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Attitudes of Professionals and the General Public in Israel Regarding ICBT

Primary Purpose

Panic Disorder, Depression

Status
Completed
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
ICBT for panic and depression
Sponsored by
Hebrew University of Jerusalem
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Panic Disorder

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Principal DSM-5 diagnosis of panic disorder or depression
  • aged 18 years or older;
  • if on medications for panic or depression, the dosage has to remain constant for 2 months prior to the start of treatment and cannot be increased during treatment;
  • the participant must have access to the internet and be willing to use it -

Exclusion Criteria:

  • substance abuse or dependence within the last 6 months;
  • active suicide potential within the last 6 months;
  • any current or history of psychosis or bipolar I disorder
  • currently in weekly or biweekly psychotherapy
  • history of a complete course of panic or depression focused CBT

Sites / Locations

    Arms of the Study

    Arm 1

    Arm Type

    Experimental

    Arm Label

    internet based CBT

    Arm Description

    all patients will be offered active treatment via internet based CBT

    Outcomes

    Primary Outcome Measures

    Change in Panic Disorder Severity Scale: Independent Evaluator Version (for panic disorder)
    measure of a severity of panic disorder assessed by an independent evaluator. Only administered to panic patients. It is comprised of 7 items that are scored from 0-4, with a total scale score ranging from 0-28. Higher scores mean more severe panic disorder symptoms.
    Change in Panic Disorder Severity Scale: Independent Evaluator Version (for panic disorder)
    measure of a severity of panic disorder assessed by an independent evaluator. Only administered to panic patients. It is comprised of 7 items that are scored from 0-4, with a total scale score ranging from 0-28. Higher scores mean more severe panic disorder symptoms.
    Change in Hamilton Depression Scale- 17 item adjusted version
    Independent evaluator measure of depression severity, higher score is more severe symptoms. total score is sum of the items, ranging from 0-52
    Change in Hamilton Depression Scale- 17 item adjusted version
    Independent evaluator measure of depression severity, higher score is more severe symptoms.total score is sum of the items, ranging from 0-52

