TY - JOUR A1 - Schwind, Julia A1 - Neng, Julia M. B. A1 - Weck, Florian T1 - Changes in Free Symptom Attributions in Hypochondriasis after Cognitive Therapy and Exposure Therapy JF - Behavioural and cognitive psychotherapy : ournal of the British Association for Behavioural and Cognitive Psychotherapies KW - Attribution KW - hypochondriasis KW - free association KW - cognitive-behavioural therapy Y1 - 2016 U6 - https://doi.org/10.1017/S1352465816000163 SN - 1352-4658 SN - 1469-1833 VL - 44 SP - 601 EP - 614 PB - Cambridge Univ. Press CY - New York ER - TY - GEN A1 - Schwind, Julia A1 - Neng, Julia M. B. A1 - Weck, Florian T1 - Changes in free symptom attributions in hypochondriasis after cognitive therapy and exposure therapy T2 - Postprints der Universität Potsdam : Humanwissenschaftliche Reihe N2 - Background: Cognitive-behavioural therapy can change dysfunctional symptom attributions in patients with hypochondriasis. Past research has used forced-choice answer formats, such as questionnaires, to assess these misattributions; however, with this approach, idiosyncratic attributions cannot be assessed. Free associations are an important complement to existing approaches that assess symptom attributions. Aims: With this study, we contribute to the current literature by using an open-response instrument to investigate changes in freely associated attributions after exposure therapy (ET) and cognitive therapy (CT) compared with a wait list (WL). Method: The current study is a re-examination of a formerly published randomized controlled trial (Weck, Neng, Richtberg, Jakob and Stangier, 2015) that investigated the effectiveness of CT and ET. Seventy-three patients with hypochondriasis were randomly assigned to CT, ET or a WL, and completed a 12-week treatment (or waiting period). Before and after the treatment or waiting period, patients completed an Attribution task in which they had to spontaneously attribute nine common bodily sensations to possible causes in an open-response format. Results: Compared with the WL, both CT and ET reduced the frequency of somatic attributions regarding severe diseases (CT: Hedges's g = 1.12; ET: Hedges's g = 1.03) and increased the frequency of normalizing attributions (CT: Hedges's g = 1.17; ET: Hedges's g = 1.24). Only CT changed the attributions regarding moderate diseases (Hedges's g = 0.69). Changes in somatic attributions regarding mild diseases and psychological attributions were not observed. Conclusions: Both CT and ET are effective for treating freely associated misattributions in patients with hypochondriasis. This study supplements research that used a forced-choice assessment. T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 457 KW - attribution KW - hypochondriasis KW - free association KW - cognitive-behavioural therapy Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-414169 IS - 457 ER - TY - JOUR A1 - Probst, Thomas A1 - Jakob, Marion A1 - Kaufmann, Yvonne Marie A1 - Müller-Neng, Julia M. B. A1 - Bohus, Martin A1 - Weck, Florian T1 - Patients’ and therapists’ experiences of general change mechanisms during bug-in-the-eye and delayed video-based supervised cognitive-behavioral therapy BT - a randomized controlled trial JF - Journal of clinical psychology N2 - ObjectiveThis secondary analysis of a randomized controlled trial investigated whether bug-in-the-eye (BITE) supervision (live computer-based supervision during a psychotherapy session) affects the manner in which patients and therapists experience general change mechanisms (GCMs) during cognitive-behavioral therapy (CBT). MethodA total of 23 therapists were randomized either to the BITE condition or the control condition (delayed video-based [DVB] supervision). After each session, both patients (BITE: n=19; DVB: n=23) and therapists (BITE: n=11; DVB: n=12) completed the Helping Alliance Questionnaire (HAQ) and the Bernese Post Session Report (BPSR). The HAQ total score and the 3 secondary factors of the BPSR (interpersonal experiences, intrapersonal experiences, problem actuation) functioned as GCMs. Multilevel models were performed. ResultsFor patients, GCMs did not develop differently between BITE and DVB during CBT. Therapists rated the alliance as well as