# Cognitive Behavioural Therapy studies and articles



## eric (Jul 8, 1999)

If you find CBT studies please post them here. Also Please don't posst comments to this forum but reserve it for studies and post to the forum comments please. ThanksAust N Z J Psychiatry 2000 Apr;34(2):300-9 Related Articles, Books, LinkOut Cognitive-behaviour therapy as a treatment for irritable bowel syndrome: a pilot study. Boyce P, Gilchrist J, Talley NJ, Rose D Department of Psychological Medicine, The University of Sydney, Nepean Hospital, Penrith, New South Wales, Australia. pboyce###mail.usyd.edu.au OBJECTIVE: The irritable bowel syndrome (IBS) is a chronic and often disabling functional bowel disorder. Psychological treatments, in particular cognitive and behavioural interventions, have been shown to be effective for this disorder. The aim of this study was to test the efficacy of a cognitive-behaviour program. METHOD: Eight participants (seven female, one male) aged between 24 and 71 years, with a diagnosis of IBS according to the Rome criteria, were recruited from among the gastroenterology outpatients at Nepean Hospital, in Sydney, Australia. Participants were administered pretreatment on measures of psychological function and bowel symptom severity. Following a 2-week baseline period, participants began a structured psychological treatment comprising eight sessions of cognitive-behaviour therapy. Throughout treatment, participants maintained daily records of symptom severity and completed homework assignments to ensure treatment compliance. The pretreatment assessment measures were repeated 1 week post-treatment. RESULTS: After treatment, five of the eight patients no longer met the Rome diagnostic criteria for IBS. There was no significant reduction in bowel symptom frequency. There were, however, significant improvements in the distress and disability associated with bowel symptoms. Anxiety and depression were also significantly reduced. CONCLUSIONS: Cognitive-behaviour therapy reduced the distress and disability associated with IBS, but not the frequency of bowel symptoms. This supports the proposed cognitive model for IBS, and cognitive-behaviour therapy appears to have its effect by altering the cognitive response to visceral hypersensitivity. PMID: 10789535, UI: 20248397 Am J Gastroenterol 2000 Apr;95(4):981-94 Related Articles, Books, LinkOut The combination of medical treatment plus multicomponent behavioral therapy is superior to medical treatment alone in the therapy of irritable bowel syndrome. Heymann-Monnikes I, Arnold R, Florin I, Herda C, Melfsen S, Monnikes H Department of Internal Medicine, Philipps-University of Marburg, Germany. OBJECTIVE: Although the standard treatments for the irritable bowel syndrome (IBS) are medical, growing evidence indicates the substantial therapeutic value of psychological therapy. However, it has not been investigated whether the combination of multicomponent behavioral therapy plus medical treatment is more effective than medical treatment alone. The aim of this study was to investigate this question in patients consulting a tertiary gastrointestinal (GI) referral center. METHODS: Twenty-four IBS outpatients were randomly assigned to the combination of standardized multicomponent behavioral therapy plus standard medical treatment (SMBT) or standard medical treatment alone (SMT). SMBT included IBS information and education, progressive muscle relaxation, training in illness-related cognitive coping strategies, problem-solving, and assertiveness training in 10 sessions over 10 wk. SMT included standardized symptom-oriented medical treatment and regular visits to a gastroenterologist every second week. Posttreatment outcome measures consisted of quantification of GI, vegetative, and psychological symptoms by means of daily symptom diaries and the assessment of changes in rectovisceral perception thresholds, as well as of questionnaire measures on psychological distress, overall well-being, illness-related coping abilities, and quality of life. Follow-ups were conducted at 3- and 6-month intervals. RESULTS: Pre- and posttreatment evaluations showed significantly (p < 0.01) greater IBS symptom reduction as measured by daily symptom diaries for the SMBT group than for the SMT group. Rectovisceral perception remained unchanged by either treatment. Overall well-being significantly improved in the SMBT group but remained unchanged in the SMT group. Subjects in the SMBT group, unlike those in the SMT group, felt significantly more in control of their health, and quality of life was significantly improved in the SMBT group but remained unchanged in the SMT group. CONCLUSIONS: The data provide evidence that the combination of medical treatment plus multicomponent behavioral treatment is superior to medical treatment alone in the therapy of IBS. Publication Types: Clinical trial Randomized controlled trial Comments: Comment in: Am J Gastroenterol 2000 Apr;95(4):863-4 PMID: 10763948, UI: 20225018 Baillieres Best Pract Res Clin Gastroenterol 1999 Oct;13(3):473-87 Related Articles, Books, LinkOut Harnessing the patient's powers of recovery: the role of the psychotherapies in the irritable bowel syndrome. Read NW Centre for Human Nutrition, University of Sheffield, Northern General  Hospital, UK. The aim of this chapter is to provide a clear and balanced account of the role of the various forms of psychotherapy in the irritable bowel syndrome (IBS). It commences with an account of the philosophical basis