Search

Much sociological and psychological research has been done on excessive or “addictive” Internet use, with increased attention paid to the use of social media sites in particular. This article attempts to understand the addictive engagement with social media from the perspective of self psychology and intersubjective systems theory. This article proposes that social media shares various characteristics with selfobject experience, thus making its use attractive to those longing for missing selfobject experience or the correction of painful self-experience from the past. We will discuss how selfobject experience transforms; outline the way in which social media mimics selfobject experience; examine how such characteristics are alluring to those craving selfobject experience; and explore how the unique interaction between the user and the site affects whether the site contributes to transforming, growth-promoting selfobject experience or becomes a form of self-experience that organizes but fails to transform. [ABSTRACT FROM PUBLISHER]

Depression presents a serious condition for the individual and a major challenge to health care and society. Internet-based cognitive behavior therapy (ICBT) is a treatment option supported in several trials, but there is as yet a lack of effective studies of ICBT in “real world” primary care settings. We examined whether ICBT differed from treatment-as-usual (TAU) in reducing depressive symptoms after 3 months. TAU comprised of visits to general practitioner, registered nurse, antidepressant drugs, waiting list for, or psychotherapy, or combinations of these alternatives. Patients, aged ≥ 18 years, who tentatively met criteria for mild to moderate depression at 16 primary care centers in the south-western region of Sweden were recruited and then assessed in a diagnostic interview. A total of 90 patients were randomized to either TAU or ICBT. The ICBT treatment included interactive elements online, a workbook, a CD with mindfulness and acceptance exercises, and minimal therapist contact. The treatment period lasted for 12 weeks after which both groups were assessed. The main outcome measure was Beck Depression Inventory-II (BDI-II). Additional measures were Montgomery Åsberg Depression Rating Scale – self rating version (MADRS-S) and Beck Anxiety Inventory (BAI). The analyses revealed no significant difference between the two groups at post treatment, neither on BDI-II, MADRS-S, nor BAI. Twenty patients (56%) in the ICBT treatment completed all seven modules. Our findings suggest that ICBT may be successfully delivered in primary care and that the effectiveness, after 3 months, is at par with TAU. [ABSTRACT FROM AUTHOR]

In this study, the authors compared guided Internet-delivered self-help with one-session exposure treatment (OST) in a sample of snake phobic patients. A total of 30 patients were included following a screening on the Internet and a structured clinical interview. The Internet treatment consisted of four weekly text modules which were presented on a web page, a video in which exposure was modelled, and support provided via Internet. The OST was delivered in a three-hour session following a brief orientation session. The main outcome was the behavioural approach test (BAT), and as secondary measures questionnaires measuring anxiety symptoms and depression were used. Results showed that the groups did not differ at post-treatment or follow-up, with the exception of a significant interaction for the BAT in favour of the OST. At post-treatment, 61.5% of the Internet group and 84.6% of the OST group achieved a clinically significant improvement on the BAT. At follow-up, the corresponding figures were 90% for the Internet group and 100% for the OST group (completer sample). Within-group effect sizes for the Snake Phobia Questionnaire were large (d = 1.63 andd = 2.31 for the Internet and OST groups, respectively, at post-treatment). It is concluded that guided Internet-delivered exposure treatment is a potential treatment option in the treatment of snake phobia, but that OST probably is better. [ABSTRACT FROM PUBLISHER]

Background: Cognitive behavior therapy (CBT) has been shown to be an effective treatment for specific phobia in youth, but not all affected seek or receive treatment. Internet-delivered CBT could be a way to increase the availability of empirically supported treatments.Aims: An open trial was conducted to evaluate Internet-delivered CBT for children with specific phobia.Method: Children (N = 30) aged 8–12, and their parents, with a principal diagnosis of specific phobia were recruited through media advertisement. Participants received six weeks of Internet-delivered CBT with therapist support. The treatment was aimed for the parents and the children, with the first part being only for the parents. The primary outcome measure was the Clinician Severity Rating (CSR), and secondary measures included clinician-rated global functioning and child- and parent-reported anxiety and quality of life. All assessments were made at pretreatment, posttreatment, and three-month follow-up.Results: At posttreatment, there were significant reductions on the CSR, with a large within-group effect size (Cohen'sd = 1.0) and 35% of children no longer meeting criteria for specific phobia. Self-report measures from parents and children showed significant effects on anxiety, with small to moderate effect sizes. Effects were maintained at three-month follow-up.Conclusions: Results show that Internet-delivered CBT with therapist support for children with specific phobia has the potential to reduce symptom severity. Randomized controlled trials are needed to further evaluate this treatment format. [ABSTRACT FROM PUBLISHER]

