Key Study Lovvall Et Al Flashcards
What is the main aim of the study?
To compare telephone treatment versus face-to-face treatment for obsessive-compulsive disorder (OCD)
The study is referred to as a non-inferiority trial.
What hypothesis is being tested in the study?
The hypothesis that telephone ERP is not less effective than face-to-face ERP
Both modes of delivery are expected to result in similar outcomes.
What type of trial is this study classified as?
Randomised control trial
It includes quantitative data collected through self-report questionnaires.
What questionnaires were used in the study?
Yale-Brown Obsessive-Compulsive Disorder Scale (Y-BOCS), Beck Depression Inventory (BDI), and a client satisfaction questionnaire
The Y-BOCS is a ten-item checklist to assess compulsive behavior.
What was the age range of participants in the study?
16-65 years
Participants were an opportunity sample of 72 people with OCD.
What were the eligibility criteria for participants?
Participants must have scored at least 16 on the Y-BOCS and be diagnosed with OCD
Exclusions included comorbid substance misuse, suicidality, or recent medication for depression/anxiety.
How were participants allocated to treatment groups?
Randomly allocated to face-to-face or telephone treatment
Each group consisted of 36 participants.
What is the total number of sessions for the face-to-face group?
Ten one-hour sessions
Sessions involved one-to-one interaction with the therapist.
What was the structure of the telephone treatment?
Two one-hour face-to-face sessions and eight weekly telephone calls lasting up to 30 minutes each
The first and last sessions were face-to-face.
What was the purpose of the initial face-to-face session?
To explain treatment and reduce anxiety/fear through gradual exposure
The session covered the same material as the control group.
What homework expectations were set for participants?
Weekly homework targets were agreed upon, with a suggested time of one hour per day
Homework record sheets were used to monitor progress.
How was progress monitored during the study?
Therapists monitored progress and assisted with target-setting and problem solving
Patients were encouraged to seek help from relatives or friends.
True or False: The therapists delivering the treatments were untrained.
False
The therapists were experienced and trained.
What was the outcome regarding obsessive-compulsive symptoms between the two treatment groups?
There was no significant difference in the severity of obsessive-compulsive symptoms between the two treatment groups at baseline or follow-up assessments.
What slight difference was noted between the two modes of delivery?
The telephone group had slightly higher depression scores at baseline compared to the face-to-face group.
What criterion defined treatment success in the study?
Treatment was seen as successful if an individual’s symptoms decreased by two standard deviations or more from the baseline mean.
What percentage of the telephone group was treated successfully using exposure and response prevention?
77 percent of the telephone group.
What percentage of the face-to-face group was treated successfully?
67 percent of the face-to-face group.
How much did OCD and depression symptoms drop in both groups?
Both OCD and depression symptoms dropped twice as much as would have been necessary to support the hypothesis that telephone therapy was no less effective than face-to-face therapy.
What was the mean Y-BOCS score for the face-to-face group at baseline visit 1?
25.5.
What was the mean BDI score for the telephone group immediately after treatment?
11.2.
What was a methodological strength of the study?
The researchers took two baseline measures using the Y-BOCS and the BDI, showing minimal change in symptoms over four weeks.
What does a minimal difference in baseline tests suggest about the study’s findings?
It suggests that the reduction in symptoms was unlikely due to spontaneous recovery.
What was a weakness of the study regarding participant blinding?
The blinding procedure broke down for some participants, compromising the validity of the data.
What percentage of participants revealed their group allocation during follow-up assessments?
13 percent of participants.
Fill in the blank: Treatment was seen as successful if symptoms decreased by _______.
two standard deviations or more from the baseline mean.
True or False: The telephone therapy sessions were longer than the face-to-face sessions.
False.
What does the study conclude about telephone-delivered exposure and response prevention therapy for OCD?
It is as effective as face-to-face therapy despite shorter session times.
How much therapist time is saved by using telephone therapy compared to face-to-face therapy?
40 percent.
What were the two baseline measures used in the study?
Y-BOCS and BDI
What did the variation of scores on the baseline measures indicate?
Minimal change in symptoms over four weeks
Why is the minimal difference in baseline tests considered a strength of the study?
It suggests that reduction in symptoms was not due to spontaneous recovery
What method was used to check the reliability of the baseline scores?
Test-retest
What does the consistency of baseline scores over time suggest?
