Computer-assisted Cognitive-behavioral Therapy Research Articles

Cost-Effectiveness of Computer-Assisted Cognitive Behavioral Therapy for Depression Among Adults in Primary Care

Approximately 1 in 5 adults are diagnosed with depression in their lifetime. However, less than half receive help from a health professional, with the treatment gap being worse for individuals with socioeconomic disadvantage. Computer-assisted cognitive behavioral therapy (CCBT) is an effective and convenient strategy to treat depression; however, its cost-effectiveness in a sociodemographically diverse population remains unknown. To evaluate the cost-effectiveness of clinician-supported CCBT compared with treatment as usual (TAU) in a primary care population with a substantial number of patients with low income, limited computer or internet access, and lack of college education. This economic evaluation was a randomized clinical trial-based cost-effectiveness analysis. The trial was conducted at the Departments of Family and Geriatric Medicine and Internal Medicine at the University of Louisville. Enrollment occurred from June 24, 2016, to May 13, 2019. Participants had mild to moderate depression and were followed up for 6 months after treatment completion. The last follow-up assessment was conducted on January 30, 2020. Statistical analysis was performed from August 2023 to August 2024. CCBT intervention was provided for 12 weeks and included 9 modules ranging from behavioral activation and cognitive restructuring to relapse prevention strategies, supported by telephonic sessions with a clinician, in addition to TAU, which included standard clinical management in primary care. The primary health outcome was quality-adjusted life years (QALYs), estimated using the Short-Form 12 questionnaire (SF-12). The secondary outcome was treatment response, defined as at least 50% improvement in the Patient Health Questionnaire. The intervention cost included sessions with mental health clinicians and the cost of the CCBT software, plus the cost of loaner computer and internet data plan for low-resource households. An incremental cost-effectiveness ratio (ICER) was computed, while adjusting for baseline scores, age, and sex. The cost-effectiveness acceptability curve presented the probability of CCBT being cost-effective for a range of willingness-to-pay values. Among the 175 primary care patients included in this study, 148 (84.5%) were female; 48 (27.4%) were African American, 2 (1.2%) were American Indian or Alaska Native, 4 (2.5%) were Hispanic, 106 (60.5%) were White, and 15 (8.6%) were multiracial; and the mean (SD) age was 47.03 (13.15) years. CCBT was associated with better quality of life and higher chance of treatment response at the posttreatment and 6-month time points, compared with the TAU group. The ICER for CCBT was $37 295 (95% CI, $22 724-$66 546) per QALY, with a probability of 89.4% of being cost-effective at a willingness-to-pay threshold of $50 000/QALY. The ICER per case of treatment response was $3623 (95% CI, $2617-$5377). In this trial-based economic evaluation, CCBT was found to be cost-effective, compared with TAU, in primary care patients with depression. As this study included individuals with low income and with limited internet access who are underrepresented in cost-effectiveness studies, it has important policy implications for addressing unmet needs in sociodemographically diverse populations.

Computer-Assisted CBT May Help Alleviate Depression

Computer-Assisted CBT May Help Alleviate Depression

The effectiveness of computer-assisted Cognitive Behavioral Therapy (cCBT) for psychological outcomes in patients with laryngectomy: Randomized controlled trial

