A RCT of a Transdiagnostic Internet-Delivered Treatment for Three Anxiety Disorders: Examination of Support Roles and Disorder-Specific Outcomes
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{"title"=>"A RCT of a transdiagnostic internet-delivered treatment for three anxiety disorders: Examination of support roles and disorder-specific outcomes", "type"=>"journal", "authors"=>[{"first_name"=>"Luke", "last_name"=>"Johnston", "scopus_author_id"=>"13404819300"}, {"first_name"=>"Nickolai", "last_name"=>"Titov", "scopus_author_id"=>"7003837684"}, {"first_name"=>"Gavin", "last_name"=>"Andrews", "scopus_author_id"=>"7202160748"}, {"first_name"=>"Jay", "last_name"=>"Spence", "scopus_author_id"=>"36446773900"}, {"first_name"=>"Blake F.", "last_name"=>"Dear", "scopus_author_id"=>"26032030100"}], "year"=>2011, "source"=>"PLoS ONE", "identifiers"=>{"scopus"=>"2-s2.0-81755184077", "sgr"=>"81755184077", "issn"=>"19326203", "doi"=>"10.1371/journal.pone.0028079", "pmid"=>"22132216", "isbn"=>"1932-6203", "pui"=>"362967333"}, "id"=>"9893b535-b7e4-377e-8c4d-89362ecf6ec9", "abstract"=>"BACKGROUND\\n\\nAnxiety disorders share common vulnerabilities and symptoms. Disorder-specific treatment is efficacious, but few access evidence-based care. Administering transdiagnostic cognitive-behavioral therapy via the internet (iCBT) may increase access to evidence-based treatment, with a recent randomized controlled trial (RCT) providing preliminary support for this approach. This study extends those findings and aims to answer three questions: Is a transdiagnostic iCBT program for anxiety disorders efficacious and acceptable? Does it result in change for specific disorders? Can good clinical outcomes be obtained when guidance is provided via a Coach rather than a Clinician?\\n\\n\\nMETHOD\\n\\nRCT (N = 131) comparing three groups: Clinician-supported (CL) vs. Coach-supported (CO) vs. waitlist control (Control). Individuals met DSM-IV criteria for a principal diagnosis of generalized anxiety disorder (GAD), social phobia (SP) or panic disorder with or without agoraphobia (Pan/Ag). Treatment consisted of an 8-lesson/10 week iCBT program with weekly contact from a Clinician or Coach, and follow-up at 3-months post-treatment.\\n\\n\\nRESULTS\\n\\nOutcomes for the pooled treatment groups (CL+CO) were superior to the Control group on measures of anxiety, depression and disability, were associated with medium to large effect sizes (Cohen's d = .76-1.44) (response rate = 89-100%), and were maintained at follow-up. Significant reductions were found on disorder-specific outcomes for each of the target diagnoses, and were associated with large effect sizes. CO participants achieved similar outcomes to CL participants at post-treatment, yet had significantly lower symptom severity scores on general anxiety, panic-disorder, depression and disability at follow-up (d = .45-.46). Seventy-four percent of CO and 76% of CL participants completed the program. Less than 70 minutes of Clinician or Coach time was required per participant during the program.\\n\\n\\nDISCUSSION\\n\\nThis transdiagnostic iCBT course for anxiety appears to be efficacious, associated with significant change for three target disorders, and is efficacious when guided by either a Clinician or Coach.\\n\\n\\nTRIAL REGISTRATION\\n\\nAustralian New Zealand Clinical Trials Registry ACTRN12610000242022.", "link"=>"http://www.mendeley.com/research/rct-transdiagnostic-internetdelivered-treatment-three-anxiety-disorders-examination-support-roles-di", "reader_count"=>137, "reader_count_by_academic_status"=>{"Unspecified"=>5, "Professor > Associate Professor"=>4, "Librarian"=>3, "Researcher"=>19, "Student > Doctoral Student"=>13, "Student > Ph. D. 