The core symptoms of bulimia nervosa, anxiety, and depression: A network analysis.

Bulimia nervosa (BN) is characterized by symptoms of binge eating and compensatory behavior, and overevaluation of weight and shape, which often co-occur with symptoms of anxiety and depression. However, there is little research identifying which specific BN symptoms maintain BN psychopathology and how they are associated with symptoms of depression and anxiety. Network analyses represent an emerging method in psychopathology research to examine how symptoms interact and may become self-reinforcing.

CBT4BN: A Randomized Controlled Trial of Online Chat and Face-to-Face Group Therapy for Bulimia Nervosa.

Objective: Although cognitive-behavioral therapy (CBT) represents the first-line evidence-based psychotherapy for bulimia nervosa (BN), most individuals seeking treatment do not have access to this specialized intervention. We compared an Internet-based manualized version of CBT group therapy for BN conducted via a therapeutic chat group (CBT4BN) to the same treatment conducted via a traditional face-to-face group therapy (CBTF2F).

Method: In a two-site, randomized, controlled noninferiority trial, we tested the hypothesis that CBT4BN would not be inferior to CBTF2F.

Predictors of dropout in face-to-face and internet-based cognitive-behavioral therapy for bulimia nervosa in a randomized controlled trial.

Objective: We sought to identify predictors and moderators of failure to engage (i.e., pretreatment attrition) and dropout in both Internet-based and traditional face-to-face cognitive-behavioral therapy (CBT) for bulimia nervosa.

Internet-Delivered Disease Management for Recurrent Depression: A Multicenter Randomized Controlled Trial.

Background: Strategies to improve the life of patients suffering from recurrent major depression have a high relevance. This study examined the efficacy of 2 Internet-delivered augmentation strategies that aim to prolong symptom-free intervals.

Methods: Efficacy was tested in a 3-arm, multicenter, open-label, evaluator-blind, randomized controlled trial.

Cost-effectiveness of an internet-based aftercare intervention after inpatient treatment in a psychosomatic hospital.

Objective: The implementation of new interventions into routine care requires the demonstration of both their effectiveness and cost-effectiveness.

Method: We explored the cost-effectiveness of an Internet-based aftercare program in addition to treatment as usual (CHAT) which was compared to treatment as usual (TAU) following inpatient treatment. Incremental cost-effectiveness ratios were calculated based on cost of the intervention, cost of outpatient treatment, and remission rates within 1 year after discharge from hospital.

[Efficacy of an internet-delivered aftercare program for patients with chronic back pain].

Chronic back pain leads to high societal costs and severely decreased quality of life for the sufferers. Pain treatment aims at sustainable behaviour changes in order to positively affect pain development in the medium term. A multicenter, randomised control trial was conducted.

Supportive monitoring and disease management through the internet: an internet-delivered intervention strategy for recurrent depression.

Major depression is a highly prevalent, disabling disorder associated with loss of quality of life and large economic burden for the society. Depressive disorders often follow a chronic or recurrent course. The risk of relapses increases with each additional episode.

[Internet- and media-assisted therapy].

With the Internet-hype around the turn of the millenium some pioneers started initiatives of what is called E-Mental Health today. Evidence is growing since then, that E-Mental Health can contribute to a better mental health care. Some approaches have proved in studies as beneficial, that transfer into clinical routine can be tried out.

CBT4BN versus CBTF2F: comparison of online versus face-to-face treatment for bulimia nervosa.

Cognitive-behavioral therapy (CBT) is currently the "gold standard" for treatment of bulimia nervosa (BN), and is effective for approximately 40-60% of individuals receiving treatment; however, the majority of individuals in need of care do not have access to CBT. New strategies for service delivery of CBT and for maximizing maintenance of treatment benefits are critical for improving our ability to treat BN. This clinical trial is comparing an Internet-based version of CBT (CBT4BN) in which group intervention is conducted via therapeutic chat group with traditional group CBT (CBTF2F) for BN conducted via face-to-face therapy group.

Technology-enhanced maintenance of treatment gains in eating disorders: efficacy of an intervention delivered via text messaging.

Objective: Given the lack of maintenance interventions for eating disorders, a program delivered via the short message service (SMS) and text messaging was developed to support patients after their discharge from inpatient treatment.

Method: The efficacy of the intervention was studied in a randomized controlled trial. Additionally, its impact on the utilization of outpatient treatment during follow-up was investigated.

Short message service reduces dropout in childhood obesity treatment: a randomized controlled trial.

Objective: Lifestyle programs can reduce the level of overweight in children; however, maintenance results and adherence to treatment are difficult to achieve. New technologies, such as the Short Message Service (SMS), might be a promising tool for enhancing interventions. The effect of an SMS approach aimed at improving treatment results and reducing dropout rates in a pediatric lifestyle intervention, is explored.

[Eating disorders on the internet: an experimental study on the effects of pro-eating disorders websites and self-help websites].

Pro-eating disorders (ED) websites are assumed to have a negative impact on internet users because these sites promote ED as a lifestyle, and present an extreme thin ideal as well as extreme weight loss measures. We tested the impact of reading pro-ED contents in a sample of 421 women. The participants were randomly assigned to one of 3 conditions in which they were exposed to either a pro-ED blog, a self-help blog, or a neutral control blog.

