Computer-assisted delivery of cognitive behavioral therapy for anxiety disorders in primary-care settings.

Abstract:

OBJECTIVES:This article describes a computer-assisted cognitive behavioral therapy (CBT) program designed to support the delivery of evidenced-based CBT for the four most commonly occurring anxiety disorders (panic disorder, posttraumatic stress disorder, generalized anxiety disorder, and social anxiety disorder) in primary-care settings. The purpose of the current report is to (1) present the structure and format of the computer-assisted CBT program, and (2) to present evidence for acceptance of the program by clinicians and the effectiveness of the program for patients. METHODS:Thirteen clinicians using the computer-assisted CBT program with patients in our ongoing Coordinated Anxiety Learning and Management study provided Likert-scale ratings and open-ended responses about the program. Rating scale data from 261 patients who completed at least one CBT session were also collected. RESULTS:Overall, the program was highly rated and modally described as very helpful. Results indicate that the patients fully participated (i.e., attendance and homework compliance), understood the program material, and acquired CBT skills. In addition, significant and substantial improvements occurred to the same degree in randomly audited subsets of each of the four primary anxiety disorders (N=74), in terms of self ratings of anxiety, depression, and expectations for improvement. CONCLUSIONS:Computer-assisted CBT programs provide a practice-based system for disseminating evidence-based mental health treatment in primary-care settings while maintaining treatment fidelity, even in the hands of novice clinicians.

journal_name

Depress Anxiety

journal_title

Depression and anxiety

authors

Craske MG,Rose RD,Lang A,Welch SS,Campbell-Sills L,Sullivan G,Sherbourne C,Bystritsky A,Stein MB,Roy-Byrne PP

doi

10.1002/da.20542

subject

Has Abstract

pub_date

2009-01-01 00:00:00

pages

235-42

issue

3

eissn

1091-4269

issn

1520-6394

journal_volume

26

pub_type

杂志文章
  • Measurement invariance of the patient health questionnaire-9 (PHQ-9) depression screener in U.S. adults across sex, race/ethnicity, and education level: NHANES 2005-2016.

    abstract:BACKGROUND:Despite its popularity, little is known about the measurement invariance of the Patient Health Questionnaire-9 (PHQ-9) across U.S. sociodemographic groups. Use of a screener shown not to possess measurement invariance could result in under/over-detection of depression, potentially exacerbating sociodemograph...

    journal_title:Depression and anxiety

    pub_type: 杂志文章

    doi:10.1002/da.22940

    authors: Patel JS,Oh Y,Rand KL,Wu W,Cyders MA,Kroenke K,Stewart JC

    更新日期:2019-09-01 00:00:00

  • Impact of impaired sleep on the development of PTSD symptoms in combat veterans: a prospective longitudinal cohort study.

    abstract:BACKGROUND:A significant proportion of soldiers return from deployment with symptoms of fatigue, sleep difficulties, and posttraumatic complaints. Disrupted sleep has been proposed as a contributing factor for the development of posttraumatic stress disorder (PTSD). This study investigates the impact of impaired sleep ...

    journal_title:Depression and anxiety

    pub_type: 杂志文章

    doi:10.1002/da.22054

    authors: van Liempt S,van Zuiden M,Westenberg H,Super A,Vermetten E

    更新日期:2013-05-01 00:00:00

  • Symptom profiles of DSM-IV-defined remission, recovery, relapse, and recurrence of depression: the role of the core symptoms.

    abstract:BACKGROUND:Depression outcomes in research and clinical practice are commonly defined by the concepts of remission, recovery, relapse, and recurrence. Despite their widespread use, there has been little empirical examination of these concepts. Therefore, we investigated profiles of individual symptoms during each of th...

    journal_title:Depression and anxiety

    pub_type: 杂志文章

    doi:10.1002/da.21960

    authors: Conradi HJ,Ormel J,de Jonge P

    更新日期:2012-07-01 00:00:00

  • Approach-avoidance coping conflict in a sample of burn patients at risk for posttraumatic stress disorder.

    abstract:BACKGROUND:Following an acute burn injury, higher distress is consistently observed among individuals exhibiting a conflict between approach coping (e.g., processing) and avoidance coping (e.g., suppression) relative to those individuals who use only one of these methods. Study objectives were to determine if contradic...