    Secondary Outcome Measures

    Change in Panic disorder severity scale - self report version
    a self-report measure of panic disorder severity. Only administered to panic patients. It consists of 7 items that are scored from 0-4, with a total scale score ranging from 0-28. Higher scores mean more severe panic disorder symptoms.
    Change in Panic disorder severity scale - self report version
    a self-report measure of panic disorder severity. Only administered to panic patients. It consists of 7 items that are scored from 0-4, with a total scale score ranging from 0-28. Higher scores mean more severe panic disorder symptoms.
    Change in Physicians Health Questionnaire (PHQ-9)
    A self report measure of depression- depression sample only, higher score is more severe symptoms, total scores are sums of items, ranging from 0-27.
    Change in Physicians Health Questionnaire (PHQ-9)
    A self report measure of depression- depression sample only, higher score is more severe symptoms.total scores are sums of items, ranging from 0-27.
    Change in Internet Patient's Experience of Attunement and Responsiveness scale (I-PEAR)
    This is an alliance scale in internet based treatment related the program and the therapist, it has been used as average between 1-5, higher score is better alliance,
    Change in Anxiety Sensitivity Index (ASI)
    The ASI-3 is an 18-item self-report measure that measures beliefs regarding panic related bodily sensations. It will be used as a total score, which ranges from 0-72. Higher scores mean more severe anxiety sensitivity.
    Change in Anxiety Sensitivity Index (ASI)
    The ASI-3 is an 18-item self-report measure that measures beliefs regarding panic related bodily sensations. It will be used as a total score, which ranges from 0-72. Higher scores mean more severe anxiety sensitivity.
    Change in Mobility Inventory (MI)
    The Mobility Inventory is a self report measure of agoraphobic avoidance in which patients are asked to rate how much they avoid 26 situations on a 1-5 scale twice, once when alone and a second time when accompanied. The average score of all times will be used, which will range from 1-5. Higher total score means higher avoidance of situations. Only administered to panic patients.
    Change in Mobility Inventory (MI)
    The Mobility Inventory is a self report measure of agoraphobic avoidance in which patients are asked to rate how much they avoid 26 situations on a 1-5 scale twice, once when alone and a second time when accompanied. The average score of all times will be used, which will range from 1-5. Higher total score means higher avoidance of situations. Only administered to panic patients.
    Change in Depression Anxiety Stress Scales (DASS-21)
    A self-report measure of depression, anxiety and stress, with each subscale ranging from 0-28. for depression sample only
    Change in Depression Anxiety Stress Scales (DASS-21)
    A self-report measure of depression, anxiety and stress, with each subscale ranging from 0-28. for depression sample only
    Change in Brown Assessment of Beliefs Scale (BABS)
    this is an independent evaluator measure of insight. Consists of 7 items that are rated on a scale 0-4. Higher score is worse insight, only administered to panic patients
    Change in Brown Assessment of Beliefs Scale (BABS)
    this is an independent evaluator measure of insight. Consists of 7 items that are rated on a scale 0-4. Higher score is worse insight, only administered to panic patients
    Change in Scale for the Assessment of Insight (SAI)
    this is an independent evaluator measure of clinical insight. Consists of 4 items that are rated on a scale 0-2. Higher score is better insight, only administered to panic patients
    Change in Scale for the Assessment of Insight (SAI)
    this is an independent evaluator measure of clinical insight. Consists of 4 items that are rated on a scale 0-2. Higher score is better insight, only administered to panic patients
    Change in The Pittsburgh Sleep Quality Index (PSQI)
    This is a self-report questionnaire that assesses sleep quality over a 1-month time interval. The measure consists of 19 individual items, creating 7 components that produce one global score, The global PSQI score is then calculated by totaling the seven component scores, providing an overall score ranging from 0 to 21, higher score is worse sleep, adminstered only to the depression sample
    Change in The Pittsburgh Sleep Quality Index (PSQI)
    This is a self-report questionnaire that assesses sleep quality over a 1-month time interval. The measure consists of 19 individual items, creating 7 components that produce one global score, The global PSQI score is then calculated by totaling the seven component scores, providing an overall score ranging from 0 to 21, higher score is worse sleep, adminstered only to the depression sample
    Change in The Sheehan Disability Scale (SDS)
    this a self-report measure of disability due to an illness or health problem in work/school, social life/leisure activities, and family life/home. It includes 3 items that are rated on a scale 0-10. Higher score indicates worse disability and impairment.
    Change in The Sheehan Disability Scale (SDS)
    this a self-report measure of disability due to an illness or health problem in work/school, social life/leisure activities, and family life/home. It includes 3 items that are rated on a scale 0-10. Higher score indicates worse disability and impairment.
    Change in Self-Appraisal of Illness Questionnaire (SAIQ)
    this is a self-report measure that assess clinical insight, administered only to the panic sample. It consists of 17 items that are rates on a scale 0-3. Higher scores means worse clinical insight.
    Change in Self-Appraisal of Illness Questionnaire (SAIQ)
    this is a self-report measure that assess clinical insight, administered only to the panic sample. It consists of 17 items that are rates on a scale 0-3. Higher scores means worse clinical insight.
    Change in Beck Cognitive Insight Scale (BCIS)
    this is a self-reported measure that assess cognitive insight, administered only to the panic sample. It consists of 15 items that are rates on a scale 0-3. Higher score means better cognitive insight.
    Change in Beck Cognitive Insight Scale (BCIS)
    this is a self-reported measure that assess cognitive insight, administered only to the panic sample. It consists of 15 items that are rates on a scale 0-3. Higher score means better cognitive insight.
    Change in Cognitive Flexibility Inventory (CFI)
    this is a self-reported measure that assess aspects of cognitive flexibility, administered only to the panic sample. It consists of 20 items that are rated on a scale 1-7. Higher score means greater cognitive flexibility.
    Change in Cognitive Flexibility Inventory (CFI)
    this is a self-reported measure that assess aspects of cognitive flexibility, administered only to the panic sample. It consists of 20 items that are rated on a scale 1-7. Higher score means greater cognitive flexibility.
    Change in Metacognition Questionnaire - 30 item version (MCQ-30)
    is a self-reported measure that assess metacognition, administered only to the panic sample. The MCQ consists of 30 items that are rated on a scale 1-4. Higher score indicated higher level of unhelpful metacognitions.
    Change in Metacognition Questionnaire - 30 item version (MCQ-30)
    is a self-reported measure that assess metacognition, administered only to the panic sample. The MCQ consists of 30 items that are rated on a scale 1-4. Higher score indicated higher level of unhelpful metacognitions.
    Change in Beck Depression Inventory -21 (BDI-21)
