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Self-selected or Predetermined Internet-based Treatment for Generalized Anxiety Disorder With Different Types of Support

Not Applicable
Completed
Conditions
Generalized Anxiety Disorder
Interventions
Behavioral: Self-selected treatment
Behavioral: Predetermined treatment
Behavioral: Weekly support
Behavioral: Support on demand
Registration Number
NCT03807193
Lead Sponsor
Linkoeping University
Brief Summary

This study evaluates two types of internet-based treatments for generalized anxiety disorder and two types of support. The treatments are a predetermined program for generalized anxiety disorder and a self-selected treatment. The different types of support are either a weekly contact trough a secure message system or support on demand.

Detailed Description

Generalized anxiety disorder (GAD) is characterize by and excessive and uncontrollable worry that is present more days than not. The disorder is best described as a chronic condition with periods with more or less symptoms. The disorder is highly disabling with low quality of life for the individual and is associated with and high costs for society. Previous studies on internet-based cognitive behavior therapy for GAD has shown positive effects but there are still room for improvement.

The aim of this study is to evaluate two different internet-based treatments as well as two types of support through the use of a factorial design. The participants will be recruited trough advertising. After registration on the study's website the potential participants will be asked to answer screening questionnaires and demographic data for an initial screening. Those meeting inclusion criteria will be contacted for a diagnostic interview based Mini-International Neuropsychiatric Interview (M.I.N.I.). If meeting the study's inclusion criteria and not the exclusion criteria the participant will be included in the study and randomized to one of the four arms. The four arms are: Predetermined treatment program with weekly support, Predetermined treatment program with support on demand, Self-selected treatment with weekly support, Self-selected treatment with support on demand.

The predetermined treatment program is designed for treatment of worry and generalized anxiety disorder. It is based on newer forms of cognitive behavior therapy and includes mindfulness and acceptance. In the self-selected treatment the participants will select treatment interventions with the help of a manual and encouraged to choose interventions that they feel address their specific problems. The interventions that will be available are all based on standard cognitive behavior therapy techniques. The weekly support will be scheduled and delivered by clinical psychology students under supervision. This contact will be based on reports from the participants on the weeks work with the program and exercises. The support on demand will be also be delivered by clinical psychology students under supervision. This support takes place if and when the participant ask for support. Treatment will be 8 weeks long and both treatments will be delivered through the same platform. Contact with the participants will be trough written messages on a secure platform.

After the eight weeks of treatment the participants will be asked to answer the same measures as before the treatment as well as questions regarding how they experience the treatment. Follow up data will be collected at later points.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
85
Inclusion Criteria
  • At least 18 years old
  • fulfilling criteria for generalized anxiety syndrome
  • 45 points or more on PSWQ
  • Able to read and write in Swedish
  • Have daily access to a computer and internet
Exclusion Criteria
  • Alcohol or substance abuse
  • Acute suicidal
  • Ongoing psychological treatment
  • Ongoing medication for anxiety or depression that is planned to be adjusted during the time of the treatment given in the study
  • Complex psychiatric illness that highly disabling

Study & Design

Study Type
INTERVENTIONAL
Study Design
FACTORIAL
Arm && Interventions
GroupInterventionDescription
Selected treatment, weekly supportSelf-selected treatmentSelect their own treatment material and have weekly support.
Selected treatment, weekly supportWeekly supportSelect their own treatment material and have weekly support.
Selected treatment, support on demandSelf-selected treatmentSelect their own treatment material and have access to support on demand.
Fixed treatment, weekly supportPredetermined treatmentReceives a predetermined treatment program and have weekly support.
Fixed treatment, support on demandPredetermined treatmentReceives a predetermined treatment program and have access to support on demand.
Fixed treatment, weekly supportWeekly supportReceives a predetermined treatment program and have weekly support.
Fixed treatment, support on demandSupport on demandReceives a predetermined treatment program and have access to support on demand.
Selected treatment, support on demandSupport on demandSelect their own treatment material and have access to support on demand.
Primary Outcome Measures
NameTimeMethod
Change from baseline in Penn State Worry Questionnaire (PSWQ)Baseline, 8 weeks, 24 months and 36 months after treatment

Measures symptoms severity of worry. 16 items, with score range 16-80. Higher score indicates worse symptoms

Secondary Outcome Measures
NameTimeMethod
Brunnsviken Brief Quality of life scale (BBQ)Baseline, 8 weeks, 24 months and 36 months after treatment

12 items, measures the quality of life. 12 items with score 0-96. Higher score indicate higher quality of life

Acceptance and Action Questionnaire II (AAQ-II)Baseline, 8 weeks, 24 months and 36 months after treatment

Measure of psychological flexibility. 7 items with score range 7-49 with higher scores indicate lower psychological flexibility

General self-efficacy scaleBaseline, 8 weeks, 24 months and 36 months after treatment

Measure of percieved self-efficay. 10 items rated on a four-point Likert scale. Score range 10-40 with a higher score indicating a higher percieved self-efficacy.

Change from baseline in Beck Anxiety Inventory (BAI)Baseline, 8 weeks, 24 months and 36 months after treatment

Measure of anxiety symptoms. 21 items with score range 0-63. Higher scores indicate greater symptom severity

Change from baseline in Patient Health Questionnaire (PHQ-9)baseline and weekly during 8 weeks treatment. 24 months and 36 months after treatment

Screening measure for depressive symptoms. 9 items with score range 0-27. Higher scores indicate greater symptom severity

Beck Depression II Inventory (BDI-II)Baseline, 8 weeks, 24 months and 36 months after treatment

Measure of severity of depressive symptoms. 21 items with score range 0-63. Higher scores indicate greater symptom severity

Change from baseline in Generalized Anxiety Disorder Questionnaire IV (GAD-Q-IV)Baseline, 8 weeks, 24 months and 36 months after treatment

Designed to capture the criteria for generalized anxiety disorder according to diagnostic and statistical manual of mental disorders (DSM), 9 items with score range 0-12. Higher scores indicate greater symptom severity

Change from baseline in Generalized Anxiety Disorder-7 (GAD-7)baseline and weekly during 8 weeks treatment. 24 months and 36 months after treatment

Screening measure for worry and anxiety symptoms. 7 items, score range 0-21. Higher scores indicate greater symptom severity

Trial Locations

Locations (1)

Linköpings universitet

🇸🇪

Linköping, Östergötland, Sweden

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