Sudden gains in internet-based cognitive behaviour therapy for severe health anxiety
Open accessAbstract
Objective A sudden gain is defined as a large and stable individual improvement occurring between two consecutive treatment sessions. Sudden gains have been shown to predict better long-term improvement in several treatment studies, including cognitive behavioural therapy for depression and anxiety disorders, but have not been studied in the treatment of health anxiety or any form of internet-based cognitive behavioural therapy. The aim of this study was to investigate the role of sudden gains in internet-based cognitive behavioural therapy for severe health anxiety. Method We examined the occurrence and significance of sudden gains in measures of health anxiety in 81 participants receiving internet-based cognitive behavioural therapy. We compared patients with sudden gains, patients without sudden gains, and patients with gradual gains. Results Thirteen participants (16%) experienced one sudden gain in health anxiety with individual sudden gains distributed across the treatment. As expected, patients with a sudden gain showed larger improvements than patients without a sudden gain at post-treatment (d = 1.04) and at one-year follow-up (d = 0.91) on measures of health anxiety. Conclusions Consistent with previous studies, sudden gains in internet-based cognitive behavioural therapy are associated with significantly larger and stable treatment effects up to one-year follow-up.
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Sudden gains predict larger improvements at both post-treatment and one-year follow-up in patients receiving ICBT for severe health anxiety.
“sudden gains (i.e., large and stable improvements occurring between two consecutive treatment sessions) have been found to predict larger improvements at both posttreatment and oneyear followup in patients receiv ing ICBT for severe health anxiety 90 .”
From Internet-delivered psychological treatments: from innovation to implementation (2019) · cites this paper as [90]
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- Authors
- Hedman, E., Lekander, M., Ljótsson, B., Lindefors, N., Rück, C., Hofmann, S. G., Andersson, E., Andersson, G., & Schulz, S. M.
- Affiliations
- Karolinska Institutet (SE)
- Boston University (US)
- Linköping University (SE)
- University of Würzburg (DE)
- Corresponding author
- Schulz, Stefan M.
- ORCID
- Venue
- Behaviour Research and Therapy
- Publisher
- Elsevier BV
- Published
- 2014-03
- Volume
- 54
- Pages
- 22-29
- ISSN
- 0005-7967 (ISSN-L)
- PMC
- PMC3943582
- OpenAlex
- W2044236450
- Semantic Scholar
- b0926e13e64f28a8967cd8014bde04554af46060
- Cited by
- 32
- References
- 66
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 3 · 2021: 4 · 2020: 3 · 2019: 6 · 2018: 3 · 2017: 5 · 2016: 3 · 2015: 2 · 2013: 1
- FWCI
- 5.16
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Behaviour Research and Therapy (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Bundesministerium für Bildung und Forschung
- Karolinska Institutet
- Stockholms Läns Landsting
- National Institutes of Health
- National Center for Complementary and Integrative Health (R01AT007257)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- sudden gains, internet-based cognitive behavioral therapy, health anxiety, treatment response, long-term treatment outcomes
- MeSH terms
- Adult, Female, Humans, Hypochondriasis, Male, Psychiatric Status Rating Scales, Cognitive Behavioral Therapy, Treatment Outcome, Cross-Over Studies, Remote Consultation, Internet
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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