Effective therapies for pathological gambling exist, but their use is limited to about 10% of the target population. In an attempt to lower the barriers for help, Internet-based cognitive behavioural therapy (ICBT) has been shown to be effective when delivered to a non-depressed sample with pathological gambling. This study sought to extend this finding to a larger, more representative population, and also test a model to predict responder status. Following advertisement, a total of 284 participants started an 8-week ICBT programme with minimal therapist contact via e-mail and weekly telephone calls of less than 15 min. The average time spent on each participant, including telephone conversations, e-mail, and administration, was 4 h. In addition to a mixed effects model to evaluate the effectiveness of the treatment, two logistic regression analyses were performed with the following eight pre-defined response predictor variables: work-life satisfaction, primary gambling activity, debts due to gambling, social support, personal yearly salary, alcohol consumption, stage of change, and dissociative gambling. ICBT resulted in statistically significant reductions in the scores of pathological gambling, anxiety, and depression as well as an increase in quality of life compared to pre-treatment levels. Follow-ups carried out in the treatment group at 6, 18, and 36 months indicated that treatment effects were sustained. Using the eight predictor variable model rendered an acceptable predictive ability to identify responders both at post-test (AUC = .72,p < .01) and at 36-month follow-up (AUC = .70,p < .01). We conclude that ICBT for pathological gamblers, even if depressed, can be effective and that outcome can partly be predicted by pre-treatment characteristics. [ABSTRACT FROM AUTHOR]

The loss of a child during pregnancy results in significant psychological stress for many women, and may lead to long-lasting grief and psychological illnesses. However, only a small percentage of those affected seek or receive traditional forms of psychological treatment, and therefore novel treatment approaches and methods are required. This article introduces an Internet-based psychotherapy programme for patients after pregnancy loss. The five-week intervention comprises two components: structured writing disclosure and cognitive-behavioural therapy. Communication between the therapist and patient is text-based and asynchronous. The writing protocol consists of three treatment phases: self-confrontation, cognitive reappraisal and social sharing. A case report is presented to illustrate the course of the treatment and clinical considerations associated with delivering Internet-based interventions to patients after pregnancy loss. [ABSTRACT FROM AUTHOR]

Background: Injured trauma victims are at risk of developing Posttraumatic Stress Disorder (PTSD) and other post-trauma psychopathology. So far, interventions using cognitive behavioral techniques (CBT) have proven most efficacious in treating early PTSD in highly symptomatic individuals. No early intervention for the prevention of PTSD for all victims has yet proven effective. In the acute psychosocial care for trauma victims, there is a clear need for easily applicable, accessible, cost-efficient early interventions. Objective: To describe the design of a randomized controlled trial (RCT) evaluating the effectiveness of a brief Internet-based early intervention that incorporates CBT techniques with the aim of reducing acute psychological distress and preventing long-term PTSD symptoms in injured trauma victims. Method: In a two armed RCT, 300 injured trauma victims from two Level-1 trauma centers in Amsterdam, the Netherlands, will be assigned to an intervention or a control group. Inclusion criteria are: being 18 years of age or older, having experienced a traumatic event according to the diagnostic criteria of the DSM-IV and understanding the Dutch language. The intervention group will be given access to the intervention's website (www.traumatips.nl), and are specifically requested to login within the first month postinjury. The primary clinical study outcome is PTSD symptom severity. Secondary outcomes include symptoms of depression and anxiety, quality of life, and social support. In addition, a cost-effectiveness analysis of the intervention will be performed. Data are collected at one week post-injury, prior to first login (baseline), and at 1, 3, 6 and 12 months. Analyses will be on an intention-to-treat basis. Discussion: The results will provide more insight into the effects of preventive interventions in general, and Internet-based early interventions specifically, on acute stress reactions and PTSD, in an injured population, during the acute phase after trauma. We will discuss possible strengths and limitations. [ABSTRACT FROM AUTHOR]

