Alstrom 1984a.
Methods | Single‐centre RCT, between 1973 and 1979, parallel design with 4 arms | |
Participants | Inclusion criteria: 18‐60 years old, sought help for social phobia at outpatient services Exclusion criteria: any form of continuous treatment for the previous 6 months; drug abuse; dementia; neurological signs of brain damage; symptoms of endogenous depression, schizophrenia, obsessive‐compulsive neurosis or mental retardation; poor knowledge of Swedish language. Study included 42 social phobic men and women. They were all assessed as not suitable for insight‐oriented psychotherapy |
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Interventions | Common to each group ‐ psychoeducation, information on prolonged exposure in vivo, encouragement to participate in anxiety‐provoking situations. Participants could continue to take medications
Control: basal therapy ‐ included the above, and meetings once a month for 20‐30 min Intervention 1: behavioural therapy (prolonged exposure in vivo) Intervention 2: relaxation therapy Intervention 3: psychodynamically oriented supportive therapy, based on Dewald 1964, 30‐min appointments once/week for 3 months (˜ 12 appointments). No mention of manual for therapy, measures of therapist adherence |
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Outcomes | Measured pre‐treatment, end (post‐) treatment, and 9 months follow‐up Measures were scales constructed by the study authors to measure indirect manifestations of anxiety (target phobia, other phobias, OCD symptom), direct manifestations of anxiety, ego‐restriction and social functions, and a global rating. In addition, intellectual ability was measured with the Synonyms Reasoning Block test, personality with the Eysenck Personality Inventory, and the Cesarec‐Marke Personality Schedule. Therapist rated measures | |
Notes | Free anxiety measures and global symptom data used | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | Comment: inadequate description |
Allocation concealment (selection bias) | Unclear risk | Comment: inadequate description |
Blinding (performance bias and detection bias) All outcomes | High risk | Comment: therapists outcome ratings (free anxiety and global symptoms) were unblinded thus considered a high risk of detection bias Blinding participants to treatment group not possible No psychotherapist was blinded to the treatment delivered |
Incomplete outcome data (attrition bias) All outcomes | High risk | Comment: all participants completed treatment but only 8/10 in the control group provided follow‐up data |
Selective reporting (reporting bias) | Unclear risk | Comment: insufficient information to permit judgement. No published report on pre‐specified outcomes |
Other bias | Unclear risk | Comment: insufficient information to permit judgement |