BackgroundThe symptom burden was tremendous and rates of psychological distress were high because of laryngectomy in Laryngeal carcinoma. Anxiety and depression as mainly psychological distress influenced their sleep, pain, and the quality of life (QOL). This study aimed to assess the effiacy of computer-assisted Cognitive Behavioral Therapy (cCBT) for psychological outcomes and QOL in patients with laryngectomy, in addition to overall experience with health care service, during the perioperative period. MethodsA cCBT program was be customized focused on improving anxiety and depressive symptoms among patients with laryngectomy, and then its effectiveness was assessed. Participants were randomly assigned to the TAU (treatment as usual) group (n=40) or CCBT group (cCBT+ TAU, n = 40). The primary outcome measures were the State Anxiety Inventory (SAI), Patients Health Questionnaire-9 (PHQ-9). The secondary outcome measures were the Athens Insomnia Scale (AIS), Visual Analogue Scale-10 (VAS-10). The outcomes were obtained from patients before intervention (T1), 1 hour before surgery (T2), postoperative 3-day (T3), postoperative 7-day (T4), and postoperative 10-day(T5: after intervention completed). Functional Assessment of Cancer Therapy-Head and Neck (FACT-H&N) and satisfaction for health care service were assessed before discharge. ResultsA mixed linear model displayed significant improvement in symptoms of anxiety, depression, insomnia, and pain in the two groups (all p<0.001); and revealed a significant decreasing on the SAI, PHQ-9, AIS, and VAS-10 scores in the CCBT group compared to that of TAU group during the post-intervention periods (all p<0.05). Furthermore, the other QOL of patients were higher except for physical well-being (p=0.176) and the satisfaction scores were higher in the CCBT group than that of TAU group (all p<0.05). ConclusionThe new developed cCBT program has a positive effect on psychosomatic symptoms surgery-related among patients with laryngectomy,. And patients with cCBT program reported high levels of QOL and satisfaction during perioperative period. To minimize face-to-face contact, the computer-assisted intervention may be an attractive approach.

The efficacy of computer-assisted cognitive behavioral therapy (cCBT) on psychobiological responses and perioperative outcomes in patients undergoing functional endoscopic sinus surgery: a randomized controlled trial

BackgroundFunctional endoscopic sinus surgery (FESS) is required to minimize bleeding to maintain a clear operative field during surgery, so it is important to preoperative anti-anxiety and stable hemodynamics. Initial evidence suggests cognitive behavioral therapy (CBT) is effective to minimize surgery-related stress and to speed up recovery. The study aimed to evaluate the efficacy of a newly developed computer-assisted CBT (cCBT) program on surgery-related psychobiological responses in patients undergoing FESS.MethodsParticipants were allocated to a CCBT group (cCBT; n = 50) or a UC group (usual care; n = 50) by random number table. The State Anxiety Inventory (SAI), Patients Health Questionnaire-9 (PHQ-9), Athens Insomnia Scale (AIS), systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were assessed before intervention (T1), at 1 h before operation (T2), at postoperative 48 h (T3), and 96 h (T4: after intervention completed) respectively. The stress hormone was assayed at T1 and T2. The duration of surgery, anesthesia, and post-anesthesia care unit (PACU) were recorded. A satisfaction survey about nursing services was completed by participants before discharge.ResultsCompared to the UC group, the SAI scores at T2 and the AIS scores at T3 were lower in the CCBT group (p < 0.01 and p = 0.002). The positive rate of participants who were moderate and severe anxiety (SAI score > 37) at T2 were lower (72% vs. 88%, p = 0.04); the cortisol levels, SBP, DBP, and HR at T2 in the CCBT group were lower (p = 0.019 and all p < 0.01); the duration of anesthesia and PACU was shorter (p = 0.001 and p < 0.01); the CCBT group showed higher satisfaction scores.ConclusionThe newly developed cCBT program was an effective non-pharmacological adjunctive treatment for improving the surgery-related psychosomatic responses and perioperative outcomes.Trial registrationThe study was registered with the Chinese Clinical Trial Registry (ChiCTR1900025994) on 17 September 2019.

A Qualitative Examination of a School-Based Implementation of Computer-Assisted Cognitive-Behavioral Therapy for Child Anxiety.

Mental health treatment in schools has the potential to improve youth treatment access. However, school-specific barriers can make implementing evidence-based interventions difficult. Task-shifting (i.e., training lay staff to implement interventions) and computer-assisted interventions may mitigate these barriers. This paper reports on a qualitative examination of facilitators and barriers of a school-based implementation of a computer-assisted intervention for anxious youth (Camp Cope-A-Lot; CCAL). Participants (N = 45) included school staff in first through fourth grades. Providers attended a training in CCAL and received weekly, hour-long group consultation calls for three months. In the second year, the sustainability of CCAL use was assessed. Qualitative interviews were conducted after the first year (initial implementation) and second year (sustainability). Interviews were analyzed using the Consolidated Framework for Implementation Research domains to classify themes. Although participants reported that CCAL included useful skills, they expressed concerns about recommended session length (45 minutes) and frequency (weekly). Time burden of consultation calls was also a barrier. School staff facilitated implementation by enabling flexible scheduling for youth to be able to participate in the CCAL program. However, the sustainability of the program was limited due to competing school/time demands. Results suggest that even with computer assisted programs, there is a need to tailor interventions and implementation efforts to account for the time restrictions experienced by school-based service providers. Optimal fit between the intervention and specific school is important to maintain the potential benefits of computer-assisted treatments delivered by lay service providers in schools.