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Student"=>28, "Student > Postgraduate"=>8, "Other"=>8, "Student > Master"=>24, "Student > Bachelor"=>18, "Lecturer"=>1, "Lecturer > Senior Lecturer"=>2, "Professor"=>4}, "reader_count_by_subject_area"=>{"Unspecified"=>14, "Nursing and Health Professions"=>3, "Agricultural and Biological Sciences"=>3, "Medicine and Dentistry"=>22, "Arts and Humanities"=>1, "Business, Management and Accounting"=>1, "Pharmacology, Toxicology and Pharmaceutical Science"=>1, "Psychology"=>84, "Chemistry"=>1, "Social Sciences"=>5, "Computer Science"=>1, "Economics, Econometrics and Finance"=>1}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>22}, "Chemistry"=>{"Chemistry"=>1}, "Social Sciences"=>{"Social Sciences"=>5}, "Psychology"=>{"Psychology"=>84}, "Economics, Econometrics and Finance"=>{"Economics, Econometrics and Finance"=>1}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>3}, "Computer Science"=>{"Computer Science"=>1}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>3}, "Business, Management and Accounting"=>{"Business, Management and Accounting"=>1}, "Unspecified"=>{"Unspecified"=>14}, "Pharmacology, Toxicology and Pharmaceutical Science"=>{"Pharmacology, Toxicology and Pharmaceutical Science"=>1}, "Arts and Humanities"=>{"Arts and Humanities"=>1}}, "reader_count_by_country"=>{"New Zealand"=>1, "Norway"=>1, "Japan"=>1, "United Kingdom"=>1, "Italy"=>1, "Australia"=>1, "Spain"=>1}, "group_count"=>36}

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Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/709873"], "description"=>"<p><i>Note.</i> The standard deviations of the means and the confidence intervals of effect sizes are shown in parentheses. Intention-to-treat model was employed with pre-treatment scores being carried forward if post-treatment or follow-up data was not available Abbreviations: GAD-7: Generalized Anxiety Disorder 7-Item; DASS-21: Depression Anxiety Stress Scales-21 item; PSWQ: Penn State Worry Questionnaire; SIAS-6/SPS-6: Social Interaction Scale and Social Phobia Scale Short Form; PDSS-SR: Panic Disorder Severity Scale – Self Rating; PHQ-9: Patient Health Questionnaire-9 item; SDS: Sheehan Disability Scale. CO: Coach-assisted; CL Clinician-assisted.</p>", "links"=>[], "tags"=>["deviations", "sizes", "pooled", "groups", "measures", "post-treatment", "3-month", "follow-up"], "article_id"=>380224, "categories"=>["Information And Computing Sciences", "Mental Health"], "users"=>["Luke Johnston", "Nickolai Titov", "Gavin Andrews", "Jay Spence", "Blake F. Dear"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0028079.t004", "stats"=>{"downloads"=>1, "page_views"=>4, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Means_standard_deviations_and_effect_sizes_Cohen_s_d_for_pooled_CL_CO_and_Control_groups_on_all_outcome_measures_at_pre_treatment_post_treatment_and_3_month_follow_up_time_points_/380224", "title"=>"Means, standard deviations and effect sizes (Cohen's d) for pooled CL+CO and Control groups on all outcome measures at pre-treatment, post-treatment and 3-month follow-up time points.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2011-11-23 00:03:44"}
  • {"files"=>["https://ndownloader.figshare.com/files/709792"], "description"=>"<p>Demographic characteristics of the Coach assisted, Clinician assisted and Control groups.</p>", "links"=>[], "tags"=>["characteristics", "clinician", "assisted"], "article_id"=>380153, "categories"=>["Information And Computing Sciences", "Mental Health"], "users"=>["Luke Johnston", "Nickolai Titov", "Gavin Andrews", "Jay Spence", "Blake F. Dear"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0028079.t001", "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Demographic_characteristics_of_the_Coach_assisted_Clinician_assisted_and_Control_groups_/380153", "title"=>"Demographic characteristics of the Coach assisted, Clinician assisted and Control groups.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2011-11-23 00:02:33"}
  • {"files"=>["https://ndownloader.figshare.com/files/709750"], "description"=>"<p><i>Note:</i> Intention-to-treat model was employed with pre-treatment diagnoses being carried forward if follow-up data was not available. Diagnostic interviews were not repeated with Control group as they had begun treatment. Abbreviations: GAD, Generalised Anxiety Disorder; SP, social phobia; Pan/Ag, panic disorder with or without agoraphobia; CO: Coach-assisted; CL: Clinician-assisted.</p>", "links"=>[], "tags"=>["diagnoses", "comorbidity", "groups", "3-month", "co", "cl"], "article_id"=>380103, "categories"=>["Information And Computing Sciences", "Mental Health"], "users"=>["Luke Johnston", "Nickolai Titov", "Gavin Andrews", "Jay Spence", "Blake F. Dear"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0028079.t003", "stats"=>{"downloads"=>1, "page_views"=>2, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Frequency_of_principal_diagnoses_and_comorbidity_for_Treatment_and_Control_groups_at_pre_treatment_and_3_month_follow_up_for_CO_and_CL_groups_/380103", "title"=>"Frequency of principal diagnoses and comorbidity for Treatment and Control groups at pre-treatment, and 3-month follow up for CO and CL groups.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2011-11-23 00:01:43"}
