- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02638792
Internet-Based Exposure Therapy Vs. Stress-Management Training for Worry
Internet-Based Exposure Therapy Vs. Stress-Management Training for Worry: A Randomized Controlled Trial
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Trial Objectives: Primary objective is to investigate whether an Internet-based exposure therapy can reduce the degree of excessive worry to a significantly greater extent than Internet-based stress-management training. The secondary objective is to a) investigate the cost-effectiveness of this treatment b) to study if any variables could moderate/mediate the treatment outcome, c) and to investigate the importance of sudden gains for the treatment outcome
Trial Design: Randomized controlled trial with an active control and a waitlist control, who also will recieve treatment after the first group has finished.
Duration: Ten weeks
Primary Endpoint:
Difference in worry symptoms between the treatment groups at week 10. Long term follow-up is also investigated (baseline to 4-months after treatment completion and baseline to 12-months after treatment completion).
Efficacy Parameters: Penn State Worry Questionnaire (PSWQ)
Safety Parameters: Adverse Events is assessed via the internet.
Description of Trial Subjects: Patients > 18 years old with a PSWQ score more than 56 points
Number of Subjects: 300
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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Stockholm, Sweden, 17177
- Karolinska Intitutet
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Outpatients
- ≥ 18 years
- Situated in Sweden
- Informed consent
- PSWQ score more than 56 points
Exclusion Criteria:
- Substance dependence during the last six months
- Post traumatic stress disorder, bipolar disorder or psychosis
- Symptoms better explained by axis 2 diagnosis (e.g. autism or borderline personality disorder)
- MADRS-S score above 25 points
- Psychotropic medication changes within two months prior to treatment that could affect target symptoms.
- Received exposure based CBT for pathological worry the last 2 years.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: NONE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
EXPERIMENTAL: Internet-based exposure therapy
The internet-based exposure therapy (I-ET) group receives a ten-week Internet-based CBT treatment, which is an extended version of the self-help book "Sluta älta och grubbla med kognitiv beteendeterapi" (How to quit worrying and ruminating with Cognitive behavior therapy) by licensed psychologist Olle Wadström (2007).
The main focus of the book is to expose to the frightening word/image and refrain from using neutralizing thoughts.
This is supposed to lead to the extinction of upsetting words/images.
|
The internet-based exposure therapy (I-ET) group receives a ten-week Internet-based CBT treatment, which is an extended version of the self-help book "Sluta älta och grubbla med kognitiv beteendeterapi" (How to quit worrying and ruminating with Cognitive behavior therapy) by licensed psychologist Olle Wadström (2007).
The main focus of the book is to expose to the frightening word/image and refrain from using neutralizing thoughts.
This is supposed to lead to the extinction of upsetting words/images.
|
ACTIVE_COMPARATOR: Internet-based stress management therapy
The I-SMT group receives a ten-week Internet-based CBT treatment focused on stress and how to manage stressful situations.
This protocol is based on current evidence based recommendations for worry and has shown to be effective when delivered via the internet for irritable bowel syndrome and hypochondric worries.
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The I-SMT group receives a ten-week Internet-based CBT treatment focused on stress and how to manage stressful situations.
This protocol is based on current evidence based recommendations for worry and has shown to be effective when delivered via the internet for irritable bowel syndrome and hypochondric worries.
|
NO_INTERVENTION: Waitlist
When the active treatment groups have finished treatment (W11), the WL group will be able to start active treatment and be assessed at post-treatment, and 4, 12 months later using the same questionnaires as the treatment group.
The participants will be able to choose which treatment they receive i.e. no randomization.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Penn State Worry Questionnaire (PSWQ)
Time Frame: week 0, week 10 (weekly measurements), at 4 months follow up, 12 months follow up.
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Change in worry from baseline to Week 10 and at 4- and 12 months after treatment has ended.
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week 0, week 10 (weekly measurements), at 4 months follow up, 12 months follow up.
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Montgomery Åsberg Depression Rating Scale (MADRS-S)
Time Frame: Week 0, Week 10, 4 and 12 months follow-up
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Change in depression from baseline to Week 10 and at 4- and 12 months after treatment has ended.
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Week 0, Week 10, 4 and 12 months follow-up
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Euroqol, EQ-5D
Time Frame: Week 0, Week 10, 4 and 12 months follow-up
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Change in general health from baseline to Week 10 and at 4- and 12 months after treatment has ended
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Week 0, Week 10, 4 and 12 months follow-up
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Cognitive Avoidance Questionnaire (CAQ)
Time Frame: Week 0, Week 10, at 4 and 12 months follow up and weekly during treatment
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Change in cognitive avoidance from baseline to Week 10, at 4- and 12 after treatment has ended, and weekly during treatment
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Week 0, Week 10, at 4 and 12 months follow up and weekly during treatment
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Intolerance of uncertainty scale
Time Frame: Week 0, Week 10, at 4 and 12 months follow-up, and weekly during treatment
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Change in thought control efforts from baseline to Week 10, at 4- and 12 months after treatment has ended, and weekly during treatment
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Week 0, Week 10, at 4 and 12 months follow-up, and weekly during treatment
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Trimbos and Institute of Medical Technology Assessment Cost Questionnaire for Psychiatry (TIC-P)
Time Frame: Week 0, Week 10, 4 and 12 months follow-up
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Change in economic costs from baseline to Week 10 and at 4- and 12 months after treatment has ended
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Week 0, Week 10, 4 and 12 months follow-up
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Brunnsviken Quality of Life Questionnaire (BBQ)
Time Frame: Week 0, Week 10, 4 and 12 months follow-up
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Change in self-perceived quality of life from baseline to week 10 and at 4 and 12 months after treatment has ended
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Week 0, Week 10, 4 and 12 months follow-up
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Thought supression subscale of the Cognitive Avoidance Questionnaire (CAQ)
Time Frame: Week 0 - Week 10 (weekly measurements)
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Weekly change in thought supression from baseline to Week 10
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Week 0 - Week 10 (weekly measurements)
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The self-regulation subscale of the Multidimensional Assessment of Interoceptive Awareness
Time Frame: Week 0 - Week 10 (weekly measurements)
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Weekly change in self-regulation from baseline to Week 10
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Week 0 - Week 10 (weekly measurements)
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Patient Health Questionnaire-2
Time Frame: Week 0 - Week 10 (weekly measurements)
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Weekly change in depressive symptom from baseline to Week 10
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Week 0 - Week 10 (weekly measurements)
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Adverse Events
Time Frame: Week 3, week 8, week 10, 4 and 12 months follow-up
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Number of adverse events from baseline to Week 10 and at 4 and 12 months
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Week 3, week 8, week 10, 4 and 12 months follow-up
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Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Treatment credibility scale
Time Frame: Week 2
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Investigate if both conditions have equal credibility in order to rule out placebo
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Week 2
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Working alliance scale
Time Frame: Week 5
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Investigate if both conditions have equal working alliance in order to rule out non-specific factors
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Week 5
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Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Erik M Andersson, PhD, Psych., Karolinska Institutet
Study record dates
Study Major Dates
Study Start
Primary Completion (ACTUAL)
Study Completion (ACTUAL)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ESTIMATE)
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
- REPN 2015/1698-31/1
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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