Bringing Evidence-Based Interventions into the Schools: An Examination of Organizational Factors and Implementation Outcomes

Although schools are one of the largest providers of behavioral health services for youth, many barriers exist to the implementation of evidence-based interventions in schools. This study used the Stages of Implementation Completion (SIC) to examine school-based implementation outcomes for a computer-assisted cognitive behavioral therapy intervention for anxious youth. Organizational factors and predictors of program startup also were examined. Results indicated that the SIC detected implementation variability in schools and suggested that spending more time completing pre-implementation activities may better prepare schools for active implementation of program delivery. Furthermore, proficiency emerged as a potentially important organizational factor to examine in future school-based implementation research.

Computer-Assisted CBT and Mobile Apps for Depression: Assessment and Integration Into Clinical Care.

A surge in the development of computer-assisted cognitive-behavioral therapy (CCBT) and mobile apps for depression has provided many tools with potential for enhancing treatment delivery. This article assesses progress in evaluation and implementation of CCBT and mobile apps for depression, with a focus on providing practical information on clinical applications. Advantage and disadvantages of these technologies are identified, outcome research is reviewed, and recommendations are made for clinical use. With increasing use of computer technology in everyday life, it is likely that clinicians and patients will pursue opportunities to employ computer tools in treatment for depression.

Computer-Assisted Cognitive-Behavioral Therapy to Treat Adolescents With Depression in Primary Health Care Centers in Santiago, Chile: A Randomized Controlled Trial.

Introduction: Evidence from developed countries shows the efficacy of computer-assisted cognitive-behavioral therapy (cCBT) in addressing adolescent depression in home and/or school settings. This paper presents the results of a randomized controlled trial (RCT) of a brief therapist-guided cCBT intervention for adolescent depression in resource-constrained primary health care (PHC) settings. Material and methods: A multicenter, two-arm parallel-group, individually RCT with a 1:1 allocation ratio assigned 216 depressed adolescents (aged 15–19) attending four PHC centers in a low-income municipality of Santiago, Chile, to receive eight weekly face-to-face therapist-guided cCBT sessions by study therapists (N = 108), or to receive an enhanced usual care (EUC) intervention by trained PHC psychologists, encouraged to adhere to the national clinical guidelines for the management of depression (N = 108). Both groups received pharmacotherapy concordant with these guidelines. The primary outcome was the Beck Depression Inventory (BDI) at 4 months post-randomization, to assess depressive symptoms. BDI at 6 months post-randomization was a secondary outcome. Additional measures included patients’ compliance, and satisfaction with different treatment components, at 6 months post-randomization. Main Results: The adjusted difference in mean BDI score between groups was -3.75 (95% CI -6.23 to -1.28; p = 0.003) at 4 months post-randomization. At 6 months post-randomization, the adjusted difference in mean BDI score between groups was -2.31 (95% CI -4.89 to 0.27; p = 0.078). The effect size was small-to-medium at 4 months post-randomization, d = 0.39 (0.12 to 0.67), and small and non-significant at 6 months post-randomization d = 0.29 (-0.00 to 0.59). Adolescents in the experimental treatment group were significantly more satisfied with treatment, with the PHC centers’ facilities, with the psychological care received, and with non-professional staff than those in the comparator treatment group. Discussion: A brief therapist-guided cCBT eight-session intervention improves the response of depressed adolescents attending PHC centers at 4 months post-randomization. At 6 months post-randomization, the differences of between groups were not significant. Future research may focus on exploring strategies to sustain and increase response. Clinical trial registration: www.ClinicalTrials.gov, identifier NCT01862913 and URL: https://clinicaltrials.gov/ct2/show/NCT01862913.