    This is a self-report measure that assess depression, 21 items, administered only to depression sample, score ranges 0-63, higher is more severe.
    Change in Beck Depression Inventory -21 (BDI-21)
    This is a self-report measure that assess depression, 21 items, administered only to depression sample, score ranges 0-63, higher is more severe.
    Change in Implicit Theories of Emotion (TOE)
    Thisis a self-reported scale to measure beliefs about the fixed versus malleable nature of anxiety, administered only to the panic sample. The TOE consists of 4 items that are rates on a scale 1-5. Higher score indicates that the individual views anxiety as being relatively malleable and controllable.
    Change in Implicit Theories of Emotion (TOE)
    This is a self-reported scale to measure beliefs about the fixed versus malleable nature of anxiety, administered only to the panic sample. The TOE consists of 4 items that are rates on a scale 1-5. Higher score indicates that the individual views anxiety as being relatively malleable and controllable.
    Change in Implicit Theories of Thoughts (TOT)
    This is a self-reported scale measure beliefs about the nature of thoughts, administered only to the panic sample.The TOT consists of 4 items that are rates on a scale 1-5. Higher score indicates that the individual views thoughts as being relatively malleable and controllable.
    Change in Implicit Theories of Thoughts (TOT)
    This is a self-reported scale measure beliefs about the nature of thoughts, administered only to the panic sample.The TOT consists of 4 items that are rates on a scale 1-5. Higher score indicates that the individual views thoughts as being relatively malleable and controllable.
    Change in Brief Body Sensations Interpretations Questionnaire (BBSIQ)
    This is a self-reported scale to measure body sensations interpretations, administered only to the panic sample. The BBSIQ includes 14 items, higher score means more negative explanation of body sensations.
    Change in Brief Body Sensations Interpretations Questionnaire (BBSIQ)
    This is a self-reported scale to measure body sensations interpretations, administered only to the panic sample. The BBSIQ includes 14 items, higher score means more negative explanation of body sensations.
    Change in Five-Dimensional Curiosity Scale (5DC)
    The DCS-5 is a self-report measure that measures 5 dimensions of curiosity via 25 items which are rated on a 1-7 scale. The total score of all 25 (ranging from 25-175) items and 5 subscales (each ranging from 5-35) will be used for this study. Higher scores reflect higher curiosity. Administered only to the panic sample.
    Change in Five-Dimensional Curiosity Scale (5DC)
    The DCS-5 is a self-report measure that measures 5 dimensions of curiosity via 25 items which are rated on a 1-7 scale. The total score of all 25 (ranging from 25-175) items and 5 subscales (each ranging from 5-35) will be used for this study. Higher scores reflect higher curiosity. Administered only to the panic sample.
    Change in The five-level EuroQol five-dimensional questionnaire (EQ-5D-5L)
    This is a self-reported measure of health related quality of life. It consists of five dimensions (Mobility, Self-care, Usual activities, Pain & discomfort, Anxiety & depression). Higher score means worse functioning in these dimensions.
    Change in The five-level EuroQol five-dimensional questionnaire (EQ-5D-5L)
    This is a self-reported measure of health related quality of life. It consists of five dimensions (Mobility, Self-care, Usual activities, Pain & discomfort, Anxiety & depression). Higher score means worse functioning in these dimensions.
    Change in Work and Social Adjustment Scale (WSAS)
    This is a self-reported measure of functional impairment. It includes 5 items that are rated on a scale 0-8. Measured as total score ranging 0-40. Higher score means worse functional impairment.
    Change in Work and Social Adjustment Scale (WSAS)
    This is a self-reported measure of functional impairment. It includes 5 items that are rated on a scale 0-8. Measured as total score ranging 0-40. Higher score means worse functional impairment.
    Change in Working Alliance Inventory (WAI-6)
    This is a self-reported measure of therapeutic alliance, total score is average of the items, ranging from 1-7
    Change in The Experiences in Close Relationship Scale (ECR-S)
    The ECR-s is a brief self report instrument that measures both anxious and avoidance adult attachment styles. The two scales each contain 6 items rated on a 1-7 scale that are averages for each subscale, ranging from 1-7. Higher score indicates an insecure adult attachment orientation.
    Change in The Experiences in Close Relationship Scale (ECR-S)
    The ECR-s is a brief self report instrument that measures both anxious and avoidance adult attachment styles. The two scales each contain 6 items rated on a 1-7 scale that are averages for each subscale, ranging from 1-7. Higher score indicates an insecure adult attachment orientation.
    Change in The Agoraphobic Cognitions Questionnaire (ACQ)
    This is a self-reported scale to measure agoraphobia cognitions, administered only to the panic sample. It consists of 15 items that are rates on a scale 1-5. Higher score indicates worse dysfunctional cognitions in relation to potential catastrophic consequences arising from panic or anxiety.
    Change in The Agoraphobic Cognitions Questionnaire (ACQ)
    This is a self-reported scale to measure agoraphobia cognitions, administered only to the panic sample. It consists of 15 items that are rates on a scale 1-5. Higher score indicates worse dysfunctional cognitions in relation to potential catastrophic consequences arising from panic or anxiety.
    Change in Social Support Questionnaire (SSQ6)
    This is a self-reported measure of social support. The SSQ6 includes 6 items. The overall support score is calculated by taking an average scores across the 27 items. Higher score indicates more optimism about life, higher prevalence of negative life events and illness.Scoring is as follows: Add the total number of people for all 27 items (questions). (Max. is 243). Divide by 27 for average item score. Add the total satisfaction scores for all 27 items (questions). (Max is 162). Divide by 27 for average item score. This gives you SSQ Satisfaction score or SSQS. Finally, you can average the above for the total number of people that are family members - this results in the SSQ family score. Participants indicate the number of people available to provide support in each of 6 areas and then rate the overall level of satisfaction with the supp
    Change in Acceptability Scale for internet Therapy (ASIT)
    This is a self-reported measure of acceptance and readiness to receive internet treatment, It consists of 19 items that are rates on a scale 1-5, total sum is ranges 1- 95, Higher score indicates more acceptability.
    Change in Acceptability Scale for internet Therapy (ASIT)
    This is a self-reported measure of acceptance and readiness to receive internet treatment, It consists of 19 items that are rates on a scale 1-5, total sum is ranges 1- 95, Higher score indicates more acceptability.
    Change in Emotional Goals Questionnaire.
    This is a self-reported measure of emotional goals. is a self-reported measure of emotional goals. The measure assesses emotional preferences ro feel unpleasant emotions of (eg., depression, anxiety, etc) and beliefs about the fixed versus malleable nature of anxiety. Higher score indicates higher ability and willingness to feel unpleasant emotions and that the individual views anxiety as being relatively malleable and controllable.

