Abstract:
OBJECTIVE:The aim of this study was to identify mediators of change in a previously published randomized controlled trial that compared Internet-delivered cognitive behavioral treatment based on exposure exercises (ICBT) with Internet-delivered stress management (ISM) for irritable bowel syndrome (IBS). ICBT and ISM targeted distinct proposed mechanisms of illness maintenance and symptom exacerbation, gastrointestinal symptom-specific anxiety (GSA), and stress reactivity, respectively. The original study found that ICBT was more effective than ISM in improving IBS symptoms. METHOD:Weekly measurements of GSA and stress reactivity (putative mediators) and treatment outcome were obtained from 195 participants with IBS, who had been randomized to ICBT or ISM. RESULTS:Parallel process growth mediational analyses revealed that the larger reduction of IBS symptoms from ICBT compared to ISM was mediated by changes in GSA, αβ = -0.42, 95% CI asymmetric [-0.71, -0.16]. In contrast, changes in stress reactivity did not mediate the difference in outcomes between treatments, αβ = 0.04, 95% CI asymmetric [-0.09, 0.20]. Analyses of the temporal sequence of week-to-week changes in process and outcome measures showed that only GSA displayed a pattern consistent with a causal model in which change in process preceded and contributed to symptom change. Furthermore, engagement in treatment specific activities was related to change in GSA but not to stress reactivity in the ICBT arm, whereas treatment specific activities were not related to change in any of the putative processes in the ISM arm. CONCLUSIONS:We conclude that ICBT works through directly targeting GSA, rather than by means of reducing stress reactivity.
journal_name
J Consult Clin Psycholjournal_title
Journal of consulting and clinical psychologyauthors
Ljótsson B,Hesser H,Andersson E,Lindfors P,Hursti T,Rück C,Lindefors N,Andersson G,Hedman Edoi
10.1037/a0033439subject
Has Abstractpub_date
2013-12-01 00:00:00pages
1113-26issue
6eissn
0022-006Xissn
1939-2117pii
2013-20192-001journal_volume
81pub_type
杂志文章,随机对照试验abstract::Snyder, Wills, and Grady-Fletcher (1991) reported a 4-year follow-up comparing insight-oriented (IOMT) with behavioral marital therapy (BMT). The effects of IOMT were more durable than those of BMT. These comments question the adequacy with which the two treatments were represented. The BMT treatment manual adequately...
journal_title:Journal of consulting and clinical psychology
pub_type: 杂志文章
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journal_title:Journal of consulting and clinical psychology
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journal_title:Journal of consulting and clinical psychology
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journal_title:Journal of consulting and clinical psychology
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abstract::Treatment outcome findings suggest that cognitive-behavioral therapy (CBT) and pharmacotherapy offer similar short-term treatment gains for panic disorder and that CBT may afford more optimal maintenance of treatment gains without the need for ongoing treatment. However, efficacy is not the only consideration for pati...
journal_title:Journal of consulting and clinical psychology
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abstract:OBJECTIVE:The failure of offenders to complete psychological treatment can pose significant concerns, including increased risk for recidivism. Although a large literature identifying predictors of offender treatment attrition has accumulated, there has yet to be a comprehensive quantitative review. METHOD:A meta-analy...
journal_title:Journal of consulting and clinical psychology
pub_type: 杂志文章,meta分析
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journal_title:Journal of consulting and clinical psychology
pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:Journal of consulting and clinical psychology
pub_type: 杂志文章
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journal_title:Journal of consulting and clinical psychology
pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:Journal of consulting and clinical psychology
pub_type: 杂志文章,多中心研究,随机对照试验
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journal_title:Journal of consulting and clinical psychology
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journal_title:Journal of consulting and clinical psychology
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更新日期:2008-08-01 00:00:00
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journal_title:Journal of consulting and clinical psychology
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更新日期:2012-08-01 00:00:00
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journal_title:Journal of consulting and clinical psychology
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更新日期:2013-04-01 00:00:00
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journal_title:Journal of consulting and clinical psychology
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journal_title:Journal of consulting and clinical psychology
pub_type: 临床试验,杂志文章,随机对照试验
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abstract::A random sample of 724 individuals across the United States were mailed a questionnaire containing demographic information, an abridged version of the Traumatic Events Survey (D. M. Elliott, 1992), and questions regarding memory for traumatic events. Of these, 505 (70%) completed the survey. Among respondents who repo...
journal_title:Journal of consulting and clinical psychology
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journal_title:Journal of consulting and clinical psychology
pub_type: 临床试验,杂志文章,多中心研究
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更新日期:2003-12-01 00:00:00
abstract::This article describes a second treatment-outcome study of cognitive trauma therapy for battered women with posttraumatic stress disorder (PTSD; CTT-BW). CTT-BW includes trauma history exploration: PTSD education; stress management; exposure to abuse and abuser reminders; self-monitoring of negative self-talk; cogniti...
journal_title:Journal of consulting and clinical psychology
pub_type: 临床试验,杂志文章,随机对照试验
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pub_type: 杂志文章,随机对照试验
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