Family Accommodation as a Predictor of Cognitive-Behavioral Treatment Outcome for Childhood Anxiety

The current study examined the association of family accommodation (i.e., assisting the child to avoid experiencing anxiety and/or removing demands secondary to anxiety) and treatment remission and response among 72 youth (ages 7 to 13 years) who participated in a randomized clinical trial of a computer-assisted cognitive-behavioral therapy for pediatric anxiety. Measures of family accommodation, anxiety, treatment improvement, and functional impairment were administered. Results suggest that every one unit increase in the level of impact of accommodation on child functioning at baseline was associated with a 26% decrease in the odds of remission at the end of treatment. None of the accommodation subscales predicted treatment response. Findings support the practitioner assessing family accommodation at baseline and further research on family accommodation and treatment outcomes.

Barriers to access and participation in community mental health treatment for anxious children

BackgroundAnxiety disorders are the most common psychiatric disorders among children in the United States; yet many children do not receive treatment due to barriers to treatment access and participation. This study examined common barriers to treatment access and participation among anxious children who participated in computer-assisted cognitive behavioral therapy. Differences in barriers reported by treatment completers/non-completers were examined, as was the association with sociodemographic characteristics, anxiety severity, and impairment. The impact of barriers on treatment response was assessed, as well as the relationship with treatment expectancy and satisfaction. MethodBarriers to access and participation, demographics, anxiety severity/impairment, treatment credibility and satisfaction were assessed among parents and children with anxiety (N=100; ages 7–13) who were enrolled in a community-based randomized clinical trial. ResultsThe most common access barrier was parents not knowing where or from whom to seek services (66%). Differences among completers and non-completers were related to stigma, confidentiality, and costs. The most common parent-reported barrier to participating was stress (32.4%) and child-reported barrier to participation was not having enough time to complete homework (22.1%). Of the sociodemographic, clinical and treatment characteristics, minority status, satisfaction, and treatment response were associated with barriers to treatment participation, although these associations varied by barriers related to treatment and external factors. LimitationsCross sectional design and lack of well-established psychometric properties for barriers measures were limitations. ConclusionFindings suggest that accessible, time-efficient, cost-effective service delivery methods that minimize stigma and maximize engagement when delivering evidence-based treatment for pediatric anxiety are needed.

Refining Clinical Judgment of Treatment Response and Symptom Remission Identification in Childhood Anxiety Using a Signal Detection Analysis on the Pediatric Anxiety Rating Scale.

The purpose of this study was to determine guidelines for delineating treatment response and symptom remission for children with anxiety disorder based on the five item and Pediatric Anxiety Rating Scale (PARS5), and replicate guidelines using the six item PARS (PARS6). Participants were 73 children 7-13 years of age with a primary anxiety disorder who received computer-assisted cognitive behavioral therapy for anxiety. Signal detection analyses utilizing receiver operating curve procedures were used to determine optimal guidelines for defining treatment response and symptom remission for youth with anxiety disorders on the PARS5 and PARS6. The percent reduction in anxiety severity was used to predict treatment responder status. The percent reduction in symptoms and posttreatment raw score were used to predict remission status. Optimal prediction of treatment response based on gold standard criteria was achieved at 15-20% reduction in symptoms on the PARS5 (with 20% reduction achieving marginally higher accuracy), and 20% reduction on the PARS6. A 25% reduction in symptoms on the PARS5 or a posttreatment raw score cutoff of 9 optimally predicted remission status. For the PARS6, a cutoff of 35% reduction or a posttreatment score of 11, was considered optimal for determining remission in clinical settings, whereas a 30% reduction or score of 12 was considered optimal for research settings. With different scoring options available for the PARS, these results provide guidelines for determining response and remission based on the PARS5 and PARS6 scores. Guidelines have implications for use in clinical trials, as well as for assessment of change in clinical practice.

A RANDOMIZED CONTROLLED TRIAL IN COMMUNITY MENTAL HEALTH CENTERS OF COMPUTER-ASSISTED COGNITIVE BEHAVIORAL THERAPY VERSUS TREATMENT AS USUAL FOR CHILDREN WITH ANXIETY.

