Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • apa.csl
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Treatment of worry and comorbid symptoms within depression, anxiety, and insomnia with a group-based rumination-focused cognitive-behaviour therapy in a primary health care setting: a randomised controlled trial
Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013).ORCID iD: 0000-0002-1692-8941
Kristianstad University, Sweden; Örebro University, Sweden.ORCID iD: 0000-0003-2008-0784
Örebro University, Sweden.
Kronoparken Primary Healthcare Center, Karlstad, Sweden.
Show others and affiliations
2023 (English)In: Frontiers in Psychology, E-ISSN 1664-1078, Vol. 14, article id 1196945Article in journal (Refereed) Published
Abstract [en]

IntroductionRepetitive negative thinking (RNT) has been described as a maintaining transdiagnostic factor for psychopathology within the areas of depression, anxiety and insomnia. We investigated the effects of rumination-focused cognitive-behaviour therapy (RF-CBT) in a group format at a primary health care centre on symptoms of depression, anxiety, insomnia, RNT, and quality of life. The participants presented clinical symptom levels of worry and at least two disorders among anxiety disorders, major depressive disorder, and insomnia disorder.MethodsA randomised controlled superiority parallel arm trial was used. 73 participants were included and randomised in pairs to either group-administered RF-CBT or a waiting list condition. The primary outcomes were self-rated worry and transdiagnostic symptoms (depression, anxiety, and insomnia). Intention-to-treat analyses of group differences were conducted using linear mixed models. Adverse side effects and incidents were presented descriptively.ResultsGroup RF-CBT significantly reduced self-reported insomnia at post-treatment and self-reported insomnia and depression at the 2 month-follow-up, relative to the wait-list control group. There was no significant difference in change in RNT, anxiety, or quality of life.DiscussionThe current study suggests that group-administered RF-CBT may be effective for insomnia and potentially effective for depression symptomatology. However, the study was underpowered to detect small and moderate effects and the results should therefore be interpreted with caution.

Place, publisher, year, edition, pages
Frontiers Media S.A., 2023. Vol. 14, article id 1196945
Keywords [en]
anxiety, depression, group therapy, insomnia, repetitive negative thinking, rumination-focused CBT
National Category
Psychiatry Psychology
Research subject
Psychology
Identifiers
URN: urn:nbn:se:kau:diva-97097DOI: 10.3389/fpsyg.2023.1196945ISI: 001068886700001PubMedID: 37744585Scopus ID: 2-s2.0-85171892073OAI: oai:DiVA.org:kau-97097DiVA, id: diva2:1806131
Available from: 2023-10-19 Created: 2023-10-19 Last updated: 2024-03-20Bibliographically approved
In thesis
1. Shifting the lens on heterogenous psychological suffering: Exploring and evaluating novel psychological treatment approaches to comorbid mental disorders
Open this publication in new window or tab >>Shifting the lens on heterogenous psychological suffering: Exploring and evaluating novel psychological treatment approaches to comorbid mental disorders
2024 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This doctoral thesis addresses heterogeneous psychological suffering within a predominantly psychiatric paradigm, emphasizing the high prevalence of comorbid mental disorders. While much of the published empirical research focuses on trials targeting single disorders, this thesis aims to explore and evaluate novel treatment approaches for populations experiencing diverse psychological suffering. It seeks to bridge the gap between traditional disorder-based treatments and the emerging trend of idiographic designs and processes of change. The first clinical trial focused on treating co-morbid insomnia and social anxiety disorder using sequential cognitive behavioral therapy protocols (CBT-I and CBT-S). Findings suggest potential efficacy in reducing symptoms of both disorders, with notable improvements in insomnia symptoms. However, treatment effects still varied among participants, making it difficult to draw clear conclusions regarding efficacy. The second trial investigated group-based Rumination-Focused Cognitive Behavior Therapy (RFCBT) for individuals with depression, anxiety, and insomnia. Results indicate significant improvements in insomnia symptoms post-treatment and at the 2-month follow-up, with potential effectiveness for depression. However, no significant effects were found for anxiety, worry, or rumination. The third trial explored feasibility and preliminary effects of a process-based psychological treatment informed by Relational Frame Theory for individuals with comorbid mental disorders (Process-Based Behavioral Therapy; PBBT). Interpretative Phenomenological analysis revealed participants' varied experiences, emphasizing challenges in emotional engagement and the therapeutic process. Mixed findings from both the qualitative analyses and the suplementary self-rating scales underscored the complexity of treatment outcomes, highlighting the need of more research on treatment approaches based on Relational Frame Theory. Overall, the thesis contributes to addressing and understanding the complexities of heterogeneous psychological suffering and clinical research. Further research should continue to explore idiographic designs and process-based treatments while carefully defining and tracking processes of change. This is particularly important for individuals who do not benefit from current evidence-based treatment approaches.

Abstract [sv]

This doctoral thesis addresses the pervasive issue of psychological suffering, underscoring the high prevalence of and common comorbidity between mental disorders. Despite the undeniable efficacy of psychological treatments in alleviating suffering, a significant proportion of individuals fail to benefit from evidence-based approaches. Research on treatments for people who meet criteria for several disorders is scarce and current evidence-based treatment approaches still tends to target and or be evaluated on delimited disorders. This raises the question of how to address heterogeneous psychological suffering.

Acknowledging the multitude of angles and paths available for evaluating and developing psychological treatments, the overarching goal of this dissertation is to explore and evaluate novel treatment approaches in populations with heterogeneous psychological suffering. By bridging the gap between nomothetic designs, disorder-based treatments, and the emerging wave of idiographic designs and process-based treatment approaches, this thesis also aims to explore some of the scientific dilemmas that arise from developing and evaluating psychological treatments in a predominantly psychiatric paradigm.

 

Place, publisher, year, edition, pages
Karlstads universitet, 2024. p. 112
Series
Karlstad University Studies, ISSN 1403-8099 ; 2024:10
Keywords
process-based, transdiagnostic, comorbidity, psychotherapy, anxiety, depression, Insomnia, OCD, PTSD
National Category
Applied Psychology
Research subject
Psychology
Identifiers
urn:nbn:se:kau:diva-98948 (URN)10.59217/zqap1593 (DOI)978-91-7867-446-6 (ISBN)978-91-7867-447-3 (ISBN)
Public defence
2024-05-17, 11D 257, Aghardsalen, Universitetsgatan 2, Karlstad, 10:15 (English)
Opponent
Supervisors
Available from: 2024-04-22 Created: 2024-03-20 Last updated: 2024-04-22Bibliographically approved

Open Access in DiVA

fulltext(1505 kB)149 downloads
File information
File name FULLTEXT01.pdfFile size 1505 kBChecksum SHA-512
2dbc017a2494ae02d4d6b4ebb32982e6d5f01fcb6fa0d5cf93b0cc4966f22078b1ef0cd27a42d0c86aa9a4c79fab94a211326f1bf1bbf657f79b1ef391fb0855
Type fulltextMimetype application/pdf

Other links

Publisher's full textPubMedScopus

Authority records

Wallsten, DanielNorell, AnnikaTillfors, Maria

Search in DiVA

By author/editor
Wallsten, DanielNorell, AnnikaTillfors, Maria
By organisation
Department of Social and Psychological Studies (from 2013)
In the same journal
Frontiers in Psychology
PsychiatryPsychology

Search outside of DiVA

GoogleGoogle Scholar
Total: 149 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 226 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • apa.csl
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf