1
|
Reuter J, Grocholewski A, Steil R. Associations between olfactory reference disorder and social phobia - results of an internet-based study. Front Psychol 2024; 15:1248496. [PMID: 38515962 PMCID: PMC10954805 DOI: 10.3389/fpsyg.2024.1248496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 02/26/2024] [Indexed: 03/23/2024] Open
Abstract
Despite the similar clinical features of Olfactory Reference Disorder (ORD) and Social Phobia (SP), or studies showing elevated comorbidity of the two disorders, and the conceptualization of ORD as a form of SP in the East Asian culture, to our knowledge, the relationship between ORD and SP has not been investigated. This study examined the association of ORD according to the 11th revision of the International Classification of Diseases (ICD-11) and SP in 225 German university / college students who completed self-ratings with regard to socio-demographic data and symptoms of SP and ORD within an anonymous internet-based survey. Symptoms of SP were assessed with the Social Phobia Inventory (SPIN). Symptoms of ORD according to the ICD-11 were assessed with the Olfactory Reference Disorder Questionnaire (ORDQ), developed for this study. In our sample, 86.6% of the participants who met the self-rated features for ORD also met the self-rated criteria for current SP. ORD severity scores were significantly related to SP. Participants with and without self-reported ORD differed significantly in their SP total scores. SP severity was also significantly correlated with poorer insight of ORD-related beliefs, greater ORD-related avoidance of intimate relationships and higher levels of shame and fear of rejection due to body odor. These preliminary findings indicate that ORD could be closely related to SP and highlight the need for future research on the relationship of ORD and SP in order to gain a better understanding of the development, maintenance, treatment and classification of ORD.
Collapse
Affiliation(s)
- Julia Reuter
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Anja Grocholewski
- Department of Clinical Psychology, Psychotherapy, and Diagnostics, Technische Universität Braunschweig, Braunschweig, Germany
| | - Regina Steil
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Goethe University Frankfurt, Frankfurt am Main, Germany
| |
Collapse
|
2
|
Li Q, Zhang X, Yang X, Pan N, He M, Suo X, Li X, Gong Q, Wang S. Pre-COVID resting-state brain activity in the fusiform gyrus prospectively predicts social anxiety alterations during the pandemic. J Affect Disord 2024; 344:380-388. [PMID: 37838273 DOI: 10.1016/j.jad.2023.10.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 09/24/2023] [Accepted: 10/09/2023] [Indexed: 10/16/2023]
Abstract
BACKGROUND Social anxiety (SA) has been linked to the coronavirus disease 2019 (COVID-19) pandemic, but the neurobiopsychological mechanisms underlying this relationship remain unclear. This study aimed to elucidate the neurofunctional markers for COVID-induced SA development and the potential role of COVID-related posttraumatic stress symptoms (PTSS) in the brain-SA alterations link. METHODS Before the COVID-19 pandemic (T1), 100 general college students underwent resting-state magnetic resonance imaging and behavioral tests. During the period of community-level outbreaks (T2), these students were re-contacted to undergo follow-up behavioral assessments. RESULTS Whole-brain correlation and prediction analyses found that pre-pandemic spontaneous neural activity (measured by fractional amplitude of low-frequency fluctuations) in the right fusiform gyrus (FG) was positively correlated to SA alterations (T2 - T1). Mediation analyses revealed that COVID-specific PTSS mediated the effects of right FG on SA alterations. LIMITATIONS The results should be interpreted carefully because only one-session neuroimaging data in a sample of normal adults were included. CONCLUSIONS The results provide evidence for neurofunctional markers of COVID-induced SA and may help develop targeted brain-based interventions that reduce SA.
Collapse
Affiliation(s)
- Qingyuan Li
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China; Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xun Zhang
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Xun Yang
- School of Public Affairs, Chongqing University, Chongqing, China
| | - Nanfang Pan
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Min He
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Xueling Suo
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Xiao Li
- Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qiyong Gong
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China; Department of Radiology, West China Xiamen Hospital of Sichuan University, Xiamen, China.
| | - Song Wang
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China.