interpersonal and intrapersonal experiences not significantly different between BITE and DVB during CBT, but they perceived problem actuation to increase significantly more in BITE than in DVB (p<.05). ConclusionBITE supervision might be helpful in encouraging CBT therapists to apply interventions, which focus on the activation of relevant problems and related emotions. KW - alliance KW - general change mechanisms KW - live supervision KW - randomized controlled trial Y1 - 2018 U6 - https://doi.org/10.1002/jclp.22519 SN - 0021-9762 SN - 1097-4679 VL - 74 IS - 4 SP - 509 EP - 522 PB - Wiley CY - Hoboken ER - TY - JOUR A1 - Weck, Florian A1 - Nagel, Laura Carlotta A1 - Richtberg, Samantha A1 - Neng, Julia M. B. T1 - Personality disorders in hypochondriasis BT - a comparison to panic disorder and healthy controls JF - Journal of personality disorders N2 - Previous studies found high prevalence rates of personality disorders (PDs) in patients with hypochondriasis; however, assessment was often based only on questionnaires. In the current study, a sample of 68 patients with hypochondriasis was compared to 31 patients with panic disorder and to 94 healthy controls. Participants were investigated with the Structured Clinical Interview for DSM-IV Personality Disorders questionnaire (SCID-II questionnaire) and the SCID-II interview. Based on the cut-off scores of the SCID-II questionnaire, we found a prevalence rate of 45.6% for PD in patients with hypochondriasis. In comparison to healthy controls, patients with hypochondriasis showed characteristics of paranoid, borderline, avoid ant, and-dependent PDs in the dimensional assessment significantly more often. However, no significant differences were found between the clinical samples. Based on the SCID-II interview, only 2.9% of the patients with hypochondriasis fulfilled the criteria for a PD. These results suggest that PDs are not a specific characteristic of hypochondriasis. Y1 - 2017 SN - 0885-579X SN - 1943-2763 VL - 31 SP - 567 EP - 576 PB - Guilford Press CY - New York ER - TY - JOUR A1 - Weck, Florian A1 - Nagel, Laura Carlotta A1 - Hoefling, Volkmar A1 - Neng, Julia M. B. T1 - Cognitive Therapy and Exposure Therapy for Hypochondriasis (Health Anxiety): A 3-Year Naturalistic Follow-Up JF - Journal of consulting and clinical psychology N2 - Objective: Cognitive-behavioral therapy (CBT) has been shown to be effective in treating hypochondriasis. However, there are doubts regarding the long-term effectiveness of CBT for hypochondriasis, in particular for follow-up periods longer than 1 year. The aim of the present study was to evaluate the long-term effectiveness of cognitive therapy (CT) and exposure therapy (ET) for the treatment of hypochondriasis. Method: Seventy-five patients with a diagnosis of hypochondriasis who were previously treated with CT or ET were contacted 3 years after treatment. Fifty (67%) patients participated and were interviewed by an independent and blinded diagnostician using standardized interviews. Results: We found further improvements after therapy in primary outcome measures (d = .37), general functioning (d = .38), and reduced doctor visits (d = .30) during the naturalistic follow-up period. At the 3-year follow-up, 72% of the patients no longer fulfilled the diagnosis of hypochondriasis. Based on the main outcome measure, we found response rates of 76% and remission rates of 68%. At follow-up, only 4% of patients were taking antidepressant medication. Additional psychological treatment was utilized by 18% of the patients during the follow-up period (only 8% because of health anxiety). We found no overall differences between CT and ET. Only a trend for a greater deterioration rate in CT (13%) in comparison to ET (0%) was found. Conclusions: Our results suggest that 2/3 of the patients with hypochondriasis were remitted in the long term. Thus, remission rates after CBT were twice as high as in untreated samples. KW - hypochondriasis KW - cognitive therapy KW - exposure therapy KW - illness anxiety disorder KW - long-term follow-up Y1 - 2017 U6 - https://doi.org/10.1037/ccp0000239 SN - 0022-006X SN - 1939-2117 VL - 85 SP - 1012 EP - 1017 PB - American Psychological Association CY - Washington ER -