The baseline data was reliable
What was a weakness of the study regarding the blinding procedure?
It broke down for some participants
What percentage of participants revealed their group during follow-up assessments?
13 percent
What is the implication of the blinding procedure breaking down?
The validity of the data may have been compromised
Fill in the blank: The two baseline measures used were the _______ and the _______.
Y-BOCS, BDI
True or False: The study included a control group for the full course.
False
What were the two baseline measures used in the study?
Y-BOCS and BDI
What did the variation of scores on the baseline measures indicate?
Minimal change in symptoms over four weeks
Why is the minimal difference in baseline tests considered a strength of the study?
It suggests that reduction in symptoms was not due to spontaneous recovery
What method was used to check the reliability of the baseline scores?
Test-retest
What does the consistency of baseline scores over time suggest?
The baseline data was reliable
What was a weakness of the study regarding the blinding procedure?
It broke down for some participants
What percentage of participants revealed their group during follow-up assessments?
13 percent
What is the implication of the blinding procedure breaking down?
The validity of the data may have been compromised
Fill in the blank: The two baseline measures used were the _______ and the _______.
Y-BOCS, BDI
True or False: The study included a control group for the full course.
False
What is a potential issue with researchers knowing the participant group during follow-up assessments?
It may lead to unintentional bias in how researchers interacted with participants.
Why is random allocation of participants to treatment groups important?
It increases validity by controlling for participant variables.
What demographic variables were similar across both treatment groups in the study?
- Gender distribution
- Mean age
- Marital status
- Employment status
What participant variable was not well controlled in the study despite random allocation?
The initial average depression score was higher in the telephone group.
Why might telephone therapy be an effective solution for people with OCD and significant depression?
Depression may impact energy and motivation, making it harder for individuals to attend face-to-face therapy.
What is attrition in the context of this study?
It refers to participants dropping out during the course of the study.
How did attrition affect the study’s assessment of treatment effectiveness?
It reduced similarity between groups and made it difficult to assess genuine treatment success.
What was the outcome for the face-to-face group regarding Y-BOCS scores?
Those who dropped out had higher Y-BOCS scores immediately after treatment.
What ethical guidelines were upheld in the study according to Lovell et al. (2006)?
- Exclusion of participants with suicidal intent
- Protection of participants from harm
What was the potential benefit of delivering therapy over the telephone?
It may save more than 40% of a therapist’s time.
What caution should be taken when generalizing the study’s results to clinical settings?
The study was conducted by experienced therapists, and results may not apply to less experienced staff.
What important research question remains unanswered regarding telephone therapy?
Whether telephone therapy is as satisfying for therapists as face-to-face sessions.
What could be a hidden cost of increased telephone therapy delivery?
Increased stress and burnout for therapists, leading to a need for more training of future therapists.
What approach does the study take to measure treatment efficacy?
Nomothetic approach
This approach focuses on generalizing findings across populations rather than individual cases.
How is clinically relevant improvement defined in the study?
Decrease in Y-BOCS scores of more than two standard deviations of the baseline mean
Y-BOCS refers to the Yale-Brown Obsessive Compulsive Scale, a common measure of OCD severity.
What is a strength of using a nomothetic approach in the study?
Provides an objective way of deciding treatment success
This increases the reliability of the data collected.
What would an idiographic approach require?
Different research methods, such as semi-structured interviews or participant observation
This approach focuses on individual cases and detailed contextual understanding.
What is one weakness identified in Lovell et al. (2006)?
Results may not be generalisable to people in countries other than the UK
This limits the applicability of the findings across different cultures.
How does Hofstede et al. (2022) describe the UK in terms of cultural dimensions?
Highly individualist with a low power distance index
Individualistic cultures prioritize personal autonomy over collective goals.
What type of therapy may be preferred in collectivist, high power distance cultures?
Group therapy or community-based approaches
These cultures may value collective experiences over individual therapy sessions.
What does research conducted in Iran suggest about ERP?
Can lead to an impressive reduction in symptoms
The study assessed this using the Y-BOCS with results evident at a 6-month follow-up.
What limitation was noted regarding the Iranian study on ERP?
Sample comprised only males
This raises concerns about the generalizability of the results to females.
Overall, what does the evidence suggest about ERP across different cultures?
Can be effective in cultures that vary widely on Hofstede’s cultural dimensions
This highlights the adaptability of ERP in diverse settings.