| |
Collapse
|
3
|
Kindred R, Bates GW, McBride NL. Long-term outcomes of cognitive behavioural therapy for social anxiety disorder: A meta-analysis of randomised controlled trials. J Anxiety Disord 2022; 92:102640. [PMID: 36265270 DOI: 10.1016/j.janxdis.2022.102640] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 08/17/2022] [Accepted: 10/11/2022] [Indexed: 11/07/2022]
Abstract
Cognitive Behavioural Therapy (CBT) is effective in treating Social Anxiety Disorder (SAD). However, less is known about whether gains achieved in disorder-specific and secondary outcomes (e.g., depression, general anxiety, quality of life, and self-esteem) are maintained 12 months or longer. A systematic literature search yielded 25 relevant studies that administered CBT to participants with SAD. Multivariate meta-analyses of post-treatment assessments, found that CBT was superior to control conditions in reducing social anxiety (g =.74), depression (g =.52), general anxiety (g =.69) and improving quality of life (g =.39). The within-groups effect sizes revealed that 12 months or more after CBT treatment, symptoms continued to improve for social anxiety (gav =.23) and quality of life (gav =.17), and gains were maintained for depressive (gav =.06) and general anxiety symptoms (gav =.03). However, meta-analyses of long-term outcomes lack comparison groups. Moderation was non-significant for the treatment model, format, number of sessions, treatment duration, or inclusion of booster sessions. Future research may investigate what drives improvement after treatment cessation and how CBT affects other co-occurring symptomatology. Taken together, CBT produces many benefits for SAD and individuals with co-occurring symptoms can benefit from extant SAD-focused treatments.
Collapse
Affiliation(s)
- Reuben Kindred
- Department of Psychological Sciences, Swinburne University of Technology, John St, Hawthorn 3122, Australia
| | - Glen W Bates
- Department of Psychological Sciences, Swinburne University of Technology, John St, Hawthorn 3122, Australia.
| | - Nicholas L McBride
- Department of Psychological Sciences, Swinburne University of Technology, John St, Hawthorn 3122, Australia
| |
Collapse
|
4
|
Zainal NH, Chan WW, Saxena AP, Taylor CB, Newman MG. Pilot randomized trial of self-guided virtual reality exposure therapy for social anxiety disorder. Behav Res Ther 2021; 147:103984. [PMID: 34740099 DOI: 10.1016/j.brat.2021.103984] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 09/14/2021] [Accepted: 10/04/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Virtual reality exposure therapy (VRE) has shown promising efficacy for the treatment of social anxiety disorder (SAD) and related comorbidities. However, most trials conducted to date were therapist-led, and little is known about the efficacy of self-guided VRE. Therefore, this randomized controlled trial (RCT) aimed to determine the efficacy of a self-directed VRE for SAD. METHOD Forty-four community-dwelling or undergraduate adults diagnosed with SAD based on the Mini International Neuropsychiatric Interview were randomly assigned to VRE designed to last four sessions or more (n = 26) or waitlist (WL; n = 18). Self-reported SAD severity (Social Phobia Diagnostic Questionnaire and Social Interaction Anxiety Scale), job interview anxiety (Measure of Anxiety in Selection Interviews), trait worry (Penn State Worry Questionnaire), and depression symptoms (Patient Health Questionnaire-9) were administered at baseline, post-treatment, 3-month-follow-up (3MFU), and 6-month-follow-up (6MFU). Piecewise multilevel modeling analyses were conducted to manage clustering in the data. RESULTS VRE vs. WL resulted in greater reductions in SAD symptom severity, job interview fear, and trait worry, with moderate-to-large effect sizes (Hedge's g = -0.54 to -1.11) from pre-to-post treatment. Although significant between-group differences did not emerge for change in depression, VRE led to change in depression, whereas waitlist did not. These gains were also maintained at 3MFU and 6MFU. Further, facets of presence increased during the course of VRE (g = 0.36-0.45), whereas cybersickness decreased (g = -0.43). DISCUSSION Brief, self-guided VRE might ameliorate SAD and comorbid worry, for young-to-middle-aged adults with SAD. Other theoretical and practical implications were also discussed.