  • {"files"=>["https://ndownloader.figshare.com/files/709924"], "description"=>"<p><i>Note.</i> The standard deviations of the means and the confidence intervals of effect sizes are shown in parentheses. Intention-to-treat model was employed with pre-treatment scores being carried forward if post-treatment or follow-up data was not available Abbreviations: GAD-7: Generalized Anxiety Disorder 7-Item; DASS-21: Depression Anxiety Stress Scales-21 item; PSWQ: Penn State Worry Questionnaire; SIAS-6/SPS-6: Social Interaction Scale and Social Phobia Scale Short Form; PDSS-SR: Panic Disorder Severity Scale – Self Rating; PHQ-9: Patient Health Questionnaire-9 item; SDS: Sheehan Disability Scale. CO: Coach assisted; CL Clinician assisted.</p>", "links"=>[], "tags"=>["deviations", "sizes", "co", "cl", "groups", "measures", "post-treatment", "3-month", "follow-up"], "article_id"=>380276, "categories"=>["Information And Computing Sciences", "Mental Health"], "users"=>["Luke Johnston", "Nickolai Titov", "Gavin Andrews", "Jay Spence", "Blake F. Dear"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0028079.t005", "stats"=>{"downloads"=>0, "page_views"=>1, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Means_standard_deviations_and_effect_sizes_Cohen_s_d_for_CO_and_CL_groups_on_all_outcome_measures_at_pre_treatment_post_treatment_and_3_month_follow_up_timepoints_/380276", "title"=>"Means, standard deviations and effect sizes (Cohen's d) for CO and CL groups on all outcome measures at pre-treatment, post-treatment and 3-month follow-up timepoints.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2011-11-23 00:04:36"}
  • {"files"=>["https://ndownloader.figshare.com/files/709713"], "description"=>"<p>Content of the Anxiety Program.</p>", "links"=>[], "tags"=>["Mental health", "computer science"], "article_id"=>380075, "categories"=>["Information And Computing Sciences", "Mental Health"], "users"=>["Luke Johnston", "Nickolai Titov", "Gavin Andrews", "Jay Spence", "Blake F. Dear"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0028079.t002", "stats"=>{"downloads"=>3, "page_views"=>3, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Content_of_the_Anxiety_Program_/380075", "title"=>"Content of the Anxiety Program.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2011-11-23 00:01:15"}
  • {"files"=>["https://ndownloader.figshare.com/files/709831"], "description"=>"<p><i>Note.</i> The standard deviations of the means and the confidence intervals of effect sizes are shown in parentheses. Intention-to-treat model was employed with pre-treatment scores being carried forward if post-treatment or follow-up data was not available Abbreviations: PSWQ: Penn State Worry Questionnaire; SIAS-6/SPS-6: Social Interaction Scale and Social Phobia Scale Short Form; PDSS-SR: Panic Disorder Severity Scale – Self Rating.</p>", "links"=>[], "tags"=>["deviations", "sizes", "pooled", "measures", "post-treatment", "3-month", "follow-up"], "article_id"=>380185, "categories"=>["Information And Computing Sciences", "Mental Health"], "users"=>["Luke Johnston", "Nickolai Titov", "Gavin Andrews", "Jay Spence", "Blake F. Dear"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0028079.t006", "stats"=>{"downloads"=>2, "page_views"=>5, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Means_standard_deviations_and_effect_sizes_Cohen_s_d_for_pooled_CL_CO_group_on_disorder_specific_outcome_measures_at_pre_treatment_post_treatment_and_3_month_follow_up_timepoints_/380185", "title"=>"Means, standard deviations and effect sizes (Cohen's d) for pooled CL+CO group on disorder specific outcome measures at pre-treatment, post-treatment and 3-month follow-up timepoints.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2011-11-23 00:03:05"}