    journal_title:Depression and anxiety

    pub_type: 杂志文章,随机对照试验

    doi:10.1002/da.20439

    authors: Fauerbach JA,Lawrence JW,Fogel J,Richter L,Magyar-Russell G,McKibben JB,McCann U

    更新日期:2009-01-01 00:00:00

  • CHRONICITY OF DEPRESSION AND MOLECULAR MARKERS IN A LARGE SAMPLE OF HAN CHINESE WOMEN.

    abstract:BACKGROUND:Major depressive disorder (MDD) has been associated with changes in mean telomere length and mitochondrial DNA (mtDNA) copy number. This study investigates if clinical features of MDD differentially impact these molecular markers. METHODS:Data from a large, clinically ascertained sample of Han Chinese women...

    journal_title:Depression and anxiety

    pub_type: 杂志文章

    doi:10.1002/da.22517

    authors: Edwards AC,Aggen SH,Cai N,Bigdeli TB,Peterson RE,Docherty AR,Webb BT,Bacanu SA,Flint J,Kendler KS

    更新日期:2016-11-01 00:00:00

  • Pharmacological treatment of social anxiety disorder: a meta-analysis.

    abstract::Placebo-controlled trials have evaluated the efficacy of several medications in the treatment of social anxiety disorder but information regarding their relative efficacy is lacking. We compared the efficacy of medications systematically studied for the treatment of social anxiety disorder using meta-analytic techniqu...

    journal_title:Depression and anxiety

    pub_type: 杂志文章,meta分析

    doi:10.1002/da.10096

    authors: Blanco C,Schneier FR,Schmidt A,Blanco-Jerez CR,Marshall RD,Sánchez-Lacay A,Liebowitz MR

    更新日期:2003-01-01 00:00:00

  • The effects of latent variables in the development of comorbidity among common mental disorders.

    abstract:BACKGROUND:Although numerous studies have examined the role of latent predispositions to internalizing and externalizing disorders in the structure of comorbidity among common mental disorders, none examined latent predispositions in predicting development of comorbidity. METHODS:A novel method was used to study the r...

    journal_title:Depression and anxiety

    pub_type: 杂志文章

    doi:10.1002/da.20760

    authors: Kessler RC,Cox BJ,Green JG,Ormel J,McLaughlin KA,Merikangas KR,Petukhova M,Pine DS,Russo LJ,Swendsen J,Wittchen HU,Zaslavsky AM

    更新日期:2011-01-01 00:00:00

  • TRAUMA EXPOSURE AND RISK OF SUICIDAL IDEATION AMONG ETHNICALLY DIVERSE ADULTS.

    abstract:BACKGROUND:Little is known about the association between trauma exposure and suicidal ideation across racial/ethnic groups. Our study aim was to determine the association between trauma exposure and suicidal ideation in a nationally representative ethnically diverse sample of adults. METHODS:This study included 14,866...

    journal_title:Depression and anxiety

    pub_type: 杂志文章

    doi:10.1002/da.22485

    authors: Beristianos MH,Maguen S,Neylan TC,Byers AL

    更新日期:2016-06-01 00:00:00

  • Sedentary behaviors, physical activity, and changes in depression and psychological distress symptoms in older adults.

    abstract:BACKGROUND:Television (TV) viewing and computer use have been associated with higher risk of depression, but studies specifically assessing the impact of these and other types of sedentary behaviors (SBs) on the mental health of older adults are scarce and their results are inconclusive. Similarly, the association betw...

    journal_title:Depression and anxiety

    pub_type: 杂志文章

    doi:10.1002/da.22804

    authors: Andrade-Gómez E,Martínez-Gómez D,Rodríguez-Artalejo F,García-Esquinas E

    更新日期:2018-09-01 00:00:00

  • Transdiagnostic versus diagnosis-specific cbt for anxiety disorders: a preliminary randomized controlled noninferiority trial.

    abstract:BACKGROUND:Transdiagnostic cognitive-behavioral treatments for anxiety disorders have been gaining increased attention and empirical study in recent years. Despite this, research on transdiagnostic anxiety treatments has, to date, relied on open trials, or comparisons to waitlist conditions, published benchmarks, or re...

    journal_title:Depression and anxiety

    pub_type: 杂志文章,随机对照试验

    doi:10.1002/da.21974

    authors: Norton PJ,Barrera TL

    更新日期:2012-10-01 00:00:00

  • Uncertainty increases neural indices of attention in obsessive-compulsive disorder.

