Standardization Study of Internet Addiction Improvement Motivation Scale

OBJECTIVE: The purpose of this study was to develop a scale to measure motivation to improve Internet addiction. Motivation is known to be important to treat Internet addiction successfully. The reliability of the scale was assessed, and its concurrent validity was evaluated. METHODS: Ninety-two adolescents participated in this study. The basic demographic characteristics were recorded and the Korean version of the Stages of Readiness for Change and Eagerness for Treatment Scale for Internet Addiction (K-SOCRATES-I) was administered. Subsequently, the Internet Addiction Improvement Motivation Scale was developed using 10 questions based on the theory of motivation enhancement therapy and its precursor version designed for smoking cessation. RESULTS: The motivation scale was composed of three subscales through factor analysis; each subscale had an adequate degree of reliability. In addition, the motivation scale had a high degree of validity based on its significant correlation with the K-SOCRATES-I. A cut-off score, which can be used to screen out individuals with low motivation, was suggested. CONCLUSION: The Internet Addiction Improvement Motivation Scale, composed of 10 questions developed in this study, was deemed a highly reliable and valid scale to measure a respondent's motivation to be treated for Internet addiction.

Standardization Study of the Korean Version of the Stages of Change Readiness and Treatment Eagerness Scale for Smoking Cessation (K-SOCRATES-S) and Its Predictive Validity

OBJECTIVE: The purpose of the study was to develop the Korean version of the Stage of Change Readiness and Treatment Eagerness Scale for Smoking Cessation (K-SOCRATES-S) based on the Korean version of the Stages of Readiness for Change and Eagerness for Treatment scale (K-SOCRATES). This paper also demonstrates its reliability and validity among patients with nicotine dependence in South Korea. METHODS: At seven healthcare promotion centers in Gyeonggi-do, 333 male smokers aged 20 to 70 who visited smoking cessation clinic were recruited for this study and the K-SOCRATES-S was administered. After three months, the number of respondents who successfully stopped smoking was assessed by testing their urine cotinine level. Subsequently, exploratory factor analysis was performed to verify the reliability and validity of the K-SOCRATES-S. Also, a logistic regression analysis was performed to examine the variables that can predict the successful cessation of smoking on subscales of the K-SOCRATES-S. RESULTS: Exploratory factor analysis of the K-SOCRATES-S showed that the scale consisted of three factors: Taking Steps, Recognition, and Ambivalence. The scales measuring Taking Steps and Recognition in this scale had a significantly positive correlation with the scores observed on Kim's smoking cessation motivation scale. The scales measuring Taking Steps and Recognition had a significantly negative correlation with Ambivalence. Overall, the results indicate that the K-SOCRATES-K scale showed high validity. CONCLUSION: The K-SOCRATES-S developed in the present study is highly reliable and valid for predicting a patient's likelihood of success in quitting smoking among patients who want to cease smoking.

Therapeutic Factors of Cognitive Behavioral Group Treatment for Social Phobia

This study investigated the therapeutic factors influencing the outcome of cognitive behavioral group treatment for social phobia and the most helpful therapeutic component. Fifty psychiatric outpatients who were diagnosed with social phobia according to the DSM-IV criteria were chosen as subjects. Patients were asked to complete the Yalom's Curative Factors Questionnaire and Therapeutic Components Evaluation Form at the end of their Cognitive Behavioral Group Treatment (CBGT). The patients who showed more improvement rated significantly higher in therapeutic factors such as "Interpersonal learning-output", "Guidance", "Universality", "Group cohesiveness" than the patients who showed less improvement. Among the four components of CBGT for social phobia, cognitive restructuring was rated as most helpful. These results suggest which therapeutic factors and components should be highlighted in CBGT for social phobia.

The Effects of Cognitive Behavioral Therapy for Discontinuation of Medication in Panic Disorder / 대한정신약물학회지