    Full Information

    First Posted
    May 23, 2020
    Last Updated
    July 31, 2022
    Sponsor
    Hebrew University of Jerusalem
    Collaborators
    Israel National Institute for Health Policy and Health Services Research
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    1. Study Identification

    Unique Protocol Identification Number
    NCT04659577
    Brief Title
    Attitudes of Professionals and the General Public in Israel Regarding ICBT
    Official Title
    Attitudes of Professionals and the General Public in Israel Regarding Therapist Guided Internet Cognitive Behavioral Therapies (ICBT) to Treat Anxiety and Depression
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    July 2022
    Overall Recruitment Status
    Completed
    Study Start Date
    November 1, 2016 (Actual)
    Primary Completion Date
    August 31, 2021 (Actual)
    Study Completion Date
    January 31, 2022 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Principal Investigator
    Name of the Sponsor
    Hebrew University of Jerusalem
    Collaborators
    Israel National Institute for Health Policy and Health Services Research

    4. Oversight

    Studies a U.S. FDA-regulated Drug Product
    No
    Studies a U.S. FDA-regulated Device Product
    No
    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    This study examines uptake and attrition for internet based treatments for panic disorder and depression in Israel The primary benefits of this work will be a) in providing better understanding of ICBT for panic disorder and depression outcomes. Both panic and depression are heavy public health burdens, associated with a significant market potential for both therapeutic and diagnostic uses. b) In providing compatible scale to measure the working alliance during internet-based treatment.
    Detailed Description
    The current study examines ICBT for panic and depression in Israel. Compelling evidence regarding the efficacy of ICBT has been reported for the treatment of depression and various anxiety disorders (Mayo-Wilson & Montgomery; 2013). This the first study to examine ICBT for panic and depression in Israel. The primary focus will be on treatment outcomes (symptom reduction and improved functioning), attrition, and acceptability and comparing outcomes to previous studies of face to face and internet treatments, including on the main proposed mechanism of change; interpretation of bodily sensations via the BBSIQ. The efficacy of ICBT has been established in many studies, but is insufficient for implementation without adaptation to local cultural needs and language. We will also examine changes in healthcare utilization and costs according to the results. For the full programs of the current study see: https://www.iterapi.se/sites/icbt_israel and https://www.iterapi.se/sites/depression_israel/ The limited role of the therapist in ICBT is mainly to allow greater scaling. a second goal of the current study is to fill this gap by examining different aspects of the alliance with treatment outcomes and attrition using a newly developed self-report measure, the Internet Patient Experiences and Attunement Responsiveness (I-PEAR). We propose that the I-PEAR and its subscales (I-PEAR program; hereafter I-PEARp, I-PEAR therapist; hereafter I-PEARt; and Therapist-rated I-PEAR; hereafter thI-PEAR) will explain more variance of the outcome and dropouts than traditional scales (i.e., WAI-6, WAI-T). In the current study we examined the relationship between the alliance measures to treatment outcomes and attrition. Alll secondary measures will be examined in terms of change and how their change is related to change in symptoms (PDSS, ASI, MI in panic, PHQ, HAM-D in depression). These analyses include changes in attachment, insight, and emotions. Research is limited about the role of insight in panic disorder, therefore another secondary aim of this study is to examine the role of clinical (i.e., SAIQ and SAI) and cognitive insight (i.e., BCIS and BABS) in panic disorder, if they change and their relationship to symptom severity (i.e., PDSS, ASI, MI), symptom change, and correlates (e.g., cognitive flexibility, metacognition, jumping to conclusions, and implicit theories). Secondary studies will examine changes in self-criticism, emotion preferences and goals, sexual functioning, and curiosity and their relationship to outcomes.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Panic Disorder, Depression

