Wannemueller André, Jöhren Hans-Peter, Borgstädt Alina, Bosch Jessica, Meyers Milena, Völse Miriam, Scholten Saskia, Margraf Jürgen
Department of Clinical Psychology and Psychotherapy, Mental Health Research and Treatment Center, Ruhr-University Bochum Bochum, Germany.
Dental Clinic Bochum Bochum, Germany.
Front Psychol. 2017 Jan 6;7:2007. doi: 10.3389/fpsyg.2016.02007. eCollection 2016.
A large-group one session treatment (LG-OST) combining exposure and diaphragmatic breathing as a bodily coping element was carried out to investigate its feasibility and effectiveness in a sample of 43 highly dental fearful individuals treated simultaneously. We assessed subjective dental fear, dysfunctional dental-related beliefs, and perceived control pre- and post-intervention and at four-month follow-up. Participants additionally performed a behavioural approach test (BAT) pre- and post-intervention. During the applied exposure exercises, four participants (9.3%) discontinued the program all reporting too high levels of distress. Regarding subjective dental fear and dysfunctional dental related beliefs post treatment effects, LG-OST showed medium to large effect sizes, ranging from Cohen's = 0.51 to = 0.84 in the Intention-to-Treat analysis. Subjective dental fear improved clinically significantly in about one fourth (25.6%) of therapy completers. All post-treatment effects remained stable over time. Concerning the behavioral fear dimension, we observed a strong ceiling effect. Already at pre-assessment, participants accomplished more than six out of seven BAT-steps. Thus, behavioral approach did not increase significantly following treatment. Overall, the LG-OST protocol proved feasible and efficient. Compared to other one-session individual and multi-session group treatments the observed LG-OST effects were smaller. However, if LG-OST could match the efficacy of highly intensive short treatments delivered in an individual setting in the future, for example, by applying a wider array of exposure exercises, it could be a very useful treatment option as an intermediate step within a stepped care approach.
开展了一项大组单次治疗（LG - OST），将暴露疗法与膈式呼吸作为身体应对要素相结合，以调查其在同时治疗的43名高度牙科恐惧症患者样本中的可行性和有效性。我们在干预前、干预后以及四个月随访时评估了主观牙科恐惧、与牙科相关的功能失调信念以及感知控制。参与者还在干预前和干预后进行了行为趋近测试（BAT）。在应用的暴露练习过程中，四名参与者（9.3%）退出了该项目，均报告痛苦程度过高。关于主观牙科恐惧和治疗后功能失调的牙科相关信念的影响，在意向性分析中，LG - OST显示出中等到较大的效应量，范围从科恩d = 0.51到d = 0.84。约四分之一（25.6%）的治疗完成者的主观牙科恐惧在临床上有显著改善。所有治疗后的效果随时间保持稳定。关于行为恐惧维度，我们观察到了很强的天花板效应。在预评估时，参与者就已经完成了七步BAT中的六步以上。因此，治疗后行为趋近没有显著增加。总体而言，LG - OST方案被证明是可行且有效的。与其他单次个体治疗和多疗程组治疗相比，观察到的LG - OST效果较小。然而，如果LG - OST未来能够匹配在个体环境中提供的高强度短期治疗的疗效，例如，通过应用更广泛的暴露练习，它可能作为阶梯式护理方法中的中间步骤成为非常有用的治疗选择。
