Biomedical subjects

Lars Ström

Publications and source records attributed to Lars Ström.

7 recordsLinked to original sources

PubMed2004

Controlled trial of Internet-based treatment with telephone support for chronic back pain.

The purpose of this study was to investigate the effects of an Internet-based cognitive-behavioral intervention with telephone support for chronic back pain. Participants who met the criteria for chronic back pain (N=56) were randomly assigned to either an Internet-based cognitive behavioral self-help treatment or to a waiting-list control condition. The study period lasted 8 weeks and consisted of 1 week of self-monitoring prior to the intervention, 6 weeks of intervention, and 1 week of post-intervention assessment. Treatment consisted of education, cognitive skill acquisition, behavioral rehearsal, generalization and maintenance. The dropout rate was 9% (N=5). Results showed statistically significant improvements in catastrophizing, control over pain and ability to decrease pain. Some improvement was found in both the control group and the treatment group. A follow-up of 3 months after treatment termination was completed in 92% (N=47) of the participants who completed the treatment intervention. Follow-up results showed that some improvement was maintained. Findings indicate that Internet-based self-help with telephone support, based on established psychological treatment methods, holds promise as an effective approach for treating disability in association with pain.

Adult↗

PubMed2004

Internet-based treatment for insomnia: a controlled evaluation.

This study investigated the effects of an Internet-based intervention for insomnia. Participants who met criteria for insomnia (N = 109) were randomly assigned to either a cognitive-behavioral self-help treatment or a waiting list control condition. The 5-week intervention mainly consisted of sleep restriction, stimulus control, and cognitive restructuring. Sleep diary data were collected for 2 weeks at baseline and at posttreatment. The dropout rate was 24% (n = 28). Results showed statistically significant improvements in the treatment group on many outcome measures, including total sleep time, total wake time in bed, and sleep efficiency. However, improvements were also found in the control group. Overall, between-groups effect sizes were low, with the exception of the Beliefs and Attitudes About Sleep Scale (Cohen's d =.81).

Adolescent↗

PubMed2004

Screening of psychiatric disorders via the Internet. A pilot study with tinnitus patients.

Tinnitus has been associated with psychiatric disorders and more recently diagnostic tools have been used in a systematic manner. In the present study, we administered the World Health Organisation's Composite International Diagnostic Interview--Short form (CIDI-SF) in a computerized Internet-based version to a self-selected sample of tinnitus patients (n=48). Using the cut-off for 'probable case' (12-month prevalence), 69% of the tinnitus patients fulfilled the criteria for depression, 60% for generalized anxiety disorder, 83% for specific phobia, 67% for social phobia, 58% for agoraphobia, 21% panic attack, 83% obsessive-compulsive disorder, 2% alcohol dependence and 0% drug dependence. Decreased percentages were found for depression (4%), specific phobia (62%) and social phobia (27%) when applying a more conservative criteria (maximum case criteria). In conclusion, the findings suggest that the Internet version of CIDI-SF can be used as a screening tool for psychiatric disturbance in somatic patients, but that diagnostic criteria need to be adjusted for Internet use.

Female↗

PubMed2003

Internet administration of the Hospital Anxiety and Depression Scale in a sample of tinnitus patients.

OBJECTIVE: To administer and validate the Hospital Anxiety and Depression Scale (HADS) via the Internet to a sample of persons with tinnitus. METHOD: The HADS was converted into a Web page and administered via the Internet to a sample of 157 persons with tinnitus who were recruited for participation in a treatment trial. Also included were the Tinnitus Reaction Questionnaire (TRQ) and the Anxiety Sensitivity Index (ASI). A clinical comparison sample (n=86) was also recruited who completed the same tests in a paper-and-pencil format. RESULTS: Both the Internet and the paper-and-pencil version yielded comparable results in terms of psychometric properties. When using the cut-off of 11 points suggested by Zigmond and Snaith [Acta Psychiatr. Scand. 67 (1983) 361] a 25% (n=40) prevalence of probable anxiety and a 17% (n=27) prevalence of probable depression were found in the Internet group. In the clinic sample, the prevalence was only 15% for both anxiety and depression, suggesting that Internet administration might result in higher percentages. The HADS correlated with both tinnitus distress and anxiety sensitivity. CONCLUSIONS: Internet administration of the HADS results in meaningful and valid data. Consistent with previous research anxiety and depression are common comorbid conditions in individuals with tinnitus, but norms should be developed for Internet based screening.