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Not Applicable
    Interventional Study Model
    Single Group Assignment
    Model Description
    All eligible people are enrolled to internet-based CBT for panic disorder or depression
    Masking
    None (Open Label)
    Allocation
    N/A
    Enrollment
    130 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    internet based CBT
    Arm Type
    Experimental
    Arm Description
    all patients will be offered active treatment via internet based CBT
    Intervention Type
    Behavioral
    Intervention Name(s)
    ICBT for panic and depression
    Other Intervention Name(s)
    Internet Cognitive behavioral therapy for panic and depressive disorder.
    Intervention Description
    The most known type of CBT for treating PD consists of two major strategies: cognitive restructuring, and interoceptive and structured exposure to bodily sensations that have become associated with panic attacks. As for depression, the most known type of CBT for treating depression consists of two major strategies: cognitive restructuring, the relationship between thoughts and feelings, behavioural activation, sleep hygiene and relaxation. Each ICBT program includes six modules, containing psychoeducation, cognitive restructuring exposures, acceptance, and consolidation of gains and relapse prevention. The online modules include reading passages, worksheets, videos, and homework assignments. After completing each module participants practice related skills and complete homework assignments. The treatment is up to 16 weeks long; participants are encouraged to complete the treatment within this time period, and reminders are sent to monitor their progress
    Primary Outcome Measure Information:
    Title
    Change in Panic Disorder Severity Scale: Independent Evaluator Version (for panic disorder)
    Description
    measure of a severity of panic disorder assessed by an independent evaluator. Only administered to panic patients. It is comprised of 7 items that are scored from 0-4, with a total scale score ranging from 0-28. Higher scores mean more severe panic disorder symptoms.
    Time Frame
    Weekly during treatment from pre treatment to post treatment, up to 6 months apart
    Title
    Change in Panic Disorder Severity Scale: Independent Evaluator Version (for panic disorder)
    Description
    measure of a severity of panic disorder assessed by an independent evaluator. Only administered to panic patients. It is comprised of 7 items that are scored from 0-4, with a total scale score ranging from 0-28. Higher scores mean more severe panic disorder symptoms.
    Time Frame
    Baseline and 1 year follow-up
    Title
    Change in Hamilton Depression Scale- 17 item adjusted version
    Description
    Independent evaluator measure of depression severity, higher score is more severe symptoms. total score is sum of the items, ranging from 0-52
    Time Frame
    Baseline and post treatment, up to 6 months apart
    Title
    Change in Hamilton Depression Scale- 17 item adjusted version
    Description
    Independent evaluator measure of depression severity, higher score is more severe symptoms.total score is sum of the items, ranging from 0-52
    Time Frame
    Baseline and 1 year follow-up
    Secondary Outcome Measure Information:
    Title
    Change in Panic disorder severity scale - self report version
    Description
    a self-report measure of panic disorder severity. Only administered to panic patients. It consists of 7 items that are scored from 0-4, with a total scale score ranging from 0-28. Higher scores mean more severe panic disorder symptoms.
    Time Frame
    Baseline and 1 year followup
    Title
    Change in Panic disorder severity scale - self report version
    Description
    a self-report measure of panic disorder severity. Only administered to panic patients. It consists of 7 items that are scored from 0-4, with a total scale score ranging from 0-28. Higher scores mean more severe panic disorder symptoms.
    Time Frame
    weekly during treatment from pre treatment to post treatment, up to 6 months apart
    Title
    Change in Physicians Health Questionnaire (PHQ-9)
    Description
    A self report measure of depression- depression sample only, higher score is more severe symptoms, total scores are sums of items, ranging from 0-27.
    Time Frame
    Weekly during treatment from pre treatment to post treatment, up to 6 months apart
    Title
    Change in Physicians Health Questionnaire (PHQ-9)
    Description
    A self report measure of depression- depression sample only, higher score is more severe symptoms.total scores are sums of items, ranging from 0-27.
    Time Frame
    Baseline and 1 year followup
    Title
    Change in Internet Patient's Experience of Attunement and Responsiveness scale (I-PEAR)
    Description
    This is an alliance scale in internet based treatment related the program and the therapist, it has been used as average between 1-5, higher score is better alliance,
    Time Frame
    Baseline and after each module during treatment from pre treatment to post treatment
    Title
    Change in Anxiety Sensitivity Index (ASI)
    Description
    The ASI-3 is an 18-item self-report measure that measures beliefs regarding panic related bodily sensations. It will be used as a total score, which ranges from 0-72. Higher scores mean more severe anxiety sensitivity.
    Time Frame
    Baseline and 1 year follow-up
    Title
    Change in Anxiety Sensitivity Index (ASI)
    Description
    The ASI-3 is an 18-item self-report measure that measures beliefs regarding panic related bodily sensations. It will be used as a total score, which ranges from 0-72. Higher scores mean more severe anxiety sensitivity.
    Time Frame
    Weekly change during treatment from pre treatment to post treatment, up to 6 months apart
    Title
    Change in Mobility Inventory (MI)
    Description
    The Mobility Inventory is a self report measure of agoraphobic avoidance in which patients are asked to rate how much they avoid 26 situations on a 1-5 scale twice, once when alone and a second time when accompanied. The average score of all times will be used, which will range from 1-5. Higher total score means higher avoidance of situations. Only administered to panic patients.
    Time Frame
    Baseline and 1 year follow-up
    Title
    Change in Mobility Inventory (MI)
    Description
    The Mobility Inventory is a self report measure of agoraphobic avoidance in which patients are asked to rate how much they avoid 26 situations on a 1-5 scale twice, once when alone and a second time when accompanied. The average score of all times will be used, which will range from 1-5. Higher total score means higher avoidance of situations. Only administered to panic patients.
    Time Frame
    Weekly change during treatment from pre treatment to post treatment, up to 6 months apart
    Title
    Change in Depression Anxiety Stress Scales (DASS-21)
