Individualized metacognitive therapy for delusions. A randomized controlled rater-blind study
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Individualized metacognitive therapy for delusions. A randomized controlled rater-blind study. / Andreou, Christina; Wittekind, Charlotte E; Fieker, Martina; Heitz, Ulrike; Veckenstedt, Ruth; Bohn, Francesca; Moritz, Steffen.
in: J BEHAV THER EXP PSY, Jahrgang 56, Nr. SI, 09.2017, S. 144-151.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Individualized metacognitive therapy for delusions. A randomized controlled rater-blind study
AU - Andreou, Christina
AU - Wittekind, Charlotte E
AU - Fieker, Martina
AU - Heitz, Ulrike
AU - Veckenstedt, Ruth
AU - Bohn, Francesca
AU - Moritz, Steffen
N1 - Copyright © 2016 Elsevier Ltd. All rights reserved.
PY - 2017/9
Y1 - 2017/9
N2 - BACKGROUND: Theory-driven interventions targeting specific factors that contribute to delusions are receiving increased interest. The present study aimed to assess the efficacy of individualized metacognitive therapy (MCT+), a short manualized intervention that addresses delusion-associated cognitive biases.METHODS: 92 patients with current or past delusions were randomized to receive 12 twice-weekly sessions of either MCT+ or a control intervention within a randomized controlled rater-blind design. Psychopathology and cognitive biases were assessed at baseline, 6 weeks and 6 months. ANCOVAs adjusted for baseline scores were used to assess differences between groups regarding outcome variables. Both per-protocol and intention-to-treat analyses were conducted.RESULTS: At 6 weeks, there was a significant difference in favor of MCT+ regarding decrease in delusion severity and improvement of self-reflectiveness (medium effect size), and a trend-wise difference regarding probability thresholds to decision. These effects increased, when only patients attending a minimum of 4 therapy sessions were considered. Control group patients subsequently showed further improvement while patients in the MCT+ group remained stable, such that there were no differences between groups at the 6-month follow-up.LIMITATIONS: Lower attendance rates in the control group possibly leading to unequal therapeutic effort; lower baseline delusion severity in the MCT+ group.CONCLUSIONS: The result pattern suggests that MCT+ led to earlier improvement in delusions and cognitive biases compared to the control intervention. The absence of a long-term effect might reflect floor effects in the MCT+ group, but may also indicate the need for further measures to promote sustainability of MCT+ effects.
AB - BACKGROUND: Theory-driven interventions targeting specific factors that contribute to delusions are receiving increased interest. The present study aimed to assess the efficacy of individualized metacognitive therapy (MCT+), a short manualized intervention that addresses delusion-associated cognitive biases.METHODS: 92 patients with current or past delusions were randomized to receive 12 twice-weekly sessions of either MCT+ or a control intervention within a randomized controlled rater-blind design. Psychopathology and cognitive biases were assessed at baseline, 6 weeks and 6 months. ANCOVAs adjusted for baseline scores were used to assess differences between groups regarding outcome variables. Both per-protocol and intention-to-treat analyses were conducted.RESULTS: At 6 weeks, there was a significant difference in favor of MCT+ regarding decrease in delusion severity and improvement of self-reflectiveness (medium effect size), and a trend-wise difference regarding probability thresholds to decision. These effects increased, when only patients attending a minimum of 4 therapy sessions were considered. Control group patients subsequently showed further improvement while patients in the MCT+ group remained stable, such that there were no differences between groups at the 6-month follow-up.LIMITATIONS: Lower attendance rates in the control group possibly leading to unequal therapeutic effort; lower baseline delusion severity in the MCT+ group.CONCLUSIONS: The result pattern suggests that MCT+ led to earlier improvement in delusions and cognitive biases compared to the control intervention. The absence of a long-term effect might reflect floor effects in the MCT+ group, but may also indicate the need for further measures to promote sustainability of MCT+ effects.
KW - Journal Article
U2 - 10.1016/j.jbtep.2016.11.013
DO - 10.1016/j.jbtep.2016.11.013
M3 - SCORING: Journal article
C2 - 27919404
VL - 56
SP - 144
EP - 151
JO - J BEHAV THER EXP PSY
JF - J BEHAV THER EXP PSY
SN - 0005-7916
IS - SI
ER -