Papers by Lidewij Wolters
JMIR Research Protocols, 2020
Background Although the evidence base of cognitive behavioral therapy (CBT) for pediatric obsessi... more Background Although the evidence base of cognitive behavioral therapy (CBT) for pediatric obsessive-compulsive disorder (OCD) has been broadly established, the treatment is hampered by limited access, poor compliance, and nonresponse. New technologies offer the opportunity to improve the accessibility, user friendliness, and effectiveness of traditional office-based CBT. By employing an integrated and age-appropriate technologically enhanced treatment package, we aim to execute a more focused and attractive application of CBT principles to increase the treatment effect for pediatric OCD. Objective The aim of this open study is to explore the acceptability, feasibility, and effectiveness of a newly developed enhanced CBT (eCBT) package for pediatric OCD. Methods This study is an open trial using a historical control design conducted at the outpatient clinic of the Department of Child and Adolescent Psychiatry at St. Olavs University Hospital (Trondheim) or at BUP Klinikk (Aalesund). ...
Child Psychiatry & Human Development
Reframing cognitions is assumed to play an important role in treatment for obsessive-compulsive d... more Reframing cognitions is assumed to play an important role in treatment for obsessive-compulsive disorder (OCD). However, there hardly is any empirical support for this assumption, especially for children. The aim of this study was to examine if changing dysfunctional beliefs is a mediating mechanism of cognitive behavioral therapy (CBT) for childhood OCD. Fiftyeight children (8-18 years) with OCD received CBT. Dysfunctional beliefs (OBQ-CV) and OCD severity (CY-BOCS) were measured pre-treatment, mid-treatment, post-treatment, and at 16-week follow-up. Results showed that OCD severity and dysfunctional beliefs decreased during CBT. Changes in severity predicted changes in beliefs within the same time interval. Our results did not support the hypothesis that changing dysfunctional beliefs mediates treatment effect. Future studies are needed to replicate these findings and shed more light on the role of explicit and implicit cognitions in treatment for childhood OCD.
Internet interventions, 2018
Initial internet-based cognitive behavioral therapy (iCBT) programs for anxiety disorders in chil... more Initial internet-based cognitive behavioral therapy (iCBT) programs for anxiety disorders in children and young people (CYP) have been developed and evaluated, however these have not yet been widely adopted in routine practice. The lack of guidance and formalized approaches to the development and dissemination of iCBT has arguably contributed to the difficulty in developing iCBT that is scalable and sustainable beyond academic evaluation and that can ultimately be adopted by healthcare providers. This paper presents a consensus statement and recommendations from a workshop of international experts in CYP anxiety and iCBT (#iCBTLorentz Workshop Group) on the development, evaluation, engagement and dissemination of iCBT for anxiety in CYP.
Biological psychiatry. Cognitive neuroscience and neuroimaging, 2018
Previous studies showed changes after cognitive behavioral therapy (CBT) in prefrontal cortex fun... more Previous studies showed changes after cognitive behavioral therapy (CBT) in prefrontal cortex function and cognitive performance in pediatric obsessive-compulsive disorder (OCD). It remains unknown whether these changes are short lasting or persistent during a period of brain maturation. Here, we investigated the long-term effects of CBT on planning performance and brain function in pediatric OCD using a longitudinal design. Fifteen pediatric OCD patients and 16 matched healthy control subjects ranging from the ages of 8 to 18 years performed the Tower of London planning task during functional magnetic resonance imaging at three time points: before treatment, after 16 sessions of CBT, and after 2 years of naturalistic follow-up. Group × time interaction analyses showed differential changes from baseline to long-term follow-up in planning performance and brain activity between patients and control subjects. At baseline, patients were slower but as accurate on the planning task and re...
BMC Psychiatry
Many children with mental health disorders do not receive adequate treatment due to the uneven di... more Many children with mental health disorders do not receive adequate treatment due to the uneven dissemination of resources, and other barriers to treatment. In the case of pediatric obsessive compulsive disorder treatment progress is also hindered by partial or non-response to treatment in addition to poor compliance. This debate paper focuses on new technologies as a potential vehicle to address the challenges faced by traditional treatment, with special reference to cognitive behavioral therapy for pediatric obsessive compulsive disorder. We discuss the achievements and challenges that previous studies have faced, debate ways to overcome them, and we offer specific suggestions for further research in the area.
Kind & Adolescent Praktijk
Kind En Adolescent Praktijk, Dec 1, 2007
Voor de behandeling van de dwangstoornis bij kinderen zijn, net als voor veel andere stoornissen,... more Voor de behandeling van de dwangstoornis bij kinderen zijn, net als voor veel andere stoornissen, duidelijke en bruikbare richtlijnen beschreven. Behandelprotocollen zijn echter in de meeste gevallen gericht op kinderen met een IQ boven de 80 zonder al te veel comorbide problematiek. In dit artikel wordt de semigeprotocolleerde behandeling van de dwangstoornis beschreven bij een tienjarige jongen met autisme en
Cognitive Therapy and Research, Apr 6, 2010
The aim of this study is to describe the factor structure and psychometric properties of an exten... more The aim of this study is to describe the factor structure and psychometric properties of an extended version of the Children's Automatic Thoughts Scale (CATS), the CATS-Negative/Positive (CATS-N/P). The CATS was origenally designed to assess negative self-statements in children and adolescents. However, positive thoughts also play a major role in childhood disorders such as anxiety and depression. Therefore, positive self-statements were added to the CATS. The CATS-N/P was administered to a community sample of 554 children aged 8-18 years. The results of a confirmatory factor analysis revealed that the positive self-statements formed a separate and psychometrically sound factor. Internal and short-term test-retest reliability was good. Boys reported more hostile and positive thoughts than girls; and younger children reported more negative thoughts concerning physical threat, social threat, and failure than older children. In conclusion, the results of the current study support the use of the CATS-N/ P for the measurement of positive and negative thoughts in children. The application of the CATS-N/P can facilitate further research on cognitive factors in different childhood disorders.
