Cited by 141Gastrointestinal motility and disordersAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesDigital Mental Health Interventions

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Provoking symptoms to relieve symptoms: A randomized controlled dismantling study of exposure therapy in irritable bowel syndrome

Ljótsson, Brjánn, Hesser, Hugo, Andersson, Erik, Lackner, Jeffrey M., El Alaoui, Samir, Falk, Lisa, Aspvall, Kristina, Fransson, Josefin, Hammarlund, Klara, Löfström, Anna, Nowinski, Sanna, Lindfors, Perjohan, Hedman, Erik·2014·Behaviour Research and Therapy

DOI 10.1016/j.brat.2014.01.007

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Abstract

An internet-delivered cognitive behavioral treatment (ICBT) based on systematic exposure exercises has previously shown beneficial effects for patients with irritable bowel syndrome (IBS). Exposure exercises may be perceived as difficult for patients to perform because of the elicited short-term distress and clinicians may be reluctant to use these interventions. The aim of this study was to compare ICBT with the same protocol without systematic exposure (ICBT-WE) to assess if exposure had any incremental value. This randomized controlled dismantling study included 309 participants diagnosed with IBS. The treatment interventions lasted for 10 weeks and included online therapist contact. ICBT-WE comprised mindfulness, work with life values, acceptance, and encouraged reduced avoidance behaviors, while ICBT also included systematic exposure to IBS symptoms and related situations. Severity of IBS symptoms was measured with the Gastrointestinal Symptom Rating Scale - IBS version (GSRS-IBS). The between-group Cohen's d on GSRS-IBS was 0.47 (95% CI: 0.23-0.70) at post-treatment and 0.48 (95% CI: 0.20-0.76) at 6-month follow-up, favoring ICBT. We conclude that the systematic exposure included in the ICBT protocol has incremental effects over the other components in the protocol. This study provides evidence for the utility of exposure exercises in psychological treatments for IBS.

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Behavioral avoidance moderates the effect of exposure therapy for irritable bowel syndrome: A secondary analysis of results from a randomized component trial
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Hybrid Cognitive Behavioral Therapy With Interoceptive Exposure for Irritable Bowel Syndrome: A Feasibility Study
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Self-citation

Authors: Ljótsson, B., Hesser, H., Andersson, E., Lackner, J. M., El Alaoui, S., Falk, L., Aspvall, K., Fransson, J., Hammarlund, K., Löfström, A., Nowinski, S., Lindfors, P., & Hedman, E.
Affiliations: Karolinska Institutet (SE)
Linköping University (SE)
Karolinska University Hospital (SE)
Erie County Medical Center (US)
Sabbatsberg Hospital (SE)
Corresponding author: Ljótsson, Brjánn
ORCID: Ljótsson, Brjánn
Hesser, Hugo
Andersson, Erik
Lackner, Jeffrey M.
Aspvall, Kristina
Nowinski, Sanna
Lindfors, Perjohan
Venue: Behaviour Research and Therapy
Publisher: Elsevier BV
Published: 2014-04
Volume: 55
Pages: 27-39
ISSN: 0005-7967 (ISSN-L)
DOI: 10.1016/j.brat.2014.01.007
OpenAlex: W2034003089
Cited by: 141
References: 71
Citations by year: 2026: 7 · 2025: 13 · 2024: 12 · 2023: 11 · 2022: 15 · 2021: 14 · 2020: 12 · 2019: 11 · 2018: 11 · 2017: 15 · 2016: 7 · 2015: 9 · 2014: 4
FWCI: 11.71
Type: journal article
Language: en
Open access: closed
Locations: Behaviour Research and Therapy (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
Keywords: irritable bowel syndrome, exposure therapy, symptom provocation, mindfulness, acceptance and commitment therapy, avoidance behavior, gastrointestinal symptom severity
MeSH terms: Adult, Combined Modality Therapy, Female, Humans, Implosive Therapy, Male, Therapy, Computer-Assisted, Cognitive Behavioral Therapy, Treatment Outcome, Internet, Irritable Bowel Syndrome, Young Adult

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Provoking symptoms to relieve symptoms: A randomized controlled dismantling study of exposure therapy in irritable bowel syndrome

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