The effectiveness of internet chat groups in relapse prevention after inpatient psychotherapy.

The majority of patients benefit from psychotherapeutic treatment. However, many fail to maintain their treatment gains following discharge. In a controlled study, we investigated the effectiveness of internet chat groups in preventing relapse following inpatient treatment.

[Transparency and outcome orientation as means to improve psychotherapeutic services: a study to evaluate outpatient psychotherapy (TRANS-OP)].

Background: There is clear evidence for the efficacy of psychotherapy. However, there is a lack of large-scale naturalistic studies on the course of psychological problems and its predictors in people in psychotherapeutic routine care.

Material And Methods: Between September 1998 and February 2000, 627 insurees of the "Deutsche Krankenversicherung", a major German health insurance company, who received outpatient psychotherapy (psychodynamic psychotherapy, analytic psychotherapy, or cognitive behavioral treatment), gave informed consent to participate in this study.

Enhancement of care through self-monitoring and tailored feedback via text messaging and their use in the treatment of childhood overweight.

Objective: This paper first illustrates the general potential of the short message service (SMS) for symptom and behavior monitoring and the provision of tailored feedback. Second, an SMS-based maintenance treatment (SMSMT) is introduced aimed at enhancing the treatment of childhood overweight.

Methods: After a 12-week cognitive behavioral group treatment (CBGT), 40 children were assigned to the SMSMT for a period of 36 weeks.

[Utilization of outpatient psychotherapy and its implications for service provision].

Time structure of outpatient psychotherapy is important for clinical practice, as well as for theoretical and cost-effectiveness reasons. In this paper, important time variables (session number and frequency, therapy duration, utilization of the allocated session contingent, extension of therapy) are studied in a sample of n=714 German insurees in outpatient psychotherapy over a four-year period. Session number and duration of therapy were modelled with survival analysis, Cox regression was used to study the influence of covariates assessed at the beginning of therapy.

Inpatient treatment to online aftercare: e-mailing themes as a function of therapeutic outcomes.

The authors applied the meaning extraction method (MEM) to 4,241 e-mails written by 297 participants of an email-based aftercare program following inpatient psychotherapy. Principal-components analysis of the most frequently used nouns in the e-mails yielded nine components: life decisions and coping, relationship conflict, psychological and physical symptoms, family of origin, social and leisure activities, present family and household, treatment, exercise and diet, and work. Relative to men, women focused more on symptoms, exercise and diet, and family of origin, but less on work.

Use of text messaging for monitoring sugar-sweetened beverages, physical activity, and screen time in children: a pilot study.

Objective: To examine acceptability, attrition, adherence, and preliminary efficacy of mobile phone short message service (SMS; text messaging) for monitoring healthful behaviors in children.

Design: All randomized children received a brief psychoeducational intervention. They then either monitored target behaviors via SMS with feedback or via paper diaries (PD) or participated in a no-monitoring control (C) for 8 weeks.

New prospects for process research in group therapy: Text-based process variables in psychotherapeutic Internet chat groups.

This study focuses on the operationalization and validation of text-based process variables in psychotherapeutic Internet chat groups. The process variables activity, outdegree (OD; i.e.

Group processes and process evaluations in a new treatment setting: inpatient group psychotherapy followed by internet-chat aftercare groups.

Little is known about processes characterizing therapeutic Internet-chat groups, which offer a novel way of providing group therapy over distances. In this study group processes and group evaluations were examined in a treatment setting where face-to-face inpatient groups are followed by chat aftercare groups. For a sample of 121 patients who participated in both treatment modalities, group processes and group evaluations were modeled using hierarchical linear modeling.

Linguistic analyses of natural written language: unobtrusive assessment of cognitive style in eating disorders.

Objective: Linguistic style analysis is introduced as a method of nonreactive measurement of cognitive style in individuals with eating disorders (ED).

Method: A journaling exercise was implemented on an ED inpatient unit. Thirty-four written essays collected from an unselected sample of 11 patients were analysed with the Linguistic Inquiry and Word Count, with regard to predefined text categories.

The exploration of the effectiveness of group therapy through an Internet chat as aftercare: a controlled naturalistic study.

Background: Modern communication technologies offer novel opportunities for the provision of stepped care for patients with mental disorders. This study investigated the effectiveness of group therapy delivered through an Internet chat following inpatient treatment. The main goal of the program was to reduce the risk of losing the therapeutic benefits achieved during the preceding inpatient treatment.

[New media - new prospects in psychotherapy process research: feedback of text-based processes in internet chat groups].

Group psychotherapy via Internet-chat offers not only an optimisation of therapeutic service provision but also new prospects for process research. The communication content could be analysed automatically and therefore text-based process variables could be fed back to the therapist immediately. In a former study , different text-based process variables in therapeutic Internet-chat aftercare groups were validated and the best concurrent validity with psychometric group evaluations was found for the text-based process variable "Activity", operationalised by the number of words and statements that a patient writes during a chat session.