Details

Autor(en) / Beteiligte

• Heinig, Ingmar
• Knappe, Susanne
• Hoyer, Jürgen
• Wittchen, Hans-Ulrich
• Richter, Jan
• Arolt, Volker
• Deckert, Jürgen
• Domschke, Katharina
• Hamm, Alfons
• Kircher, Tilo
• Lueken, Ulrike
• Margraf, Jürgen
• Neudeck, Peter
• Rief, Winfried
• Straube, Benjamin
• Ströhle, Andreas
• Pauli, Paul
• Pittig, Andre

Titel

Effective—and Tolerable: Acceptance and Side Effects of Intensified Exposure for Anxiety Disorders

Ist Teil von

• Behavior therapy, 2023-05, Vol.54 (3), p.427-443

Ort / Verlag

England: Elsevier Ltd

Erscheinungsjahr

2023

Quelle

MEDLINE

Beschreibungen/Notizen

• •First study on patient acceptance of prediction error-based exposure (PeEx).•PeEx is well accepted regarding credibility, satisfaction and engagement.•42% of patients report any side effect, while 94% report “positive side effects”.•Most side effects are minor, transient, or inherent to psychotherapy (e.g., stigma).•Temporally intensified exposure is tolerated despite higher treatment burden. Despite striking empirical support, exposure-based treatments for anxiety disorders are underutilized. This is partially due to clinicians’ concerns that patients may reject exposure or experience severe side effects, particularly in intensive forms of exposure. We examined acceptance and side effects of two randomly assigned variants of prediction error-based exposure treatment differing in temporal density (1 vs. 3 sessions/week) in 681 patients with panic disorder, agoraphobia, social anxiety disorder, and multiple specific phobias. Treatment acceptance included treatment satisfaction and credibility, engagement (i.e., homework completion), and tolerability (i.e., side effects, dropout, and perceived treatment burden). Side effects were measured with the Inventory for the Balanced Assessment of Negative Effects of Psychotherapy (INEP). We found treatment satisfaction, credibility, and engagement to be equally high in both variants of exposure-based treatment, despite higher treatment burden (β = 0.25) and stronger side effects (β = 0.15) in intensified treatment. 94.1% of patients reported positive effects in the INEP. 42.2% reported side effects, with treatment stigma (16.6%), low mood (14.8%) and the experience to depend on the therapist (10.9%) being the most frequently reported. The mean intensity of side effects was low. We conclude that prediction error-based exposure treatment is well accepted by patients with different anxiety disorders and that patients also tolerate temporally intensified treatment, despite higher perceived treatment burden and stronger side effects. Clinicians should be aware of the most frequent side effects to take appropriate countermeasures. In sum, temporal intensification appears to be an acceptable strategy to achieve faster symptom reduction, given patients’ well-informed consent.