This study aims to examine the real-world effectiveness of a computer-assisted cognitive behavioral therapy (CBT) protocol relative to treatment as usual (TAU) among anxious children presenting at community mental health centers. One hundred children (7-13 years) with clinically significant anxiety were randomized to receive either 12 weekly computer-assisted CBT sessions or TAU for an equivalent duration. Assessments were conducted by independent evaluators at screening/baseline, midtreatment, posttreatment, and 1-month followup (for computer-assisted CBT treatment responders). There were significant between-group effects favoring thecomputer-assisted CBTcondition on primary anxiety outcomes. Thirty of 49 (61.2%) children randomized to computer-assisted CBT responded to treatment, which was superior to TAU (6/51, 11.8%). Relative to TAU, computer-assisted CBT was associated with greater reductions in parent-rated child impairment and internalizing symptoms, but not child-rated impairment and anxiety and depressive symptoms. Treatment satisfaction and therapeutic alliance in those receiving computer-assisted CBT was high. Treatment gains in computer-assisted CBT responders were maintained at 1-month followup. Within the limitations of this study, computer-assisted CBT is an effective and feasible treatment for anxious children when used in community mental health centers by CBT-naïve clinicians.

An examination of the bidirectional relationship between functioning and symptom levels in patients with anxiety disorders in the CALM study.

Patients with anxiety disorders suffer marked functional impairment in their activities of daily living. Many studies have documented that improvements in anxiety symptom severity predict functioning improvements. However, no studies have investigated how improvements in functioning simultaneously predict symptom reduction. We hypothesized that symptom levels at a given time point will predict functioning at the subsequent time point, and simultaneously that functioning at a given time point will predict symptom levels at a subsequent time point. Patients were recruited from primary-care centers for the Coordinated Anxiety Learning and Management (CALM) study and were randomized to receive either computer-assisted cognitive-behavioral therapy and/or medication management (ITV) or usual care (UC). A cross-lagged panel design examined the relationship between functional impairment and anxiety and depression symptom severity at baseline, 6-, 12-, and 18-month follow-up assessments. Prospective prediction of functioning from symptoms and symptoms from functioning were both important in modeling these associations. Anxiety and depression predicted functioning as strongly as functioning predicted anxiety and depression. There were some differences in these associations between UC and ITV. Where differences emerged, the UC group was best modeled with prospective paths predicting functioning from symptoms, whereas symptoms and functioning were both important predictors in the ITV group. Treatment outcome is best captured by measures of functional impairment as well as symptom severity. Implications for treatment are discussed, as well as future directions of research.

Computer-assisted cognitive behavioral therapy for pregnant women with major depressive disorder.

Pregnant women with major depressive disorder (MDD) report that psychotherapy is a more acceptable treatment than pharmacotherapy. However, although results of several studies suggest that psychotherapy is an effective treatment for pregnant women, logistical barriers-including cost and traveling for weekly visits-can limit real-world utility. We hypothesized that computer-assisted cognitive behavior therapy (CCBT) would be both acceptable and would significantly decrease depressive symptoms in pregnant women with MDD. As a preliminary test of this hypothesis, we treated 10 pregnant women with MDD using a standardized CCBT protocol. The pilot results were very promising, with 80% of participants showing treatment response and 60% showing remission after only eight sessions of CCBT. A larger, randomized controlled trial of CCBT in pregnant women with MDD is warranted.

Computer-assisted cognitive-behavioral therapy for adolescent depression in primary care clinics in Santiago, Chile (YPSA-M): study protocol for a randomized controlled trial.