for psychotherapy, attempting to integrate the concepts of autonomic arousal, repression, conversion and a developmental disorder of thinking and emotional expression. These concepts are used to explain why separation and loss can lead to the development of IBS and how the gut is such an important vehicle for emotional expression. Against this background the role and philosophy of relaxation therapy, hypnotherapy, biofeedback, cognitive behavioural therapy and analytical psychotherapy are discussed. These therapies describe a philosophical approach that is quite different from biomedical treatments in that it attempts to harness the patient's own powers for recovery. For that reason the efficacy of psychotherapies cannot be evaluated by randomized controlled trials. Psychotherapies rely on the relationship between therapist and patient and vary according to whether the locus of responsibility lies mainly with the therapist or mainly with the patient. Different patients may well require different therapies. Publication Types: Review Review, tutorial PMID: 10580923, UI: 20045408 Psychosom Med 1998 Jul-Aug;60(4):492-7 Related Articles, Books, LinkOut The development of a cognitive scale for functional bowel disorders. Toner BB, Stuckless N, Ali A, Downie F, Emmott S, Akman D Women's Mental Health Research Programme, Clarke Institute of Psychiatry, Toronto, Ontario, Canada. OBJECTIVE: The importance of psychosocial factors in patients with Functional Bowel Disorders (FBD) has been well-established. However, most psychosocial measures used in research with FBD patients were not designed or validated on this population. A recent international team report recommended that psychosocial measures be developed to increase our understanding and treatment of FBD. The purpose of this study was to develop a reliable and valid instrument designed specifically to assess cognitions of patients with FBD. METHOD: An initial set of 204 scale items was generated from a large pool of thought diaries from patients diagnosed with FBD. Items were additionally refined using several methods, including consultation with a multidisciplinary team of international experts on FBD. The remaining 95 items were administered, along with a set of validating questionnaires, to a new sample of 75 FBD patients in Canada and the United States. RESULTS: The findings indicate that the final 25-item scale has high reliability (Cronbach's alpha = .93; inter-item correlation = .36); high concurrent criterion validity evidenced by the correlation of the scale with a global rating of life interference caused by bowel symptoms (r = .71; p<.001); acceptable convergent validity evidenced by the correlation of the scale with the Dysfunctional Attitudes Scale (r = .38; p<.01); high content validity and face validity; and minimal social desirability contamination (r = .15; NS). CONCLUSIONS: The Cognitive Scale for Functional Bowel Disorders is a valid and reliable scale that can be used as an outcome measure in evaluating the efficacy of different forms of psychotherapeutic intervention for FBD, and can also serve as a helpful assessment tool for health professionals working with patients diagnosed with FBD. PMID: 9710296, UI: 98374070 Int J Group Psychother 1998 Apr;48(2):215-43 Related Articles, Books, LinkOut Cognitive-behavioral group therapy for patients with irritable bowel syndrome. Toner BB, Segal ZV, Emmott S, Myran D, Ali A, DiGasbarro I, Stuckless N Women's Mental Health Research Program, Clarke Institute of Psychiatry, University of Toronto. This article is divided into two parts, the first of which focuses on a general overview of irritable bowel syndrome (IBS) and provides a rationale for the use of cognitive-behavioral therapy (CBT) for IBS based on both theoretical and research perspectives. This section includes a critical review of CBT therapies for IBS and provides a model of CBT for IBS. The second section provides the clinician with practical information concerning the application of cognitive-behavioral group therapy for IBS. Possible scripts and case examples are incorporated into this section to highlight factors that may arise in working with IBS patients relative to other clinical groups. The second section also contains themes that are suggested content areas for group sessions. Contingent on the formulation of the presenting or emerging issues and goals, the order and inclusion of themes can be changed to fit the particular needs of a given group. Finally, this section provides initial preliminary data from a randomized controlled study that is suggestive of the efficacy of cognitive-behavioral therapy for IBS. Publication Types: Clinical trial Randomized controlled trial Review Review, tutorial PMID: 9563239, UI: 98224343 Psychosom Med 1996 Sep-Oct;58(5):508-14 Related Articles, Books, LinkOut Cognitive-behavioral group therapy for irritable bowel syndrome: effects and long-term follow-up. van Dulmen AM, Fennis JF, Bleijenberg G Department of General Practice and Social Medicine, University of Nijmegen, The Netherlands. Little is known about the effectiveness of cognitive behavioral treatment for patients with irritable bowel syndrome on a group basis. Previous studies have used only small samples, and studies with long term follow-up are lacking. The arm of the present study was to investigate: a) the effectiveness of a cognitive-behavioral group treatment compared with a waiting list control condition in alleviating abdominal complaints and