    abstract:BACKGROUND:Patients with obsessive-compulsive disorder (OCD) experience abnormally high levels of uncertainty, and unpredictability is evaluated negatively and not well tolerated. The current study examined neural correlates of attentional processing in response to experimentally induced uncertainty in OCD. METHODS:Tw...

    journal_title:Depression and anxiety

    pub_type: 杂志文章

    doi:10.1002/da.22655

    authors: Dieterich R,Endrass T,Kathmann N

    更新日期:2017-11-01 00:00:00

  • Role of serotonergic and noradrenergic systems in the pathophysiology of depression and anxiety disorders.

    abstract::There is abundant evidence for abnormalities of the norepinephrine (NE) and serotonin (5HT) neurotransmitter systems in depression and anxiety disorders. The majority of evidence supports underactivation of serotonergic function and complex dysregulation of noradrenergic function, most consistent with overactivation o...

    journal_title:Depression and anxiety

    pub_type: 杂志文章,评审

    doi:10.1002/1520-6394(2000)12:1+<2::AID-DA2>3.0.CO;2-4

    authors: Ressler KJ,Nemeroff CB

    更新日期:2000-01-01 00:00:00

  • Physical health problems in depressed and nondepressed children and adolescents of parents with opiate dependence.

    abstract::The increased risk of physical health problems in adult depressed patients has been shown in numerous studies. A recent study of the offspring of depressed parents found similar associations. The purpose of this study is to examine the strength and specificity of the association between depression and physical health ...

    journal_title:Depression and anxiety

    pub_type: 临床试验,杂志文章

    doi:

    authors: McAvay G,Nunes EV,Zaider TI,Goldstein RB,Weissman MM

    更新日期:1999-01-01 00:00:00

  • Intrinsic functional and structural connectivity of emotion regulation networks in obsessive-compulsive disorder.

    abstract::Despite emotion regulation being altered in patients with obsessive-compulsive disorder (OCD), no studies have investigated its relation to multimodal amygdala connectivity. We compared corticolimbic functional and structural connectivity between OCD patients and healthy controls (HCs), and correlated this with the di...

    journal_title:Depression and anxiety

    pub_type: 杂志文章

    doi:10.1002/da.22845

    authors: Picó-Pérez M,Ipser J,Taylor P,Alonso P,López-Solà C,Real E,Segalàs C,Roos A,Menchón JM,Stein DJ,Soriano-Mas C

    更新日期:2019-02-01 00:00:00

  • Associations between socioeconomic status and psychological therapy outcomes: A systematic review and meta-analysis.

    abstract:BACKGROUND:Socioeconomic deprivation is associated with higher prevalence of mental health problems; however, the influence of socioeconomic status (SES) on psychological therapy outcomes is as yet unclear. AIM:To review published evidence on the association between indicators of SES (income, education, employment, ne...

    journal_title:Depression and anxiety

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/da.22765

    authors: Finegan M,Firth N,Wojnarowski C,Delgadillo J

    更新日期:2018-06-01 00:00:00

  • Attention bias to threat faces in severe mood dysregulation.

    abstract:BACKGROUND:We used a dot-probe paradigm to examine attention bias toward threat (i.e., angry) and happy face stimuli in severe mood dysregulation (SMD) versus healthy comparison (HC) youth. The tendency to allocate attention to threat is well established in anxiety and other disorders of negative affect. SMD is charact...

    journal_title:Depression and anxiety

    pub_type: 杂志文章

    doi:10.1002/da.22145

    authors: Hommer RE,Meyer A,Stoddard J,Connolly ME,Mogg K,Bradley BP,Pine DS,Leibenluft E,Brotman MA

    更新日期:2014-07-01 00:00:00

  • Understanding the impact of complicated grief on combat related posttraumatic stress disorder, guilt, suicide, and functional impairment in a clinical trial of post-9/11 service members and veterans.

    abstract:BACKGROUND:Complicated grief (CG) is a bereavement-specific syndrome distinct from but commonly comorbid with posttraumatic stress disorder (PTSD). While bereavement is common among military personnel (Simon et al., 2018), there is little research on the impact of CG comorbidity on PTSD treatment outcomes. METHODS:To ...

