Contents of It's not All in Your Head by Asmundson and Taylor

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3.3. Discussion Health anxiety is an extreme form of health awareness. Individuals with health anxiety believe they are physically ill, have recurrent thoughts about illness, and are hypervigilant to sensations and changes in their bodies (Taylor & Asmundson, 2004). Numerous studies have indicated that CBT is a very efficacious treatment for health anxiety (e.g., Barsky & Ahern, 2004; Bleichhardt et al., 2005; Bouman, 2002; Bouman & Van Duijn, 2008; Buwalda et al., 2008; Martínez & Botella, 2005; Sorensen et al., 2010; Seivewright et al., 2008; Wattar et al., 2005) and it can be relatively brief (8 to 16 sessions; Avia, 2005). CBT for health anxiety includes cognitive therapy, behaviour therapy, ERP, BSM, and psychoeducation (Asmundson & Taylor, 2005; Bouman & Visser, 1998; Warwick & Salkovskis, 2001). It’s Not All in Your Head by Asmundson and Taylor (2005) provides a multimodal health anxiety treatment that includes all of the efficacious components of CBT in a self-help format. Self-help is an MC therapy that can reduce the need for therapist contact (Mead et al., 2005; Newman et al., 2003). Previous research indicates self-help treatments are beneficial and more therapist contact can increase treatment efficacy (Mead et al., 2005; Newman et al., 2003). The present randomized controlled feasibility trial was a pilot study that followed the CONSORT standards for randomized controlled clinical trials (Moher et al., 2001). It can be used to inform a future, large-scale trial of the efficacy of self-help for health 75
anxiety. After ethical clearance was obtained for the study, individuals with maladaptive levels of health anxiety were recruited in the city of Regina, Saskatchewan. Individuals completed telephone or online screening followed by an assessment interview and random assignment to one of two groups. Some were randomly assigned to the SHB group where they received CBT in book-form (It’s Not All in Your Head, Asmundson & Taylor; 2005) and weekly in-person or telephone check-ins with a trained facilitator or the Head Researcher (n = 10; 7 females and 2 males). The SHB treatment was a guided self-help MC because facilitators or the Head Researcher introduced the self-help book and helped participants to use it effectively (Mead et al., 2005; Newman et al., 2003). Other participants were assigned to the WLC group waiting for the SHB treatment (n = 4; 3 females and 1 male). Both conditions had a duration of 8 weeks and all participants completed questionnaires pre-, mid-, and post-treatment to assess symptoms of health anxiety, general anxiety, depression, and self-reported physical and mental functioning. It was hypothesized that using a CBT self-help book would be a more efficacious treatment than WLC. It was expected that relative to WLC, SHB would be more efficacious in reducing health anxiety as evidenced by reductions in scores on measures of health anxiety and related constructs. ITT analysis (LOCF procedure; Hollis & Campbell, 1999) was used for all participants who were randomly assigned, and remained in the study until T2 including 4 participants who dropped out of the SHB group. Paired samples t tests were used to analyze within-group differences. Analyses 76
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RANDOMIZED CONTROLLED FEASIBILITY T
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Abstract The purpose of this feasib
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Acknowledgement This research was f
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Table of Contents Abstract………
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3.2.1. Content analysis…………
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List of figures Figure 1. The cogni
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Table C7. Comparison of WLC pre- an
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this study will inform a future, la
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Disorders Draft (APA, 2010) propose
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The cognitive symptoms of health an
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somatosensory amplification have a
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clients with health anxiety from cl
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Interview Schedule [Robins, Helzer,
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Today, effective clinically-support
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decreased disease conviction, witho
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identification and reattribution of
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within treatment sessions and as ho
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more efficacious than wait-list con
Page 37 and 38: participants‘ functioning. The CB
Page 39 and 40: at follow-up (e.g., Bouman, 2002, a
Page 41 and 42: et al., 2003). Self-help treatments
Page 43 and 44: 1.2. Statement of purpose The purpo
Page 45 and 46: an Internet format because it was m
Page 47 and 48: � Do you carry things to use in t
Page 49 and 50: dimensional scales: (a) affective s
Page 51 and 52: severe (15 - 19), and extremely sev
Page 53 and 54: 86 indicate a poor alliance. The HA
Page 55 and 56: included depression symptoms, gener
Page 57 and 58: mailed Part 1, Part 2, and Part 3 o
Page 59 and 60: equests were honored. All randomize
Page 61 and 62: literature; therefore, we had reaso
Page 63 and 64: 3. RESULTS 3.1. Quantitative data a
Page 65 and 66: Table 2 Demographic statistics Mean
Page 67 and 68: Table 3 Comparison of SHB pre- and
Page 69 and 70: was no significant change (t = 1.28
Page 71 and 72: subscale (n = 5); T1 M = 16.80 (SD
Page 73 and 74: treatment participants would have o
Page 75 and 76: At T2 there were significant differ
Page 77 and 78: Table 7 SHB and WLC effect size and
Page 79 and 80: sample size or greater effect size
Page 81 and 82: 3.2.1. Content analysis 3.2. Qualit
Page 83 and 84: analysis resulted in the descriptio
Page 85 and 86: During the creating subcategories a
Page 87: coded the entire data set. There we
Page 91 and 92: SHB group symptoms when compared to
Page 93 and 94: pain, fatigue, and poor health, tha
Page 95 and 96: 3.4. Limitations The results of thi
Page 97 and 98: usy schedules, worry about reading
Page 99 and 100: attery of tests is not recommended
Page 101 and 102: ecommended that the program is exte
Page 103 and 104: 4. REFERENCES American Psychiatric
Page 105 and 106: Barsky, A. J., Geringer, E., & Wool
Page 107 and 108: Coull, G, & Morris, P. G. (2011). T
Page 109 and 110: Furer, P., Walker, J. R., & Freesto
Page 111 and 112: Lidbeck, J. (1997). Group therapy f
Page 113 and 114: Nguyen, T. D., Attkisson, C. C., &
Page 115 and 116: Salkovskis, P. M., Rimes, K. A., Wa
Page 117 and 118: Taylor, S., Thordarson, D. S., Jang
Page 119 and 120: 5. APPENDICIES Appendix A Contents
Page 121 and 122: o Week 4 o Week 5 o Things to Remem
Page 123 and 124: Appendix B SELF-HELP PROGRAM FOR HE
Page 125 and 126: Table C2 Comparison of SHB complete
Page 127 and 128: Table C4 Comparison of SHB and WLC
Page 129 and 130: Table C6 Comparison of WLC pre- and
Page 131 and 132: Appendix D Draft of unconstrained c
Page 133 and 134: Questionnaires the questionnaires T
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