the long term effectiveness of cognitive-behavioral group treatment. In study 1, we performed a controlled study with 25 patients in the group treatment condition and 20 patients in the waiting list control condition. Treatment consisted of eight 2-hour group sessions over a period of 3 months. In study 2, all patients were treated and followed up for an average of 2.25 years (range 6 months-4 years) after the completion of the group treatment. The abdominal complaints of the patients who underwent treatment were found to improve significantly more than the complaints of the patients awaiting treatment. Moreover, in agreement with the purpose of the therapy, the number of successful coping strategies was found to increase more and patients' avoidance behavior was found to decrease more in the treatment group than in the waiting list control group. The positive changes appeared to persist during follow-up. Cognitive-behavioral group treatment is effective in alleviating irritable bowel syndrome, in stimulating coping strategies, and in reducing avoidance behavior. At long term follow-up, the abdominal complaints, the number of successful coping strategies, and the avoidance behavior were still improved compared with the pretreatment assessment. PMID: 8902902, UI: 97058583 J Consult Clin Psychol 1995 Oct;63(5):779-86 Related Articles, Books, LinkOut A controlled comparison of cognitive therapy and self-help support groups in the treatment of irritable bowel syndrome. Payne A, Blanchard EB Center for Stress and Anxiety Disorders, University at Albany, State University of New York, USA. Thirty-four patients with irritable bowel syndrome were randomly assigned to 1 of 3 treatment conditions: individualized cognitive treatment (CT), self-help support group (SG), or symptom-monitoring waiting-list control (WL). Each of the 3 conditions lasted approximately 8 weeks. Pre- to posttreatment analyses revealed significantly greater reductions in both individual gastrointestinal (GI) symptoms and in a composite index for GI symptom change for the CT condition than for the SG or WL conditions. When compared with the SG and WL conditions, the CT condition also showed significant improvement on psychological measures of depression and anxiety. At 3-month follow-up, the results for the CT condition were maintained and revealed further numerical improvements. Publication Types: Clinical trial Randomized controlled trial PMID: 7593870, UI: 96052274 J Consult Clin Psychol 1994 Jun;62(3):576-82 Related Articles, Books, LinkOut Cognitive therapy for irritable bowel syndrome. Greene B, Blanchard EB  Center for Stress and Anxiety Disorders, State University of New York, Albany 12203. Twenty patients with irritable bowel syndrome (IBS) were randomly assigned either to intensive, individualized cognitive therapy (10 sessions over 8 weeks) or to 8 weeks of daily gastrointestinal (GI) symptom monitoring. Pre- to posttreatment evaluations showed significantly (p = .005) greater GI symptom reduction for those receiving cognitive therapy than for those in symptom monitoring. At posttreatment, 80% of the cognitive therapy group showed clinically significant improvement, whereas only 10% of the monitoring group showed this. Results held up well at a 3-month follow-up. Within the cognitive therapy group, GI symptom reductions correlated significantly with increases in positive and reductions in negative automatic thoughts. Publication Types: Clinical trial Randomized controlled trial PMID: 8063984, UI: 94342558


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## eric (Jul 8, 1999)

Bump------------------I work with Mike and the IBS Audio Program. www.ibshealth.com www.ibsaudioprogram.com


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## cookies4marilyn (Jun 30, 2000)

bump


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