    Description
    A self-report measure of depression, anxiety and stress, with each subscale ranging from 0-28. for depression sample only
    Time Frame
    After each module during treatment from pre treatment to post treatment, up to 6 months apart
    Title
    Change in Depression Anxiety Stress Scales (DASS-21)
    Description
    A self-report measure of depression, anxiety and stress, with each subscale ranging from 0-28. for depression sample only
    Time Frame
    Baseline and 1 year follow-up
    Title
    Change in Brown Assessment of Beliefs Scale (BABS)
    Description
    this is an independent evaluator measure of insight. Consists of 7 items that are rated on a scale 0-4. Higher score is worse insight, only administered to panic patients
    Time Frame
    Baseline and post treatment, up to 6 months apart
    Title
    Change in Brown Assessment of Beliefs Scale (BABS)
    Description
    this is an independent evaluator measure of insight. Consists of 7 items that are rated on a scale 0-4. Higher score is worse insight, only administered to panic patients
    Time Frame
    Baseline and 1 year follow-up
    Title
    Change in Scale for the Assessment of Insight (SAI)
    Description
    this is an independent evaluator measure of clinical insight. Consists of 4 items that are rated on a scale 0-2. Higher score is better insight, only administered to panic patients
    Time Frame
    Baseline and post treatment, up to 6 months apart
    Title
    Change in Scale for the Assessment of Insight (SAI)
    Description
    this is an independent evaluator measure of clinical insight. Consists of 4 items that are rated on a scale 0-2. Higher score is better insight, only administered to panic patients
    Time Frame
    Baseline and 1 year follow-up
    Title
    Change in The Pittsburgh Sleep Quality Index (PSQI)
    Description
    This is a self-report questionnaire that assesses sleep quality over a 1-month time interval. The measure consists of 19 individual items, creating 7 components that produce one global score, The global PSQI score is then calculated by totaling the seven component scores, providing an overall score ranging from 0 to 21, higher score is worse sleep, adminstered only to the depression sample
    Time Frame
    Baseline and post treatment, up to 6 months apart
    Title
    Change in The Pittsburgh Sleep Quality Index (PSQI)
    Description
    This is a self-report questionnaire that assesses sleep quality over a 1-month time interval. The measure consists of 19 individual items, creating 7 components that produce one global score, The global PSQI score is then calculated by totaling the seven component scores, providing an overall score ranging from 0 to 21, higher score is worse sleep, adminstered only to the depression sample
    Time Frame
    Baseline and 1 year follow-up
    Title
    Change in The Sheehan Disability Scale (SDS)
    Description
    this a self-report measure of disability due to an illness or health problem in work/school, social life/leisure activities, and family life/home. It includes 3 items that are rated on a scale 0-10. Higher score indicates worse disability and impairment.
    Time Frame
    Baseline and post treatment, up to 6 months apart
    Title
    Change in The Sheehan Disability Scale (SDS)
    Description
    this a self-report measure of disability due to an illness or health problem in work/school, social life/leisure activities, and family life/home. It includes 3 items that are rated on a scale 0-10. Higher score indicates worse disability and impairment.
    Time Frame
    Baseline and 1 year follow-up
    Title
    Change in Self-Appraisal of Illness Questionnaire (SAIQ)
    Description
    this is a self-report measure that assess clinical insight, administered only to the panic sample. It consists of 17 items that are rates on a scale 0-3. Higher scores means worse clinical insight.
    Time Frame
    Baseline and post treatment, up to 6 months apart
    Title
    Change in Self-Appraisal of Illness Questionnaire (SAIQ)
    Description
    this is a self-report measure that assess clinical insight, administered only to the panic sample. It consists of 17 items that are rates on a scale 0-3. Higher scores means worse clinical insight.
    Time Frame
    Baseline and 1 year follow-up
    Title
    Change in Beck Cognitive Insight Scale (BCIS)
    Description
    this is a self-reported measure that assess cognitive insight, administered only to the panic sample. It consists of 15 items that are rates on a scale 0-3. Higher score means better cognitive insight.
    Time Frame
    Baseline and 1 year follow-up
    Title
    Change in Beck Cognitive Insight Scale (BCIS)
    Description
    this is a self-reported measure that assess cognitive insight, administered only to the panic sample. It consists of 15 items that are rates on a scale 0-3. Higher score means better cognitive insight.
    Time Frame
    After each module during treatment from pre treatment to post treatment, up to 6 months apart
    Title
    Change in Cognitive Flexibility Inventory (CFI)
    Description
    this is a self-reported measure that assess aspects of cognitive flexibility, administered only to the panic sample. It consists of 20 items that are rated on a scale 1-7. Higher score means greater cognitive flexibility.
    Time Frame
    Baseline and post treatment, up to 6 months apart
    Title
    Change in Cognitive Flexibility Inventory (CFI)
    Description
    this is a self-reported measure that assess aspects of cognitive flexibility, administered only to the panic sample. It consists of 20 items that are rated on a scale 1-7. Higher score means greater cognitive flexibility.
    Time Frame
    Baseline and 1 year follow-up
    Title
    Change in Metacognition Questionnaire - 30 item version (MCQ-30)
    Description
    is a self-reported measure that assess metacognition, administered only to the panic sample. The MCQ consists of 30 items that are rated on a scale 1-4. Higher score indicated higher level of unhelpful metacognitions.
    Time Frame
    Baseline and post treatment, up to 6 months apart
    Title
    Change in Metacognition Questionnaire - 30 item version (MCQ-30)
    Description
    is a self-reported measure that assess metacognition, administered only to the panic sample. The MCQ consists of 30 items that are rated on a scale 1-4. Higher score indicated higher level of unhelpful metacognitions.
    Time Frame
    Baseline and 1 year follow-up
    Title
    Change in Beck Depression Inventory -21 (BDI-21)
    Description
    This is a self-report measure that assess depression, 21 items, administered only to depression sample, score ranges 0-63, higher is more severe.
    Time Frame
    Baseline and post treatment, up to 6 months apart
    Title
    Change in Beck Depression Inventory -21 (BDI-21)
    Description
    This is a self-report measure that assess depression, 21 items, administered only to depression sample, score ranges 0-63, higher is more severe.
