Cited by 223Psychotherapy Techniques and ApplicationsDigital Mental Health InterventionsAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Negative Effects of Psychological Treatments: An Exploratory Factor Analysis of the Negative Effects Questionnaire for Monitoring and Reporting Adverse and Unwanted Events

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Rozental, Alexander, Kottorp, Anders, Boettcher, Johanna, Andersson, Gerhard, Carlbring, Per·2016·PLOS ONE

Abstract

Research conducted during the last decades has provided increasing evidence for the use of psychological treatments for a number of psychiatric disorders and somatic complaints. However, by focusing only on the positive outcomes, less attention has been given to the potential of negative effects. Despite indications of deterioration and other adverse and unwanted events during treatment, little is known about their occurrence and characteristics. Hence, in order to facilitate research of negative effects, a new instrument for monitoring and reporting their incidence and impact was developed using a consensus among researchers, self-reports by patients, and a literature review: the Negative Effects Questionnaire. Participants were recruited via a smartphone-delivered self-help treatment for social anxiety disorder and through the media (N = 653). An exploratory factor analysis was performed, resulting in a six-factor solution with 32 items, accounting for 57.64% of the variance. The derived factors were: symptoms, quality, dependency, stigma, hopelessness, and failure. Items related to unpleasant memories, stress, and anxiety were experienced by more than one-third of the participants. Further, increased or novel symptoms, as well as lack of quality in the treatment and therapeutic relationship rendered the highest self-reported negative impact. In addition, the findings were discussed in relation to prior research and other similar instruments of adverse and unwanted events, giving credence to the items that are included. The instrument is presently available in eleven different languages and can be freely downloaded and used from www.neqscale.com.

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Authors
Rozental, A., Kottorp, A., Boettcher, J., Andersson, G., & Carlbring, P.
Affiliations
  • Stockholm University (SE)
  • Karolinska Institutet (SE)
  • Freie Universität Berlin (DE)
  • Linköping University (SE)
Corresponding author
Rozental, Alexander
Venue
PLOS ONE
Published
2016-06-22
Volume
11
Issue
6
Pages
e0157503
ISSN
1932-6203 (ISSN-L)
OpenAlex
W2472395746
Cited by
223
References
94
Citations by year
2026: 23 · 2025: 39 · 2024: 23 · 2023: 27 · 2022: 31 · 2021: 20 · 2020: 16 · 2019: 25 · 2018: 12 · 2017: 6 · 2016: 1
FWCI
19.61
Type
journal article
Language
en
Open access
Locations
  • PLoS ONE (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DiVA (Linkoping University) (submittedVersion, other-oa)
  • Zürcher Hochschule für Angewandte Wissenschaften digital collection (Zurich University of Applied Sciences) (submittedVersion, cc-by-nc-nd)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Refubium (Universitätsbibliothek der Freien Universität Berlin) (submittedVersion, cc-by)
  • ZHAW Digital Collection (cc-by)
Funders
FORTE (FORTE 2013-1107)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
  • Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
adverse events, unwanted events, self-report instrument development, social anxiety disorder, symptom deterioration, treatment quality, therapeutic relationship, stigma, hopelessness, factor structure
MeSH terms
Adult, Mental Disorders, Demography, Factor Analysis, Statistical, Female, Humans, Male, Surveys and Questionnaires

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