Objective: To examine memory self-awareness abilities in individuals with moderate-to-severe traumatic brain injury (TBI) using both ‘online assessment’ and ‘offline assessment’ methodologies. Design and methods: Participants were 23 individuals with TBI and 23 controls matched on age, education and sex. Online assessment of memory was assessed by comparing the predicted amount of information participants expected that they would remember following trial 1, trial 5 and a 20-minute delay with actual memory performance on list-learning and visuospatial memory tests. Offline assessment of memory involved contrasting self-ratings provided by TBI participants about their everyday memory functioning with ratings from knowledgeable informants and with performance on objective memory tests. Results: Individuals with TBI displayed poorer recall for newly learned information than control participants, but no significant group differences emerged in the online assessment of memory self-awareness. The offline assessment comparisons similarly demonstrated that the individuals with TBI exhibited accurate awareness for their everyday memory performances. Conclusions: These findings suggest intact memory self-awareness following moderate-to-severe TBI during the early stages of recovery (2–10 months post-injury). [ABSTRACT FROM AUTHOR]

The current study evaluated the dropout rate from an internet-based treatment program for erectile dysfunction (ED), and determined reasons for attrition from this program. Only 12 of 40 treatment group men and 19 of 20 control group men completed the post-test measures. Reasons for the men being excluded or dropping out of the study are discussed. These reasons included medical conditions that contributed to their ED, the man's partner not being interested in participating in the program, a lack of motivation from the man, or the time commitment being too demanding. [ABSTRACT FROM AUTHOR]

Results are described of a pilot study of the efficacy of sex therapy through the Internet for thirty-nine men with erectile dysfunction or rapid ejaculation. Treatment consisted of sex therapy (Masters & Johnson, 1970), had a duration of three months, and was conducted entirely through e-mail. Forty-six percent of the participants dropped out. Fourteen (67%) participants reported an improvement of their sexual functioning. Seven (47%) participants reported the improvement had sustained one month after termination, eight (53%) participants reported no further change. We conclude that sex therapy through the Internet may yield positive results and that further controlled studies are warranted. [ABSTRACT FROM AUTHOR]

The current study evaluated a new Internet-based self-help guide based on cognitive–behavioural therapy for patients with bulimic symptoms. Thirty-eight participants from a waiting list at an eating-disorder outpatient unit were assessed pre-treatment, post-treatment and at a 2-month follow-up using the Rating of Anorexia and Bulimia interview-revised version, an anamnesis questionnaire, the Eating Disorder Inventory-2 (EDI-2) and Symptom Check List-90-Revised (SCL-90R). The SCL-90R Global Severity Index and most EDI-2 subscales showed significant differences from pre-to post-treatment and the 2-month follow-up, apart from ineffectiveness, impulse regulation and social insecurity. Expert ratings revealed a significant reduction in vomiting, dietary restraints and weight phobia, with the exception of binge eating from pre-treatment to the 2-month follow-up. Exercise increased significantly, indicating that participants changed their method of compensation. An Internet-based self-help guide for bulimic symptoms is a promising new tool and can be used effectively as the first step in a stepped-care model. Further evaluations with randomized controlled trials are necessary. [ABSTRACT FROM AUTHOR]

We investigated a group of men suffering from electric dysfunction (ED) who visited the website www.erectie.info and who had received consultation through the Internet ( n = 219). We measured the treatment's effectiveness using the 5-item version of the International Index of Erectile Function (IIEF-5; Rosen et al., 1996; Rosen, Cappelleri, Smith, Lipsky, & Pena, 1999) and a global assessment question (GAQ). We investigated the motives and characteristics of the users of electronics consultation using a questionnaire. After a few months, the consultation group showed a considerably higher IIEF-5 score compared with their baseline score. Eighty-one percent replied in the affirmative to the GAQ. E-consultation is likely to be effective when treating ED, especially among men who find the medium convenient and for men who experience much embarrassment. [ABSTRACT FROM AUTHOR]