BackgroundDepression is a common and disabling condition. In Chile, assistance is guaranteed by law through a national program for depression in primary care services, and there is evidence of effective treatment for depressed women. However, there is a shortage of evidence-based treatments for depression in adolescents. The incorporation of technology to expand therapeutic options is becoming more common. This proposal aims to compare the efficacy of therapy that enhances traditional face-to-face cognitive-behavioral therapy (CBT) with a computer-based program versus usual care to treat depression in adolescents in primary care clinics in Santiago, Chile.Methods and designThis is a two-arm, single-blind, randomized controlled trial with a target enrollment of 216 depressed adolescents between 15 and 19 years of age, attending four primary care clinics in Santiago, Chile. In the active arm, depressed adolescents will receive eight sessions of computer-assisted CBT, led by trained psychologists on a weekly basis. In the control arm, depressed adolescents will receive treatment as usual from the primary care centers. Mean depression scores and indicators of dysfunctional thoughts, problem-solving strategies, and health-related quality of life will be measured at baseline and four and six months after randomization.DiscussionAs far as we know, this is the first randomized controlled trial of a computer-assisted CBT intervention for depressed adolescents in a Latin American country.Trial registrationClinical Trials: NCT01862913

Cognitive Behavior Therapies (CBT) in Childhood and Adolescent Mood Disorders and Anxiety Disorders: A Review

In this study, it is aimed to review efficacy of Cognitive Behavioral Therapy (CBT) and Cognitive Behavioral Group Therapy (CBGT) on childhood and adolescence in mood and anxiety disorders. Many researches have shown that cognitive behaviour therapy (CBT) can be effective in the treatment of depression and anxiety in children and adolescents. Child and adolescent depression and anxiety are frequent disorders which may have a recurring and chronic course. PsycINFO, Medline and the Turkish Psychiatric databases were searched, using the key words ‘depressive disorder’, ‘anxiety disorders’ ‘cognitive behavioural treatment’. Then, the journals were examined which had been published in recent years. Individual cognitive behavioral therapy (ICBT) and group cognitive behavioral therapy (GCBT) are the treatment options whose efficacies have been proven in the treatment of depression and anxiety in children and adolescents. Furthermore, some cognitive behavioral therapy-based programs such as “Coping Cat”, “Coping Koala”, “FRIENDS” and family anxiety management programs, have been used among depressive and anxious children and adolescents. Currently, there are different treatment options like computer-assisted cognitive behavioral therapy, computer-based cognitive behavioral therapy and also, internet-based CBT. However, preliminary evidence suggests that computerised cognitive behaviour therapies (cCBT), are acceptable and effective interventions for children and adolescents. In this study is to review not only the effectiveness of cognitive behaviour treatments of depression and anxiety in children and adolescents but also the tecniques which have been used and their effects on the course and the treatments.

A randomized controlled trial of ecological momentary intervention plus brief group therapy for generalized anxiety disorder.

Momentary intervention has been proposed as a cost-effective, generalizable, and ecologically valid method to increase the efficiency of face-to-face cognitive-behavioral therapy (CBT). The purpose of the current pilot study was to evaluate the efficacy of a six-session palmtop computer-assisted Group CBT for generalized anxiety disorder (GAD) (CAGT6) in comparison with a six-session Group CBT for GAD without the computer (CBGT6) and typical (12 session) Group CBT for GAD (CBGT12) in a randomized controlled trial. Thirty-four individuals with a primary diagnosis of GAD were randomized to one of the three conditions and completed measures of GAD and anxiety before therapy, after therapy, and at 6-, and 12-month follow-ups. Results indicated that CAGT6 was superior to CBGT6 at posttreatment, but not significantly different from CBGT12. At 6- and 12-month follow-ups, CAGT6 was neither significantly different from CBGT6, nor from CBGT12. Percentages of individuals achieving reliable change on two of the three GAD measures favored CAGT6 over CBGT6 at posttreatment, suggesting promise for the added value of the mobile technology.

