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Mengin AC, Nourry N, Severac F, Berna F, Bemmouna D, Costache ME, Fritsch A, Frey I, Ligier F, Engel N, Greth P, Khan A, Chauvet-Gelinier JC, Chabridon G, Haffen E, Nicolier M, Zinetti-Bertschy A, Vidailhet P, Weiner L. Efficacy of the my health too online cognitive behavioral therapy program for healthcare workers during the COVID-19 pandemic: A randomized controlled trial. Internet Interv 2024; 36:100736. [PMID: 38617386 PMCID: PMC11015127 DOI: 10.1016/j.invent.2024.100736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 02/23/2024] [Accepted: 03/16/2024] [Indexed: 04/16/2024] Open
Abstract
Background Healthcare workers' mental health has been impacted by the COVID-19 pandemic, emphasizing the need for mental health interventions in this population. Online cognitive behavioral therapy (CBT) is efficient to reduce stress and may reach numerous professionals. We developed "MyHealthToo", an online CBT program to help reduce stress among healthcare workers during the COVID-19 pandemic. Objective The aim of our study is to investigate the efficacy of an online CBT program on stress and mental health conditions among healthcare workers during a health crisis. Methods We performed a multicentric randomized controlled trial among 155 participants allocated either to the experimental or active control group (bibliotherapy). The primary outcome was the decrease of perceived stress scores (PSS-10) post-treatment. Secondary outcomes included depression, insomnia and PTSD symptoms along with self-reported resilience and ruminations. Assessments were scheduled pretreatment, mid-treatment (4 weeks), post-treatment (8 weeks), and at 1-month and 4-months follow-up. Results For both interventions, mean changes on the PSS-10 were significant post-therapy (W8), as at 1-month (W12) and 4-months (W24) follow-ups. The between-group comparison showed no difference at any time point (ps > 0.88). Work-related ruminations significantly decreased in the experimental group with a significant between-group difference at W8 (Δ = -1.83 [-3.57; -0.09], p = 0.04). Posttraumatic stress symptoms significantly decreased in the experimental group with a significant between-group difference at W12 (Δ = -1.41 [-2.68; -0.14], p = 0.03). The decrease in work-related ruminations at W8 mediated the decrease in posttraumatic stress symptoms at W12 (p = 0.048). Conclusion The "MyHealthToo" online CBT intervention may help reduce ruminations about work and posttraumatic stress symptoms among healthcare workers during a major health crisis. Work-related ruminations may represent a relevant target of online interventions to improve mental health among healthcare workers.
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Affiliation(s)
- Amaury C. Mengin
- Department of Psychiatry, Mental Health & Addictology, Strasbourg University Hospital, Strasbourg, France
- Regional Great East Center for Psychotraumatism, Strasbourg, France
- Strasbourg University, Faculty of Medicine, Strasbourg, France
- INSERM U1329, Strasbourg Translational NEuroscience and Psychiatry (STEP), Team Psychiatry, Strasbourg, France
- Fédération de Médecine Translationnelle de Strasbourg, France
| | - Nathalie Nourry
- Strasbourg University, Faculty of Medicine, Strasbourg, France
- Fédération de Médecine Translationnelle de Strasbourg, France
- Hôpitaux Universitaires de Strasbourg, Service de Pathologies Professionnelles et Médecine du Travail, Strasbourg, France
| | - François Severac
- Hôpitaux Universitaires de Strasbourg, Département de Santé Publique, GMRC, Strasbourg, France
- Université de Strasbourg, Laboratoire de Biostatistique et Informatique Médicale, iCUBE UMR, 7357 Illkirch, France
| | - Fabrice Berna
- Department of Psychiatry, Mental Health & Addictology, Strasbourg University Hospital, Strasbourg, France
- Strasbourg University, Faculty of Medicine, Strasbourg, France
- INSERM U1329, Strasbourg Translational NEuroscience and Psychiatry (STEP), Team Psychiatry, Strasbourg, France
- Fédération de Médecine Translationnelle de Strasbourg, France
| | - Doha Bemmouna
- Strasbourg University, Faculty of Psychology, Strasbourg, France
| | - Mădălina Elena Costache
