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  • HU Berlin  (3)
  • FU Berlin
  • Jüdisches Museum
  • 2020-2024  (3)
  • Koelkebeck, Katja
  • Frei verfügbar (Open Access)  (3)
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  • HU Berlin  (3)
  • FU Berlin
  • Jüdisches Museum
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  • 2020-2024  (3)
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  • Frei verfügbar (Open Access)  (3)
  • 1
    UID:
    edochu_18452_27039
    Umfang: 1 Online-Ressource (19 Seiten)
    Inhalt: Background Autism spectrum disorder (ASD) is a chronic neurodevelopmental condition with a prevalence rate above 1%, characterized by deficits in social communication and interaction; restrictive, repetitive patterns of behavior, interests, or activities; and a preference for sameness and routines. The majority of adult ASD patients suffer from comorbid conditions such as depression and anxiety. Therapy options for adult ASD patients are lacking, with presently no available evidence-based interventions in Germany. Recently, two interventions to improve social responsiveness have been published. FASTER (“Freiburger Asperger-Spezifische Therapie für ERwachsene” = Freiburg Asperger-specific therapy for adults) is a manualized group psychotherapy program including three modules on psychoeducation, stress regulation management, and non-verbal and verbal social communication training with videotaped tasks. SCOTT&EVA (“Social Cognition Training Tool”, and its enhancement “Emotionen Verstehen und Ausdruecken” = understanding and expressing emotions) is a computer-based training program to enhance social cognition including video and audio material of emotional expressions and complex real-life social situations. Initial studies for both programs have shown good feasibility and efficacy. Methods Three hundred sixty adult participants with an autism spectrum disorder (ASD) will take part in a randomized controlled three-armed multi-center trial to prove the efficacy of manualized group psychotherapy and a manualized computer-based training program. Both interventions will be compared with a treatment as usual (TAU) group, aiming to establish evidence-based psychotherapy approaches for adult individuals with ASD. The primary outcome is evaluated by parents, spouses, or others who have sufficient insight into the respective participant’s social communication and interaction, and will be measured with the Social Responsiveness Scale. First, each of both interventions will be compared to TAU. If at least one of the differences is significant, both interventions will be compared against each other. The primary outcome will be measured at baseline (T0) and 4 months after baseline (T1). Discussion The trial is the first to validate psychiatric therapeutic and training interventions for adult ASD patients in Germany. A trial is needed because the prevalence of ASD in adulthood without intellectual disability is high, and no evidence-based intervention can be offered in Germany. Trial registration German Clinical Trial Register DRKS00017817. Registered on 20 April 2020.
    Inhalt: Peer Reviewed
    In: London : BioMed Central, 22,1
    Sprache: Englisch
    URL: Volltext  (kostenfrei)
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 2
    UID:
    edochu_18452_27853
    Umfang: 1 Online-Ressource (13 Seiten)
    Inhalt: Background The need to optimize exposure treatments for anxiety disorders may be addressed by temporally intensified exposure sessions. Effects on symptom reduction and public health benefits should be examined across different anxiety disorders with comorbid conditions. Methods This multicenter randomized controlled trial compared two variants of prediction error-based exposure therapy (PeEx) in various anxiety disorders (both 12 sessions + 2 booster sessions, 100 min/session): temporally intensified exposure (PeEx-I) with exposure sessions condensed to 2 weeks (n = 358) and standard nonintensified exposure (PeEx-S) with weekly exposure sessions (n = 368). Primary outcomes were anxiety symptoms (pre, post, and 6-months follow-up). Secondary outcomes were global severity (across sessions), quality of life, disability days, and comorbid depression. Results Both treatments resulted in substantial improvements at post (PeEx-I: dwithin = 1.50, PeEx-S: dwithin = 1.78) and follow-up (PeEx-I: dwithin = 2.34; PeEx-S: dwithin = 2.03). Both groups showed formally equivalent symptom reduction at post and follow-up. However, time until response during treatment was 32% shorter in PeEx-I (median = 68 days) than PeEx-S (108 days; TRPeEx-I = 0.68). Interestingly, drop-out rates were lower during intensified exposure. PeEx-I was also superior in reducing disability days and improving quality of life at follow-up without increasing relapse. Conclusions Both treatment variants focusing on the transdiagnostic exposure-based violation of threat beliefs were effective in reducing symptom severity and disability in severe anxiety disorders. Temporally intensified exposure resulted in faster treatment response with substantial public health benefits and lower drop-out during the exposure phase, without higher relapse. Clinicians can expect better or at least comparable outcomes when delivering exposure in a temporally intensified manner.
    Inhalt: Peer Reviewed
    In: New York, NY [u.a.] : Wiley Interscience, 38,11, Seiten 1169-1181
    Sprache: Englisch
    URL: Volltext  (kostenfrei)
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 3
    UID:
    edochu_18452_27031
    Umfang: 1 Online-Ressource (19 Seiten)
    ISSN: 2167-7026 , 2167-7026
    Inhalt: Individual responses to behavioral treatment of anxiety disorders vary considerably, which requires a better understanding of underlying processes. In this study, we examined the violation and change of threat beliefs during exposure. From 8,484 standardized exposure records of 605 patients with different anxiety disorders, learning indicators were derived: expectancy violation as mismatch between threat expectancy before exposure and threat occurrence, expectancy change as difference between original and adjusted expectancy after exposure, and prediction-error learning rate as extent to which expectancy violation transferred into change. Throughout sessions, high threat expectancy but low occurrence and adjusted expectancy indicated successful violation and change of threat beliefs by exposure. Expectancy violation, change, and learning rate substantially varied between patients. Not expectancy violation itself, but higher learning rate and expectancy change predicted better treatment outcome. Successful exposure thus requires expectancy violation to induce actual expectancy change, supporting learning from prediction error as transdiagnostic mechanism underlying successful exposure therapy.
    Inhalt: Peer Reviewed
    In: London [u.a.] : Sage Publ., 11,2, Seiten 199-217, 2167-7026
    Sprache: Englisch
    URL: Volltext  (kostenfrei)
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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