Consumers’ and Providers’ Perceptions of Utilizing a Computer-Assisted Cognitive Behavioral Therapy for Childhood Anxiety

Computer-assisted cognitive behavioral therapy (CCBT) programs for childhood anxiety are being developed, although research about factors that contribute to implementation of CCBT in community mental health centers (CMHC) is limited. The purpose of this mixed-methods study was to explore consumers' and providers' perceptions of utilizing a CCBT for childhood anxiety in CMHC in an effort to identify factors that may impact implementation of CCBT in CMHC. Focus groups and interviews occurred with 7 parents, 6 children, 3 therapists, 3 project coordinators and 3 administrators who had participated in CCBT for childhood anxiety. Surveys of treatment satisfaction and treatment barriers were administered to consumers. RESULTS suggest that both consumers and providers were highly receptive to participation in and implementation of CCBT in CMHC. Implementation themes included positive receptiveness, factors related to therapists, treatment components, applicability of treatment, treatment content, initial implementation challenges, resources, dedicated staff, support, outreach, opportunities with the CMHC, payment, and treatment availability. As studies continue to demonstrate the effectiveness of CCBT for childhood anxiety, research needs to continue to examine factors that contribute to the successful implementation of such treatments in CMHC.

Computer-assisted cognitive behavioral therapy for children with epilepsy and anxiety: A pilot study

Anxiety disorders are prevalent in children with epilepsy. The purpose of this study was to evaluate the efficacy, adaptability, and feasibility of a manual-based, computer-assisted cognitive behavioral therapy (CBT) intervention for anxiety disorders in children with epilepsy. Fifteen anxious youth (aged 8–13years) with epilepsy completed 12weeks of manualized computer-assisted CBT. The children and parents completed a semi-structured interview at baseline, and questionnaires assessing symptoms of anxiety, depression, and behavior problems were completed prior to treatment, at treatment midpoint, after treatment completion, and at three months posttreatment. There were significant reductions in the symptoms of anxiety and depression reported by the children at completion of the intervention and at the three-month follow-up. Similarly, the parents reported fewer symptoms of anxiety and a reduction in behavior problems. No adverse events were reported. This CBT intervention for children with epilepsy and anxiety disorders appears to be safe, effective, and feasible and should be incorporated into future intervention studies.

SKOMPUTERYZOWANA LINGWISTYKA I PSYCHOLOGIA POKONUJĄC OGRANICZENIA POLIGRAFU

We developed an auxiliary tool, named “Software Human Reliability Estimator” (SHRE), which in certain cases can replace the polygraph. The polygraph is not always effective in measuring the reliability of a witness. For instance, the polygraph is ineffective when the witness believes that the testimony is the truth even when in reality it is not. In such cases, an alternative objective test is required. Another disadvantage of the polygraph test lies in the lack of discreetness owing to the requirement that the witness must agree to undergo a polygraph test. In addition, the polygraph test cannot be performed in real time because of its cumbersome and bulky nature. These drawbacks have motivated the search for alternatives to the polygraph. Herein, we suggest a methodology accompanied by a corresponding software package that overcomes the mentioned shortcomings of the polygraph. The methodology is based on a computer-assisted cognitive behavioral therapy methodology (CBT) (Burns 1999). CBT was originally developed for psychological treatment and can be used to characterize personalities. This methodology can also be used to find the individual’s personality disturbances and to evaluate the reliability of a witness. The CBT methodology assumes that the cognitive thoughts of a human are expressed in his language. In the literature, about ten categories of thoughts are determined, and so called distorted thoughts, indicate a behavioral deviation. Based on the above assumption, it is possible to map thoughts, including distorted thoughts and analyze them methodically with the help of linguistic tools. These tools should be able to scan the mapping and discover distorted thoughts as classified by the CBT method. We will use extreme situations as examples to illustrate distorted thoughts. The mentioned situations will refer to time description (always, never), location (everywhere, nowhere), quantity (everything, nothing, nobody), possibility (must, forced, incapable) etc. These types of expressions leave no doubt as to their meanings. The linguistic analysis is performed at two levels: semantic and syntactic. The first stage is the semantic analysis. Here, the vocabulary of the sentence is analyzed. The known linguistic term, quantitative-semantics, is given a special significance since it enables a pre-ranking of the nouns, adjectives, adverbs beyond their regular usage. Quantitative semantics analysis searches especially for superlatives such as “never”, which indicate an extreme case. This analysis is supported in the first stage by using an expression named “distinguished”. In order to find distinguished expressions it is recommended to use in the second stage of the analysis a methodology borrowed from formal-languages, a field in computer sciences. This analysis is supposed to strengthen or eliminate the indications found in the first analysis stage, the semantic analysis.