- Strasbourg University, Faculty of Psychology, Strasbourg, France
- Laboratoire de Psychologie des Cognitions, Université de Strasbourg, Strasbourg, France
| | - Aurélie Fritsch
- Strasbourg University, Faculty of Psychology, Strasbourg, France
- Laboratoire de Psychologie des Cognitions, Université de Strasbourg, Strasbourg, France
| | - Isabelle Frey
- Department of Psychiatry, Mental Health & Addictology, Strasbourg University Hospital, Strasbourg, France
| | - Fabienne Ligier
- PUPEA, Centre Psychothérapeutique de Nancy, Laxou; EA 4360 APEMAC, Université de Lorraine, Nancy, France
- Centre Psychothérapeutique de Nancy, Laxou, France
| | - Nadia Engel
- PUPEA, Centre Psychothérapeutique de Nancy, Laxou; EA 4360 APEMAC, Université de Lorraine, Nancy, France
- Centre Psychothérapeutique de Nancy, Laxou, France
| | - Philippe Greth
- Pôle de Psychiatrie et Santé Mentale du Groupe Hospitalier Mulhouse Sud Alsace, Mulhouse, France
| | - Anastasia Khan
- Pôle de Psychiatrie et Santé Mentale du Groupe Hospitalier Mulhouse Sud Alsace, Mulhouse, France
| | - Jean-Christophe Chauvet-Gelinier
- Service de Psychiatrie Adultes, Centre Hospitalier Universitaire Dijon-Bourgogne, Unité INSERM LNC-UMR 1231, Université de Bourgogne, Dijon, France
| | - Guillaume Chabridon
- Service de Psychiatrie Adultes, Centre Hospitalier Universitaire Dijon-Bourgogne, Unité INSERM LNC-UMR 1231, Université de Bourgogne, Dijon, France
| | - Emmanuel Haffen
- Service de Psychiatrie, CIC-1431 INSERM, CHU de Besançon, Laboratoire de Neurosciences, Université Bourgogne-Franche-Comté, Besançon, France
| | - Magali Nicolier
- Service de Psychiatrie, CIC-1431 INSERM, CHU de Besançon, Laboratoire de Neurosciences, Université Bourgogne-Franche-Comté, Besançon, France
| | - Anna Zinetti-Bertschy
- Department of Psychiatry, Mental Health & Addictology, Strasbourg University Hospital, Strasbourg, France
- Strasbourg University, Faculty of Psychology, Strasbourg, France
| | - Pierre Vidailhet
- Department of Psychiatry, Mental Health & Addictology, Strasbourg University Hospital, Strasbourg, France
- Regional Great East Center for Psychotraumatism, Strasbourg, France
- Strasbourg University, Faculty of Medicine, Strasbourg, France
- INSERM U1329, Strasbourg Translational NEuroscience and Psychiatry (STEP), Team Psychiatry, Strasbourg, France
- Fédération de Médecine Translationnelle de Strasbourg, France
| | - Luisa Weiner
- Department of Psychiatry, Mental Health & Addictology, Strasbourg University Hospital, Strasbourg, France
- Strasbourg University, Faculty of Psychology, Strasbourg, France
- Laboratoire de Psychologie des Cognitions, Université de Strasbourg, Strasbourg, France
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Weibel S, Bicego F, Muller S, Martz E, Costache ME, Kraemer C, Bertschy G, Lopez R, Weiner L. Two Facets of Emotion Dysregulation Are Core Symptomatic Domains in Adult ADHD: Results from the SR-WRAADDS, a Broad Symptom Self-Report Questionnaire. J Atten Disord 2022; 26:767-778. [PMID: 34189990 DOI: 10.1177/10870547211027647] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Emotional dysregulation (ED) in adult ADHD is frequent but definition and tools for its evaluation are not consensual. Our aim was to determine the core ADHD symptomatic domains via the Self-Reported Wender-Reimherr Adult Attention Deficit Disorder Scale (SR-WRAADDS) following its validation in a large clinical sample of adults with ADHD and controls. METHOD Three hundred sixty-nine adult patients with ADHD and 251 healthy participants completed the SR-WRAADDS and questionnaires about ADHD, depression, and ED. We analyzed the psychometric properties of the SR-WRAADDS and a factor analysis yielded symptomatic domains. RESULTS The SR-WRAADDS has good reliability. The 30 symptoms were best organized in a four-factor solution: attention/disorganization, hyperactivity/restlessness, impulsivity/emotional outbursts, and emotional lability. CONCLUSIONS The symptomatic structure of the SR-WRAADDS includes two distinct dimensions related to ED: "impulsivity/emotional outbursts" and "emotional lability." The SR-WRAADDS is a reliable and clinically useful tool that assesses all ADHD symptom domains, including facets of ED.