  • {"files"=>["https://ndownloader.figshare.com/files/359872", "https://ndownloader.figshare.com/files/359939"], "description"=>"<div><h3>Background</h3><p>Anxiety disorders share common vulnerabilities and symptoms. Disorder-specific treatment is efficacious, but few access evidence-based care. Administering transdiagnostic cognitive-behavioral therapy via the internet (iCBT) may increase access to evidence-based treatment, with a recent randomized controlled trial (RCT) providing preliminary support for this approach. This study extends those findings and aims to answer three questions: Is a transdiagnostic iCBT program for anxiety disorders efficacious and acceptable? Does it result in change for specific disorders? Can good clinical outcomes be obtained when guidance is provided via a Coach rather than a Clinician?</p> <h3>Method</h3><p>RCT (N = 131) comparing three groups: Clinician-supported (CL) vs. Coach-supported (CO) vs. waitlist control (Control). Individuals met DSM-IV criteria for a principal diagnosis of generalized anxiety disorder (GAD), social phobia (SP) or panic disorder with or without agoraphobia (Pan/Ag). Treatment consisted of an 8-lesson/10 week iCBT program with weekly contact from a Clinician or Coach, and follow-up at 3-months post-treatment.</p> <h3>Results</h3><p>Outcomes for the pooled treatment groups (CL+CO) were superior to the Control group on measures of anxiety, depression and disability, were associated with medium to large effect sizes (Cohen's <em>d</em> = .76 – 1.44) (response rate = 89–100%), and were maintained at follow-up. Significant reductions were found on disorder-specific outcomes for each of the target diagnoses, and were associated with large effect sizes. CO participants achieved similar outcomes to CL participants at post-treatment, yet had significantly lower symptom severity scores on general anxiety, panic-disorder, depression and disability at follow-up (<em>d</em> = .45 – .46). Seventy-four percent of CO and 76% of CL participants completed the program. Less than 70 minutes of Clinician or Coach time was required per participant during the program.</p> <h3>Discussion</h3><p>This transdiagnostic iCBT course for anxiety appears to be efficacious, associated with significant change for three target disorders, and is efficacious when guided by either a Clinician or Coach.</p> <h3>Trial Registration</h3><p>Australian New Zealand Clinical Trials Registry <a href=\"http://www.anzctr.org.au/trial_view.aspx?ID=335181\">ACTRN12610000242022</a></p> </div>", "links"=>[], "tags"=>["rct", "transdiagnostic", "internet-delivered", "roles", "disorder-specific", "outcomes"], "article_id"=>131123, "categories"=>["Information And Computing Sciences", "Mental Health"], "users"=>["Luke Johnston", "Nickolai Titov", "Gavin Andrews", "Jay Spence", "Blake F. Dear"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0028079.s001", "https://dx.doi.org/10.1371/journal.pone.0028079.s002"], "stats"=>{"downloads"=>8, "page_views"=>8, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/A_RCT_of_a_Transdiagnostic_Internet_Delivered_Treatment_for_Three_Anxiety_Disorders_Examination_of_Support_Roles_and_Disorder_Specific_Outcomes/131123", "title"=>"A RCT of a Transdiagnostic Internet-Delivered Treatment for Three Anxiety Disorders: Examination of Support Roles and Disorder-Specific Outcomes", "pos_in_sequence"=>0, "defined_type"=>4, "published_date"=>"2011-11-23 00:18:43"}
  • {"files"=>["https://ndownloader.figshare.com/files/709598"], "description"=>"<p>PHQ-9, Patient Health Questionnaire – 9 Item; MINI 5.0.0, Mini International Neuropsychiatric Interview.</p>", "links"=>[], "tags"=>["Mental health", "computer science"], "article_id"=>379961, "categories"=>["Information And Computing Sciences", "Mental Health"], "users"=>["Luke Johnston", "Nickolai Titov", "Gavin Andrews", "Jay Spence", "Blake F. Dear"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0028079.g001", "stats"=>{"downloads"=>1, "page_views"=>6, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_CONSORT_R_participant_flow_chart_/379961", "title"=>"CONSORT-R participant flow chart.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2011-11-23 02:46:01"}

PMC Usage Stats | Further Information

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Relative Metric

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