    journal_title:Depression and anxiety

    pub_type: 杂志文章,随机对照试验

    doi:10.1002/da.22911

    authors: Simon NM,Hoeppner SS,Lubin RE,Robinaugh DJ,Malgaroli M,Norman SB,Acierno R,Goetter EM,Hellberg SN,Charney ME,Bui E,Baker AW,Smith E,Kim HM,Rauch SAM

    更新日期:2020-01-01 00:00:00

  • Periloss dissociation, symptom severity, and treatment response in complicated grief.

    abstract:BACKGROUND:Complicated grief (CG) is a bereavement-specific syndrome characterized by traumatic and separation distress lasting over 6 months. Little is known about the role of dissociation experienced during or immediately after the loss of a loved one (i.e., periloss dissociation [PLD]) in CG. The present study aimed...

    journal_title:Depression and anxiety

    pub_type: 杂志文章,随机对照试验

    doi:10.1002/da.22029

    authors: Bui E,Simon NM,Robinaugh DJ,Leblanc NJ,Wang Y,Skritskaya NA,Mauro C,Shear MK

    更新日期:2013-02-01 00:00:00

  • Predictors of response to synchronized transcranial magnetic stimulation for major depressive disorder.

    abstract:BACKGROUND:Synchronized transcranial magnetic stimulation (sTMS) is a new modality to reduce symptoms of major depressive disorder (MDD). sTMS uses rotating neodymium magnets to deliver low-field stimulation matched to the individual alpha frequency (IAF). A previous multisite study showed that sTMS significantly reduc...

    journal_title:Depression and anxiety

    pub_type: 杂志文章

    doi:10.1002/da.22862

    authors: Philip NS,Leuchter AF,Cook IA,Massaro J,Goethe JW,Carpenter LL

    更新日期:2019-03-01 00:00:00

  • Internet psychotherapy and the future of personalized treatment.

    abstract::Internet-delivered cognitive behavioral therapy (iCBT) was developed to overcome some of the barriers in accessing best practice face-to-face CBT. iCBT affords many benefits, such as high fidelity, greater accessibility, convenience, and reduced cost to patients and health-care systems. Recent meta-analyses of iCBT fo...

    journal_title:Depression and anxiety

    pub_type: 杂志文章

    doi:10.1002/da.22302

    authors: Andrews G,Williams AD

    更新日期:2014-11-01 00:00:00

  • The efficacy of metacognitive therapy for anxiety and depression: a meta-analytic review.

    abstract:BACKGROUND:Metacognitive therapy (MCT) is a relatively new approach to treating mental disorders. The aim of the current meta-analysis was to examine the efficacy of MCT in patients with mental disorders. METHOD:A comprehensive literature search revealed 16 published as well as unpublished studies on the efficacy of M...

    journal_title:Depression and anxiety

    pub_type: 杂志文章,meta分析

    doi:10.1002/da.22273

    authors: Normann N,van Emmerik AA,Morina N

    更新日期:2014-05-01 00:00:00

  • Sleep, circadian rhythm, and physical activity patterns in depressive and anxiety disorders: A 2-week ambulatory assessment study.

    abstract:BACKGROUND:Actigraphy may provide a more valid assessment of sleep, circadian rhythm (CR), and physical activity (PA) than self-reported questionnaires, but has not been used widely to study the association with depression/anxiety and their clinical characteristics. METHODS:Fourteen-day actigraphy data of 359 particip...

    journal_title:Depression and anxiety

    pub_type: 杂志文章

    doi:10.1002/da.22949

    authors: Difrancesco S,Lamers F,Riese H,Merikangas KR,Beekman ATF,van Hemert AM,Schoevers RA,Penninx BWJH

    更新日期:2019-10-01 00:00:00

  • Face-to-face versus remote administration of the Montgomery-Asberg Depression Rating Scale using videoconference and telephone.

    abstract::Although the use of telemedicine in psychiatry has a long history in providing clinical care to patients, its use in clinical trials research has not yet been commonly employed. Telemedicine allows for the remote assessment of study patients, which could be done by a centralized, highly calibrated, and impartial cohor...

    journal_title:Depression and anxiety

    pub_type: 杂志文章

    doi:10.1002/da.20392

    authors: Kobak KA,Williams JB,Jeglic E,Salvucci D,Sharp IR

    更新日期:2008-01-01 00:00:00

  • Comparison of pramipexole, fluoxetine, and placebo in patients with major depression.

