Group Metacognitive Therapy for Generalized Anxiety Disorder: A Pilot Feasibility Trial

Background: Individual metacognitive therapy (MCT) for generalized anxiety disorder (GAD) is well established, but only one study has investigated the effectiveness of Group MCT (g-MCT) for GAD. The aim of the current study was therefore to evaluate the feasibility and effectiveness of g-MCT for GAD within a community mental health setting whilst addressing limitations evident in the previous study.Methods: The study used an open trial design, and 23 consecutively referred adults with GAD completed 10 sessions (90 min) of g-MCT, delivered by two therapists trained in MCT. Diagnoses were assessed by trained raters using the Anxiety Disorder Interview Schedule-IV. All patients but one had previous psychosocial treatment, and 17 (73.9%) had at least one comorbid axis-I disorder. Self-reported symptoms were assessed using the Penn State Worry Questionnaire, the Generalized Anxiety Disorder-7, and the Patient Health Questionnaire-9 at pre- and post-treatment as well as 3-month follow-up. Feasibility was assessed using rates of patients who declined group treatment in favor of individual treatment, patients not able to attend due to pre-scheduled dates for sessions, and drop-out rate.Results: Of 32 eligible participants, six patients (19%) declined g-MCT in favor of individual MCT, and three (9%) were unable to attend due to scheduling conflicts. No patients dropped out during treatment, but two patients did not complete the self-report questionnaires at 3-month follow-up. g-MCT was associated with significant reductions in worry, anxiety, depression, metacognitive beliefs, and maladaptive coping. According to the standardized Jacobson criteria for recovery, 65.3% were recovered at post-treatment, whereas 30.4% were improved and 4.3% showed no change. At 3-month follow-up, the recovery rate increased to 78.3%. Moreover, recovery rates were comparable for patients with- and without comorbidity. Number of therapist hours per patient was 6.5 and the treatment has now been implemented as a standard treatment option at the clinic.Conclusion: g-MCT for GAD is an acceptable treatment which may offer a cost-effective alternative approach to individual MCT. Recovery rates and effect sizes suggested that g-MCT could be just as efficient as individual MCT and cognitive behavioral therapy

Metacognitions, responsibility, and perfectionism in obsessive-compulsive disorder

The aim of this paper was to further test Wells` (1997) metacognitive model of obsessive-compulsive disorder (OCD). Metacognitions` (thought-fusion beliefs and beliefs about rituals) influence on obsessive-compulsive symptoms was evaluated and compared to the role of two central cognitive beliefs; inflated responsibility (Salkovskis, 1985, 1999), and perfectionism (e.g. Frost & Steketee, 1997). The following hypotheses were tested: (1) Metacognitions, inflated responsibility, and perfectionism will be positively and significantly correlated with obsessive-compulsive symptoms, (2) Metacognitions will be an independent predictor of obsessive-compulsive symptoms, even when depression and the cognitive beliefs are controlled, (3) The relationship between the cognitive beliefs and obsessive-compulsive symptoms will be dependent on metacognitions. The sample consisted of 62 OCD-patients, who completed an in-patient cognitive-behavioral treatment (CBT) with duration of three weeks. A series of correlational and multiple regression analyses were performed, and all three hypotheses were confirmed. The results provide further support for the metacognitive model of OCD (Wells, 1997)

Three-Week Inpatient Treatment of Obsessive-Compulsive Disorder: A 6-Month Follow-Up Study

Background: Specialized inpatient or residential treatment might be an alternative treatment approach for patients with obsessive-compulsive disorder (OCD) that do not respond satisfactorily to the standard outpatient treatment formats.Method: The aim of this open trial was to investigate the 6-month effectiveness of a 3-week inpatient treatment of OCD, where exposure with response prevention (ERP) was the main treatment intervention. The sample consisted of 187 adult patients with OCD, all with previous treatment attempts for OCD.Results: The sample showed significant reductions in symptoms of OCD and depression. The effect sizes were large for obsessive-compulsive symptoms and moderate to large for depressive symptoms. At discharge, 79.7% of the intent-to-treat (ITT) group were classified as treatment responders (≥35% reduction in Y-BOCS scores). However, some participants experienced relapse, as 61.5% of the ITT group were classified as treatment responders at 6-month follow-up. Antidepressant use appeared not to influence the outcome. Only pre-treatment levels of obsessive-compulsive symptoms emerged as a significant predictor of relapse.Conclusion: The 3-week inpatient programme produced similar treatment effects as previous inpatient and residential studies of longer duration (2 – 3 months). The results suggest that patients with severe OCD can be treated efficiently using this brief inpatient format. However, better relapse prevention interventions are needed

