期刊
BEHAVIOR THERAPY
卷 53, 期 6, 页码 1205-1218出版社
ELSEVIER INC
DOI: 10.1016/j.beth.2022.06.006
关键词
persistent somatic symptoms; internet intervention; cognitive behavioral therapy; emerging adults; therapist guidance
Internet-delivered cognitive behavioral therapy with regular guidance is not significantly superior to guidance-on-demand in alleviating somatic symptom distress and associated psychopathology in emerging adults.
Persistent somatic symptoms of varying etiology are very common in emerging adults and can lead to distress and impairment. Internet-delivered interventions could help to prevent the burden and chronicity of persistent somatic symptoms. This study investigated the impact of therapist guidance on the effectiveness of a cognitive-behavioral Internet intervention for somatic symptom distress (iSOMA) in emerging adults, as a secondary analysis of a two-armed randomized controlled trial. We included 149 university students (83.2% female, 24.60 yrs) with varying degrees of somatic symptom distress who were either allo-cated to the 8-week intervention with regular, written ther-apeutic guidance (iSOMA guided) or to the control group (waitlist), which was afterwards crossed over to receive iSOMA with guidance-on-demand (iSOMA-GoD). Pri-mary outcomes were somatic symptom distress (assessed by the PHQ-15) and psychobehavioral symptoms of the somatic symptom disorder (assessed by the SSD-12) at pre-and post-treatment. Secondary outcomes included depression, anxiety, and disability. Both treatments showed statistically significant pre-post improvements in primary (iSOMA-guided: d= 0.86-0.92, iSOMA-GoD: d= 0.55-0.63) and secondary outcomes. However, intention-to-treat analysis revealed non-significant between-group effects for all outcomes (ps > .335), after controlling for confounding variables, and effect sizes were marginal (d =-0.06 to 0.12). Overall, our findings indi-cate that Internet-delivered cognitive behavioral therapy with regular guidance is not unequivocally superior to guidance-on-demand in alleviating somatic symptom dis-tress and associated psychopathology in emerging adults. As a next step, non-inferiority studies are needed to test the robustness of these findings and their impact on clinical populations.
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