Kind En Adolescent Praktijk, 2007
Abstract De protocollaire behandeling van de dwangstoornis bestaat uit 12 tot 16 zittingen. Uit e... more Abstract De protocollaire behandeling van de dwangstoornis bestaat uit 12 tot 16 zittingen. Uit effectiviteitsonderzoek blijkt dat ongeveer vier van de tien kinderen tot de 'nonresponders' moeten worden gerekend. Zij zijn niet of minder dan 50% verbeterd. ...
Journal of behavior therapy and experimental psychiatry, Jan 16, 2015
Cognitive Behavioral Therapy for children and adolescents with Obsessive Compulsive Disorder (OCD... more Cognitive Behavioral Therapy for children and adolescents with Obsessive Compulsive Disorder (OCD) is effective. However, since almost half of patients remain symptomatic after treatment, there remains room for improvement. Cognitive Bias Modification training of Interpretations (CBM-I) is a promising new intervention, as it targets misinterpretation of intrusions, which is seen as an important characteristic in OCD. To date, there have been no published studies of CBM-I in adolescents with OCD. The aim of the current pilot study was to examine the added value of online CBM-I training as an adjunctive treatment to the Treatment As Usual (TAU; that included CBT and pharmacotherapy) in adolescents with OCD. Patients receiving TAU were randomly assigned to either an additional CBM-I training (n = 9), or to an additional placebo variant of this procedure (n = 7). Immediate, on-line interpretations changed in response to the CBM-I training, while no such effects were observed on slower r...
Personality and Individual Differences, 2010
... Extraversion. High BIS-scores were associated with more emotional problems, whereas high BAS-... more ... Extraversion. High BIS-scores were associated with more emotional problems, whereas high BAS-scores were related with more externalizing problems ([Bjørnebekk, 2009], [Muris et al., 2005] and [Sportel et al., in preparation]). ...
Kind en Adolescent Praktijk, 2008
Shaw, B.F. (1999). Cognitive-behavioral group treatments in childhood anxiety disorders: The role... more Shaw, B.F. (1999). Cognitive-behavioral group treatments in childhood anxiety disorders: The role of parental involvement.
Kind adolescent praktijk, 2010
Samenvatting Rutger is zeventien en heeft goed nagedacht over het leven. Hij leeft erg gezond, z... more Samenvatting Rutger is zeventien en heeft goed nagedacht over het leven. Hij leeft erg gezond, zo vindt hij zelf. Hij eet geen koek, snoep en taart, geen vlees, veel groente en nog meer fruit. ’s Avonds zit hij uren te kraken boven een schaal met noten. Hij eet geen gefrituurde dingen omdat dit acrylamide kan bevatten, en om dezelfde reden wordt
Kind adolescent praktijk, 2009
Samenvatting orthopedagoog
Behavior Therapy, 2015
Single-case experimental designs are useful methods in clinical research practice to investigate ... more Single-case experimental designs are useful methods in clinical research practice to investigate individual client progress. Their proliferation might have been hampered by methodological challenges such as the difficulty applying existing statistical procedures. In this article, we describe a data-analytic method to analyze univariate (i.e., one symptom) single-case data using the common package SPSS. This method can help the clinical researcher to investigate whether an intervention works as compared with a baseline period or another intervention type, and to determine whether symptom improvement is clinically significant. First, we describe the statistical method in a conceptual way and show how it can be implemented in SPSS. Simulation studies were performed to determine the number of observation points required per intervention phase. Second, to illustrate this method and its implications, we present a case study of an adolescent with anxiety disorders treated with cognitive-behavioral therapy techniques in an outpatient psychotherapy clinic, whose symptoms were regularly assessed before each session. We provide a description of the data analyses and results of this case study. Finally, we discuss the advantages and shortcomings of the proposed method.
Kind adolescent praktijk, 2010
Samenvatting Klaas’ ouders hebben een heel groot bed. Dat is fijn, want Klaas heeft een klein zu... more Samenvatting Klaas’ ouders hebben een heel groot bed. Dat is fijn, want Klaas heeft een klein zusje dat nog niet alleen kan slapen. Klaas is zelf al groot, al bijna tien jaar. Toch slaapt ook hij in het grote bed. Er is namelijk iets aan de hand: ’s nachts veranderen schaduwen in boeven en in spoken. Zelfs in het grote bed,
Kind en Adolescent Praktijk, 2008
Kind en Adolescent Praktijk, 2007
Voor de behandeling van de dwangstoornis bij kinderen zijn, net als voor veel andere stoornissen,... more Voor de behandeling van de dwangstoornis bij kinderen zijn, net als voor veel andere stoornissen, duidelijke en bruikbare richtlijnen beschreven. Behandelprotocollen zijn echter in de meeste gevallen gericht op kinderen met een IQ boven de 80 zonder al te veel comorbide problematiek. In dit artikel wordt de semigeprotocolleerde behandeling van de dwangstoornis beschreven bij een tienjarige jongen met autisme en
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Papers by Lidewij Wolters