Machulska, Alla
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Publication Access status: Open Access , Intensive smoking cessation treatment as an adjunct to concurrent psychotherapy: study protocol for a randomized controlled trialTobacco use is globally recognized by the World Health Organization as the foremost risk factor for premature mortality. Individuals with mental disorders exhibit a notably heightened dependence on tobacco, approximately twice as high as that of the general population. The long-term effects of nicotine consumption include an exacerbation of depressive symptoms and a decline in mental health, which can be considered additional risk factors for the vulnerable population of smokers with preexisting mental disorders. Successful smoking cessation is associated with an increase in mental health, comparable or superior to that of pharmacological antidepressant treatments. However, smoking is frequently disregarded within the realm of psychotherapeutic care, unlike in the treatment of other substance use disorders. Smoking may hinder patients' recovery and responsiveness to psychotherapy, potentially distorting improvements in symptom severity or negative affect. Integrating smoking cessation initiatives into standard psychotherapeutic interventions thus holds significant potential and may be considered essential for long-term mental health. The current study's objective is to assess the potential of a guideline-based smoking cessation intervention within an outpatient psychotherapeutic setting concerning changes in smoking intensity, nicotine dependence, and mental health outcomes among patients with a mental disorder adjunct to concurrent psychotherapy. This trial aims to bridge the gap between the state of research in light of evidence of the positive effects of successful smoking cessation and the actual practical provision of care in Germany.Source Type:Article10 55 - Some of the metrics are blocked by yourconsent settings
Publication Access status: Open Access , Nicotine-related interpretation biases in cigarette smoking individualsAddictive behaviors are characterized by information processing biases, including substance-related interpretation biases. In the field of cigarette smoking, such biases have not been investigated yet. The present study thus adopted an open-ended scenario approach to measure smoking-related interpretation biases. Individuals who smoke, those who ceased smoking, and those without a smoking history (total sample N = 177) were instructed to generate spontaneous continuations for ambiguous, open-ended scenarios that described either a smoking-related or neutral context. Overall, people who smoke generated more smoking-related continuations in response to smoking-relevant situations than non-smoking individuals or people who had stopped smoking, providing evidence for a smoking-related interpretation bias. When differentiating for situation type within smoking-relevant scenarios, smoking individuals produced more smoking-related continuations for positive/social and habit/addictive situations compared to negative/affective ones. Additionally, the tendency to interpret habit/addictive situations in a smoking-related manner was positively associated with cigarette consumption and levels of nicotine dependence. Exploratory analyses indicated that other substance-related continuations were correlated with their respective behavioral counterparts (e.g., the level of self-reported alcohol or caffeine consumption). The present study is the first to demonstrate smoking-related interpretation biases in relation to current cigarette smoking. Future studies should investigate the causal role of such biases in the initiation and/or maintainance of nicotine addiction and the merit of Interpretation-Bias-Modification training to support smoking cessation.Source Type:Article4 74 - Some of the metrics are blocked by yourconsent settings
Publication Access status: Open Access , Self-guided digital treatment with virtual reality for panic disorder and agoraphobiaBackground Cognitive behavioral therapy is the first-line treatment for patients with panic disorder (PD) and agoraphobia (AG). Yet, many patients remain untreated due to limited treatment resources. Digital self-guided short-term treatment applications may help to overcome this issue. While some therapeutic applications are already supported by health insurance companies, data on their efficacy is limited. The current study investigates the effect of self-guided digital treatment comprising psychoeducation and virtual reality exposure therapy (VRET). Methods Thirty patients diagnosed with PD, AG, or panic disorder with agoraphobia (PDA) will be randomly assigned to either the experimental group (EG) or the control group (CG). Participants of both groups will undergo baseline diagnostics in the first two sessions. The subsequent treatment for the EG consists of a self-guided 6-week phase of application-based psychoeducation, one therapy session preparing for the VRET, and 4 weeks of application-based self-guided VRET. To control for the potential effects of the therapy session with the therapist, the CG will receive relaxation and stress-reduction training instead. All patients will then undergo a closing session which terminates with the post-assessment (~ 10 weeks after baseline assessment) and a follow-up assessment 6 weeks following the closing session. Symptom severity (primary outcome) will be assessed at baseline, interim, post-treatment, and follow-up. Additionally, remission status (secondary outcome) will be obtained at follow-up. Both measures will be compared between the groups. Discussion The current study aims at providing insights into the efficacy of short-term treatment applications including psychoeducation and self-guided VRET. If successful, this approach might be a feasible and promising way to ease the burden of PD, AG, and PDA on the public health system and contribute to a faster access to treatment.Source Type:Article516 255 - Some of the metrics are blocked by yourconsent settings
Publication Access status: Open Access , Self-guided virtual reality therapy for social anxiety disorderBackground Social anxiety disorder (SAD) is a highly prevalent mental disorder associated with enormous stress and suffering. Cognitive behavior therapy (CBT) is the first-line treatment for SAD, yet its accessibility is often constrained with long waiting times. Digital therapeutic applications, including psychoeducation and self-guided behavioral experiments in virtual reality (VR), could facilitate access and reduce waiting times. The study aims to investigate if ultra-short-time therapy involving self-guided digital therapeutic applications with VR components can reduce the severity of SAD. Methods Forty SAD patients will participate in this randomized controlled trial. Half will get access to a self-guided, digital therapeutic application with exposure-based behavioral experiments in VR, while the other half will receive a control treatment. Both treatments include four therapeutic appointments. Changes in the severity of SAD will be measured after each appointment and on a 6-week follow-up assessment and will be compared between groups, with the change in SAD measured at baseline- and post-assessment as primary outcome. Discussion Self-guided digital therapeutic applications including ultra-short-time therapy combined with VR could help reduce the waiting time for patients and relieve the health system. The results of this study may inform psychotherapists regarding the potential of self-guided digital therapeutic applications including exposure-based behavioral experiments in VR for SAD and will provide important insight for future research on VR therapy.Source Type:Article503 225