    abstract::Pramipexole, a dopamine D2 receptor agonist, was tested in 174 patients with major depression, with or without melancholia and without psychotic features. Three daily dose levels (0.375 mg, 1.0 mg, and 5.0 mg) were compared to fluoxetine (Prozac) at 20 mg and placebo in a randomized, double-blind, parallel-group study...

    journal_title:Depression and anxiety

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1002/(sici)1520-6394(2000)11:2<58::aid-da2>3.0.

    authors: Corrigan MH,Denahan AQ,Wright CE,Ragual RJ,Evans DL

    更新日期:2000-01-01 00:00:00

  • Symptomatic and syndromal anxiety and depression.

    abstract::The diagnosis of anxiety disorders and major depression can be reliably made based on signs and symptoms. However there are significant limitations to the current system of classification including overlapping criteria, high comorbidity, and the issue of subthreshold syndromes. The literature on treatment response doc...

    journal_title:Depression and anxiety

    pub_type: 杂志文章,评审

    doi:10.1002/da.1049

    authors: Ninan PT,Berger J

    更新日期:2001-01-01 00:00:00

  • Anxiety sensitivity as a predictor of the clinical course of panic disorder: a 1-year follow-up study.

    abstract:BACKGROUND:There is evidence that negative affect (NA) and anxiety sensitivity (AS) predict the development of anxiety disorders, particularly panic disorder (PD). The main purpose of this study was to examine whether NA and AS will also predict the clinical course of PD. METHODS:Participants were 136 individuals with...

    journal_title:Depression and anxiety

    pub_type: 杂志文章

    doi:10.1002/da.20423

    authors: Benítez CI,Shea MT,Raffa S,Rende R,Dyck IR,Ramsawh HJ,Edelen MO,Keller MB

    更新日期:2009-01-01 00:00:00

  • A three-year follow-up of major depression, dysthymia, minor depression and subsyndromal depression: results from a population-based study.

    abstract::This study examined the 3-year outcome of major depression (MD)/dysthymic disorder (DD), minor depression (MinD), and subsyndromal symptomatic depression (SSD) in a population-based sample. The aims were to study the fluctuating nature of the symptoms of depression and to analyze the risk of fulfilling the criteria fo...

    journal_title:Depression and anxiety

    pub_type: 杂志文章

    doi:10.1002/da.20231

    authors: Forsell Y

    更新日期:2007-01-01 00:00:00

  • Shame, personality, and social anxiety symptoms in Chinese and American nonclinical samples: a cross-cultural study.

    abstract::Shame has been observed to play an important role in social anxiety in China [Xu, 1982]. Shame and personality factors, such as neuroticism and introversion-extraversion, are also related to social anxiety symptoms in Chinese college students [Li et al., 2003]. The aim of this study was to explore cross-cultural diffe...

    journal_title:Depression and anxiety

    pub_type: 杂志文章

    doi:10.1002/da.20358

    authors: Zhong J,Wang A,Qian M,Zhang L,Gao J,Yang J,Li B,Chen P

    更新日期:2008-01-01 00:00:00

  • PTSD REMISSION AFTER PROLONGED EXPOSURE TREATMENT IS ASSOCIATED WITH ANTERIOR CINGULATE CORTEX THINNING AND VOLUME REDUCTION.

    abstract:BACKGROUND:Brain structures underlying posttraumatic stress disorder (PTSD) have been a focus of imaging studies, but associations between treatment outcome and alterations in brain structures remain largely unexamined. We longitudinally examined the relation of structural changes in the rostral anterior cingulate cort...

    journal_title:Depression and anxiety

    pub_type: 杂志文章

    doi:10.1002/da.22471

    authors: Helpman L,Papini S,Chhetry BT,Shvil E,Rubin M,Sullivan GM,Markowitz JC,Mann JJ,Neria Y

    更新日期:2016-05-01 00:00:00

  • A biopsychosocial model as a guide for psychoeducation and treatment of depression.

    abstract::Effective treatment of severe or chronic unipolar depression requires the combination of pharmacological and psychotherapeutic interventions, and demands a theoretical paradigm integrating biological and psychosocial aspects of depression. Supported by recent research, we propose in our article a biopsychosocial diath...

    journal_title:Depression and anxiety

    pub_type: 杂志文章,评审

    doi:10.1002/da.20177

    authors: Schotte CK,Van Den Bossche B,De Doncker D,Claes S,Cosyns P

    更新日期:2006-01-01 00:00:00