Post-treatment predictors of follow-up status for obsessive-compulsive disorder treated with concentrated exposure therapy

Recommended psychological treatment for obsessive-compulsive disorder (OCD) is cognitive behavioral therapy (CBT) including exposure with response prevention (ERP). Previous studies have identified few consistent predictors of both short- and long-term treatment outcomes in CBT for OCD. The aim of the current study was to investigate the relation between the combined burden of three post-treatment predictors (subclinical symptoms of OCD, anxiety, and depression) and long-term treatment outcome. A total of 97 patients with a diagnosis of OCD from an outpatient clinic in Norway completed a concentrated four-day group treatment of ERP for OCD. Results revealed that patients in the high-risk group had 2.5 times the risk (odds ratio = 10.1) of having OCD at follow-up compared to patients in the low risk group. Pre-treatment levels of depression, anxiety and OCD were not significantly related to follow-up status. The results indicate an advantage of a combined post-treatment predictor model over single pre-treatment predictors. Furthermore, we argue that the intensive four-day treatment format provides a unique setting for investigating predictors of treatment outcome

Post-treatment predictors of follow-up status for obsessive-compulsive disorder treated with concentrated exposure therapy

Recommended psychological treatment for obsessive-compulsive disorder (OCD) is cognitive behavioral therapy (CBT) including exposure with response prevention (ERP). Previous studies have identified few consistent predictors of both short- and long-term treatment outcomes in CBT for OCD. The aim of the current study was to investigate the relation between the combined burden of three post-treatment predictors (subclinical symptoms of OCD, anxiety, and depression) and long-term treatment outcome. A total of 97 patients with a diagnosis of OCD from an outpatient clinic in Norway completed a concentrated four-day group treatment of ERP for OCD. Results revealed that patients in the high-risk group had 2.5 times the risk (odds ratio = 10.1) of having OCD at follow-up compared to patients in the low risk group. Pre-treatment levels of depression, anxiety and OCD were not significantly related to follow-up status. The results indicate an advantage of a combined post-treatment predictor model over single pre-treatment predictors. Furthermore, we argue that the intensive four-day treatment format provides a unique setting for investigating predictors of treatment outcome

Vilka faktorer är viktiga för inlärning med laborativ matematik?

Laborativ matematik har under flera år varit ett viktigt inslag i min matematikundervisning. När jag skulle göra en undersökning passade det bra att titta på vilka faktorer som påverkar inlärningen med hjälp av laborationer. Vi fick fram faktorerna genom en diskussion i fokusgrupp. Dessa faktorer viktades och betygsattes både allmänt för laborationer och efter en laboration vi utförde i klassen. Det jag kan se utifrån elevernas betygsättning och viktning är att de tycker att samarbetet i gruppen och respekten för individens egna tankar är det viktigaste. Eleverna tyckte att det var viktigt att få jobba självständigt i gruppen utan lärarstyrning. När eleverna fick olika styrning på genomförandet av laborationen kunde de upptäcka olika saker som de sedan delade med sig till varandra

Changes in contamination-related obsessions and compulsions during the COVID-19 pandemic: A Norwegian longitudinal study

Background: Early stages of the COVID-19 pandemic have been associated with increasing obsessive-compulsive symptoms (OCS), but less is known regarding these symptoms’ long-term trajectories. The aim of this study was to examine changes in contamination-related OCS in the Norwegian public during early and late stages of the pandemic, as well as characteristics that might be associated with these changes. Methods: In a longitudinal online survey, 12 580 participants completed self-report questionnaires in April 2020, including a retrospective assessment of contamination-related OCS severity (DOCS-SF) prior to COVID-19. In December 2020, 3405 (27.1%) of the participants completed the survey again. Results: In April, participants retrospectively recalled that their contamination-related OCS were lower prior to COVID-19 (d = 1.09). From April to December, symptoms slightly decreased (d = −0.16). The proportion of participants scoring above the clinical cut-off on DOCS-SF (≥16) changed accordingly from 2.4% pre-COVID to 27.8% in April and 24.0% in December. Previous severity of contamination-related OCS and symptoms of distress related to COVID-19 were the most powerful predictors of contamination-related OCS severity during the pandemic. Conclusions: Elevated levels of contamination-related OCS were detected at both early and late stages of the pandemic, but the long-term symptom trend seems to be slightly declining.publishedVersio