    Time Frame
    Baseline and 1 year follow-up
    Title
    Change in Implicit Theories of Emotion (TOE)
    Description
    Thisis a self-reported scale to measure beliefs about the fixed versus malleable nature of anxiety, administered only to the panic sample. The TOE consists of 4 items that are rates on a scale 1-5. Higher score indicates that the individual views anxiety as being relatively malleable and controllable.
    Time Frame
    Baseline and 1 year follow-up
    Title
    Change in Implicit Theories of Emotion (TOE)
    Description
    This is a self-reported scale to measure beliefs about the fixed versus malleable nature of anxiety, administered only to the panic sample. The TOE consists of 4 items that are rates on a scale 1-5. Higher score indicates that the individual views anxiety as being relatively malleable and controllable.
    Time Frame
    After each module during treatment from pre treatment to post treatment, up to 6 months apart
    Title
    Change in Implicit Theories of Thoughts (TOT)
    Description
    This is a self-reported scale measure beliefs about the nature of thoughts, administered only to the panic sample.The TOT consists of 4 items that are rates on a scale 1-5. Higher score indicates that the individual views thoughts as being relatively malleable and controllable.
    Time Frame
    Baseline and 1 year follow-up
    Title
    Change in Implicit Theories of Thoughts (TOT)
    Description
    This is a self-reported scale measure beliefs about the nature of thoughts, administered only to the panic sample.The TOT consists of 4 items that are rates on a scale 1-5. Higher score indicates that the individual views thoughts as being relatively malleable and controllable.
    Time Frame
    After each module during treatment from pre treatment to post treatment, up to 6 months apart
    Title
    Change in Brief Body Sensations Interpretations Questionnaire (BBSIQ)
    Description
    This is a self-reported scale to measure body sensations interpretations, administered only to the panic sample. The BBSIQ includes 14 items, higher score means more negative explanation of body sensations.
    Time Frame
    Baseline and post treatment, up to 6 months apart
    Title
    Change in Brief Body Sensations Interpretations Questionnaire (BBSIQ)
    Description
    This is a self-reported scale to measure body sensations interpretations, administered only to the panic sample. The BBSIQ includes 14 items, higher score means more negative explanation of body sensations.
    Time Frame
    Baseline and 1 year follow-up
    Title
    Change in Five-Dimensional Curiosity Scale (5DC)
    Description
    The DCS-5 is a self-report measure that measures 5 dimensions of curiosity via 25 items which are rated on a 1-7 scale. The total score of all 25 (ranging from 25-175) items and 5 subscales (each ranging from 5-35) will be used for this study. Higher scores reflect higher curiosity. Administered only to the panic sample.
    Time Frame
    Baseline and post treatment, up to 6 months apart
    Title
    Change in Five-Dimensional Curiosity Scale (5DC)
    Description
    The DCS-5 is a self-report measure that measures 5 dimensions of curiosity via 25 items which are rated on a 1-7 scale. The total score of all 25 (ranging from 25-175) items and 5 subscales (each ranging from 5-35) will be used for this study. Higher scores reflect higher curiosity. Administered only to the panic sample.
    Time Frame
    Baseline and 1 year follow-up
    Title
    Change in The five-level EuroQol five-dimensional questionnaire (EQ-5D-5L)
    Description
    This is a self-reported measure of health related quality of life. It consists of five dimensions (Mobility, Self-care, Usual activities, Pain & discomfort, Anxiety & depression). Higher score means worse functioning in these dimensions.
    Time Frame
    Baseline and post treatment, up to 6 months apart
    Title
    Change in The five-level EuroQol five-dimensional questionnaire (EQ-5D-5L)
    Description
    This is a self-reported measure of health related quality of life. It consists of five dimensions (Mobility, Self-care, Usual activities, Pain & discomfort, Anxiety & depression). Higher score means worse functioning in these dimensions.
    Time Frame
    Baseline and 1 year follow-up
    Title
    Change in Work and Social Adjustment Scale (WSAS)
    Description
    This is a self-reported measure of functional impairment. It includes 5 items that are rated on a scale 0-8. Measured as total score ranging 0-40. Higher score means worse functional impairment.
    Time Frame
    Baseline and post treatment, up to 6 months apart
    Title
    Change in Work and Social Adjustment Scale (WSAS)
    Description
    This is a self-reported measure of functional impairment. It includes 5 items that are rated on a scale 0-8. Measured as total score ranging 0-40. Higher score means worse functional impairment.
    Time Frame
    Baseline and 1 year follow-up
    Title
    Change in Working Alliance Inventory (WAI-6)
    Description
    This is a self-reported measure of therapeutic alliance, total score is average of the items, ranging from 1-7
    Time Frame
    Baseline and post treatment, up to 6 months apart
    Title
    Change in The Experiences in Close Relationship Scale (ECR-S)
    Description
    The ECR-s is a brief self report instrument that measures both anxious and avoidance adult attachment styles. The two scales each contain 6 items rated on a 1-7 scale that are averages for each subscale, ranging from 1-7. Higher score indicates an insecure adult attachment orientation.
    Time Frame
    Baseline and post treatment, up to 6 months apart
    Title
    Change in The Experiences in Close Relationship Scale (ECR-S)
    Description
    The ECR-s is a brief self report instrument that measures both anxious and avoidance adult attachment styles. The two scales each contain 6 items rated on a 1-7 scale that are averages for each subscale, ranging from 1-7. Higher score indicates an insecure adult attachment orientation.
    Time Frame
    Baseline and 1 year follow-up
    Title
    Change in The Agoraphobic Cognitions Questionnaire (ACQ)
    Description
    This is a self-reported scale to measure agoraphobia cognitions, administered only to the panic sample. It consists of 15 items that are rates on a scale 1-5. Higher score indicates worse dysfunctional cognitions in relation to potential catastrophic consequences arising from panic or anxiety.
    Time Frame
    Baseline and post treatment, up to 6 months apart
    Title
    Change in The Agoraphobic Cognitions Questionnaire (ACQ)
    Description
    This is a self-reported scale to measure agoraphobia cognitions, administered only to the panic sample. It consists of 15 items that are rates on a scale 1-5. Higher score indicates worse dysfunctional cognitions in relation to potential catastrophic consequences arising from panic or anxiety.