Adult↗

PubMed2003

Internet-based treatment of headache: does telephone contact add anything?

OBJECTIVE: To study the contribution of therapist-initiated telephone contact in the treatment of recurrent headache via the Internet. BACKGROUND: Internet-based cognitive behavioral self-help is a promising new venue for the treatment of recurrent headache. While cost-effective, there are indications that this modality may be associated with high dropout rates. DESIGN AND METHODS: The role of therapist-initiated contact was investigated in a randomized controlled trial in which 44 self-recruited headache sufferers were randomized to either a Web-based self-help program with e-mail support or to a group receiving, in addition, weekly individual telephone calls. An additional 8 control subjects were recruited to receive similar treatment outside of the study. RESULTS: Dropout rates were 29% in the telephone support group and 35% in the control group, suggesting that the telephone calls did not affect dropout. Results showed significant reductions in headache-related disability, depression, maladaptive coping strategies, and perceived stress but little to indicate any superior performance in the Internet-only group and little improvement in the headache index. In short, therapist-initiated telephone calls did not influence the results. CONCLUSIONS: Internet-based treatment for headache is not affected by minimal therapist-initiated telephone contact.

Adult↗

PubMed2003

Randomized controlled trial of internet-based stress management.

This study investigated the effects of an internet-based self-help stress management program with a randomized controlled design. Of 85 participants, 26% dropped out, leaving a final sample of 63 participants with 23 in the treatment group and 40 in the waiting list control group. Treatment included applied relaxation, problem solving, time management and cognitive restructuring. All information and treatment interventions were provided via the internet. Results were evaluated with the Perceived Stress Scale and the Hospital Anxiety and Depression Scale. Improvements were seen in both groups, with greater improvements in the self-help treatment group. It is concluded that the internet can be used to provide stress management techniques and result in stress relief. However, spontaneous improvement, differential dropout rate and compliance need to be monitored in future studies.

Journal Article↗

PubMedDate not supplied

Randomized controlled trial of internet-based cognitive behavior therapy for distress associated with tinnitus.

OBJECTIVE: The aim of this study was to investigate if cognitive behavior therapy (CBT) provided via the Internet results in significant decreases of distress in individuals with tinnitus. METHODS: Participants were recruited through Web pages and newspaper articles and thereafter randomly allocated to a CBT self-help manual in six modules or to a waiting-list control group (WLC). All treatment and contact with participants were conducted via the Internet with Web pages and E-mail correspondence. Participants were 117 individuals with tinnitus of duration of more than 6 months. In the first randomized controlled phase of the study, 26 completed all stages of treatment (51% dropout), and 64 of the WLC group completed measures. At 1-year follow-up, all participants had been offered the program and 96 provided outcome measures (18% dropout rate from baseline). Tinnitus-related problems were assessed before and after treatment and at the 1-year follow-up. Daily diary ratings were included for 1 week before and 1 week following the treatment period. RESULTS: Tinnitus-related distress, depression, and diary ratings of annoyance decreased significantly. Immediately following the randomized controlled phase (with a WLC), significantly more participants in the treatment group showed an improvement of at least 50% on the Tinnitus Reaction Questionnaire. At the uncontrolled follow-up, 27 (31%) of all participants had achieved a clinically significant improvement. CONCLUSIONS: CBT via the Internet can help individuals decrease annoyance associated with tinnitus. High dropout rates or delay in completing treatment can be a characteristic of treatment studies using the Internet but should be contrasted with the cost effectiveness and accessibility of the Internet.

Anxiety↗