Collapse
|
5
|
Akkuş K, Peker M. Exploring the Relationship Between Interpersonal Emotion Regulation and Social Anxiety Symptoms: The Mediating Role of Negative Mood Regulation Expectancies. COGNITIVE THERAPY AND RESEARCH 2021; 46:287-301. [PMID: 34413552 PMCID: PMC8364411 DOI: 10.1007/s10608-021-10262-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2021] [Indexed: 01/10/2023]
Abstract
Background This study aimed to investigate the relationship between interpersonal emotion regulation (IER) and social anxiety symptoms and the mediating role of negative mood regulation expectancies (NMRE). We hypothesised that IER is positively associated with social anxiety symptoms, controlling for depression and intrapersonal emotion regulation strategies of suppression and reappraisal, and NMRE mediate this relationship. Methods Study 1 was conducted with a student sample (N = 400) and Study 2 included a community sample with 271 participants. Results Study 1 showed that, of four IER strategies, soothing and social modeling were positively, and perspective-taking was negatively related to social anxiety symptoms controlling for depression, suppression and reappraisal. Study 2 replicated these findings and extended them by showing the mediated relationship between the two IER strategies (i.e. enhancing positive affect and soothing) and social anxiety symptoms through NMRE. Conclusions The results contribute to the limited research on IER by portraying its relationship with social anxiety symptoms and revealing the mediating role of NMRE in this relationship.
Collapse
Affiliation(s)
- Koray Akkuş
- Department of Psychology, Ege University, Bornova, 35030 Izmir, Turkey
| | - Mehmet Peker
- Department of Psychology, Ege University, Bornova, 35030 Izmir, Turkey
| |
Collapse
|
6
|
Predictors of Treatment Satisfaction Among Adolescents Following an Intensive Cognitive-Behavioral Intervention for Panic Disorder. Child Psychiatry Hum Dev 2021; 52:669-680. [PMID: 32880783 DOI: 10.1007/s10578-020-01052-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/27/2020] [Indexed: 10/23/2022]
Abstract
No studies to date examine predictors of treatment satisfaction following intensive cognitive-behavioral therapy interventions among adolescents. Given the challenges to treatment adherence among adolescents, and the promise intensive interventions hold for providing rapid symptom relief and increasing access to care, data examining adolescents' satisfaction with intensive programs are needed. Twenty-four adolescents (ages 12-17) with panic disorder received an eight-day intensive cognitive-behavioral therapy intervention. Pre-treatment characteristics and clinical outcome variables were examined as predictors of satisfaction at post-treatment and three-months follow-up. Multiple regression analyses revealed that higher levels of overall symptom interference at baseline and greater reductions in agoraphobic fear during treatment predicted greater treatment satisfaction at post-treatment. Only satisfaction at post-treatment significantly predicted treatment satisfaction at follow-up, highlighting the potential influence of treatment satisfaction on long-term perceptions of treatment. Considerations for fostering treatment satisfaction in the context of intensive interventions are discussed.
Collapse
|
7
|
Shu K. The effect of cognitive behavioral therapy on the release of interpersonal stress. Work 2021; 69:625-636. [PMID: 34120940 DOI: 10.3233/wor-213504] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND interpersonal communication in workplace is a problem that is faced by every employee. It is common in all industries and increasingly lethal. When they are unable to bear such overload of psychological pressure, they tend to suffer from anxiety, irritability, depression, and other psychological disorders and even mental diseases. It is urgent to explore how to help employees relieve psychological stress. OBJECTIVE the study aimed to analyze the effects of cognitive behavioral therapy (CBT) on workplace interpersonal stress, and provide help for professionals, especially newcomers, to relieve social pressure. METHODS 125 employees of Internet enterprises were given multi-baseline designed CBT (with baseline phase, treatment phase, and post-baseline phase). 43 subjects who did not finish the therapist program were set as the control group and 82 subjects who finished the treatment program were set as the experimental group. First, the differences of interpersonal stress of subjects with different gender, age, educational background, and monthly salary were analyzed. Then, social avoidance, distress, anxiety, and depression scores in baseline, treatment, and post-baseline periods were compared. Finally, the effects of gender, age, educational background, and monthly salary on social avoidance, distress, anxiety, and depression scores of the experimental group were analyzed by multiple regression. and the influence paths of the workplace interpersonal pressure was constructed. RESULTS Social avoidance, distress, anxiety, and depression of employees earning 10000 or more per month were less than those earning 10000 or more per month. Social avoidance, distress, anxiety, and depression of employees aged 30-50 were higher than those aged < 30 and > 50 (P < 0.05). Social avoidance, social distress, and depression in males were lower than those in females (P < 0.05). Social distress, anxiety, and depression of employees with master's degree or above were less than those with bachelor's degree or junior college degree. There were significant differences between the two groups in the post baseline phase. The monthly salary had the greatest influence on the social avoidance and distress, anxiety, and depression scores of the employees after treatment, with the path coefficients of -0.183, -0.169, and -0.184, respectively. CONCLUSIONS CBT can effectively relieve social avoidance and distress of workplace employees and can improve the symptoms of anxiety and depression. Educational level, age, and monthly salary had a certain influence on the improvement of social avoidance, distress, anxiety and depression.
Collapse
Affiliation(s)
- Kunyao Shu
- School of Marxism, Wuhan University of Technology, Hubei, Wuhan, China.,Social Science Division, North China University of Water Resources and Electric Power, Zhengzhou, Henan, China. E-mail:
| |
Collapse
|
8
|
Pelissolo A, Abou Kassm S, Delhay L. Therapeutic strategies for social anxiety disorder: where are we now? Expert Rev Neurother 2019; 19:1179-1189. [PMID: 31502896 DOI: 10.1080/14737175.2019.1666713] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Introduction: Classical well-established treatments of social anxiety disorder (SAD) are now complemented by more recent therapeutic strategies. This review aims to summarize available therapies for SAD and discuss recent evidence-based findings on the management of this disorder.Areas covered: Recent guidelines recommend psychotherapy, particularly cognitive-behavioral therapy (CBT), and pharmacotherapy, as first-line treatments of patients with SAD, without a clear superiority of one option over the other. CBT includes classical approaches such as in vivo exposure to social situations and cognitive therapy, but new modalities and techniques have been recently developed: third-wave approaches, internet-delivered therapy, virtual reality exposure, and cognitive bias modification. Selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors have been also extensively studied and shown to be effective in SAD. Two alternative strategies have been developed to treat SAD with disappointing results: cognitive bias modification, and pharmacological augmentation of psychotherapy using D-cycloserine during exposure sessions.Expert opinion: Personalized treatments for SAD patients are now available. Innovative strategies such as online psychotherapy and virtual reality exposure are useful alternatives to CBT and SSRIs. Future developments and optimization of attention bias modification and of pharmacological augmentation of psychotherapy can be promising.
Collapse
Affiliation(s)
- Antoine Pelissolo
- AP-HP, Psychiatry Department, Hôpitaux Universitaires Henri-Mondor, Faculté de médecine, Créteil, France
| | - Sandra Abou Kassm
- Faculty of Medical Sciences, Psychiatry Department, Lebanese University, Beirut, Lebanon
| | - Lauriane Delhay
- AP-HP, Psychiatry Department, Hôpitaux Universitaires Henri-Mondor, Créteil, France
| |
Collapse
|
9
|
Yang L, Zhou X, Pu J, Liu L, Cuijpers P, Zhang Y, Zhang H, Yuan S, Teng T, Tian L, Xie P. Efficacy and acceptability of psychological interventions for social anxiety disorder in children and adolescents: a meta-analysis of randomized controlled trials. Eur Child Adolesc Psychiatry 2019; 28:79-89. [PMID: 30006672 DOI: 10.1007/s00787-018-1189-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 06/28/2018] [Indexed: 11/26/2022]
Abstract
Social anxiety disorder (SAD) is highly prevalent and persistent in children and adolescents. However, evidence for the efficacy and acceptability of psychological interventions for SAD in children and adolescents remains unclear. Seven electronic databases (PubMed, CENTRAL, Embase, Web of Science, PsycINFO, CINAHL, and ProQuest) were searched. Randomized controlled trials (RCTs) that compared psychological interventions for SAD with control conditions in children and adolescents were included. Primary outcomes were the efficacy (mean change in anxiety symptom scores) and acceptability (dropouts for all reasons). Secondary outcomes were remission, quality of life/functional improvement, and depressive symptoms measures. Seventeen RCTs were included in this meta-analysis. Psychological interventions (including cognitive behavioral therapy and behavioral therapy) were significantly more effective than control conditions, with a standardized mean difference (SMD) of - 1.13, and remission with a risk ratio (RR) of 8.99, the number needed to treat was 3.3. There was no statistically significant difference between psychological interventions and control conditions for all-cause dropouts (RR = 1.00). Psychological interventions were superior to control conditions in improving quality of life/functioning (SMD = 0.79) and reducing depressive symptoms (SMD = - 0.39). Given considerable heterogeneity of primary efficacy outcome, a series of subgroup analyses of different variables were conducted. Psychological interventions are probably efficacious in the treatment of SAD among children and adolescents, and may markedly improve quality of life and functioning in this population. However, this finding should be interpreted with caution because of the high heterogeneity of trials and low literature quality.
