitoring prior to the intervention group accessing the program for one week, followed by one week of post-intervention assessment. Participants were assessed on measures pertaining to panic, negative affect, body vigilance, anxiety sensitivity and self-efficacy in managing panic. The treatment condition was associated with significant reductions in all variables except anxiety sensitivity and depressive affect. This type of intervention for people with fearful panic attacks holds promise as an efficacious and economical method for treating spontaneous panic.
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
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- 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.
Rewriting the agenda for training in clinical and counselling psychology
- Authors: Richards, Jeffrey
- Date: 2001
- Type: Text , Journal article
- Relation: Australian Psychologist Vol. 36, no. 2 (2001), p. 99-106
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- Description: This paper describes a model for future training in clinical and counselling psychology. The model is based on the results of psychotherapy outcome research, and the development of empirically supported therapies, as well as recent developments in the use of information technology in psychotherapeutic interventions. It is also argued that developments such as the increasing cost of mental health interventions, the wide disparities in access to specialised mental health assistance, and the rise of the mental health consumer movement all provide a context for recommendations as to optimum developments in training for clinical and counselling psychologists.
Serum lipids and their relationships with angry affect and behaviours in men
- Authors: Richards, Jeffrey , Hof, Alexandra , Alvarenga, Marlies
- Date: 2001
- Type: Text , Journal article
- Relation: Australian Journal of Psychology Vol. 53, no. (2001), p. 171-171
- Full Text: false
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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.