Targeting excessive avoidance behavior to reduce anxiety related to asthma: A feasibility study of an exposure-based treatment delivered online

Internet Interventions

Josefin Särnholm¹  Erik Andersson²  Cecilia Lundholm³  Catarina Almqvist⁴  Maria Lalouni⁵  Sten-Erik Bergström⁵  Marianne Bonnert⁶  Eva Serlachius⁷ 

[1] Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Sweden, Norra Stationsgatan 69, 113 64 Stockholm, Sweden;Corresponding author at: Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden, Nobels väg 12, 171 65 Stockholm, Sweden.;Stockholm Health Care Services, Region Stockholm, CAP Research Centre, Gävlegatan 22, SE-113 30 Stockholm, Sweden;Department of Clinical Neuroscience, Division of Neuro, Karolinska Institutet, Sweden, Nobels väg 9, 171 65 Stockholm, Sweden;Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Sweden, Nobels väg 9, 171 65 Stockholm, Sweden;Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden, Nobels väg 12, 171 77 Stockholm, Sweden;Pediatric Allergy and Pulmonology Unit at Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden;

关键词: Asthma;    Anxiety;    Avoidance behavior;    Cognitive behavior therapy;   

DOI  :  

来源: DOAJ

【 摘 要 】

There is an established relationship between anxiety and asthma, which is associated with poor health outcomes. Most previous cognitive behavior therapies (CBT) have focused on comorbid panic disorder whereas anxiety related to asthma may rather be illness-specific. The feasibility of an online CBT targeting avoidance behavior in anxiety related to asthma was evaluated, using a pretest-posttest design. Thirty participants with self-reported anxiety related to asthma were offered an eight-week treatment with therapist support. Mean adherence was good (80% of content), and most participants (89%) reported adequate relief after treatment. Catastrophizing about asthma (CAS), assessed at 2 months after treatment, improved significantly with a large effect size (Cohen's d = 1.52). All secondary outcomes, including asthma control, avoidance behavior, fear of asthma symptoms and quality of life, improved significantly with moderate to large effect sizes (d: 0.40–1.44). All improvements were stable at 4 months follow up. Weekly ratings showed that a decrease in avoidance behavior predicted a decrease in CAS the following week throughout the treatment period. We conclude that CBT targeting avoidance behavior is a feasible treatment for anxiety related to asthma. The results justify investigation of efficacy and mechanisms of change in a randomized controlled trial.ClinicalTrials.gov, ID: NCT03486756.

【 授权许可】

Unknown