Collapse
Affiliation(s)
- Lining Yang
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Yixueyuan Road, Yuzhong District, Chongqing, 400016, People's Republic of China
| | - Xinyu Zhou
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Juncai Pu
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Yixueyuan Road, Yuzhong District, Chongqing, 400016, People's Republic of China
| | - Lanxiang Liu
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Yixueyuan Road, Yuzhong District, Chongqing, 400016, People's Republic of China
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Van der Boechorststraat 1, 1081 BT, Amsterdam, The Netherlands.
| | - Yuqing Zhang
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Yixueyuan Road, Yuzhong District, Chongqing, 400016, People's Republic of China
| | - Hanping Zhang
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Yixueyuan Road, Yuzhong District, Chongqing, 400016, People's Republic of China
| | - Shuai Yuan
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Yixueyuan Road, Yuzhong District, Chongqing, 400016, People's Republic of China
| | - Teng Teng
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Yixueyuan Road, Yuzhong District, Chongqing, 400016, People's Republic of China
| | - Lu Tian
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Yixueyuan Road, Yuzhong District, Chongqing, 400016, People's Republic of China
| | - Peng Xie
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Yixueyuan Road, Yuzhong District, Chongqing, 400016, People's Republic of China.
| |
Collapse
|
10
|
Waldron SM, Maddern L, Wynn A. Cognitive-behavioural outreach for an adolescent experiencing social anxiety, panic and agoraphobia: A single-case experimental design. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2018; 31:120-126. [PMID: 30565788 DOI: 10.1111/jcap.12216] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 09/13/2018] [Accepted: 10/11/2018] [Indexed: 11/30/2022]
Abstract
PROBLEM Previous research suggests that the adult-focussed Clark and Wells (1995) model of social anxiety disorder (SAD) can be used to guide clinic-based treatment for adolescents. This single-case study (N = 1) investigated whether this model could also guide community-based outreach work for a 16-year-old female who was unable to attend clinic-based appointments due to social anxiety comorbid with panic and agoraphobia. METHODS An experimental A-B-A design was used with three assessment-formulation sessions and 12 intervention sessions, focussing on exposure, cognitive restructuring, attention training, behavioural experiments and imagery rescripting. The Revised Child Anxiety and Depression Scale (RCADS), the Session Rating Scale (SRS) and the Goal Based Outcome form were administered at regular intervals. FINDINGS AND CONCLUSIONS Social anxiety and panic scores reduced below the clinical threshold and the young person was able to leave home, travel independently (short-term goal) and re-engage with her social-family life (medium-term goal). SRS scores suggest that the intervention was acceptable and the therapeutic alliance was maintained throughout. In summary, this case study suggests that the Clark and Wells (1995) model of SAD can be used to guide community-based outreach work with adolescents unable to leave their home. Limitations and ideas for future research are discussed.
Collapse
Affiliation(s)
- Samuel M Waldron
- Avon & Wiltshire Mental Health Partnership NHS Trust, South Bristol Child & Adolescent Mental Health Services, Avon, UK.,Clinical Department of Psychology, University of Bath, Claverton Down, Bath, UK
| | - Lynn Maddern
- Avon & Wiltshire Mental Health Partnership NHS Trust, East & Central Bristol Child & Adolescent Mental Health Services, Avon, UK
| | - Amber Wynn
- Avon & Wiltshire Mental Health Partnership NHS Trust, East & Central Bristol Child & Adolescent Mental Health Services, Avon, UK
| |
Collapse
|
11
|
Hollis C, Falconer CJ, Martin JL, Whittington C, Stockton S, Glazebrook C, Davies EB. Annual Research Review: Digital health interventions for children and young people with mental health problems - a systematic and meta-review. J Child Psychol Psychiatry 2017; 58:474-503. [PMID: 27943285 DOI: 10.1111/jcpp.12663] [Citation(s) in RCA: 387] [Impact Index Per Article: 55.