OBJECTIVE: The purpose of this study is to determine whether CBT is effective in tapering or discontinuing medication regardless of the type of medication and its maintenance effects after long-term follow up. METHOD: 224 patients meet DSM-IV criteria for panic disorder with or without agoraphobia completed 12 weekly sessions of Panic Control Therapy (PCT;Barlow et al.). 80 patients who were using benzodiazepines alone and 144 patients who were using benzodiazepines and Antidepressants were measured with several screening scales at the pre- and post-treatment. The scales were Beck Depression Inventory (BDI), Spielberg State Anxiety Inventory (STAI-State), Spielberg Trait Anxiety Inventory (STAI-Trait), Body Sensation Questionnaire (BSQ), Agoraphobic Cognition Questionnaire (ACQ), Anxiety Sensitivity Index (ASI), Panic Belief Questionnaire (PBQ). These patients were assessed at 3 months, 6 months, 12 months of follow up and they were also assessed for their medications, panic frequency, and End-State Functioning. RESULTS: After the completion of PCP, both benzodiazepines alone group and benzodiazepines and antidepressants combination group showed significant improvement (p<0.001) in all the results of 7-self reported questionnaires. 54% of patients discontinued their medication and 90.9% of patients were in HES at post-treatment. 70 % of patients were in HES at 3 month, 6 month, and 12 month follow up. The patients who could not discontinue medication also tapered their medication afterwards. The rate of discontinuing medication was significantly higher for the patients using benzodiazepines alone (86.3%) than patients using combination of benzodiazepines and antidepressants (56.3%). CONCLUSION: These findings support cognitive behavioral therapy can replace medication and these effects seem to last long.

Impact of Group Cognitive Behavioral Therapy on Quality of Life in Patients with Panic Disorder / 신경정신의학

OBJECTIVES: We examined the impact of 12-session group cognitive behavioral trerapy(GCBT) on quality of life in patients with panic disorder, and also investigated correlation with the change of some clinical characteristics. METHODS: Patients(N=108) who met DSM-IV criteria for panic disorder with or without agoraphobia were treated by 12-session GCBT. We assessed the quality of life using SF-36 and some clinical characteristics including symptom profiles. We measured anxiety and depression levels using the Spielberger State-Trait Anxiety Inventory(STAI) and the Beck Depression Inventory(BDI), and also measured some cognitive behavioral indexes typically found in panic patients using the Anxiety Sensitivity Index(ASI), the Agoraphobic Cognition Questionnaire(ACQ), the Panic Belief Questionnaire(PBQ), and the Body Sensation Questionnaire(BSQ). RESULTS: GCBT-treated patients showed significant improvement in quality of life in all subscales of SF-36(general health, t=-5.23; , physical functioning, t=-5.89; , role physical, t=-3.67; , body pain, t=-6.36; , vitality t=-8.29; , social functioning, t=-6.56; , role emotion, t=-3.62; , mental health, t=-6.81). Multiple regression analysis showed that the change of anxiety sensitivity was the best predictor of the improvement of SF-36(mental health, R2=.19, p<0.001;, vitality, R2=.14, p<0.001; , social functioning, R2=.15, p<0.001). Otherwise the change of panic belief(general health, R2=.11, p< 0.01; , body pain, R2=15, p<0.001), BDI(role emotion, R2=.08, p<0.05) could explain the improvement of one of subscales of SF-36. CONCLUSION: Our results suggested that 12-session GCBT could significantly improve quality of life in patients with panic disorder. Especially, the reduction of anxiety sensitivity, panic belief and depression with the correction of cognitive distortion and sensitivity might play an important role in improving quality of life in panic patients.

Predicting Factors of Discontinuation of medication after Cognitive Behavioral Therapy for Panic Disorder

OBJECTIVE: The authors experienced that cognitive begavioral therapy(CBT) could replace medication for controlling panic attacks and anticipatory anxiety symptoms. The objective of this study was finding out predicting factors of discontinuation of medication after CBT for patients with panic disorder. METHOD: A hundred forty-eight patients who met DSM-IV criteria for panic disorder with or without agoraphobia for at least 3 months had completed 12 weekly sessions of Panic Control Therapy(CT ; Barlow et al). Eighty-one patients who could discontinue medication and sixty-seven patients who could not discontinue medication were measured with several scales as the pre- and post-treatment assessment. The scales were Beck Depression Inventory(BDI), Clinical Global Impression(CGI), Spiellberger State Anxiety Inventory(STAI-state), Anxiety Sensitivity Index(ASI), Body Sensation Questionnaire(BSQ), Panic Belief Questionnaire(PBQ), Agoraphobic Cognition Questionnaire(ACQ), Fear Questionnaire(FG), Toronto Alexithymia Scale(TAS). RESULTS: At the pre-treatment assessment, the scores of BDI, CGI, STAI-state, ACQ, BSQ were higher in the patients who could discontinue medication than in the patients who could not discontinue medication(t=-2.68, t=-4.88, t=-3.07, t=-3.68, t=-3.35, p<0.01). CONCLUSION: Patients with panic disorder who were less depressed, less anxious, less agoraphobic and who had less negative cognitions for the bodily sensation and who had higher scores in the therapist's assessment could discontinue their medications.