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Affiliation(s)
- Sébastien Weibel
- University Hospital of Strasbourg, France.,Inserm U1114, Strasbourg, France
| | | | | | | | | | - Charlotte Kraemer
- University Hospital of Strasbourg, France.,Private Practice, Strasbourg, France
| | - Gilles Bertschy
- University Hospital of Strasbourg, France.,Inserm U1114, Strasbourg, France
| | - Regis Lopez
- National Reference Centre for Orphan Diseases, Narcolepsy- Rare hypersomnias, Sleep Unit, Department of Neurology, CHU Montpellier, Univ Montpellier, Montpellier, France; University of Montpellier, France
| | - Luisa Weiner
- University Hospital of Strasbourg, France.,Laboratoire de psychologie des cognition, University of Strasbourg, France
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Costache ME, Frick A, Månsson K, Engman J, Faria V, Hjorth O, Hoppe JM, Gingnell M, Frans Ö, Björkstrand J, Rosén J, Alaie I, Åhs F, Linnman C, Wahlstedt K, Tillfors M, Marteinsdottir I, Fredrikson M, Furmark T. Higher- and lower-order personality traits and cluster subtypes in social anxiety disorder. PLoS One 2020; 15:e0232187. [PMID: 32348331 PMCID: PMC7190155 DOI: 10.1371/journal.pone.0232187] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 04/08/2020] [Indexed: 02/03/2023] Open
Abstract
Social anxiety disorder (SAD) can come in different forms, presenting problems for diagnostic classification. Here, we examined personality traits in a large sample of patients (N = 265) diagnosed with SAD in comparison to healthy controls (N = 164) by use of the Revised NEO Personality Inventory (NEO-PI-R) and Karolinska Scales of Personality (KSP). In addition, we identified subtypes of SAD based on cluster analysis of the NEO-PI-R Big Five personality dimensions. Significant group differences in personality traits between patients and controls were noted on all Big Five dimensions except agreeableness. Group differences were further noted on most lower-order facets of NEO-PI-R, and nearly all KSP variables. A logistic regression analysis showed, however, that only neuroticism and extraversion remained significant independent predictors of patient/control group when controlling for the effects of the other Big Five dimensions. Also, only neuroticism and extraversion yielded large effect sizes when SAD patients were compared to Swedish normative data for the NEO-PI-R. A two-step cluster analysis resulted in three separate clusters labelled Prototypical (33%), Introvert-Conscientious (29%), and Instable-Open (38%) SAD. Individuals in the Prototypical cluster deviated most on the Big Five dimensions and they were at the most severe end in profile analyses of social anxiety, self-rated fear during public speaking, trait anxiety, and anxiety-related KSP variables. While additional studies are needed to determine if personality subtypes in SAD differ in etiological and treatment-related factors, the present results demonstrate considerable personality heterogeneity in socially anxious individuals, further underscoring that SAD is a multidimensional disorder.
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Affiliation(s)
| | - Andreas Frick
- The Beijer Laboratory, Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Kristoffer Månsson
- Department of Psychology, Uppsala University, Uppsala, Sweden
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
- Max Planck UCL Centre for Computational Psychiatry and Ageing Research, Berlin, Germany and London, United Kingdom
- Center for Lifespan Psychology, Max Planck Institute for Human Development, Berlin, Germany
| | - Jonas Engman
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Vanda Faria
- Department of Psychology, Uppsala University, Uppsala, Sweden
- Center for Pain and The Brain, Department of Anesthesiology, Harvard Medical School, Boston Children’s Hospital, Perioperative and Pain Medicine, Boston, MA, United States of America
- Department of Otorhinolaryngology, Smell & Taste Clinic, TU Dresden, Dresden, Germany
| | - Olof Hjorth
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | | | - Malin Gingnell
- Department of Psychology, Uppsala University, Uppsala, Sweden
- Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Örjan Frans
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Johannes Björkstrand
- Department of Psychology, Uppsala University, Uppsala, Sweden
- Department of Psychology, Lund University, Lund, Sweden
| | - Jörgen Rosén
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Iman Alaie
- Department of Psychology, Uppsala University, Uppsala, Sweden
- Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden
| | - Fredrik Åhs
- Department of Psychology and Social Work, Mid Sweden University, Östersund, Sweden
| | - Clas Linnman
- Harvard Medical School, Spaulding Rehabilitation Hospital, Boston, MA, United States of America
| | - Kurt Wahlstedt
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Maria Tillfors
- Department of Social and Psychological Studies, Karlstad University, Karlstad, Sweden
| | - Ina Marteinsdottir
- Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Mats Fredrikson
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Tomas Furmark
- Department of Psychology, Uppsala University, Uppsala, Sweden
- * E-mail:
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