Tillfors Maria, Carlbring Per, Furmark Tomas, Lewenhaupt Susanne, Spak Maria, Eriksson Anna, Westling Bengt E, Andersson Gerhard
Department of Behavioural, Social and Legal Sciences, Orebro University, Orebro, Sweden.
Depress Anxiety. 2008;25(8):708-17. doi: 10.1002/da.20416.
This study investigated the efficacy of an Internet-based self-help program with minimal therapist contact via e-mail for Swedish university students with social phobia and public speaking fears. The main objective was to test if the Internet-based self-help program would be more effective if five live group exposure sessions were added.
Thirty-eight students meeting the diagnostic and statistical manual of mental disorders, 4th edition criteria for social phobia were randomized into two different treatment groups: Internet delivered cognitive behavior therapy combined with five group exposure sessions (ICBT+ exp) or the Internet program alone (ICBT).
Results were analyzed on an intention-to-treat basis. Both treatment groups showed significant improvement from pre- to post-test, and from pre-test to 1-year follow-up, on all measured dimensions (social anxiety, general anxiety, depression levels, and quality of life). For both the groups, the average within-group effect sizes for the primary social anxiety scales, expressed as Cohen's d, were comparable to those seen in traditionally administered cognitive behavioral therapy both at post-test and at 1- year follow-up.
The results suggest that the Internet-based self-help program on its own is efficient in the treatment of university students with social phobia. Adding group exposure sessions did not improve the outcome significantly.
本研究调查了一种基于互联网的自助项目对患有社交恐惧症和公众演讲恐惧的瑞典大学生的疗效,该项目通过电子邮件与治疗师进行最少的接触。主要目的是测试如果增加五次现场团体暴露治疗课程,基于互联网的自助项目是否会更有效。
38名符合《精神障碍诊断与统计手册》第四版社交恐惧症标准的学生被随机分为两个不同的治疗组:基于互联网的认知行为疗法结合五次团体暴露治疗课程(ICBT+exp)或仅互联网项目(ICBT)。
在意向性分析的基础上对结果进行了分析。两个治疗组在所有测量维度(社交焦虑、一般焦虑、抑郁水平和生活质量)上从测试前到测试后以及从测试前到1年随访均显示出显著改善。对于两个组,主要社交焦虑量表的组内平均效应量(以科恩d表示)在测试后和1年随访时与传统实施的认知行为疗法中所见的效应量相当。
结果表明,基于互联网的自助项目本身对患有社交恐惧症的大学生治疗有效。增加团体暴露治疗课程并未显著改善治疗效果。