The Efficacy and Effectiveness of Online CBT - Jeroen Ruwaard
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The Efficacy and Effectiveness of Online CBT - Jeroen Ruwaard

The Efficacy and Effectiveness of Online CBT - Jeroen Ruwaard The Efficacy and Effectiveness of Online CBT - Jeroen Ruwaard

interapy.nl
10.07.2015 Views

76 Chapter 4. Online CBT of Panic SymptomsTable 4.3: Web-CBT vs. waiting-list control: clinical relevance analysis (intention-totreat)a .Measure b Criterion Criterion met % b OR c P dTreatmentControlAttack Frequency -50% 52% 14% 6.3 .02Full-Blown Attacks 0 70% 47% 2.7 .11PDSS-SR

4.3. Results 77Table 4.4: Web-CBT: pooled outcome at posttest (N = 58) and after three years (n =47) ạ Pre Post FU Pre-FU ES cMeasure b M SD M SD M SD d CI .95Attack Frequency 4.2 3.4 2.4 2.6 .6 1.3 1.4 ±.4Symptom Count 3.1 1.7 2.0 1.7 1.5 2.7 .7 ±.4Attack intensity 4.3 2.2 2.6 2.3 1.4 2.6 1.2 ±.4PDSS-SR 8.6 5.0 5.5 4.0 4.0 4.7 .9 ±.3MI-AAL 2.5 1.0 2.1 .9 1.8 .8 .8 ±.2DASS Dep 8.9 8.2 4.3 5.4 4.1 6.2 .7 ±.3DASS Anx 12.3 8.2 6.3 5.6 4.8 5.8 1.1 ±.4DASS Str 13.5 8.6 8.4 6.6 6.2 5.4 1.0 ±.4a To account for attrition at follow-up (19%), pre-treatment to follow-up data were analyzed through multilevel regressionmodeling. Missing posttest data was imputed using pretest scores.b PDSS-SR: Panic Disorder Severity Scale Self-Report; MI-AAL: Mobile Inventory - Alone subscale; DASS: Depression AnxietyStress Scales (Dep: Depression; Anx: Anxiety; Str: Stress). Higher scores indicate less favourable conditions.c ES: Effect size: Cohen’s d point estimate and 95% confidence interval (d- CI.95 to d + CI .95 ).after the start of the trial, participants reported significant further improvements withregard to the frequency and intensity of attacks (z = 6.2, P < .001; z = 2.5, p = .01)and avoidance (MI-AAL; z = 3.1, P = .002). Overall, compared to the immediate(posttest) effects, pretest to follow-up effect sizes were substantially higher (.7 < d< 1.4). A majority of the follow-up participants (n = 32; 68%) reported no panicattacks in the week preceding follow-up measurement. With regard to the PDSS-SR,83% of the follow-up participants (n = 39) scored below the clinical cut-off (8).Additional treatment. In the period between the posttest and follow-up, 12 participants(26% of those completing the follow-up) received further treatment (medicationand/or psychotherapy) for their panic symptoms. With respect to the primary outcomemeasures, those who received additional treatment did not score differently fromthose without additional treatment.Participant satisfaction. At posttest, participants rated the overall value of thetreatment with a mean score of 8.6 on a 1 to 10 point scale (SD = 1.3; range: 4-

76 Chapter 4. <strong>Online</strong> <strong>CBT</strong> <strong>of</strong> Panic SymptomsTable 4.3: Web-<strong>CBT</strong> vs. waiting-list control: clinical relevance analysis (intention-totreat)a .Measure b Criterion Criterion met % b OR c P dTreatmentControlAttack Frequency -50% 52% 14% 6.3 .02Full-Blown Attacks 0 70% 47% 2.7 .11PDSS-SR

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