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Treatment of Panic Disorder: Live Therapy vs. Self-Help via Internet
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
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2005 (English)In: Behaviour Research and Therapy, ISSN 0005-7967, E-ISSN 1873-622X, Vol. 43, no 10, 1321-1333 p.Article in journal (Refereed) Published
Abstract [en]

A randomized trial was conducted comparing 10 individual weekly sessions of cognitive behaviour therapy for panic disorder (PD) with or without agoraphobia with a 10-module self-help program on the Internet. After confirming the PD diagnosis with an in-person structured clinical interview (SCID) 49 participants were randomized. Overall, the results suggest that Internet-administered self-help plus minimal therapist contact via e-mail can be equally effective as traditional individual cognitive behaviour therapy. Composite within-group effect sizes were high in both groups, while the between-group effect size was small (Cohen's d=16). One-year follow-up confirmed the results, with a within-group effect size of Cohen's d=0.80 for the Internet group and d=0.93 for the live group. The results from this study generally provide evidence to support the continued use and development of Internet-distributed self-help programs.

Place, publisher, year, edition, pages
2005. Vol. 43, no 10, 1321-1333 p.
Keyword [en]
Internet, Panic disorder, Self-help techniques, Bibliotherapy
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-91571DOI: 10.1016/j.brat.2004.10.002OAI: oai:DiVA.org:uu-91571DiVA: diva2:164346
Available from: 2004-04-13 Created: 2004-04-13 Last updated: 2016-04-28
In thesis
1. Panic! Its Prevalence, Diagnosis and Treatment via the Internet
Open this publication in new window or tab >>Panic! Its Prevalence, Diagnosis and Treatment via the Internet
2004 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

As evidenced by several trials, cognitive behavior therapy (CBT) is a highly effective treatment for Panic disorder with or without agoraphobia (PD). However, therapists are short in supply, and patients with agoraphobia may not seek therapy due to fear of leaving their homes or traveling certain distances. A major challenge therefore is to increase the accessibility and affordability of evidence-based psychological treatments.

This thesis is based on five studies; three treatment studies set up as randomized controlled trails (RCT), one prevalence study, and one study testing the equivalence of an Internet-administered diagnostic assessment tool with a clinician-administered interview.

Study I showed that the Swedish 12-month PD prevalence is consistent with findings in most other parts of the Western world (2.2%; CI 95% 1.0%-3.4%). There was a significant sex difference, with a greater prevalence for women (3.6%) compared to men (0.7%).

Study II showed that the validity of the computerized diagnostic interview (CIDI-SF) was generally low. However, the agoraphobia and obsessive-compulsive disorder modules had good specificity and sensitivity, respectively.

The three RCTs showed, directly or indirectly, that Internet-based self-help is superior to a waiting-list. When 10 individual weekly sessions of CBT for PD was compared with a 10-module self-help program on the Internet, the results suggest that Internet-administered self-help, plus minimal therapist contact via e-mail, is as effective as traditional individual CBT (80% vs. 67% no longer met criteria for panic disorder; composite within-group effect size was Cohen’s d= 0.78 vs. 0.99). One-year follow-up confirmed the results (92% vs. 88% no longer met criteria for panic disorder; d= 0.80 vs. 0.93). The results generally provide evidence to support the continued use and development of Internet-distributed self-help programs.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2004. 75 p.
Series
Comprehensive Summaries of Uppsala Dissertations from the Faculty of Social Sciences, ISSN 0282-7492 ; 136
Keyword
Psychology, panic disorder, self-help techniques, agoraphobia, bibliotherapy, internet, randomized controlled trail, prevalence, screening, Psykologi
National Category
Psychology
Identifiers
urn:nbn:se:uu:diva-4148 (URN)91-554-5927-7 (ISBN)
Public defence
2004-05-19, Sal X, Universitetshuset, St Olofsgatan, Uppsala, 10:15
Opponent
Supervisors
Available from: 2004-04-13 Created: 2004-04-13Bibliographically approved

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Waara, JohanBuhrman, MonicaEkselius, Lisa

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