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/29/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND Digital health interventions (DHIs), including computer-assisted therapy, smartphone apps and wearable technologies, are heralded as having enormous potential to improve uptake and accessibility, efficiency, clinical effectiveness and personalisation of mental health interventions. It is generally assumed that DHIs will be preferred by children and young people (CYP) given their ubiquitous digital activity. However, it remains uncertain whether: DHIs for CYP are clinically and cost-effective, CYP prefer DHIs to traditional services, DHIs widen access and how they should be evaluated and adopted by mental health services. This review evaluates the evidence-base for DHIs and considers the key research questions and approaches to evaluation and implementation. METHODS We conducted a meta-review of scoping, narrative, systematic or meta-analytical reviews investigating the effectiveness of DHIs for mental health problems in CYP. We also updated a systematic review of randomised controlled trials (RCTs) of DHIs for CYP published in the last 3 years. RESULTS Twenty-one reviews were included in the meta-review. The findings provide some support for the clinical benefit of DHIs, particularly computerised cognitive behavioural therapy (cCBT), for depression and anxiety in adolescents and young adults. The systematic review identified 30 new RCTs evaluating DHIs for attention deficit/hyperactivity disorder (ADHD), autism, anxiety, depression, psychosis, eating disorders and PTSD. The benefits of DHIs in managing ADHD, autism, psychosis and eating disorders are uncertain, and evidence is lacking regarding the cost-effectiveness of DHIs. CONCLUSIONS Key methodological limitations make it difficult to draw definitive conclusions from existing clinical trials of DHIs. Issues include variable uptake and engagement with DHIs, lack of an agreed typology/taxonomy for DHIs, small sample sizes, lack of blinded outcome assessment, combining different comparators, short-term follow-up and poor specification of the level of human support. Research and practice recommendations are presented that address the key research questions and methodological issues for the evaluation and clinical implementation of DHIs for CYP.
Collapse
Affiliation(s)
- Chris Hollis
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK.,NIHR MindTech Healthcare Technology Co-operative, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Caroline J Falconer
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK.,NIHR MindTech Healthcare Technology Co-operative, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Jennifer L Martin
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK.,NIHR MindTech Healthcare Technology Co-operative, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | | | - Sarah Stockton
- Department of Psychiatry, Warneford Hospital, Oxford, UK
| | - Cris Glazebrook
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK.,NIHR MindTech Healthcare Technology Co-operative, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - E Bethan Davies
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK.,NIHR MindTech Healthcare Technology Co-operative, Institute of Mental Health, University of Nottingham, Nottingham, UK
| |
Collapse
|
12
|
Ben-Moussa M, Rubo M, Debracque C, Lange WG. DJINNI: A Novel Technology Supported Exposure Therapy Paradigm for SAD Combining Virtual Reality and Augmented Reality. Front Psychiatry 2017; 8:26. [PMID: 28503155 PMCID: PMC5408008 DOI: 10.3389/fpsyt.2017.00026] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 02/01/2017] [Indexed: 12/28/2022] Open
Abstract
The present paper explores the benefits and the capabilities of various emerging state-of-the-art interactive 3D and Internet of Things technologies and investigates how these technologies can be exploited to develop a more effective technology supported exposure therapy solution for social anxiety disorder. "DJINNI" is a conceptual design of an in vivo augmented reality (AR) exposure therapy mobile support system that exploits several capturing technologies and integrates the patient's state and situation by vision-based, audio-based, and physiology-based analysis as well as by indoor/outdoor localization techniques. DJINNI also comprises an innovative virtual reality exposure therapy system that is adaptive and customizable to the demands of the in vivo experience and therapeutic progress. DJINNI follows a gamification approach where rewards and achievements are utilized to motivate the patient to progress in her/his treatment. The current paper reviews the state of the art of technologies needed for such a solution and recommends how these technologies could be integrated in the development of an individually tailored and yet feasible and effective AR/virtual reality-based exposure therapy. Finally, the paper outlines how DJINNI could be part of classical cognitive behavioral treatment and how to validate such a setup.
Collapse
Affiliation(s)
- Maher Ben-Moussa
- Information Science Institute, Computer Science Centre, University of Geneva, Geneva, Switzerland
| | - Marius Rubo
- Experimental Clinical Psychology, Department of Psychology, University of Würzburg, Würzburg, Germany
| | - Coralie Debracque
- Neuroscience of Emotion and Affective Dynamics Lab, Swiss Center for Affective Sciences, Department of Psychology, University of Geneva, Geneva, Switzerland
| | - Wolf-Gero Lange
- Department of Clinical Psychology, Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, Netherlands
| |
Collapse
|