Robert Schibbye, Erik Hedman-Lagerlöf, Viktor Kaldo, Göran Dahllöf, Shervin Shahnavaz
{"title":"基于网络的认知行为治疗儿童和青少年牙科或注射恐惧症：1年随访评估。","authors":"Robert Schibbye, Erik Hedman-Lagerlöf, Viktor Kaldo, Göran Dahllöf, Shervin Shahnavaz","doi":"10.2196/80376","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Dental phobia (DP) and injection phobia (IP) are common in pediatric populations, resulting in inability to receive dental care. Internet-based cognitive behavioral therapy (ICBT) has demonstrated efficacy, but its long-term effects are unexplored.</p><p><strong>Objective: </strong>This study aimed to evaluate the long-term effects of ICBT on DP and IP in children and adolescents.</p><p><strong>Methods: </strong>In total, 49 participants (mean age 11.1 years, SD 2.1) with DP, IP, or both underwent a 12-week, parent-guided, exposure-based ICBT, supplemented by visits at local dental clinics and weekly psychologist correspondence. Assessments occurred at baseline, posttreatment, and 1-year follow-up. Primary outcomes included diagnostic status (clinical interview) and ability to receive dental procedures. Secondary outcomes included measures of dental anxiety, injection anxiety, negative cognitions, and self-efficacy. The study was conducted in Sweden.</p><p><strong>Results: </strong>Of the 49 participants, 42 (86%) completed the 1-year follow-up. At 1-year follow-up, 19 (53%) of 36 (86%) participants who initially met the criteria for DP no longer did (P<.001), and 17 (46%) of 37 (88%) participants who initially met the criteria for IP did not fulfill the IP diagnosis (P<.001). Repeated-measures ANOVA showed significant improvements, with large effect sizes for self-reported ability to undergo dental procedures (d=1.1, P<.001), dental fear (d=1.0, P<.001), negative cognitions (d=0.9, P<.001), injection fear (d=0.7, P<.001), and self-efficacy (d=1.1, P<.001). Predictor analysis showed greater improvements in older participants and males.</p><p><strong>Conclusions: </strong>This study discussed the clinical implications of and approaches to ICBT implementation. ICBT for children and adolescents with DP and IP maintains its effects over a 1-year follow-up period, facilitating improved self-reported willingness to undergo dental treatment. Given its accessibility and sustained efficacy, ICBT should be considered for managing severe dental fear in pediatric dentistry.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT02588079; https://clinicaltrials.gov/study/NCT02588079.</p>","PeriodicalId":36223,"journal":{"name":"JMIR Pediatrics and Parenting","volume":"8 ","pages":"e80376"},"PeriodicalIF":2.3000,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489423/pdf/","citationCount":"0","resultStr":"{\"title\":\"Internet-Based Cognitive Behavioral Therapy for Children and Adolescents With Dental or Injection Phobia: 1-year Follow-Up Assessment.\",\"authors\":\"Robert Schibbye, Erik Hedman-Lagerlöf, Viktor Kaldo, Göran Dahllöf, Shervin Shahnavaz\",\"doi\":\"10.2196/80376\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Dental phobia (DP) and injection phobia (IP) are common in pediatric populations, resulting in inability to receive dental care. Internet-based cognitive behavioral therapy (ICBT) has demonstrated efficacy, but its long-term effects are unexplored.</p><p><strong>Objective: </strong>This study aimed to evaluate the long-term effects of ICBT on DP and IP in children and adolescents.</p><p><strong>Methods: </strong>In total, 49 participants (mean age 11.1 years, SD 2.1) with DP, IP, or both underwent a 12-week, parent-guided, exposure-based ICBT, supplemented by visits at local dental clinics and weekly psychologist correspondence. Assessments occurred at baseline, posttreatment, and 1-year follow-up. Primary outcomes included diagnostic status (clinical interview) and ability to receive dental procedures. Secondary outcomes included measures of dental anxiety, injection anxiety, negative cognitions, and self-efficacy. The study was conducted in Sweden.</p><p><strong>Results: </strong>Of the 49 participants, 42 (86%) completed the 1-year follow-up. At 1-year follow-up, 19 (53%) of 36 (86%) participants who initially met the criteria for DP no longer did (P<.001), and 17 (46%) of 37 (88%) participants who initially met the criteria for IP did not fulfill the IP diagnosis (P<.001). Repeated-measures ANOVA showed significant improvements, with large effect sizes for self-reported ability to undergo dental procedures (d=1.1, P<.001), dental fear (d=1.0, P<.001), negative cognitions (d=0.9, P<.001), injection fear (d=0.7, P<.001), and self-efficacy (d=1.1, P<.001). Predictor analysis showed greater improvements in older participants and males.</p><p><strong>Conclusions: </strong>This study discussed the clinical implications of and approaches to ICBT implementation. ICBT for children and adolescents with DP and IP maintains its effects over a 1-year follow-up period, facilitating improved self-reported willingness to undergo dental treatment. 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Internet-Based Cognitive Behavioral Therapy for Children and Adolescents With Dental or Injection Phobia: 1-year Follow-Up Assessment.
Background: Dental phobia (DP) and injection phobia (IP) are common in pediatric populations, resulting in inability to receive dental care. Internet-based cognitive behavioral therapy (ICBT) has demonstrated efficacy, but its long-term effects are unexplored.
Objective: This study aimed to evaluate the long-term effects of ICBT on DP and IP in children and adolescents.
Methods: In total, 49 participants (mean age 11.1 years, SD 2.1) with DP, IP, or both underwent a 12-week, parent-guided, exposure-based ICBT, supplemented by visits at local dental clinics and weekly psychologist correspondence. Assessments occurred at baseline, posttreatment, and 1-year follow-up. Primary outcomes included diagnostic status (clinical interview) and ability to receive dental procedures. Secondary outcomes included measures of dental anxiety, injection anxiety, negative cognitions, and self-efficacy. The study was conducted in Sweden.
Results: Of the 49 participants, 42 (86%) completed the 1-year follow-up. At 1-year follow-up, 19 (53%) of 36 (86%) participants who initially met the criteria for DP no longer did (P<.001), and 17 (46%) of 37 (88%) participants who initially met the criteria for IP did not fulfill the IP diagnosis (P<.001). Repeated-measures ANOVA showed significant improvements, with large effect sizes for self-reported ability to undergo dental procedures (d=1.1, P<.001), dental fear (d=1.0, P<.001), negative cognitions (d=0.9, P<.001), injection fear (d=0.7, P<.001), and self-efficacy (d=1.1, P<.001). Predictor analysis showed greater improvements in older participants and males.
Conclusions: This study discussed the clinical implications of and approaches to ICBT implementation. ICBT for children and adolescents with DP and IP maintains its effects over a 1-year follow-up period, facilitating improved self-reported willingness to undergo dental treatment. Given its accessibility and sustained efficacy, ICBT should be considered for managing severe dental fear in pediatric dentistry.
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