Berg Matilda, Rozental Alexander, de Brun Mangs Josefine, Näsman Maja, Strömberg Karin, Viberg Linn, Wallner Erik, Åhman Hanna, Silfvernagel Kristin, Zetterqvist Maria, Topooco Naira, Capusan Andrea, Andersson Gerhard
Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Front Psychiatry. 2020 Jun 10;11:503. doi: 10.3389/fpsyt.2020.00503. eCollection 2020.
Increased awareness of anxiety in adolescents emphasises the need for effective interventions. Internet-based cognitive behavioural therapy (ICBT) could be a resource-effective and evidence-based treatment option, but little is known about how to optimize ICBT or which factors boost outcomes. Recently, the role of knowledge in psychotherapy has received increased focus. Further, chat-sessions are of interest when trying to optimize ICBT for youths. This study aimed to evaluate the role of learning support and chat-sessions during ICBT for adolescent anxiety, using a factorial design.
A total of 120 adolescents were randomised to one of four treatment groups, in a 2x2 design with two factors: with or without learning support and/or chat-sessions.
Anxiety and depressive symptoms were reduced (Beck Anxiety Inventory- BAI; Cohen's =0.72; Beck Depression Inventory- BDI; =0.97). There was a main effect of learning support on BAI ( =0.38), and learning support increased knowledge gain ( =0.42). There were no main effects or interactions related to the chat-sessions. Treatment effects were maintained at 6-months, but the added effect of learning support had by then vanished.
ICBT can be an effective alternative when treating adolescents with anxiety. Learning support could be of importance to enhance short-term treatment effects, and should be investigated further.
青少年焦虑意识的提高凸显了有效干预措施的必要性。基于互联网的认知行为疗法(ICBT)可能是一种资源高效且基于证据的治疗选择,但对于如何优化ICBT或哪些因素能提高治疗效果知之甚少。最近,知识在心理治疗中的作用受到了更多关注。此外,在尝试为青少年优化ICBT时,聊天环节也备受关注。本研究旨在采用析因设计评估学习支持和聊天环节在青少年焦虑症ICBT治疗中的作用。
共有120名青少年被随机分配到四个治疗组之一,采用2×2设计,有两个因素:有无学习支持和/或聊天环节。
焦虑和抑郁症状减轻(贝克焦虑量表 - BAI;科恩效应量 =0.72;贝克抑郁量表 - BDI;效应量 =0.97)。学习支持对BAI有主效应(效应量 =0.38),且学习支持增加了知识获取(效应量 =0.42)。与聊天环节无关的主效应或交互作用不存在。治疗效果在6个月时得以维持,但那时学习支持的附加效果已经消失。
ICBT在治疗青少年焦虑症时可以是一种有效的替代方法。学习支持对于增强短期治疗效果可能很重要,应进一步研究。