    Time Frame
    Baseline and 1 year follow-up
    Title
    Change in Social Support Questionnaire (SSQ6)
    Description
    This is a self-reported measure of social support. The SSQ6 includes 6 items. The overall support score is calculated by taking an average scores across the 27 items. Higher score indicates more optimism about life, higher prevalence of negative life events and illness.Scoring is as follows: Add the total number of people for all 27 items (questions). (Max. is 243). Divide by 27 for average item score. Add the total satisfaction scores for all 27 items (questions). (Max is 162). Divide by 27 for average item score. This gives you SSQ Satisfaction score or SSQS. Finally, you can average the above for the total number of people that are family members - this results in the SSQ family score. Participants indicate the number of people available to provide support in each of 6 areas and then rate the overall level of satisfaction with the supp
    Time Frame
    Baseline and post treatment, up to 6 months apart
    Title
    Change in Acceptability Scale for internet Therapy (ASIT)
    Description
    This is a self-reported measure of acceptance and readiness to receive internet treatment, It consists of 19 items that are rates on a scale 1-5, total sum is ranges 1- 95, Higher score indicates more acceptability.
    Time Frame
    Baseline and post treatment, up to 6 months apart
    Title
    Change in Acceptability Scale for internet Therapy (ASIT)
    Description
    This is a self-reported measure of acceptance and readiness to receive internet treatment, It consists of 19 items that are rates on a scale 1-5, total sum is ranges 1- 95, Higher score indicates more acceptability.
    Time Frame
    Baseline and 1 year follow-up
    Title
    Change in Emotional Goals Questionnaire.
    Description
    This is a self-reported measure of emotional goals. is a self-reported measure of emotional goals. The measure assesses emotional preferences ro feel unpleasant emotions of (eg., depression, anxiety, etc) and beliefs about the fixed versus malleable nature of anxiety. Higher score indicates higher ability and willingness to feel unpleasant emotions and that the individual views anxiety as being relatively malleable and controllable.
    Time Frame
    Baseline and post treatment, up to 6 months apart
    Other Pre-specified Outcome Measures:
    Title
    Change in questionnaire of Implicit Association Test (qIAT) for Experiences in Close Relationship Scale-Short
    Description
    The Questionnaire-based Implicit Association Test (qIAT) associated with the conventional self-concept IAT, and it enables an indirect assessment that is based on the items of standard self-reports. The current qIAT is related the ECR for attachment and administered separetely for anxious (4 items) for avoidant (4 items).
    Time Frame
    Baseline and post treatment, up to 6 months apart
    Title
    Change in Depressive Experience Questionnaire (DEQ)
    Description
    A self -report scale about self critisism which is related to depressive symptoms, 11 items, higher is more severe, administered to depression sample only.
    Time Frame
    After each module from pre treatment to post treatment, up to 6 months apart
    Title
    Change in Depressive Experience Questionnaire (DEQ)
    Description
    A self -report scale about self critisism which is related to depressive symptoms,11 items, ranging 1-7 higher is more severe, administered to depression sample only.
    Time Frame
    Baseline and 1 year follow-up
    Title
    Change in Distressing Thoughts
    Description
    A task about distressing thoughts. Participants have to imagine distressing situation and then after 4 minutes to describe their thoughts.
    Time Frame
    Baseline and post treatment, up to 6 months apart
    Title
    Change in Distressing Thoughts
    Description
    A task about distressing thoughts. Participants have to imagine distressing situation and then after 4 minutes to describe their thoughts.
    Time Frame
    Baseline and 1 year follow-up
    Title
    Change in Current Emotion
    Description
    A self report about current emotions, more sad emotion is related to depression, 8 items, total score is average ranging 1-7,administered to depression sample only . administered to depression sample only
    Time Frame
    Baseline and post treatment, up to 6 months apart
    Title
    Change in Current Emotion
    Description
    A self report about current emotions, more sad emotion is related to depression, 8 items, total score is average ranging 1-7,administered to depression sample only . administered to depression sample only
    Time Frame
    Baseline and 1 year follow-up
    Title
    Change in Emotional Preferences
    Description
    A self report about emotional preferences, more sad emotion is related to depression, 10 items, total score is average ranging 1-7, administered to depression sample only
    Time Frame
    Baseline and post treatment, up to 6 months apart
    Title
    Change in Emotional Preferences
    Description
    A self report about emotional preferences, more sad emotion is related to depression, 10 items, total score is average ranging 1-7, administered to depression sample only
    Time Frame
    Baseline and 1 year follow-up
    Title
    Change in Emotional Preferences Task
    Description
    A task about emotional preferences, in this task participants choose which photo they prefer to see. administered to depression sample only
    Time Frame
    Baseline and post treatment, up to 6 months apart
    Title
    Change in State-Reappraisal Inventory (SRI)
    Description
    A self report scale about state reappraisal, related to self regulation, 12 items, total score is avarge ranging 1-5, lower score related to more ability to reappraisal and self regulation. administered in depression sample only.
    Time Frame
    after each module during treatment from pre treatment to post treatment, up to 6 months apart

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    75 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Principal DSM-5 diagnosis of panic disorder or depression aged 18 years or older; if on medications for panic or depression, the dosage has to remain constant for 2 months prior to the start of treatment and cannot be increased during treatment; the participant must have access to the internet and be willing to use it - Exclusion Criteria: substance abuse or dependence within the last 6 months; active suicide potential within the last 6 months; any current or history of psychosis or bipolar I disorder currently in weekly or biweekly psychotherapy history of a complete course of panic or depression focused CBT

    12. IPD Sharing Statement

    Learn more about this trial

    Attitudes of Professionals and the General Public in Israel Regarding ICBT

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